Government embraces respectful maternity care and fair treatment of midwives in Malawi

By Luke Chiwala, Midwife and White Ribbon Alliance Malawi Citizen Journalist

Women in Kasungu and Lilongwe routinely experience abuse and disrespect during maternity care at healthcare facilities, a finding revealed by the White Ribbon Alliance-led respectful maternity care project.

Expressing gratitude to White Ribbon Alliance Malawi and its partner AMAMI for the eye-opening information, Ministry of Health and Population Chief of Health Services Dr. Charles Mwansambo said he now understood why, despite the government recruiting more midwives to help women, mothers could not – and would not – use the new services.

Responding to challenges faced during implementation of the respectful maternity care (RMC) project, AMAMI president Dr. Ann Phoya expressed that there was currently a poor sense of ownership by the government team: “After the training [by WRA Malawi and AMAMI], we feel the matrons did not do much, we kept on going to the facilities trying to support them so that they take it as their own initiative and include RMC into their supervision and we need policy support to ensure that hospitals do practice RMC. We will also use other avenues like the quality assurance department to ensure that hospitals do practice RMC.”

However, she was optimistic that the government will take up the responsibility of integrating RMC more holistically, as AMAMI will continue to monitor progress now that it has officially been handed over to the government.

In the handover, several points were discussed to ensure sustainability for RMC at the policy, practice, education and community levels.

Handover ceremony to government of Malawi representatives of the Respectful Maternity Care project. Photo: White Ribbon Alliance Malawi.

Handover ceremony to government of Malawi representatives of the Respectful Maternity Care project. Photo: White Ribbon Alliance Malawi.

Delegates to the official event agreed that all hospital leaders should discipline their staff and begin to ensure that a feedback system be instituted so that clients can report issues of disrespect and abuse. It was also discussed that a feedback system be established at the community level and that citizen hearings be integrated into cultural events. On education, the RMC module should be added to the midwifery curriculum and students should be assessed on their knowledge of respectful care.

In order to make respectful care standard in all hospitals, it was further discussed that the ministry should ensure that each facility has its own RMC policy and that RMC charters are well displayed for staff and clients.

The occasion was graced by the Secretary for Health in the Ministry of Health Dr. Dan Namarika, and included representation from AMAMI, UNFPA, Bwaila Rotary Club, Ministry of Health Chief of Health Services, Nursing and Midwifery Services Directorate, White Ribbon Alliance for Safe Motherhood Malawi, midwives and members of the media.