WASHINGTON D.C. - The US Agency for International Development (USAID) awarded $1.2 million in two grants to develop and evaluate interventions addressing disrespect and abuse of women during childbirth.

Through the Translating Research into Action (TRAction) project with University Research Co., LLC, USAID awarded the Population Council and the Columbia University Mailman School of Public Health's Averting Maternal Death and Disability (AMDD) Program each two -year $600,000 grants to conduct separate research studies of disrespect and abuse of women during childbirth at health facilities. "Investing in women-including providing quality and dignified pregnancy-related care-is essential to the prosperity and opportunity of all people," said USAID Administrator Dr. Rajiv Shah.

In developed and developing countries alike disrespect and abuse of women during childbirth, a time of intense vulnerability, constitutes both a human rights issue and an important quality of care problem. Various approaches have been developed to address these issues, including quality improvement, stigma reduction, and accountability measures.

In countries with high maternal and infant mortality, disrespect and abuse can discourage women from delivering their infants in facilities with skilled birth attendants. This research aims to better understand the extent of the problem and to document effective approaches to designing and implementing interventions to reduce the abuse. Ultimately, the initiative aims to increase use of skilled care to ensure safe deliveries and to reduce maternal mortality, a United Nations Millennium Development Goal.

The Population Council will conduct research in five districts in Kenya and AMDD will carry out research in two districts in the Tanga Region of Tanzania. Both organizations will collaborate closely with local communities and health systems stakeholders.

The U.S. Government's Global Health Initiative seeks to remove barriers that prevent women from accessing lifesaving health services such as assisted delivery with skilled birth attendants.

When women are able to access needed quality health services and protect themselves from the many health risks they face, long-term social and economic progress can be achieved.

In global health, USAID has prioritized three areas that have maximum impact on the health of women and children: maternal and child health, malaria and family planning. USAID is focusing on highly cost-effective interventions that target complications of pregnancy and birth; and working to ensure women have quality and dignified care at the time of delivery.

Disrespect and abuse of women during childbirth may encompass many points along a continuum from maternity care that is non-dignified to overtly abusive treatment. Examples of disrespect and abuse include humiliation, not respecting a woman's privacy and dignity, examinations and even surgery performed without her consent, discrimination based on attributes such as tribe, race, caste, or socio-economic status, abandonment or denial of care, and physical and verbal abuse during childbirth.

Exploring Evidence and Action for Respectful Care at Birth, written by URC's Dr. Kathleen Hill and Diana Bowser of the Harvard School of Public Health, presents evidence on disrespect and abuse of women during facility-based childbirth, contributors to the problem, and approaches to tackle this issue. An interview in the report quotes a woman who said: "I think most of our women don't know they have the right to respectful treatment….They accept what they get."

TRAction and its awardees will also collaborate with the White Ribbon Alliance for Safe Motherhood (WRA). The WRA is also receiving support from USAID to develop advocacy strategies and campaigns targeting this issue and will form a Leadership Action Committee to Promote Respectful Care at Birth to provide global leadership in raising awareness of disrespectful and abusive care of women during childbirth as a critical issue crosscutting the fields of maternal health, human rights and gender. The WRA will also foster country-level partnerships to affect policy change.

To learn more about USAID and its programs, please visit www.usaid.gov.