Respectful maternity care interventions to address women mistreatment in childbirth: What has been done?

INTRODUCTION: Over the last decade, there has been an increasing number of studies regarding experiences of mistreatment, disrespect and abuse (D&A) during facility-based childbirth. These negative experiences during labour have been proven to create a barrier for seeking both facility-based childbirth and postnatal health care, as well as increasing severe postpartum depression among the women who experienced them. This constitutes a serious violation of human rights. However, few studies have carried out specifically designed interventions to reduce these practices. The aim of this scoping review is to synthetise available evidence on this subject, and to identify initiatives that have succeeded in reducing the mistreatment, D&A that women suffer during childbirth in health facilities. METHODS: A PubMed search of the published literature was conducted, and all original studies evaluating the efficacy of any type of intervention specifically designed to reduce these negative experiences and promote RMC were selected. RESULTS: Ten articles were included in this review. Eight studies were conducted in Africa, one in Mexico, and the other in the U.S. Five carried out a before-and-after study, three used mixed-methods, one was a comparative study between birth centres, and another was a quasi-experimental study. The most common feature was the inclusion of some sort of RMC training for providers at the intervention centre, which led to the conclusion that this training resulted in an improvement in the care received by the women in childbirth. Other strategies explored by a small number of articles were open maternity days, clinical checklists, wall posters and constant user feedback. DISCUSSION: These results indicate that there are promising interventions to reduce D&A and promote RMC for women during childbirth in health facilities. RMC training for providers stands as the most proven strategy, and the results suggest that it improves the experiences of care received by women in labour. CONCLUSION: The specific types of training and the different initiatives that complement them should be evaluated through further scientific research, and health institutions should implement RMC interventions that apply these strategies to ensure human rights-based maternity care for women giving birth in health facilities around the world.

Evolution of the epidemiological surveillance indicators of the main sexually transmitted infections in Spain: A retrospective observational study (2011-2019).

INTRODUCTION: One of the most relevant aspects of sexual health promotion is the need to carry out health education by promoting a healthy affective-sexual education, with the capacity and resources to prevent sexually transmitted infections (STIs) and unwanted pregnancies. The aim of this study was to collect the evolution of epidemiological surveillance indicators of the main STIs, stratified by autonomous community after the publication of the Sexual and Reproductive Health Strategy in Spain in 2011 and until 2019. METHODS: A retrospective observational study of the Spanish population with STIs from 2011-2019. The study variables were indicators of the main STIs, including annual rates of notification of infections per 100,000 inhabitants. RESULTS: There is a lack of homogeneous and systematic epidemiological surveillance records for STIs. Overall, in Spain there was an upward trend in STIs, except for HIV, which showed a clear decrease. DISCUSSION: Despite existing regulations, strategies, and sex education programs in Spain, the main STIs have been increasing over the years, and Spain is one of the countries with the highest rates in Europe.