THE COMMITMENT OF CITTADINANZATTIVA FOR MATERNITY AND NATALITY PROTECTION

Cittadinanzattiva has more than 30 year experience in the citizens’ rights protection in healthcare sector started with its Tribunal for patient’s  rights (Tribunale per i diritti del malato) in 1980 and strengthened  through the National Coordination of  the Association of patients affected by chronic diseases in 1996.
Some of the areas we decided to strengthen in the last years are pregnancy, maternity and fertility protection and defense, intervening particularly on this last topic in order to overcome prejudices and fears, explaining the opportunities given by the current regulatory framework to couples who want to have children but have difficulties in the conception.
The commitment of Cittadinanzattiva can be demonstrated with different kind of activities:

  • Daily protection of citizens’ individual rights, through the service of free expert advice, information, and support provided by the 300 local offices of Tribunal for patients’ rights (Tribunale per i Diritti del Malato) all over Italy  and by the 84 local Citizen Advisory Center called “PiT” (integrated project of citizen protection) connected at national level to our headquarter. PiT is a service of information, orientation and protection for citizens who experienced inefficiency in the healthcare services. Every year, more than 20,000 requests of protection, information and complaints in the healthcare area are managed by  Cittadinanzattiva.
  • Legal aid to guarantee the right to access to the medically assisted insemination in Italy

In Italy, the medically assisted insemination is an area where many aspects are unclear and difficult to deal with for citizens still also due to the differences depending on the areas and considering the fact that it is something not present in the essential healthcare services level. On the topic, Cittadinanzattiva launched pilot legal actions to take position against the restrictions imposed by  Italian law n. 40 and finished with judgements in favour in April 2009. Moreover, Cittadinanzattiva provided legal aid to couples dealing with medically assisted insemination issues. Meanwhile, information and in-depht analysis documents were produced. To have further information please see the following pages of the Cittadinanzattiva wesite: 1, 2, 3, 4.

  • Civic information production:

3.1 ANNUAL REPORT ON HEALTHCARE
For 17 years we have been elaborating and publishing an annual report in which we collect everything pointed out by citizens and gathered by local and national Citizen Advisory and local offices of Tribunal for patients’ rights all over Italy. The aim of this report is to give a picture of the Italian healthcare system from a citizens’ point of view.
In particular, citizens’ warnings show that the main issues concerning treatments and services delivery in maternity and natality areas are:

  • Geographical differences in access to neonatal screening
  • Waiting lists for diagnostic tests, specialist visits, surgery
  • Presumed malpractice in diagnosis and therapy

For more information, see our Report on Health “PIT 2014”, and read the article Fecondazione assistita in Svizzera published in 2014

 

3.2 CIVIC SURVEY ON “HOSPITAL DELIVERY WARDS”
Last November 29th 2011, Cittadinanzattiva-Tribunal for patients’ rights presented the civic survey on “Hospital delivery wards” to the Italian Parliament, during an audition at the Hygiene and Health Commission. The document identifies and underlines the main critical situations  concerning the protection of women when choosing between giving birth naturally or with caesarean section.

3.3 “HOSPITAL DELIVERY WARDS” OF MIGRANT MOTHERS
The project which aim is to improve the access to the “hospital delivery wards” for migrant women was realized by Cittadinanzattiva between 2012-2013 thanks to the support of Ministry of Labour and Social Policies.
The project consisted of a civic evaluation in hospitals and other local premises in order to verify the access to the “hospital delivery wards” for migrant women.
The reason of this project is to be found in the crucial need to verify that migrant mothers and their children are treated with equity in the access to the services during pregnancy and giving birth process with dignity and guarantee of safety, with no discrimination based on ethnicity or social status.

3.4 HUMANIZATION IN PEDIATRIC AND OBSTETRICAL HOSPITAL DEPARTMENTS: A CIVIC ASSESSMENT (2014)
It is a big research done by National Agency for regional healthcare services (Age.na.s) and the Agency of Civic Evaluation of Cittadinanzattiva involving treatment centres, 286 local associations, 241 équipes and 594 citizens all over Italy. The focus was on pediatrics and obstetrics, but also on emergency, multiculturality, intensive therapy and hospital without pain.
In Italy, the topic of “humanization of treatment” was put this year for the first time  in the Operational Plan led by Italian Ministry of Health called “Pact for Health 2014-2016” that invites regions to do all necessary interventions that has to do with structural, organizational and communicational aspects of care. This plan also includes drafting an annual program of humanization of treatments with at least one project activity concerning professionals training and organizational changes.

  • Awareness raising campaigns in Italy, such as:

4.1 Insemination, to deal with and protect women and men fertility;
4.2 One plus one is three, launched when the Italian law 40/2004 “Rules for medically assisted procreation”. was approved.
4.3 “Aware maternity” Guide for migrant mothers. The guide, translated in five languages (Italian, Arabic, Chinese, French and English) provides information not only about the right to have access to healthcare services during the “hospital delivery wards” for migrant mothers, but also about the relationship between maternity and work.

  • Commitment related to chronic and pediatric rare diseases:

Through the National Coordination of Chronic Patients Associations (CnAMC), Cittadinanzattiva gives particular attention to treatments and protection of minors affected by chronic and rare diseases.

  • Political-institutional activity at a local, regional, national level

Continuous relationships and dialogue with the Italian Ministry of Health, Government and Parliament, regional departments, healthcare services providers.  Click to know more and have some examples at regional and national level.

  • Civic activism

Through the involvement  and support to the referendum campaign linked to the Italian law 40/2004 concerning the closure of small hospitals, with particular focus on the closure of hospital delivery wards. Emblematic in this context is what happened in the region of Piemonte in 2003: after the closure provisions of many small hospitals, a group of mothers starts to protest after the decision of Domodossola primary care services providers decision to close the maternity ward. The reason is mainly that for pregnant women this decision would mean drive for 60 km to reach the closest hospital. At the end with their protest and activism they impeded the closure of the maternity ward and this was also thanks to the support of Cittadinanzattiva. Afterwards these mothers create a local Assembly  of Active Citizenship. More recent cases happened in  Puglia  Abruzzo Italian regions.

  • Manuals

In 2014 we presented the “The Manual of Standard Certification for the Evaluation of hospital delivery wards”. Different scientific societies, universities and associations (such as Cittadinanzattiva) participated in the creation of this Manual. Click here to know more.

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