Under the Free Maternity Policy (FMP), Kenya has witnessed an increase in health facility deliveries rather than home deliveries with Traditional Birth Attendants (TBA) resulting in improved maternal and neonatal outcomes. Despite these gains, maternal and infant mortality and morbidity rates in Kenya remain unacceptably high indicating that more needs to be done. Using data from the Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project’s qualitative gender assessment, this paper examines women’s experience of disrespectful care during pregnancy, labour, and delivery. The goal is to promote an improved understanding of the actual care conditions to inform the development of interventions that can lift the standard of care, increase maternity facility use, and improve health outcomes for both women and newborns. We conducted sixteen focus group discussions (FGDs), two each for adolescent females, adult females, adult males, and community health committee members. As well, twenty-four key Informants interviews (KII) were also conducted including religious leaders, and persons from local government representatives, Ministry of Health (MOH), and local women’s organizations. Data were captured through audio recordings and reflective field notes. Kisii and Kilifi Counties in Kenya. Findings show nursing and medical care during labour and delivery were at times disrespectful, humiliating, uncompassionate, neglectful, or abusive. In both counties, male health workers were preferred by women giving birth, as they were perceived as more friendly and sensitive. Adolescent females were more likely to report abuse during maternity care while women with disabled children reported being stigmatized. Structural barriers related to transportation and available resources at facilities associated with disrespectful care were identified. A focus on quality and compassionate care as well as more facility resources will lead to increased, successful, and sustainable use of facility care. Interpreting these results within a systems perspective, Kenya needs to implement, enforce, and monitor quality of care guidelines for pregnancy and delivery including respectful maternity care of pregnant women. To ensure these procedures are enforced, measurable benchmarks for maternity care need to be established, and hospitals need to be regularly monitored to ensure these benchmarks are achieved.

In 2017, the Government of Mozambique declared localized acute malnutrition crises in a range of districts across Mozambique including Cabo Delgado. This is in spite of intensive efforts by different non-governmental organizations (NGO) and the Government of Mozambique to expand access to information on good nutritional practices as well as promote nutrition-specific interventions, such as cooking demonstrations, home gardens and the distribution of micronutrient powder to children. This paper examines and discusses key nutritional influences on the health of pregnant and breastfeeding mothers in Cabo Delgado province, Mozambique. We conducted 21 key informant interviews (KIIs) with a wide range of stakeholders and 16 in-depth interviews (IDIs) with women. In addition, we conducted four focus group discussions with each of the following groups: (1) pregnant adolescent girls, (2) pregnant women >20 yrs, (3) women >20 yrs with babies 20 yrs of children <2 yrs and (5) with fathers of children <2 yrs. Data were analyzed thematically using NVIVO software. There is no single widely held influence on pregnant and breast-feeding women’s nutritional decision-making, choices and food consumption. Rather, variables such as social-cultural, environmental, economic, gender, knowledge and information intersect in their roles in nutritional food choices.

Background Under the Free Maternity Policy (FMP), Kenya has witnessed an increase health facility deliveries rather than home deliveries with Traditional Birth Attendants (TBA) resulting in improved maternal and neonatal outcomes. Despite these gains, maternal and infant mortality and morbidity rates in Kenya remain unacceptably high indicating that more work needs to be done. Aim Using data from the Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project’s qualitative gender assessment, this paper examines and describes women’s experience of disrespectful care during pregnancy, labour and delivery. The goal is to promote improved understanding of actual care conditions in order to develop interventions that can lift the standard of care, increase maternity facility use, and improve health outcomes for both women and newborns. Methodology We conducted sixteen focus group discussions (FGDs) with female adolescents, women, men and community health committee members. Twenty four key informants interviews (KII) including religious leaders, local government representatives, Ministry of Health (MOH) and local women’s organizations were conducted. Data were captured through audio recordings and reflective field notes. Research site Kisii and Kilifi Counties in Kenya. Findings Findings show Nursing and medical care was sometimes disrespectful, humiliatings, uncompassionate, and neglectful. In both sites, male health workers were the most preferred by women as they were friendly and sensitive. Young women were more likely to be abused and women with disabled children were stigmatized. Conclusions Kenya needs to enforce the implementation of the quality of care guidelines for pregnancy and delivery, including respectful maternity care of pregnant women. To make sure these procedures are enforced, measurable benchmarks for maternity care need to be established, and hospitals need to be regularly monitored to make sure they are achieved. Quality of care and compassionate and caring staff may lead to successful and sustainable use of facility care.

This paper assesses how household context and characteristics shape the welfare trajectory and more specifically the accumulation of productive assets among beneficiaries of the Vision 2020 Umurenge Programme in Rwanda, the government's flagship social assistance program. The analysis is based on a unique data set combining panel household survey data with in-depth qualitative interviews of a subsample of male and female beneficiaries from the survey data collected between 2009 and 2015. By combining quantitative and qualitative information, the paper draws a more nuanced picture of how household characteristics?structural and temporal?contextualize opportunities for poor men and women and their households and shape how well they can leverage access to the Vision 2020 Umurenge Programme to accumulate productive assets. The mixed method analysis reveals that household composition, gender power dynamics, disability, care responsibilities, marital arrangements, intrahousehold communication, and access to other social programs and institutions play a crucial role in access to the Vision 2020 Umurenge Programme and related asset accumulation. The findings suggest that households would benefit from a broader definition of the eligibility criteria and the availability of flexible and complementary programming, to reap the benefits of the income transfer received from the program.