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Table 1 Domains of respectful maternity care framework

From: Overview of literature on RMC and applications to Tanzania

Domain Number

Domain Description of Disrespect and Abuse

Universal Childbirth Right

1

Physical abuse (e.g., painful or embarrassing procedures without warning or unnecessarily performed)

1. freedom from harm and ill treatment

2

Non-consented care (e.g. lacks provision of information to make an intelligent decision, lack of permission or courtesy for invasive and traumatic procedures)

2. informed consent and refusal and respect for choices

3

Non-confidential care (e.g., lack of covering to provide culturally desired modesty, inappropriate sharing of client’s information, inability to track or secure patient records)

3. right to privacy and confidentiality

4

Non-dignified care (e.g. verbal abuse, psychological abuse)

4. right to dignity and respect

5

Discrimination based on specific attributes (e.g. lack of equitable maternity care regardless of group membership)

5. equality, freedom from discrimination and equitable care

6

Abandonment or denial of highest quality of care available (e.g., Provision of efficient and effective care)

6. Access to healthcare and the highest attainable level of health

7

Detention of mother or baby in facilities (e.g., for lack of payment, lack of universal access to care)

7. liberty, autonomy, self-determination, and freedom from coercion

8

Enhancing quality of physical environment and resources

6. Access to healthcare and the highest attainable level of health

9

Engaging with effective communication

4. right to dignity and respect and 5. equality, freedom from discrimination and equitable care

10

Availability of competent and motivated human resources, inability to provide continuity of care and continuity of carer (e.g., less than optimal staffing, poor fiscal management, poor recruitment and retention of personnel, loss of morale and lack of workforce job satisfaction, poor remuneration for work, poor working conditions and policies, lack of emotional and professional support for staff, lack of staff training)

6. Access to healthcare and the highest attainable level of health

11

Restriction from movement or position changes, disempowering or inequitable behaviours or policies (denying the client a culturally safe space)

4. right to dignity and respect

12

Lack of support for desires and choices (e.g. having a labour support person present at birth, declining a test or procedure, policies at the facility or governmental level that do not support the desire of mother to be accompanied by a desired family member or partner, lack of support for the special psychosocial needs of adolescents or other vulnerable populations)

2. informed consent and refusal and respect for choices and preferences even when the choice is to reject recommended community standards