Creating Transformational Change for Families, Providers, and Facilities

Caught in the Middle: Understanding the Experience of Maternal and Newborn Health (MNH) Providers through the Lens of Organizational Theory for Mistreatment in Childbirth

Reports of mistreatment in childbirth have emerged around the globe, reducing trust in health systems at a profound moment of human life. The similar patterns and dynamics indicate its systemic nature. Limited research to date has focused on developing explanatory theory. Organizational sociology provides one lens for theory development, unearthing the experience of providers within the broader system that leads to its persistence.

Organisational and Individual Readiness for Change to Respectful Maternity Care Practice and Associated Factors in Ibadan, Nigeria: A Survey

Readiness for change is a known determinant of implementation success. Respectful maternity care (RMC) has been recommended as the standard for all women during childbirth. However, many RMC-promoting interventions have been conducted without prior assessment of the readiness for change. This study explored the relevance of readiness for change theories to the RMC literature. Health providers' organisational and individual readiness for change to RMC practice and the associated factors were assessed.

Embedding Inclusive, Supportive, and Dignified Maternity Care (SDMC) in Public Health Facilities: An Evaluation of a Theory-Driven Service-Delivery Intervention Package

Disrespect, discrimination, abuse, and lack of emotional support characterise intrapartum care in many low- and middle-income countries. While the World Health Organization (WHO) provides affirmative guidelines to address this issue, no operational model has effectively incorporated those guidelines into routine public health services. Therefore, we developed and evaluated a theory-driven service-delivery intervention to promote inclusive, supportive, and dignified maternity care (SDMC) in public health systems. Our SDMC intervention worked with maternity teams in a participatory, consensus-driven process, theoretically underpinned by the COM-B framework (Capability, Opportunity and Motivation drivers for respectful maternity Behaviour). Components included (a) capacity-building of staff (respectful care, rights-based care, medical ethics, values clarification, psychosocial support), and (b) improved governance (enhanced management information systems, care coordination) and accountability mechanisms (patient feedback, performance review). Technical content drew from WHO's intrapartum care guidelines, WHO's mental health GAP strategy, and contextual evidence.

Promoting Caregiver Well-Being as Part of Holistic Nurturing Care Programming in Ghana and the Kyrgyz Republic

The stress of parenting can have negative consequences on caregiver well-being, and the period immediately after birth is a particularly high-risk period for maternal depression. The Responsive Care and Early Learning (RCEL) Addendum is designed for integration with nutrition and health counseling packages to promote holistic nurturing care. One training module focuses on supporting caregivers to engage in self-care and support-seeking for their own well-being and also because a child's healthy development largely depends on their caregiver's capacity and well-being, particularly mothers. This study aims to understand the feasibility and acceptability of this training module among health workers and community volunteers, as well as initial effectiveness in reducing parenting stress in Ghana and the Kyrgyz Republic.