Category Archives: Uncategorized

Series 2, episode 4 – When birth companions are part of the problem: a story of disrespect and abuse during childbirth in Western Tanzania

A recent study conducted in Ghana, Guinea, Myanmar and Nigeria and published in the Lancet showed that one in three women experienced physical or verbal mistreatment during childbirth in health facilities.

Adrienne Strong is a medical anthropologist and Assistant Professor of Anthropology at the University of Florida who studies maternal mortality and women’s health in Tanzania, and the notions of ideal comfort, care, and support for pregnant women in labour.

She observed a birth companionship programme run by an NGO in maternity wards in the Kigoma region of Tanzania in 2018. She explains how the programme designed to improve both the women’s experience of care and clinical outcomes failed to reduce  the disrespect and abuse directed at the patients. In fact, in some cases, the birth companions themselves justified the mistreatment or took part in it, targeting the very women they were meant to support.

For more on respectful maternal care from Adrienne Strong, check out her new book: Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania. Strong, A. 2020;Berkeley, CA: University of California Pres, which will be available in the Spring of 2020 at this address


Series 2, episode 3 – In India, a group of medical and nursing students bring quality improvement skills in their life and work

Chhavi Sharma, a medical student at the Lady Hardinge Medical College in New Delhi, explains how learning Quality Improvement skills, in addition to her clinical skills, is changing the way she approaches patients, and preparing her to be a better medical professional.

Chhavi is a founding member of  Be the Change,  a group of medical and nursing students committed to improving quality of care and supported by India’s Nationwide Quality of Care Network.

Series 2, episode 2 – In Ghana, a simple tool designed to engage communities helped increase the transparency, accountability and quality of care in health services

Emmanuel Ayire Adongo, from the World Health Organisation Country Office in Ghana explains how a simple tool – a scorecard, building on an existing policy and community engagement structures – has made it possible to engage communities in the planning, roll-out and assessment of health services. From community representatives touring facilities, to community members pitching in to improve the infrastructure, listen to the impact this tool had on the involvement of the community, the accountability of the health system, and, ultimately, the quality of care.

The Policy, Planning, Monitoring and Evaluation Division (PPME) of the Ghana Health Service is now planning to expand the roll-out of the scorecard country wide.

Series 2, episode 1- In Ebonyi and Kogi states, health workers learn quality improvement skills on top of clinical skills, and are improving quality of care on the day of birth


Over 90 health facilities in the Eboni and Kogi states of Nigeria have joined a quality improvement initiative to improve the quality of care for women and newborn on the day of birth.

In just two years, they have seen massive improvement in some of the key clinical practices such as managing post-partum haemorrhage, resuscitating a newborn or encouraging early breastfeeding. And the communities they are serving are seeing a difference in the care they receive.

Dr Ugo Okoli is the Deputy Chief of Party of the Maternal and Newborn Child Survival Programme (MCSP) in Nigeria, leading the quality improvement work in reproductive, maternal and newborn health in Ebonyi and Kogi States. She explains what are the success factors of this initiative, and some of the pitfalls to watch out for.