For the five year period 2016-2020, UNICEF’s Strategy for Health sets two overarching goals: 1. End preventable maternal, newborn and child deaths 2. Promote the health and development of all children. To achieve these goals, the Strategy considers the health needs of the child at all life stages. It highlights the need for intensified efforts to address growing inequities in health outcomes, including a particular focus on addressing gender-specific needs and barriers that may determine whether boys and girls are able to reach their full potential in health and well-being. Working together with global and local partners, UNICEF will promote three approaches to contribute to these goals: addressing inequities in health outcomes; strengthening health systems including emergency preparedness, response and resilience; and promoting integrated, multisectoral policies and programmes. The three approaches described underpin a "menu of actions” from which country offices can select, based on their situation analysis, country programme focus, and context.
The Reproductive and Child Health Section (RCHS) of the Ministry of Health and Social Welfare, Tanzania, in collaboration with developmental partners, particularly Saving Newborn Lives / Save the Children carried out this analysis to guide implementation of newborn health interventions in Tanzania
This publication is the report of a project to scale-up a community-based model, in Kenya, that enabled women to give birth safely at home or be referred to a hospital when attended by a self-employed skilled midwife living in the community. The findings of the project were that community midwifery contributed to increasing the proportion of women assisted by skilled attendants during birth in the four districts in which the scheme was trialed, amounting to just under half of all skilled attended births in the districts. Although the skilled birth attendant rate in these districts was well below the national average of 42 percent, there was a steady increase in the proportion of attended deliveries since CMs were introduced in 2005. The districts also reported an increase in postnatal assessments in the first 48 hours and increase in immunization coverage
This publication provides a wide-ranging assessment of the current state of child survival and primary health care for mothers, newborns and children. It examines lessons learned in child health during the past few decades and outlines the most important emerging precepts and strategies for reducing deaths among children under age five and for providing a continuum of care for mothers, newborns and children
‘Progress for Children’ is a series that monitors progress towards the Millennium Development Goals. This edition focuses on maternal health and, in particular, maternal mortality. It considers general progress and then examines particular regions. The report card acknowledges progress in improving maternal health, but argues that it is not sufficient to meet the MDG target of reducing maternal mortality by three quarters between 1990 and 2015
This report arose from recognition of the need to provide better care and follow up of mothers and infants in the postnatal period in order to improve maternal and neonatal outcomes in Swaziland. The objectives of the study were to determine if changes to the guidelines on postnatal care would result in improvements to provision of of maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum (PP) women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirmed that the introduction of an improved postnatal package with revised timing and content provided key components of maternal, newborn, and HIV care, and increased the utilization of services among postpartum women and their infants. An assessment of the quality of care during client-provider interactions for all postpartum women demonstrated a fourfold increase in the proportion that included all aspects of care: maternal and newborn health, counseling for HIV, family planning, and improved provider-client relationships
This paper contains five tables listing recommendations to improve maternal and newborn health and survival, through health services, family and community. Table 1. Care in pregnancy, childbirth and postpartum period for mother and newborn infant; Table 2. Place of care, providers, interventions and commodities; Table 3. Home care, family, community and workplace support for the woman during pregnancy and childbirth and for the newborn infant; Table 4. Care for the woman before and between pregancies; Table 5. Pregnant women not wanting child
This report explores why maternal mortality continues to be so high in developing countries, and why emergency obstetric services are little utilized, through research carried out in poor areas in Ghana (Kassena-Nankana district), India (Uttar Pradesh state), and Kenya (Nairobi slums)
This document has been prepared for maternal and newborn health experts as well as reproductive health experts coordinating and assisting with emergency care during the humanitarian crisis. It describes the ways to estimate the number of pregnant women and those who are about to deliver, highlights some important aspects of emergency care related to pregnancy, childbirth and newborn care, and describes the content of UN kits for such care in three different scenarios
This summary is based on the CHANGE Maternal Survival Toolkit, available online at: www.changeproject.org and on CD-ROM. It explores ways of influencing behaviours and encouraging use of health services and health professionals during childbirth and the postpartum period. A number of factors can prevent pregnant women from accessing skilled care, often putting themselves and the child at risk. They include availability of health services and high costs but also, and crucially, local culture, family and community behaviours and traditional practices. The CHANGE Project's approach and this document stress locally appropriate, behaviour-based interventions that integrate what is happening in homes, communities and health facilities. This tool is aimed at organisations and individuals working in the field of mother and child health, and willing to look at maternal and child survival issues from a behaviour change perspective
"This paper summarizes the importance of improving maternal and reproductive health, the progress made to date and lessons learned, and the major challenges confronting programs today. The paper highlights the progress that some countries, including very poor ones, have made in reducing maternal mortality, but cautions that progress in many countries remains slow. Relying on evidence from the most recent research and survey information, the paper also analyzes the key determinants and evidence on effective interventions for attaining the maternal health MDG. The paper finds that key interventions to improve maternal and reproductive health and reduce maternal mortality include the following mutually reinforcing strategies: (a) mobilizing political commitment and fostering an enabling policy environment; (b) investing in social and economic development such as female education, poverty reduction, and improvements in women’s status; (c) providing family planning services; (d) ensuring quality antenatal care, skilled attendance during childbirth, and availability of emergency obstetric services for pregnancy complications; and (e) strengthening the health system and community involvement. The paper emphasizes that carrying out interventions remains a challenge in environments where political commitment, policies, as well as institutions and health systems, are weak. The paper concludes with guiding lessons from some of the countries that have successfully improved maternal health and with a discussion of some of the difficulties of measuring maternal mortality and morbidity outcomes"
"The Men in Maternity (MiM) study investigated the feasibility, acceptability and cost of a new, more comprehensive, model of maternity care that encouraged husbands' participation in their wives' antenatal and postpartum care. The study specifically assessed the impact of the intervention on family planning in the postpartum period and STI preventitive practices among men and women. The study was conducted in collaboration with the Employees' State Insurance Corporation (ESIC), Delhi Directorate at their primary health facilities called dispensaries"
This publication identifies three components of an effective strategy to reduce maternal mortality rates: a) The existence of an extensive midwifery cadre which is well trained, autonomous, and embedded in the referral system; b) Adequate facilities for institutional deliveries, and c) An implemented strategy to support widespread access to these services. The importance of access to care and services is stressed
This book raises critical issues arising from the national and international policies, programmes and services whose aim is to prevent maternal mortality and morbidity. It analyses where safe motherhood initiatives stand today, what has been achieved and what remains to be done, and offers perspectives on making pregnancy, childbirth and abortion safer for women in future. The book reviews work in Bangladesh, Indonesia, Kenya, Uganda, Vietnam, India, Tanzania, Mexico, Nigeria, Bolivia, Ghana and South Africa
Each of the 11 fact sheets presents global and selected country-specific data, summaries of the major lessons learned, and recommendations for future action to reduce maternal mortality and morbidity. Titles include: Maternal mortality; Safe motherhood as a matter of human rights and social justice; Safe motherhood as a vital social and economic investment; Delay marriage and first birth; every pregnancy faces risks; Ensure skilled attendance at delivery; Improve the quality of maternal health care; Improve access to maternal health services; Prevent unwanted pregnancy; Address unsafe abortion; and Measure progress
This toolkit explores ways of influencing behaviours and encouraging use of health services and health professionals during childbirth and the postpartum period. A number of factors can prevent pregnant women from accessing skilled care, often putting themselves and the child at risk. They include availability of health services and high costs but also, and crucially, local culture, family and community behaviours and traditional practices. The CHANGE Project's approach, and this tool in particular, stress locally appropriate, behaviour-based interventions that integrate what is happening in homes, communities and health facilities. Key topics discussed include: seeking skilled care; seeking skilled care early postpartum; birth preparedness; providing skilled care. For each topic a summary is provided together with a range of useful tools and documents. This tool is aimed at organisations and individuals working in the field of mother and child health, and willing to look at maternal and child survival issues from a behaviour change perspective
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