Population Council Research that makes a difference

The Heshima (which means "dignified" in Kiswahili) project aims to reduce disrespectful and abusive care of women during labor and delivery at healthcare facilities in Kenya. Through the Translating Research into Action (TRAction) project with University Research Co., LLC, USAID awarded the Population Council and its partners (the Federation of Women Lawyers, Kenya, and the National Nurses Association of Kenya, Midwives' Chapter) a two-year grant to conduct a research study to identify causes of disrespect and abuse during clinic-based childbirth, and to understand how these problems deter skilled birth attendance.

In developed and developing countries alike, disrespectful and abusive care of women during childbirth, a time of intense vulnerability, is both a human rights issue and an important quality-of-care problem. It is also a subject that has not received the attention it deserves. Examples of disrespect and abuse include care that does not respect a woman's privacy and dignity or interventions performed without her consent, discrimination based on certain attributes, abandonment or denial of care, and physical and verbal abuse during childbirth. Various approaches have been developed to address these issues, including quality improvement, stigma reduction, and accountability measures.

In countries with high maternal and infant mortality, disrespectful and abusive care can discourage women from delivering their infants in facilities with skilled birth attendants. This research project aims to better understand the extent of the problem and implement health care interventions to reduce the abuse. The Council will conduct research in four districts and one large maternity hospital in Nairobi. This research builds on the Population Council’s reproductive health vouchers evaluation in Kenya and aims to increase use of skilled care to ensure safe deliveries and reduce maternal mortality, a United Nations Millennium Development Goal.

Through the project, the Council will collaborate with the White Ribbon Alliance for Safe Motherhood, which will form a Leadership Action Committee to Promote Respectful Care at Birth to raise awareness of the issue.