A conceptual framework to promote respectful maternity care
Article Sidebar
Main Article Content
Abstract
Background. This study presents a conceptual framework for respectful, woman-centred maternity care, integrating insights from the literature, systems theory, and critical theory. The framework incorporates healthcare institution and provider factors, ensuring dignity, respect and high-quality care throughout the maternity experience.
Objectives. To outline the development process of this framework, which serves as a foundation for promoting respectful maternity care (RMC) in South Africa’s public healthcare settings.
Methods. A theory-generative methodology was applied, using both inductive and deductive strategies to derive key conclusions, ensuring a comprehensive approach to theory construction.
Results. The framework identifies and describes essential concepts that foster synergy in promoting RMC. By integrating diverse knowledge sources, it establishes a strong theoretical foundation, linking its principles to RMC and broader quality healthcare standards.
Conclusion. The conceptual framework provides a structured approach for enhancing maternity care through a woman-centred perspective. It underscores the value of combining multiple viewpoints to inform maternity care strategies, aiming to improve the overall maternal experience and healthcare outcomes.
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The SAJCH is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
How to Cite
References
1. White Ribbon Alliance. Respectful maternity care: The universal rights of women and newborns. 2019. https://www.healthynewbornnetwork.org/ hnn-content/uploads/Respectful-Maternity-Care-Charter-2019.pdf (accessed 8 September 2025).
2. World Health Organization. Standards for improving quality of maternal and newborn care in health facilities. 2016. https://qualityhealthservices.who.int/ quality-toolkit/qt-catalog-item/standards-for-improving-quality-of-maternal- and-newborn-care-in-health-facilities (accessed 8 September 2025).
3. Bohren MA, Vogel JP, Hunter EC, et al. The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review. PLoS Med 2015;12(6):e1001847. https://doi.org/10.1371/journal.pmed.100184
4. Human Rights Watch. ‘Stop making excuses’: Accountability for maternal health care in South Africa. 8 August 2011. https://www.hrw.org/report/2011/08/08/ stop-making-excuses/accountability-maternal-health-care-south-africa (accessed 8 September 2025).
5. World Health Organization. The prevention and elimination of disrespect and abuse during facility-based childbirth. 2014. https://iris.who.int/server/api/ core/bitstreams/a287bfd1-97c0-4af6-ba57-a4469f1d3ed8/content (accessed 8 January 2026).
6. Tamene EH. Theorizing conceptual framework. Asian J Edu Res 2016;4(2):50-56. 7. Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D. The health and health system of South Africa: Historical roots of current public health challenges. Lancet 2009;374(9692):817-834. https://doi.org.10.1016/S0140-
6736(09)60951-X
8. Harris B, Goudge J, Ataguba JE, et al. Inequities in access to health care in South Africa. J Public Health Policy 2011;32(Suppl 1):S102-S123. https://doi. org.123.10.1057/jphp.2011.35
9. Jewkes R, Abrahams N, Mvo Z. Why do nurses abuse patients? Reflections from South African obstetric services. Soc Sci Med 1998;47(11):1781-1795. https://doi.org.10.1016/S0277-9536(98)00240-8
10. Dutton JE, Workman KM, Hardin AE. Compassion at work. Annu Rev Organ Psychol Organ Behav 2014;1(1):277-304. https://doi.org.10.1146/annurev- orgpsych-031413-091221
11. Oosthuizen SJ, Bergh AM, Grimbeek J, Pattinson RC. Midwife-led obstetric units working ‘CLEVER’: Improving perinatal outcome indicators in a South African health district. S Afr Med J 2019;109(2):95-101. https://doi.org.10.7196/ SAMJ.2019.v109i2.13429
12. Moran NF, Naidoo M, Moodley J. Reducing maternal mortality on a countrywide scale: The role of emergency obstetric training. Best Pract Res Clin Obstet Gynaecol 2015;29(8):1102-1118. https://doi.org.10.1016/j. bpobgyn.2015.08.002
13.Embrace. Our Motherhood Manifesto. https://www.embrace.org.za/our- motherhood-manifesto/ (accessed 8 October 2025).
14. National Department of Health, South Africa. National Integrated Maternal and Perinatal Care Guidelines for South Africa. 5th ed. 2024. https:// knowledgehub.health.gov.za/elibrary/national-integrated-maternal-and- perinatal-care-guidelines-south-africa (accessed 8 January 2026).
15. Sarma H, D’Este C, Ahmed T, Bossert TJ, Banwell C. Developing a conceptual framework for implementation science to evaluate a nutrition intervention scaled up in a real-world setting. Public Health Nutr 2017;24(S1):s7-s22. https://doi.org/10.1017/S1368980019004415
16. Hughes S, Davis, TE, Imenda SN. Demystifying theoretical and conceptual frameworks: A guide for students and advisors of educational research. J Soc Sci 2019;58(1-3):24-35. https://doi.org/10.31901/24566756.2019/58.1-3.2188
17. Imenda S. Is there a conceptual difference between theoretical and conceptual frameworks? J Soc Sci 2014;38(2):185-195. https://doi.org/10.1080/09718923 .2014.11893249
18. Freshwater D, Maslin-Prothero SE, eds. Blackwell’s Nursing Dictionary. 2nd ed. Cape Town: Juta, 2015.
19. Chikere CC, Nwoka J. The systems theory of management in modern day organizations – a study of Aldgate Congress Resort Limited Port Harcourt. Int J Sci Res Pub 2015;5(9):1-7. http://www.ijsrp.org/research-paper-0915/ ijsrp-p4554.pdf (accessed 8 January 2026).
20. Hayajneh Y. Systems & Systems Theory. Management for Health Care Professionals Series. 2007. https://www.semanticscholar.org/paper/Management-for-Health- Care-Professionals-Series-%26-Hayajneh/8e3b585cdcf178e287e2bc6631938940 712537eb (accessed 8 January 2026).
21. Ryan G. Introduction to positivism, interpretivism and critical theory. Nurse Res 2018;25(4):14-20. https://doi.org/10.7748/nr.2018.e1466
22. Castro A. Witnessing obstetric violence during fieldwork: Notes from Latin America. Health Hum Rights 2019;21(1):103-111.
23. McCormack B, McCance TV. Development of a framework for person-centred nursing. J Adv Nurs 2006;56(5):472-479. https://doi.org/10.1111/j.1365- 2648.2006.04042.x
24. Sudhinaraset M, Afulani P, Diamond-Smith N, Bhattacharyya S, Donnay F, Montagu D. Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity. Gates Open Res 2017;1:1. https://doi.org/10.12688/gatesopenres.12756.1
25. Freedman LP, Ramsey K, Abuya T, et al. Defining disrespect and abuse of women in childbirth: A research, policy and rights agenda. Bull World Health
Organ 2014;92(12):915-917. https://doi.org/10.2471/BLT.14.137869