How power and knowledge hierarchies affect communication in intrapartum care: findings from public health facilities in two southern Indian districts.

Background: Effective communication is a key element of medical care; it can foster a warm interpersonal relationship, facilitate the exchange of information, and enable shared decision-making. In the context of obstetric care, it is associated with a range of positive clinical and social outcomes for mother and baby. Extant communication frameworks and respectful maternity care (RMC) guidelines emphasize the importance of effective communication during intrapartum care.

ASHA Kirana: when digital technology empowered front-line health workers.

This practice paper describes our experience of implementing accredited social health activists (ASHA) Kirana, a digital technology-enabled Maternal Clinical Assessment Tool (M-CAT) and how the ASHAs felt empowered in the process. M-CAT aimed to train ASHAs to collect data that assists doctors in identifying maternal risks, in Karnataka, India. Systematic clinical assessment is not common in rural public health institutions.

Adapting maternal health practice to co-morbidities and social inequality: A systematic approach.

The process of adapting universal guidelines to local institutional and cultural settings is recognized as important to their implementation and uptake. However, clarity on what, why and how to adapt in an evidence-based manner is still somewhat elusive. Health providers in low and middle income country contexts often have to deal with widely present co-morbidities and social inequalities among pregnant women.

Deciphering Rashomon: an approach to verbal autopsies of maternal deaths.

The paper discusses an approach to verbal autopsies that engages with the Rashomon phenomenon affecting ex post facto constructions of death and responds to the call for maternal safety. This method differs from other verbal autopsies in its approach to data collection and its framework of analysis. In our approach, data collection entails working with and triangulating multiple narratives, and minimising power inequalities in the investigation process.

Acceptability and use of emergency contraception among married women in Bangalore, India.

Objective: To assess knowledge, acceptability, and use of emergency contraceptive pills (ECs) among lower-income married women in Bangalore, India.

Methods: EC counseling and supplies were offered to 322 women aged 18-25 years participating in a longitudinal reproductive health study. Participants completed interviews at enrollment and were followed for 1 year.