Direct observation of respectful maternity
Increasing access of pregnant women to skilled care during childbirth is a key strategy for reducing maternal and
early neonatal mortality and morbidity. Most maternal deaths are considered preventable  and the majority
could be averted by increased access to a skilled care provider supported by the resources of a functioning health system . Recent modeling of the effect of scaling up selected evidence-based interventions during facility-based labor and delivery confirms a 79 % decrease in maternal deaths is possible . With the global
agenda historically focused on increasing access, or quantity, of skilled care, the need to improve quality of
care has received less attention [4, 5]. To save women’s lives and improve maternal and newborn health, women
must both come to the facility to give birth with a skilled health provider and receive high quality care to prevent
and address complications that may arise.