Table 1 Types of disrespectful and abusive care as categorized by Bohren and colleagues in their systematic review [5]. Each is paired with the systems-level drivers of this care (Propagating Factors) and specific supports that care navigators can provide in order to address them (Care Navigator Roles)

1) Physical, sexual, or verbal abuse

Normalization of patient abuse

Role modeling of behaviors by superiors

Mitigate through emotional support

Deter through mediation

2) Discrimination

Social inequalities and segregation

Lack of consequences and oversight for discriminatory treatment

Advocate for incorporation of traditional birthing practices

Use cultural capital to identify both with patients and providers

3) Failure to provide professional standard of care (including patient’s autonomy)

Medical paternalism

High patient volume

Hierarchy of hospital staff

Lack of mechanisms to measure and improve quality of care

Advocate for appropriate and timely care

Assist providers in obtaining patient consent

Take steps to protect patients’ dignity (ex: shielding while changing into gown in public exam room)

Educate patients and hospital staff on mothers’ rights

4) Poor communication

Language barriers

Lack of training on effective communication

Translate between patients and providers

Report back to family and traditional midwife

5) Poor rapport

Social stratification

Burnout-motivated behaviors

Act as cultural broker

Provide emotional and labor support

7) Health system constraints

Provider frustration due to lack of resources Lack of basic resources to provide care

Uncomfortable working conditions

Provide economic support for medical needs

Contextualize limitations faced by medical providers for patients and family

8) Health system conditions

Excessive bureaucracy Inadequate support staff

Navigate complex work flows Coordinate care across settings (ex: between rural health post and hospital) Cultivate relationships with frontline health workers