5% to 15% of women present with complications during pregnancy and childbirth, resulting in major sequelae for the child or mother if these complications are not properly managed. Thus, disease and injuries occurring during pregnancy, childbirth and the early weeks of a newborns life are the main causes of death and disability among mothers and children in low-income countries.
Maternal, newborn, child and reproductive health projects often overlook aspects of morbidity that could lead toward impairments and disability during these key periods in the life of a woman, a man or a child. However, there are opportunities to prevent many of these impairments through interventions targeting pregnancy, childbirth and the early years of a life. In addition, there is evidence that early detection of impairments in a child or parent leading to prompt medical care and rehabilitation can considerably improve the child and mothers functioning.
Inclusive maternal, newborn, child and reproductive health interventions can include the following areas: primary prevention of impairment related to reproductive health for mother and child; detection and early intervention or stimulation of children with disabilities; access for women with disabilities to mainstream reproductive health services, including family planning, preconception care, ante- and postnatal care, safe childbirth, emergency obstetric care and HIV / AIDS related services; prevention, care and rehabilitation of women with obstetric fistula; and prevention, care and support for women surviving sexual violence.
This key list highlights inclusive maternal, newborn, child and reproductive health resources that present barriers and interventions along with practical grassroots examples. We welcome your suggestions, please send comments or suggested additions to firstname.lastname@example.org.
"This booklet, a companion to the publication ‘Working from Within’, colorfully presents 24 tips, one per page, for culturally sensitive programming, based on research carried out by UNFPA"
This article explores the "household practices that can affect neonatal health, from the perspective of caregivers and health workers; to identify signs in neonates leading either to recognition of illness or health-care seeking; and to ascertain the proportion of caregivers who recognize the individual items of the integrated management of neonatal and childhood illnesses (IMNCI) programme"
Bulletin of the World Health Organization, 84(10)
This report presents the findings of a review of the grey literature on the epidemiology of the unimmunized child
"This report reviews both published and gray literature from the past 25 years that addresses intra-household roles and dynamics related to infant and young child nutrition-specifically the roles and influence of senior women, or grandmothers, and men. The report examines infant and young child nutrition and other maternal and child health interventions explicitly involving grandmothers and/or men and reports on each intervention’s effectiveness"
This article aims to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies. The findings suggest that there may be a misalignment between current antenatal care provision and the social and cultural context of some women in low and middle income countries
PLoS Med, Vol 10, Issue 1
"The Early Childhood Development Kit was created to strengthen the response for young children caught in conflict or emergencies. In complement to basic services related to young children's hygiene and sanitation, health and nutrition, protection and education, the Kit offers young children access to play, stimulation and early learning opportunities and permits them to retrieve a sense of normalcy"
"This discussion paper provides a brief overview of issues pertaining to early childhood development (ECD) and disability. It lays the foundation for a long-term strategic and collaborative process aimed at improving the developmental outcomes, participation and protection of young children with disabilities. Essential to this effort is dialogue between United Nations agencies and relevant stakeholders to identify sustainable strategies which build on existing efforts, and expand on multisectoral approaches to guarantee the rights of young children with disabilities and their families"
"This report reviews the effectiveness of early childhood stimulation interventions in developing countries. The report aims to answer the questions: What works in terms of early stimulation for young children in developing countries? For whom and under what conditions do these programs work and why do they work. The report is divided into several sections. Firstly, a brief discussion of the importance of early stimulation for young children in developing countries is provided. Secondly, the methods used to identify and characterize studies are provided and a review of randomized or quasi-experimental trials is presented. Thirdly, a review of the evidence for who benefits most from early interventions is presented followed by a review of program characteristics that affect the success of interventions and an examination of potential mechanisms through which interventions achieve their effects. Finally, recommendations for practice and future research are provided"
IDB working paper series
“This technical brief presents information and guidance on implementing early childhood development (ECD) programmes for young orphans and vulnerable children (OVC) with disabilities and their families. It provides a basic overview of the fundamental elements a program manager should consider to integrate disability positively into ECD programmes and address specific disabilities individually, as needed. This technical brief describes “twin-track” and “triple-track” approaches that promote participation, attention to specific needs, and equal access for OVC with disabilities and their families. It also lists six critical elements for HIV programmes seeking to address the needs of children with disabilities”
"This document is written for local and international staff running nutrition programmes in emergencies, and for local, regional and national authorities and donors involved in such programmes. The note explains WHY nutrition programmes need to include early childhood development (ECD) activities to maximize the child’s development. It provides practical suggestions as to WHAT simple steps are necessary to create integrated programmes in situations of famine or food insecurity and it gives examples of HOW such integrated programmes have been established in other situations"
"This booklet explains how principles of programme communication are part of a holistic approach to Early Child Development (ECD). It is designed for programme planners, designers, artists, and communicators to improve their ability to use programme communication for holistic early child development"
Note: This is a companion publication to ‘Programming Experiences in Early Child Development’
This document presents examples and case studies from 21 countries. They demonstrate the benefit of cross-sectoral programming to support early childhood development, some building on early child care or education programme
Malnutrition can lead to disability, and disability can also lead to malnutrition. This paper will focus mainly on under-nutrition causing disability and disability causing or contributing to under-nutrition. Both nutrition and disability are key human rights issues. There is increasing knowledge about optimal nutrition-related practices and implementation of often low cost interventions to tackle issues of malnutrition in children. It is essential that governments, international actors and service providers consider and include the needs of children with disabilities in these efforts to ensure that children with disabilities have equitable access to nutrition in order to allow them to grow and thrive
This study aimed to assess whether children with disabilities were included within humanitarian and food security response programmes and whether there was an association between disability and malnutrition. The fieldwork was conducted in 2013 in the Turkana region of Kenya, a region repeatedly classified as experiencing a humanitarian emergency, and used both qualitative and quantitative methods. The key finding of the report is that children with disabilities are more likely to be malnourished and the key recommendations are that children with disabilities should be targeted in food aid and food assistance programmes, and that further efforts are needed to include children with disabilities in education. The report is intended for stakeholders to inform policy
"The Lufwanyama Neonatal Survival Project ("LUNESP") was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs) to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness"
PLoS ONE 7(4)
"This 28-page learning paper describes Malaria Consortium’s experience with Integrated Community Case Management (ICCM) in malaria prevention and treatment in Mozambique and Uganda. ICCM is an approach where community-based health workers are trained to identify, treat, and refer complex cases malaria (and other diseases) in children"
The Learning Series Papers
"This article discusses the training of mental health workers whose basic job is with clients that have been seriously affected by armed conflict and/or natural disasters by using ‘helping through talking’, and who have had little education that is relevant to this work. It sums up the characteristics required of the workers, their learning needs, the messages that the training needs to convey, and the characteristics and potential contents of a tailor made, participants-oriented programme"
Intervention, Vol 9, Issue 2
In this editorial, the author comments on the feasibility of the Integrated Management of Childhood Illness (IMCI) strategy of the World Health Organization aimed at serving the poor. He analyses the reasons behind the failure of IMCI strategy to reach the poor. According to the author, IMCI failed due to several faults in its implementation including its initiation in well-off areas, a horizontal approach, and bad financial infrastructure of the poor regions
Bulletin of the World Health Organization, 84(10)
IK Notes report on indigenous knowledge initiatives in Sub-Saharan Africa and occasionally on such initiatives outside the region. It is published by the World Bank Africa region’s Knowledge and Learning Centre as part of an evolving partnership between the World Bank, communities, NGOs, development institutions and multilateral organisations. This edition outlines the high rate of maternal and infant mortality in Mali, despite interventions by the government and donors in the past ten years. It then outlines the methodology used in developing a close collaboration between the traditional system of assistance to pregnancy and childbirth (of which traditional birth assistants (TBAs) are the protagonists) and the modern system of management of obstetrical emergencies. This involved a new role for the TBAs in breaking down cultural barriers in access to modern health care. The first results appear promising, and the authors stress the importance of taking into account traditional knowledge in birthing practices when developing a national strategy for the control of maternal and infant mortality
This paper presents qualitative and quantitative research that describes the type and severity of disability of married women in the study area, describes their participation in community groups and analyses associations between maternal and new-born care behaviours and disability. Health workers and field researchers were also interviewed about their experience with disabled women in rural Makwanpur
Cross-cutting Disability Research Programme, Background Paper: 01
This article "reviews interventions that affect maternal and child undernutrition and nutrition-related outcomes. These interventions included promotion of breastfeeding; strategies to promote complementary feeding, with or without provision of food supplements; micronutrient interventions; general supportive strategies to improve family and community nutrition; and reduction of disease burden (promotion of handwashing and strategies to reduce the burden of malaria in pregnancy). (The authors) showed that although strategies for breastfeeding promotion have a large effect on survival, their effect on stunting is small"
The Lancet, Vol 371, Issue 9610
This book deals with practical advice on health care for women with disabilities. It has been developed in partnership with health care professionals and disabled women in over 42 countries. It covers the key issues of disability in the community; accessible health care; mental health; sexual health; family planning; and child birth. The book is written in a practical and accessible style, suitable for anyone with an interest in disability, social development and women's health issues. In particular, the book offers a valuable insight into 'real-life' personal experiences of disabled women
"People with disabilities are often amongst the poorest in the developing world. Yet they are usually left out of development projects. This is not because of ill-will. Development organisations simply do not know how to include them. This book offers suggestions based on the experience of organisations that participated in a two-year learning programme. It is full of useful tips on how to launch inclusive programmes and projects, how to prepare your staff for working with people with disabilities and how to adapt your organisational processes and systems"
Available in Braille, high resolution, low resolution and word formats.
Available in Portuguese: "Inclusão de pessoas com deficiência nos projectos de desenvolvimento: Um guia prático para organizações do Norte e do Sul".
Available in French: "Tiens compte de moi - L'inclusion de personnes en situation de handicap dans les projets de développement"
Available in Spanish: "Cuenta conmigo - Incluir a las personas con discapacidad en los proyectos de desarrollo"
This article presents information about a series of four Grassroots Comics workshops for its members organised by Shivyawata Mwanza, an umbrella organisation for disabled people's organisations in Mwanza region Tanzania in January 2010. The workshops were designed to work with disabled people to create a series of short comics that highlight issues related to disability in Tanzania
There is a need for organisations working in the field of women and gender to better understand how disability is experienced. The information in this practical resource is relevant for both women-specific activities along with gender programs. It provides practical about how to include women with disabilities in development programmes
This article examines the factors of inclusive nutrition for children and adults with disabilities
The Lancet Global Health, Vol 1, Issue 4
In 2007, a Norwegian theatre director Morten Traavik arrived in Cambodia to stage a beauty pageant, with funding from the government of Norway, for girls and women who had lost limbs in landmine explosions. This opinion article analyses the project which "continues to raise questions about what it means for a foreign project to offer 'freedom' and 'opportunity' to women with disabilities in Cambodia and stoke debates about the sexualisation of women with disabilities from the global South"
Malnutrition and neurodisability are both major public health problems in Africa. This review highlights key areas where they interact. These areas of interaction include maternal malnutrition, toxin ingestion, macronutrient malnutrition and micronutrient deficiencies - all of which cause or are caused by neurodisability, The article concludes that there is an urgent need for nutrition and disability programmes to work more closely together
Seminars in Pediatric Neurology, Volume 21, Issue 1
"The Dictionary includes an illustrated guide to signing and signing for individual letters, along with illustrations and descriptions for common words and for those new HIV/SRHR signs that have been developed, making it an invaluable reference for both those with hearing impairments and those without hearing challenges. The dictionary is suitable for use in educational institutions (schools, colleges and universities) as well as in health institutions such as hospitals, clinics and VCT centres. Counsellors and all staff working directly and indirectly in the HIV and SRHR sectors will find the dictionary most useful"
"This is an overview of evidence of the effectiveness of antenatal care in relation to maternal mortality and serious morbidity, focused in particular on developing countries"
"This document discusses disabilities resulting from pregnancy and childbirth in less developed countries. It describes the causes of maternal disabilities as well as some of the major disabilities that may result from pregnancy- and childbirth-related complications, and presents the impact on infant and child health, consequences for families and societies, interventions to improve maternal health and the benefits of interventions"
This resource addresses issues of sexual and reproductive health (SRH) programming for persons with disabilities. SRH, in particular, deserves attention because these needs have been so widely and so deeply neglected. At the same time, however, the approaches discussed here apply broadly to all aspects of health programming for persons with disabilities. This note outlines a general approach to programming and does not address specific protocols for the SRH care and treatment of persons with disabilities It is intended for SRH experts and advocates within UNFPA and WHO as well as those in other development organisations and partners
"The aim of this paper is to present the current situation in sub-Saharan Africa for mothers, newborns, and children under age 5 years—including the progress towards the MDGs for maternal and child health, why and where deaths occur, what known interventions can be employed to prevent these deaths, and current coverage of these interventions. All data used in this review are from the most recent UN databases, national household surveys, and peer-reviewed papers where appropriate, which are referenced accordingly"
PLoS Medicine, 7(6)
This resource presents a list of priority medicines for mothers and children to help countries and partners select and make available those medicines that will have the biggest impact on reducing maternal, newborn and child morbidity and mortality
"This article provides an overview of the history, epidemiology, clinical findings, treatment, and prevention of nu¬tritional rickets from both global and Bangladeshi perspectives. In so doing, an agendum for future research is proposed"
Rickets Convergence Group Meeting
26-27 January 2006
Journal of Health, Population and Nutrition (JHPN), 26(1)
"This article presents the results of study that aimed to develop a standardized method for calculating years lived with disability (YLD) after injury. The method developed consists of obtaining data on injury cases seen in emergency departments as well as injury-related hospital admissions, using the EUROCOST system to link the injury cases to disability information and employing empirical data to describe functional outcomes in injured patients. The novel method for calculating YLD after injury can be applied in different settings, overcomes some limitations of the method used to calculate the global burden of disease, and allows more accurate estimates of the population burden of injury"
Bull World Health Organ, 90
In this article, the author discusses the judicious use of practical, reliable standardized screens which aims to increase the likelihood of identifying children with developmental disabilities
The Journal of Family Practice, Vol 55, No 5
"This report investigates tools and methods for assessing aid efficiency. It explains concepts of efficiency and efficiency analysis and presents a catalogue of 15 methods that can be used to assess the efficiency of aid interventions. Each method is described and characterised. Several general observations and recommendations conclude the report"
BMZ Evaluation Working Papers