The Strengthening Teamwork and Respect (STAR) project led by the SAMRC’s Health Systems Research Group has received new funding from the Medical Research Foundation based in the United Kingdom. The Foundation is an independent charity formed by the UK Medical Research Council over 100 years ago that aims to support vital medical research in underfunded areas. The STAR project, led by Tanya Doherty, has been awarded a Changing Policy and Practice Award designed to support researchers in disseminating their research findings beyond the scientific peer-reviewed press. The aim is to maximise the impact of health research by taking results directly to patients, healthcare practitioners and policy makers. Support for this funding comes from the Fleming Memorial Fund for Medical Research, which was established in 1959 in memory of Sir Alexander Fleming, with co-funding from the MRC as part of UK Research and Innovation (UKRI).
Prof. Doherty and her STAR project team work with nurses and doctors in rural hospitals in South Africa to improve how women are treated during labour and birth. Respectful maternal and newborn care is a priority, yet little evidence exists on what works to improve it.
“Efforts to improve respectful maternity care in South Africa have focused mainly on training individual healthcare workers through short courses,” explained Doherty. “Training is important. But often overlooks a crucial factor: the organisational culture in which health professionals work. This is the first study to assess the feasibility and effects of an intervention addressing both organisational culture and women’s experience of care.”
STAR tackles this challenge through participatory learning processes, embedded in routine service delivery. The intervention has been implemented in nine KwaZulu-Natal district hospitals. The strategies have produced an intervention toolkit, comprising champion identification and training, team creation, learning sessions, implementation and monitoring of projects, and mentorship. The trained 'local champions' lead learning sessions, where maternity staff reflect on their challenges and create their own solutions. These include allowing birth companions, improving privacy, and strengthening communication with women. After one year, hospitals showed better teamwork and women reported more positive experiences of care. The study findings were recently published in The Lancet Regional Health − Africa.
“The significance of this research lies in showing that respectful maternity care can be improved in resource-limited settings using a low-cost, practical approach,” said Doherty. “STAR builds on the skills, experience and motivation of existing health workers, and changes are immediately embedded into routine practice.”
With this award, Doherty's team will be able to scale up this approach to more hospitals, offering an important opportunity to influence maternity care practice and policy, and helping more women experience childbirth with dignity, respect and support. The hope is that STAR will advance the evidence base for improving respectful care and cultures of teamwork and learning in maternity units in rural, low- and middle-income settings.
The team have recently published their work in The Conversation. Read more here.