TABLE 3.

Summary of Mechanisms of Change Resulting in More Dignified, Supportive, and Respectful Maternity Care in Secondary Public Health Facilities in Sindh, Pakistan

ComponentMechanisms of Change
S-RMC training
  • Insight into women's feelings and rights

  • Realization of the worthiness of the role nonclinical staff can play

  • Understanding how to operationalize team coordination

  • Orientation in psychosocial component and its place within maternity care

Assessment of women's demographic and psychosocial vulnerabilities
  • Identification of women's differential (psychosocial) needs beyond routine care

  • Provision of woman-centered care

Benchmarking dignified care and psychosocial support
  • Effective engagement with pregnant women and within maternity teams

  • Customization of woman- and companion-focused care

Care coordination
  • Collective commitment of team to achieve personalized care

  • Psychosocial needs also supported by nonclinical staff

  • Continuity of service—proper handover

Assessment of quality of care
  • Identification of service gaps

  • Empowerment of women within the health system

Performance review and accountability
  • Creation of a means of communication among team members

  • Systematic awareness of the maternity team's performance and challenges

  • Implementation of collective corrective actions

  • Abbreviation: S-RMC, supportive and respectful maternity care.