Indicators and rights in dialogue: participatory review of the WHO criteria for safe and respectful maternity

Context: In Costa Rica, between 2016 and 2018, 57.7% of women reported experiencing obstetric violence, demonstrating that, despite normative advances to promote rights-based maternity care, challenges persist in sensitizing health personnel and ensuring effective policy implementation. Within this context, the “WHO Recommendations for a Positive Childbirth Experience” were reviewed to analyze their incorporation into Costa Rican regulations. The process included identifying 72 criteria, selecting regulations issued since 2007, systematizing content, and classifying each criterion as incorporated or pending.

 

The mapping identified 12 key documents; eleven integrate WHO criteria. Overall, 57 of 72 criteria are reflected in national regulations, while 15 remain pending. This establishes a baseline for closing implementation gaps and strengthening alignment between global recommendations and actual practice.

 

Session purpose: To collaboratively identify advances and gaps related to WHO criteria and indicators for ensuring a positive childbirth experience and respectful, safe maternity care. The session will compare these criteria with clinical and user experiences; prioritize indicators requiring improvement using a rights-based, gender-responsive, and intercultural lens; and develop recommendations from civil society, health services, academia, and policy sectors. The aim is to generate inputs for research, service management, and advocacy, strengthening correspondence between policy frameworks and real-world practices.

 

Audience: The session convenes professionals from health services, public health and equity researchers and academics, decision-makers, civil society representatives, and women. Their participation is essential to foster multisectoral dialogue on implementing WHO recommendations and to contrast regulatory provisions with everyday practice. The inclusion of women provides lived experience perspectives that help orient services toward autonomy, companionship, and reproductive rights.

 

Approach: This will be a practical and collaborative session focused on strengthening positive childbirth experiences through an integrated care perspective. The opening will include a welcome, session objectives, and a brief activity to learn about participants’ backgrounds and experience. Subsequently, findings from the normative analysis and comparative review across childbirth stages will be presented.

Participants will then work in thematic groups to map advances, challenges, and practices that promote or hinder a positive childbirth experience. In the co-creation phase, each group will develop proposed recommendations and potential indicators within their sphere of action, encouraging articulation between community and institutional levels. Finally, a plenary session will share findings and commitments, highlighting opportunities for regional collaboration and joint evidence generation.

 

 

Expected results: The workshop is expected to identify gaps and good practices in adopting WHO recommendations, strengthen understanding of how regulatory frameworks can translate into concrete actions in health services, and generate inputs to enhance awareness and training for respectful childbirth care. It will also promote the co-creation of strategies to reduce obstetric violence, ensure reproductive autonomy, and advance models of care grounded in rights, equity, and cultural respect.