Kuzuuia na kuondoa kutoheshimiwa na dhuluma wakati wa kujifungua katika vituo

Kuzuuia na kuondoa kutoheshimiwa na dhuluma wakati wa kujifungua katika vituo

Kila mwanamke ana haki ya kupata kiwango cha juu iwezekanavyo cha matibabu vikiwemo haki ya kuheshimiwa

Taarifa ya WHO

Usuli

Kuhakikisha kuwa wote wanapata huduma zinazo kubalika, zenye salama, za kijinsia , za afya ya uzazi hasaa kupata dawa za kuzuia mimba na utunzaji wa afya ya akina mama , zinaweza kwa kiasi kikubwa kupunguza kuugua na kufariki kwa akina mama . Katika miongo ya hivi majuzi , viwango vya kuzalishwa katika vituo vya afya vimeendelea kupanda huku wanawake wakipewa motisha kujifungulia katika vituo vya Afya kupitia kwa kuhakikisha kuwa vituo hivi vinatakikana, kupewa pesa , elimu , hamasisho za kijamii na sera za kufuatwa.

Hata hivyo , kikosi kinachokua kinachofanya utafiti kuhusu wanayoyapitia wanawake wakati wa uja uzito na hasa wakati wa kujifungua , wanadhihirisha picha ya kuogofya.

Wanawake wengi ulimwenguni hupata dhuluma , matusi au hata kutelekezwa wakati wa kujifungua katika vituo vya Afya.(1 - 3)Hii hujujumuisha ukiukaji wa imani kati ya wanawake na wahudumu wa Afya na hili linaweza kuwakatisha tamaa wanawake kutafuta na kutumia huduma za kiafya za akina mama . (4) Huku dhuluma na matusi kwa akina mama yaweza kutokea wakati wote wa ujauzito , kipindi cha wakati wa kujifungua na kile baada ya kujifungua , wanawake wako kwenye hatari Zaidi hasaa wakati wa kujingua. Vitendo kama hivi vinaweza kuwa na athari haswa kwa mama na mtoto.

Wanake wengi hupitia dhuluma na kutoheshimiwa wanapojifungua katika vituo vya Afya kote ulimwenguni. Wanayopitia hayakeuki tu haki za wanawake za kupata utunzaji wa heshima tu bali pia yanatahadharisha haki zao za uhai , matibabu , uadilifu wa kimwili na uhuru wa kutodhulumiwa k.Maelezo haya yanastahili matendo makubwa zaidi , mazungumzo , utafiti na utetezi kwa haya jambo hili muhimu la afya ya umma na haki za kibinadamu.

photo: UNICEF

Ripoti kuhusu dhuluma na matusi wakati wa kujifungua kwenye vituo vya Afya ni pamoja na kupigwa ,

kudhalilishwa , kutukanwa , kushurutishwa , kufanyiwa taratibu za kimatibabu (ikiwemo kumzuia mama kuzaa milele) , kukosa kuwekwa siri , kukosa kupata idhini inayotokana na kuarifiwa , kunyimwa dawa za maumivu , maagano ya siri kuvunjwa kabisa , kukatzwa kulazwa kwenye vituo vya Afya , kuzembea wanawake wakati wa kujifungua kupelekea wao kupata matatizo yanayoweza kuepukwa yanayohatarisha maisha yao , kufungiwa kwa wanawake na watoto wao wachanga kwenye vituo vya Afya kwa kushindwa kulipa. (5) Miongoni mwa wengine, vijana , wanawake ambao hawajaolewa , wanawake wa tabaka lamapato ya chini, wanawake wanaotoka katika kabila lililo na watu wachache , wanawake wahamiaji na wanawake wanaoishi na virusi vya Ukimwi ndio hasa wanaoweza kupata dhuluma na unyanyasaji.

Kila mwanamke ana haki ya kupata kiwango cha juu iwezekanavyo cha matibabu vikiwemo haki ya kuheshimiwa , kupewa huduma ya matibabu iliyo ya heshima kipindi chote cha uja uzito na kujifungua , sawaAmerican Refugee Committeena kuwa huru kutokana na vurigu na kubaguliwa. Matusi , kutelekezwa au kutoheshimiwa kunaafikia kutelekezwa kwa haki za kimsingi za mwanamke , jinsi inavyoelezwa katika kanuni mahususi za kimataifa zilizotwaliwa kuhusu haki za kibinadamu. (6 - 9) Hususan wanawake waja

wazito wana haki ya kubebwa sawa kiheshima , huru kutafuta , kupokea na kupeana habari , huru kutokana na ubaguzi , na kufurahia kiwango cha juu ambacho kinaweza kuafikiwa cha Afya ya kimaumbile na kiakili , ikiwemo ujinsia na ile ya uzazi.

Licha ya ushaidi ulioko ambao unapendekeza kuwa visa vya wamama kupitia dhuluma na matusi katika vituo vya Afya wanapojifungua kuenea kwingi , (1 – 3 , 5) hakuna kwa sasa maafikiano ya kitaifa jinsi ya dhuluma na matusi zitafafanuliwa na kupimwa. Kwa hivyo , mapendeleo na athari zake kwa Afya ya wanawake , ustawi na maamuzi havijulikani. Mawazo ya agenda za utafiti zimo zinazotaka kuboresha ufafanuzi ,kipimo na kuelewa dhuluma na matusi wanayopitia wanawake wakati wa kujifungua mtoto na jinsi inavyoweza kuzuiwa na kuondolewa.

Ili kupata kiwango cha juu cha heshima wakati wa kujifungua mtoto , mifumo ya Afya lazima ipangwe na kuendeshwa kwa njia ambayo inahakikisha heshima kwa wanawake kwa Afya ya sehemu zao za siri na ile ya uzazi na haki zao za kibinadamu. Huku serikali , jamii ya weledi , watafiti , mashirika ya kimataifa , mashirika ya watumishi wa kiserikali na jamii kote nchini tayari wameakisi mwanga kuwepo kwa haja ya kushughulikia tatizo hili , (11 - 14) na mara nyingi kanuni za kukuza heshima wanayopewa akina mama hazijatwaliwa , haziko bayana , au hazijatafsiriwa kuenda kwa vitendo vilivyo na maana.

Ili kuzuia na kuondoa kutoheshimiwa na dhulumai wakati wa kujifungua kwenye vituo vya Afya kote ulimwenguni, matendo yafuatayo yanastahili kuangaliwa:

1. Kuungwa mkono zaidi kutoka kwa serikali na wenzi wa maendeleo kwa utafiti na ya kufanywa juu ya kutoheshimiwa na matusi

Serikali na wenzi wa maendeleo wanastahili kuunga mkono zaidi na utafiti wa juu ya kutambua na kuekea mipaka ukosefu wa heshima na matusi katika vituo vya umma na vile vya kibinafsi kote ulimwenguni na kusaidia katika kuelewa athari na maamuzi ya wanawake juu ya Afya yao. Ushaidi kuhusu matokeo na kutekelezwa kwa kuingilia kati katika miktadha mbalimbali kunahitajika ili kupatiana ushauri wa kiteknikali kwa serikali na kwa wanaopatiana huduma za Afya.

2. Kuanzilisha ,kuunga mkono na kumudu mipango iliyokelezwa ili kuboresha huduma za Afya kwa akina mama iliyo na lengo kuu la huduma za heshima kama sehemu muhimu ya huduma iliyo bora

Matendo makubwa yanahitajika ili kusaidia mabadiliko katika upeanaji wa huduma , mazingira ya kliniki , na mifumo ya Afya ili kuhakikisha kuwa wanawake wote wanapata huduma zilizo za heshima , za hali ya juu na za kujali Afya ya akina mama ambao wamejifungua. Haya ni kama vile (lakini hayajikiti kwa ) kupatiana msaada wa kijamii kupitia kwa mwandani wa kujichagulia , kutembeatembea , kupata maji na chakula , uamininifu , siri , habari kwa wanawake kuhusu haki zao , mambo ya kuzingatia taratibu za kufuatilia wakati wa kurekebisha yaliyokeukwa , na kuhakikisha viwango vya juu vya weledi katika huduma za kliniki. Kulenga usalama , uliyo bora zaidi , unaodhamini watu kama sehemu ya Afya kuafikiwa na inaweza kusaidia katika marekebisho.

3. Kusisitiza haki za wanawake kupewa taadhima na heshima katika huduma za Afya katika kipindi chote cha ujauzito na cha kujifungua

Jopo la kimataiiifa linaloshughulikia haki za kibinadamu huangaza kutoheshimiwa na matusi wakati wa kujifungua kama jambo muhimu kwa haki za binadamu , (6 – 8 , 15) na yanaweza kusaidia wanaotetea huduma ya Afya ya wanawake katika

photo: World bank

Kuzuuia na kuondoa kutoheshimiwa na dhuluma wakati wa kujifungua katika vituo

kufahamisha na kuunda kanuni juu ya umuhumu wa kuheshimu Afya ya akina mama. Mitazamo inayozingatia haki kwa kupanga na kuendeleza mifumo ya Afya ambayo inawezesha upeanaji wa huduma ya heshima ya hali ya juu wakati wa kujifungua.

4. Kuunda data yenye matendo yanayohusiana na heshima na yasiyo na heshima , mifumo ya uwajibikaji na usaidizi wa ueledi wa maana

Mifumo ya Afya lazima iwajibike jinsi

wanavyohudumia wanawake wakati wanapozaa , kuhakikisha kanuni zilizo wazi juu ya haki na viwango vya maadili zimeundwa na kutekelezwa. Wahudumu wa Afya katika viwango vyote wanahitaji kusaidiwa na mafunzo kuhakikisa kuwa wanawake ambao wamepata watoto wanapewa huduma kwa njia ya kujali na kiheshima. Vile vituo ambavyo tayari vinapatiana huduma za kujifungua kwa njia ya

heshima , vinakuza ushiriki wa wanawake na jamii na vimetekeleza mikakati ya kufuatilia kuendelea kuboresha huduma zinazopeanwa ni za kiheshima vinastahili kutambuliwa , kutafitiwa na kuhifadhiwa kihati.

5. Kuhusisha washika dau wote , wakiwemo wanawake , katika kuboresha huduma wanazopewa na kuondoa mazoea katika kutokuwa na heshima na matusi.

Kumaliza kutokuwa na heshima na matusi wakati wa kujifungua yaweza kuafikiwa kupitia kujumuisha katika utendaji , kushirikisha utendaji wa wanawake , jamii , wahudumu wa afya , meneja , mafunzo ya weledi wa matibabu , elimu na vikundi vy kuhakiki vyeti , mashirika ya weledi , serikali , washika dau katika mifumo ya Afya , watafiti , vikundi vinavyofanya kazi na serikali na mashirika ya kitaifa. Tunaomba vikundi hivi kuhakikisha kuwa matusi na kutoheshimiwa vimetambuliwa na kuripotiwa , njia za kuzuia magonjwa na vifo na kuponya zimetekelezwa.

Marejeo

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4. Bohren M, Hunter EC, Munther-Kaas HM, Souza JP, Vogel JP, Gulmezoglu AM. Facilitators and barriers to facility-based delivery in low- and middle-income countries: A systematic review of qualitative evidence. Submitted to Reprod Health. 2014.

5. Bowser D, Hill K. Exploring Evidence for Disrespect and Abuse in Facility-based Childbirth: report of a landscape analysis. USAID / TRAction Project; 2010.

6. UN General Assembly. Universal Declaration of Human Rights. UN General Assembly; 1948 Dec.

7. UN General Assembly. Declaration on the Elimination of Violence against Women. UN General Assembly; 1993 Dec.

8. UN General Assembly. International Covenant on Economic, Social and Cultural Rights. UN General Assembly; 1976 Jan.

9. White Ribbon Alliance. Respectful Maternity Care: The Universal Rights of Childbearing Women [Internet]. Washington DC: White Ribbon Alliance; 2011 Oct. Available from: http://whiteribbonalliance.org/wp-content/uploads/2013/10/Final_RMC_Charter.pdf 10. Office of the United Nations High Commissioner for Human Rights. Technical guidance on the application of a human rights based

approach to the implementation of policies and programmes to reduce preventable maternal morbidity and mortality. UN General Assembly; 2012 Jul.

11. Warren C, Njuki R, Abuya T, Ndwiga C, Maingi G, Serwanga J, et al. Study protocol for promoting respectful maternity care initiative to assess, measure and design interventions to reduce disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth. 2012 Dec 31;13:21–1.

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15. UN General Assembly. Convention on the Elimination of All Forms of Discrimination Against Women. UN General Assembly; 1979 Dec.

Kuzuuia na kuondoa kutoheshimiwa na dhuluma wakati wa kujifungua katika vituo

© Translation by Jhpiego, Kenya. This is a translation of The prevention and elimination of disrespect and abuse during facility-nbased chidlbirth. WHO/RHR/14.23. © World Health Organization 2014 (English).

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For more information, please contact: Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland. E-mail: reproductivehealth@who.int • www.who.int/reproductivehealth This statement is endorsed by:

American Refugee Committee Artemis Association

Association for Improvements in the Maternity Services Averting Maternal Death and Disability, Mailman School of Public Health, Columbia University

Barts Health NHS Trust, United Kingdom

Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom

BirthHouse Association (Hungary)

BJOG: An International Journal of Obstetrics and Gynaecology California Association of Midwives

CARE

Center for Health and Gender Equity (CHANGE) Center for Reproductive Rights

Center for the Right to Health (CRH) Commonwealth Medical Trust (Commat)

DONA LLUM, Associació Catalana per un Part Respectat El Parto Es Nuestro, Spain

Elizabeth Glaser Pediatric AIDS Foundation ENCA European Network of Childbirth Associations Family Care International

GFA Health Project in Central Asia Hadhramout Health Organization, Yemen Human Rights in Childbirth

Human Rights Watch

Hungarian Alternatal Foundation

Hungarian Association of Independent Midwives Hypnobabies Childbirth Hypnosis

Ifakara Health Institute, Tanzania Immpact, University of Aberdeen ImprovingBirth.org

Initiativ Liewensufank, Luxembourg

International Federation of Gynecology and Obstetrics (FIGO) International Initiative on Maternal Mortality and Human Rights International Islamic Center for Population Studies and Research, Al Azhar University

International Motherbaby Childbirth Organization IntraHealth International

International Society of Psychosomatic Obstetrics and Gynaecology Jhpiego-an affiliate of Johns Hopkins University

Karnataka Health Promotion Trust

Le Regroupement Les Sages-femmes du Québec

Makarere University College of Health Sciences, School of Medicine Department of Obstetrics and Gynaecology

Maternal Adolescent Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine

Maternal and Child Survival Program Maternal Health Task Force

Midwives Alliance of North America National Advocates for Pregnant Women Partners in Population and Development (PPD) Pathfinder International

Perinatal Mental Health Project (PMHP), University of Cape Town, South Africa

Plan International Population Council

Red Latinoamericana y del Caribe por la Humanización del Parto y del Nacimiento (Latin American and Caribbean Network for the Humanization of Childbirth)

Reproductive Health Matters RODA Parents in Action, Croatia Royal College of Midwives

Safe Motherhood Program, Bixby Center for Global Reproductive Health and Policy, Dept. of Obstetrics, Gynecology & Reproductive Sciences at UCSF

SafeHands for Mothers SQUAT Birth Journal

Swedish International Development Cooperation Agency Swiss Tropical and Public Health Institute

The Soapbox Collaborative

Thrive Center for Birth & Family Wellness Umeå Centre for Global Health Research University Research Co., LLC (URC) University of Ibadan, Ibadan, Nigeria

United States Agency for International Development (USAID) White Cross Foundation

Wits Reproductive Health & HIV Institute, South Africa The White Ribbon Alliance

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