27
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Towards a better tomorrow: addressing intersectional gender power relations to eradicate inequities in maternal health

      review-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Summary

          An equity lens to maternal health has typically focused on assessing the differences in coverage and use of healthcare services and critical interventions. While this approach is important, we argue that healthcare experiences, dignity, rights, justice, and well-being are fundamental components of high quality and person-centred maternal healthcare that must also be considered. Looking at differences across one dimension alone does not reflect how fundamental drivers of maternal health inequities—including racism, ethnic or caste-based discrimination, and gendered power relations—operate. In this paper, we describe how using an intersectionality approach to maternal health can illuminate how power and privilege (and conversely oppression and exclusion) intersect and drive inequities. We present an intersectionality-informed analysis on antenatal care quality to illustrate the advantages of this approach, and what is lost in its absence. We reviewed and mapped equity-informed interventions in maternal health to existing literature to identify opportunities for improvement and areas for innovation. The gaps and opportunities identified were then synthesised to propose recommendations on how to apply an intersectionality lens to maternal health research, programmes, and policies.

          Related collections

          Most cited references56

          • Record: found
          • Abstract: not found
          • Article: not found

          Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health.

            To assess the utility of an acronym, place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital ("PROGRESS"), in identifying factors that stratify health opportunities and outcomes. We explored the value of PROGRESS as an equity lens to assess effects of interventions on health equity.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

              Background Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. Methods and Findings We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. Conclusions This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.
                Bookmark

                Author and article information

                Contributors
                Journal
                eClinicalMedicine
                EClinicalMedicine
                eClinicalMedicine
                Elsevier
                2589-5370
                06 December 2023
                January 2024
                06 December 2023
                : 67
                : 102180
                Affiliations
                [a ]Gender and Women's Health Unit, Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
                [b ]Ramalingaswami Centre on Equity & Social Determinants of Health, Public Health Foundation of India, Bangalore, India
                [c ]International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, RS, Brazil
                [d ]Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
                [e ]Department of Mother and Child Health, Institute for Clinical Effectiveness and Health Policy (IECS-Argentina), Buenos Aires, Argentina
                [f ]London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
                [g ]Indigenous Health Equity Unit, School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
                [h ]Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
                [i ]Birth Place Lab, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
                [j ]Department of Obstetrics & Gynecology, University of Toronto, Toronto, Ontario, Canada
                [k ]Vitala Global Foundation, Vancouver, British Columbia, Canada
                [l ]Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
                [m ]UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
                [n ]School of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville, Western Cape, South Africa
                [o ]South African Medical Research Council, South Africa
                Author notes
                []Corresponding author. 207 Bouverie Street, Carlton, Victoria 3053, Australia. meghan.bohren@ 123456unimelb.edu.au
                Article
                S2589-5370(23)00357-7 102180
                10.1016/j.eclinm.2023.102180
                10837533
                38314054
                90e5f96b-7a23-4a63-a3f4-d95b55cae5c2
                © 2023 World Health Organization

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/igo/).

                History
                : 20 December 2022
                : 3 August 2023
                : 10 August 2023
                Categories
                Series

                health equity and justice,intersectionality,maternal health,quality of care

                Comments

                Comment on this article