Curricula, Toolkits, and Guides

Measuring disrespect and abuse to promote respectful maternity care

Measuring disrespect and abuse to promote respectful maternity care

The Heshima project developed the following study instruments to measure disrespect and abuse throughout the study’s formative, baseline, and endline stages. The quasi-experimental implementation research design applied a mixed methods approach to understanding the meaning and factors that drive disrespect and abuse in maternity settings in Kenya. These tools allowed the project to measure the prevalence of disrespect and abuse in this setting, as well as the changes affected by the project.

The Heshima project involved a complex set of multi-level interventions that sought to curb disrespectful and abusive practices during childbirth and promote dignified and respectful maternity care. The evidence collected using the surveys, assessments, interview, and discussion guides were informed through participatory research mechanisms, which also enabled the design of an intervention package rooted in local values and reality of the health system.

This toolkit is intended to support researchers, evaluators, monitoring systems, and other practitioners interested in measuring and conducting implementation research around respectful maternity care. Data collection tools and measures should be adapted to socio-cultural context through rigorous qualitative research. 

We request that those using any of these tools please let us know ( and and reference the Population Council in their work.

The following qualitative tools informed the quantitative survey design, the intervention package, and baseline tools:

The following quantitative tools were used at baseline and endline to evaluate the changes following implementation:

The following qualitative tools were used at endline as explanatory measures: