Maternal, newborn, child and reproductive health

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 newborn’s 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 mother’s 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 sourceassistant@hi-uk.org.

Selected resources

Barriers

24 tips for culturally sensitive programming

UNITED NATIONS POPULATION FUND (UNFPA)
2004

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"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"

Danger signs of neonatal illnesses : perceptions of caregivers and health workers in northern India

AWASTHI, Shally,
VERMA, Tuhina,
AGARWAL, Monica
October 2006

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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)

The roles and influence of grandmothers and men : evidence supporting a family-focused approach to optimal infant and young child nutrition

AUBEL, Judi
2011

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"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"

Why do women not use antenatal services in low- and middle-Income countries? a meta-synthesis of qualitative studies

FINLAYSON, Kenneth,
DOWNE, Soo
January 2013

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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

Early childhood

Early child development kit : a treasure box of activities

UNITED NATIONS CHILDREN’S FUND (UNICEF)
2009

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"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"

Early childhood development and disability : a discussion paper

WORLD HEALTH ORGANIZATION (WHO),
UNITED NATIONS CHILDREN'S FUND (UNICEF)
2012

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"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"

Early childhood stimulation interventions in developing countries : a comprehensive literature review

BAKER-HENNINGHAM, Helen,
BOO, Florencia Lopez
September 2010

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"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

Including orphans and vulnerable children with disabilities in early childhood development programs : technical brief

LEVY, Marcy,
MESSNER, Lyn,
WERTLIEB, Donald
January 2014

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“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”

Integrating early childhood development (ECD) activities into nutrition programmes in emergencies : why, what and how

WORLD HEALTH ORGANIZATION (WHO),
United Nation Children’s Fund (UNICEF)
2011

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"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"

Programme communication for early child development

KOLUCKI, Barbara
November 2006

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"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’

Programming experiences in early childhood development

UNITED NATIONS CHILDREN'S FUND (UNICEF)
November 2006

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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

Stronger together : nutrition-disability links and synergies|Briefing note

GROCE, Nora,
CHALLENGER, Eleanor,
KERAC, Marko
2013

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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

Grassroots

Childhood disability and malnutrition in Turkana Kenya : a summary report for stakeholders and policy

KISIA, James
et al
2014

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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

Costs and cost-effectiveness of training traditional birth attendants to reduce neonatal mortality in the Lufwanyama neonatal survival study (LUNESP)

SABIN, Lora L
et al
2012

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"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)

Developing intervention strategies to improve community health worker motivation and performance

FRANK, Tine,
KALLANDER, Karin
2012

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"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

Field based training for mental health workers, community workers, psychosocial workers and counselors : a participant-oriented approach

VAN DER VEER, Guus,
FRANCIS, Felician Thayalara
July 2011

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"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

IMCI : what can we learn from an innovation that didn’t reach the poor?

GWARTKIN, Davidson
October 2006

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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)

Mali : traditional knowledge and the reduction of maternal and infant mortality

SANOGO, Rokia,
GIANI, Sergio
November 2003

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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

Maternal and new-born care practices among disabled women, and their attendance in community groups in rural Makwanpur, Nepal

LEONARD CHESHIRE DISABILITY AND INCLUSIVE DEVELOPMENT CENTRE
2013

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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

What works? interventions for maternal and child under nutrition and survival

BHUTTA, Zulfigar
et al
January 2008

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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

Inclusion

A health handbook for women with disabilities

MAXWELL, Jane,
WATTS BELSER, Julia,
DAVID, Darlena
February 2007

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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

Count me in - Include people with disabilities in development projects | A practical guide for organisations in the North and South

BRUIJN, Paulien
et al
November 2012

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"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"

Grassroots comics by disabled people

WORLD COMICS FINLAND
2010

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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

Inclusion made easy : part B|Disability inclusion : women

CHRISTOFFEL BLINDENMISSION (CBM)
2012

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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

Miss landmine Cambodia pageant : provocative art or pejorative ‘project’?

MOMAYA, Masum
2012

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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"

The interaction of malnutrition and neurologic disability in Africa

KERAC, Marko
et al
March 2014

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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

Zimbabwe sexual and reproductive health sign language dictionary

THE HIV AND AIDS MANAGEMENT AND SUPPORT ORGANIZATION (THAMASO-ZIMBABWE),
DISABILITY AND HIV AND AIDS TRUST(DHAT)
2012

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"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"

Reproductive health

Hidden suffering : disabilities from pregnancy and childbirth in less developed countries

ASHFORD, Lori
2002

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"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"

Promoting sexual and reproductive health for persons with disabilities : WHO/UNFPA guidance note

GROCE, Nora
et al
2009

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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

Sub-Saharan Africa's mothers, newborns, and children : where and why do they die?

KINNEY, Mary V
et al
2010

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"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)

Medical

Priority medicines for mothers and children 2011

WORLD HEALTH ORGANIZATION (WHO)
2011

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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
WHO/EMP/MAR/2011.1

Rickets : an overview and future directions, with special reference to Bangladesh

CRAVIARI, Thierry
March 2008

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"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
Dhaka, Bangladesh
26-27 January 2006
Journal of Health, Population and Nutrition (JHPN), 26(1)

Methods

Improved and standardized method for assessing years lived with disability after injury

HAAGSMA, JA
et al
2012

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"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

Tools and methods for evaluating the efficiency of development interventions

PALENBERG, Markus A
April 2011

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"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