Respectful care in healthcare is often misunderstood as a luxury, but it is, in fact, a fundamental human right that shapes health outcomes and people’s experiences of care. The alarming prevalence of mistreatment in maternal and newborn health services, including neglect, abuse, and non-consensual medical procedures, underscores the need for global action. A 2019 study by the UN’s Special Programme in Human Reproduction (HRP) found that over 40% of women experienced abuse or discrimination during labour or childbirth, with significant communication gaps also prevalent. This mistreatment takes various forms, including:

• Neglect: Women are not provided with adequate care or support, leading to poor health outcomes.
• Abuse: Women are subjected to physical or verbal mistreatment during childbirth or medical procedures.
• Non-consensual medical procedures: Women are performed medical procedures without their consent, undermining their autonomy and dignity.

The Compendium on respectful maternal and newborn care aims to address these issues by providing a framework for countries to improve the quality of care. The compendium is a global resource for local action, gathering recent evidence and providing practical tools for health programme managers.

History of the Effort

The World Health Organization (WHO) has been working on this issue for over a decade. The WHO’s 2014 statement on preventing disrespect and abuse during childbirth marked the beginning of this effort. The new compendium reflects growing global recognition that mistreatment in healthcare not only harms individuals but also undermines trust in health systems and jeopardizes people’s health.

The Compendium’s Objectives

The Compendium has several key objectives:

1. Provide a framework for countries to improve the quality of care and eliminate mistreatment in maternal and newborn health services.
2. Offer practical tools and evidence-based recommendations for decision-makers to strengthen respectful care.
3. Identify and address root causes of mistreatment, including harmful policies, stigma, and heavy workloads of health workers.

Key Interventions

The Compendium highlights several critical areas where mistreatment is often overlooked, including:

1. Perinatal mental health and support for bereaved families.
2. Support for parents caring for small and sick newborns.

The guide urges decision-makers to identify and address root causes of mistreatment. These may include:

1. Harmful policies, such as forced detention for non-payment of medical bills or mother–baby separation.
2. Stigma and discrimination, such as against younger or unmarried women or those from disadvantaged backgrounds.
3. Heavy workloads of health workers or under-resourcing in health systems.

Building a Global Resource

The Compendium is published by WHO together with UNFPA, UNICEF, and the United Nations’ Special Programme on Human Reproduction (HRP), with support from Jhpiego and the MOMENTUM Country and Global Leadership programme. This global collaboration aims to provide a comprehensive resource for countries to improve their maternal and newborn health services.

Making Respectful Care a Reality

Over the past decade, research and advocacy in this area have significantly expanded. WHO has developed various tools and standards to support quality improvements, from advancing midwifery models of care to WHO’s rights-based clinical recommendations for maternal and newborn health. The new compendium complements these resources, providing a useful ‘one-stop’ reference for available resources and evidence on respectful care. “Respectful care is not a luxury – it is a fundamental human right that shapes health outcomes and people’s experiences of care,” said Dr. Hedieh Mehrtash, Technical Officer and co-lead of the compendium. “Yet too often, women are not part of decision-making and are treated with contempt or even abuse. This new publication is a call to action for health systems to proactively embed dignity, equity, and respect into every aspect of maternity and newborn care.”

A Decade of Focus

Representing the first global effort to translate principles of respectful care into tangible implementation strategies, WHO’s new Compendium on respectful maternal and newborn care marks a major milestone in this area. The compendium builds on the Organization’s 2014 statement on preventing disrespect and abuse during childbirth, and reflects growing global recognition that mistreatment in healthcare not only harms individuals but also undermines trust in health systems and jeopardizes people’s health. “Ending mistreatment and achieving respectful care doesn’t happen by chance – it needs the commitment of health authorities and all stakeholders so that these principles are purposefully integrated within the health system,” said Anayda Portela, Scientist at WHO, also a co-lead of the compendium. “This means creating environments where women, parents and health workers feel safe, heard and valued, while ensuring services are equipped to provide the quality care every woman, baby and family needs and deserves.”

The Compendium on respectful maternal and newborn care is a crucial step towards creating a culture of respect and dignity in healthcare. It is a testament to the power of collaboration and the commitment of global health leaders to improving the lives of women and families around the world.

The Future of Respectful Maternal and Newborn Care

The development of the Compendium on respectful maternal and newborn care is a significant milestone in the history of global health. As the world continues to recognize the importance of respectful care, it is essential that countries and health systems prioritize the implementation of this compendium. By working together, we can create a world where women and families receive the respectful, dignified care they deserve.

Recommendations

The Compendium offers several recommendations for countries and health systems to improve their maternal and newborn health services, including:

1. Enact supportive laws and policies.
2. Train and support health workers.
3. Involv women and families in planning and monitoring of care.
4. Address root causes of mistreatment.

By following these recommendations, countries can improve the quality of care and eliminate mistreatment in maternal and newborn health services. The Compendium provides a comprehensive resource for countries to take action and create a culture of respect and dignity in healthcare.