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 [1] and the majority
could be averted by increased access to a skilled care provider supported by the resources of a functioning health system [2]. 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 [3]. 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.

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