BACKGROUND:
Maternal and neonatal mortality remain a global concern. There is growing evidence that disrespect during childbirth contributes to poor outcomes. The Midwifery Led Ward at Limbe Health Centre (LHC) is strengthening provision of Responsive Respectful Maternity Care (RRMC) to improve health outcomes.

OBJECTIVES:
To; establish the baseline for adherence to aspects of RRMC by midwives; develop tailor made interventions to address RRMC gaps.

METHODS:
Structured observations of midwife-client interactions using a checklist and client exit interviews to evaluate midwives’ adherence to the aspects of RRMC were introduced. A baseline assessment was conducted in June 2023 to identify gaps in following areas; Respect and communication; Privacy and Safety; Support and comfort during labour; Supportive birth environment. To address identified gaps, interventions in July 2023 included trainings, installing new privacy curtains, pasting of guidelines on walls and holding dissemination meetings. Follow up data on adherence was collected between December 2023 and February 2025.

RESULTS:
Baseline data included 16 observations of midwife-client interactions and 34 client exit interviews. Post interventions, 51 observations and 117 exit interviews were conducted across three assessments to monitor adherence. Greeting clients, privacy and communication remained above 98% in all assessments. Midwives’ self-introduction increased from 6% to 69%, declined slightly to 45% in the final assessment. Seeking consent increased significantly, from 63% to 96%. No abuse was observed during assessments although 2% of women reported physical abuse and 6% reported verbal abuse in the final assessment. Encouragement of preferred birthing positions ranged from 50% to 93%, while birth companions increased from 88% to 100% in the later assessments.

CONCLUSIONS:
While midwives generally adhere well to RRMC standards, further efforts are needed to improve self-introductions, refrain from abuse and encourage women to give birth in their preferred positions.

KEY MESSAGE:
Prioritising provision of RRMC is an opportunity to improve health outcomes. Poster session 2 (Group A)