Applying Rights-based Approaches with Midwife Training: Experiences from South Africa

Session: Applying Human Rights Based Approaches to Preventing Maternal Mortality and Morbidity: Strategies, Challenges and Lessons from Civil Society Experiences in Four Countries

Presenter: Busisiwe Kunene, Society of Midwives South Africa

South Africa is making some gains towards reducing neonatal deaths but is less likely to achieve reduction of maternal mortality and realise the MGD goal.  While HIV has undermined most of the contribution towards achieving this, the Society of Midwives, South Africa (SOMSA) have raised concerns that unless the country plans accurately on human resources and competency skill for midwifery cadre that is responsible for 72% of all MNH care service in the country, it cannot achieve goals for maternal and newborn health.  SOMSA has developed a manual on most relevant principles of HRBA selected from the TGN, and conducted a workshop with selected educators who then conduct workshops with their students.  The advanced course requires that the students go back into clinical work and take up a community project in an obstetrics unit, to apply what they have learned during their course. The students during their community work assignment in the Midwifery Obstetric Unit used their training in HRBA. They attempted concrete actions, such as encouraging women to choose their most preferred position during labour, ensuring privacy for antenatal examinations and labour rooms, allowing disposal of the placenta in accordance with women’s own customs and practices, and ensuring a basket of contraceptive choices were offered to postpartum women during counselling with no coercion to accept contraception. For any grievances, a notice in the reception area prominently displayed a number where patients could call with complaints.  Students acknowledged that implementing HRBA in their work made them feel more responsible to the women they cared for. As one of them said, ‘I am taking accountability to bring change, to do good to the women” and yet another felt that HRBA helped her to “Speak up and do the right thing.”