Discussion
We used the analyses presented in this paper to develop a
new evidence-based framework that describes a system
for high-quality maternal and newborn care as a basis for
improvements in maternal and neonatal outcomes. Our
analyses began, not with the needs of professionals or
the health system, but with those described by pregnant
and postnatal women. Women’s perceptions of their
experiences are important in and of themselves,176 but if
systems do not meet their needs, women are less likely to
access services and might even reject them altogether.177
For women, good quality clinical care and improved
communication, education, information, and respect
from their providers are essential aspects of their care.
The combination of these factors is needed to keep them
and their newborn infants safe. Low quality services or
disrespectful care compromise the health and wellbeing
of women and children, and can stall global reduction in
maternal and newborn mortality and morbidity.178