Table 2 Documents detailing interventions promoting awareness of women’s rights for maternity care services or rights for other health areas without reported specified health outcomes (N = 22)
# | Document | Document type and study type if applicable | Setting | Nature of intervention/ initiative/ project |
|---|---|---|---|---|
1 | Bajpai 2009 | Report | Rajasthan, India 15 villages across 5 districts of Rajasthan, India | The project supported a Maternal Health Right Awareness program. They supported capacity building of community based organizations, women’s self- help groups, health committees, observed outreach maternal and child health days, improved linkages with frontline health workers and held public hearings. Booklets on maternal health entitlements were distributed, meetings held and street plays, folk theatre performed. |
2 | Burket, Hainsworth & Boyce 2008 | Report | Angola, Ethiopia, Ghana, Kenya, Nigeria, Mozambique, Tanzania, Uganda | Pathfinder implemented youth friendly post-abortion care across the eight countries tailored to their specific contexts. Across all eight countries the project worked to improve facility level care through facility assessments, action plans, provider training, orientation meetings for the remaining staff, facility renovations and supportive supervision. In addition, community level work supported sensitization meetings and peer educator training. In particular, in Mozambique, youth associations undertook community mobilization and outreach to raise awareness on rights related to accessing post-abortion care. |
3 | CARE International & ICRW 2010 | Report | Uttar Pradesh, India 2 districts in Uttar Pradesh, India | ISOFI (Inner Spaces Outer Faces Initiative) was from 2007 to 2010. Integrated into an existing maternal health program, interventions facilitated dialogues that explored personal values and challenged assumptions related to gender and sexuality. For example, pictorial flash cards that prompted discussion on men’s role as supporters for women’s rights, the division of household labor, domestic violence, and women’s rights to seek care with a skilled provider. The project also brought couples together in a public location to allow them to learn and discuss MNH care in a safe space and carried out media campaigns (e.g., puppet shows, theater, etc.) focused on gender-related discrimination. CARE also worked closely with district health staff to build community-level capacity. Examples include training for CHWs on counseling men on their role in MNH and the integration of iterative and open-ended exercises for discussion on gender and sexuality with district and sub-district health meetings. |
4 | CARE International 2012 | Report | Bangladesh, Bolivia, DRC, India, Peru, Tanzania | The following case studies were documented: Bangladesh-Community Support Systems in two sub-districts from 2006 to 2010 that tracked every pregnant woman, supported community awareness and resources for maternal health, strengthened local governance mechanisms (based on the Dinajpur Safe Mother Initiative); India-Inners Spaces Outer Faces (ISOFI) see above; Bolivia- Participatory Community Management implemented for 1 year in four rural and peri-urban departments that tracked pregnant women and other types of service utilization, raised community awareness, supported community monitoring of services (based on FEMME program in Peru); DRC -Uzazi Bora Project in Kasongo district from 2007 to 2011 supporting local governance mechanisms, raising community awareness; Peru-FEMME program in Ayacucho region from 2000 to 2005, subsequent policy advocacy to scale up through FEMME+ from 2006 onwards; Tanzania - HEqP Initiative – highlighting inequities and rights violations; community scorecard process, community awareness, advocacy and policy work from 2007 to 2011. |
5 | Crump 2003 | Report | Nepal, Mexico | Nepal newborn case study decided against following a rights approach because it brought in too much complexity, though it included Minister of Human Rights into their work. Findings conflict with other case studies on a rights-based approach to maternal health in Nepal; Mexico Safe Motherhood committee worked on a charter for patient’s rights and promoted reproductive rights in reviewing policies, working with other stakeholders, but mostly an overview case study; Indonesia Involvement of Minister of Human Rights in maternal health advocacy |
6 | Das & Dasgupta 2013 | Report | Uttar Pradesh, India | Reflects on the experience of the Mahila Swasthya Adhikar Manch (MSAM) or Women’s Health Rights Forum in Uttar Pradesh, India, which raised women’s awareness of entitlements and supported their role in monitoring service delivery and dialoguing with policy makers to improve access to health services to improve maternal health. |
7 | Dasgupta 2011 | Journal article Descriptive study | Uttar Pradesh, India | Describes the experiences of a NGO, SAHAYOG, developing ‘rights based’ strategies around maternal health. Uses recent frameworks on accountability and gendered rights to draw out lessons. Multiple initiatives discussed that raised awareness of rights: forums, campaigns, etc. |
8 | Davis-Floyd, Pascali-Bonaro, Davies & Gomez Ponce de Leon 2010 | Newsletter | Includes examples from Bangladesh, Cambodia, Canada, China, Honduras, Ghana, India, Nepal, Romania, Uruguay. | Outlines 10 steps through which IMBCI aims to improve care throughout the childbearing continuum to save lives as well as prevent illness and harm from the overuse of obstetric technologies and promote health for mothers and babies around the world. Cites the approach as a “testament to and an affirmation of women’s fundamental rights during childbirth”. Cites the launching of a demonstration project in Canada and Uruguay. |
9 | DFID 2005 | Guideline | Includes examples from Bangladesh, Cambodia, China, Ghana, Honduras, India, Nepal, Romania | Provides guidance to program managers specifically on how to put a human rights-based approach into practice and mentions specific case study examples. |
10 | DFPA 2010 | Report | Bangladesh, India, Pakistan, Nepal | Supports civil society engagement for accountability in health governance Women’s Health and Rights Advocacy Partnership (WHRAP) with a focus on sexual and reproductive health and rights in India (Sahayog/Chetna), Pakistan (Shirkat Gah), Nepal (Beyond Beijing Committee), Bangladesh (Naripokkho) through ARROW based in Malaysia from 2003 to 2010. Targets vulnerable women in the most remote areas and applies 1) a rights-based approach recognizing that the rights are at all times relational between citizens (rights-holders) and the state (duty-bearers) and between international obligations and local citizens’ claims, 2) a policy engagement approach to increase the influence of civil society in political decision making in health. Community mobilization strategy involving community members and organizations in evidence production and in monitoring government accountability; an advocacy strategy to mobilize political will; an alliance strategy to build civil society coalitions; a boomerang strategy to leverage external and national actors. |
11 | Kayongo, Esquiche, Luna, Frias, Vega-Centeno & Bailey 2006 | Journal article Descriptive study | Peru | AMDD and CARE began Femme project in 2000 focusing on 5 facilities improving EmOC and promoting a human rights approach in health care (specific effort to provide non-discriminatory care to local cultures, signs with information on health services, birthing chairs according to women’s preference, improved privacy during childbirth, microwave oven for hot food, name tags to address women by name, community human rights initiatives to demand accountability). |
12 | Kenney, Siupsinskas, Sharman, Adilbekova & Zues 2005. | Report | Kazakhstan | ZdravPlus is a health reform project, supported by USAID, which assists five Central Asian countries in providing effective and efficient health services through technical assistance to improve quality of care, strengthen the financing systems and management of health services, and enhance the population’s involvement in health care decisions. Interventions are linked to the context of de-medicalizing and rationalizing care, reducing the number of ANC visits, unnecessary examinations, tests, episiotomies, increasing attendance of partners at birth and empowering women to choose the position they give birth in, more individual vs. shared rooms, use of partograph, changing sterile to clean enough environment so that family members can more readily access laboring woman, increasing skin to skin, breast-feeding on demand, reducing extent of hospitalization. |
13 | Molina, Michelini, Escobar & Robinson 2010 | Report Internal self-evaluation External qualitative study | Argentina | Evaluation of the ‘Child Rights Education for Professionals’ initiative, including in its annexes references to ‘Te Escucho’ a project promoting the rights of children and women within health. |
14 | Natoli, Renzaho & Rinaudo 2008 | Journal article Qualitative study | Ethiopia | Lessons learned on reducing harmful traditional practices from the Adjibar Safe Motherhood project. |
15 | Papp, Gogoi & Campbell 2013. | Journal article Qualitative study | Orissa, India | Case study of efforts to improve accountability focusing on the role of local women, intermediary groups, health providers and politicians. It highlights three drivers of success: [1] generation of demand for rights and better services, [2] leverage of intermediaries to legitimize the demands of poor and marginalized women and [3] the sensitization of leaders and health providers to women’s needs. |
16 | Reis, Deller, Carr & Smith 2012 | Report | 19 countries | Outlines findings of RMC survey with key stakeholders about their experience implementing interventions to promote respectful maternity care (48 individuals, 19 countries). Discusses how safe motherhood initiatives must beyond the prevention of morbidity or mortality encompass respect for women’s basic human rights. Case studies outlining strategies to ensure that women are better informed of their SRHRs and how to exercise them. |
17 | Schooley, Mundt, Wagner, Fullerton & O’Donnell 2009 | Journal article Qualitative study | Guatemala | Qualitative study of women’s support groups seeking care at Casa Materna; a maternity waiting home that provides prenatal, postnatal, infant and well women care inclusive of family planning |
18 | Shepard 2002 | Book chapter Qualitative study | Peru | Qualitative case study documenting the experience of Consorcio Mujer, an initiative by several feminist NGOs, to work with communities and health providers in six municipalities. The first phase involved sharing the results of an evaluation showcasing violations of women’s rights when accessing health centers and initial dialogues about the results. The second phase supported trainings and meetings with both women in communities and providers separately, before bringing them together for dialogues, that would agree on action plans to improve quality of care in facilities in ways that would respect women’s rights. |
19 | SORAK Development Agency 2013 | Report | Uganda | Community-based approach that empowers women with relevant knowledge and skills to demand and access care and commodities to exercise their rights. Discussion of SORAK’s projects (2011–2012) and key achievements. Of specific interest is the Women’s Maternal Rights Promotion Project, which is only touched upon briefly. The only indicator provided is process-level (number of women trained). Empowers women (particularly members of marginalized groups) to understand and claim their rights through the establishment of a complaint mechanism |
20 | Stoffregen, Andion, Dasgupta, Frisancho & Mutunga 2010 | Report | India, Kenya, Peru | Field projects undertaken 2008–2009 to increase understanding of rights based approaches to maternal mortality reduction efforts by NGOs in three countries: SAHAYOG in India, FCI in Kenya and CARE in Peru. SAHAYOG supported the Mahila Swasthya Adhikar Manch (MSAM) or Women’s Health Rights Forum in two districts to document case studies representing women’s experiences of facility delivery and to discuss this with national policy makers as part of a ‘Voices from the Ground’ meeting; briefing kits for elected officials developed and distributed; public hearings with local officials and women facilitated; booklet that supported discussion meetings following Friere methodology with local NGOs and women members. FCI in coordination with government partners implemented the Right to Care project that conducted workshops with community and religious leaders and health providers on maternal health and rights that resulted in action plans to ensure women’s rights to maternal health. CARE worked through its DFID funded Participatory Voices Project in Azangaro and Ayaviri provinces of Puno to support capacity building workshops, alliance building among local civil society networks, community monitoring of services, dialogues with community leaders and local authorities responsible for health services. |
21 | Strecker, Stuttaford & London 2012 | Journal article | South Africa | Evaluation of pamphlets developed on the right to health as a part of a broader action research effort supported by a Learning Network for Health and Human Rights between local universities and civil society organisations. |
22 | Srofenyoh, Ivester T, Engmann, Olufolabi, Bookman & Owen 2012 | Journal article Descriptive study | Ghana | Quality improvement in a hospital where “Customer service was addressed including a patient’s right to respect, privacy, emotional support, pain relief, communication, and timely access to care. These elements were promoted through lectures, informal discussion, and bedside example. Satisfaction surveys are conducted to monitor progress. Staff members who demonstrate excellent customer care are recognized”. |