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
The 2009 report ..."examines critical issues in maternal and newborn health, underscoring the need to establish a comprehensive continuum of care for mothers, newborns and children. "The report outlines the latest paradigms in health programming and policies for mothers and newborns, and explores policies, programmes and partnerships aimed at improving maternal and neonatal health. Africa and Asia are a key focus for this report, which complements the previous year's issue on child survival." The report can be downloaded as a PDF or a multi-media version is also available in four languages
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
‘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 report reviews current knowledge of the immediate and long-term nutritional and health benefits of: delayed umbilical cord clamping; immediate and continued skin-to-skin contact between mother and infant; and immediate initiation of exclusive breastfeeding and aims to to illustrate that these three practices can be feasibly and safely implemented together for the benefit of both mother and infant
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
The African region has the highest rates of neonatal mortality in the world, and has shown the slowest progress so far in reducing neonatal deaths. New policies, however, seem to provide opportunities to accelerate progress for maternal, newborn and child health. Section 1 presents an overview of neonatal deaths, and lives that could be saved in Africa in order to guide policy and programme priority setting. Section 2 explores the the continuum of care through pre-pregnancy, pregnancy, childbirth and the postnatal period, highlighting current gaps in coverage of care and opportunities to address these gaps at all levels - family and community care, outreach services, and primary and referral care facilities. Section 3 contains an overview of the current situation for 9 key programmes related to newborn health. Section 4 discusses lessons learned and existing gaps between new policies and their implementation. Section 5, finally, contains a summary of relevant data for decision making for 46 countries in sub-Saharan Africa regarding maternal, newborn and child health status and policy. This accessible and comprehensive tool will be of use to policy makers, health and community workers and programme managers
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 is a publication produced by the United Nations Children's Fund and is a statistical analysis of birth registration. Birth registration is a fundamental human right and an essential means of protecting a child's identity. This objective of this study is to present available empirical evidence to understand which factors are associated with children who obtain a birth certificate. By analysing levels of birth registration in the context of other health, education and poverty indicators, the study points to opportunities to integrate advocacy and behaviour change campaigns for birth registration with early childhood care and immunisation. By linking birth registration to early childhood care programmes, a legal hurdle can become a helpful referral to promote improved health, education and protection for disadvantaged children and their caretakers. Particular references to ethnic groups and minorities appear on page 12 and on page 22
The purpose of this guide is to provide a ready reference tool for conducting qualitative research and planning a behaviour change communications strategy to improve newborn care practices
"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"
"The Reproductive Health Research Unit (RHRU) University of the Witwatersrand, in partnership with the FRONTIERS Program of the Population Council, and the KwaZulu Natal Department of Health conducted a three-year operations research study titled "Men in Maternity" (MIM) in the Ethekwini district. The study was completed in July 2003...The intervention was clinic-based and included two broad strategies: improving antenatal care services by strengthening the existing antenatal package and service monitoring and supervision; and introducing couple counseling by providing training to health providers, inviting partners of antenatal women to attend counseling twice during pregnancy and once post delivery, and providing information to couples with a new antenatal booklet...At follow-up few differences were found between the control and intervention groups to support the hypothesized effect of the intervention. Significant differences were found only in changing communication, partner assistance during pregnancy emergencies, and knowledge of the condom as a method of dual protection"
This Digest looks at birth registration -- a fundamental human right that opens the door to other rights, including education and health care, participation and protection. Unregistered children are often the children of the poor and excluded, such as refugees or particular indigenous groups. Lack of registration exacerbates their poverty and underscores their marginalisation. Non-registration also has serious implications for national goverments. Countries need to know how many people they have and how many there are likely to be in the future, in order to plan effectively. This Digest emphasizes the crucial importance of birth registration, explores the obstacles to universal registration and highlights the actions -- including awareness raising, legislative changes, resource allocation and capacity building -- that are needed to ensure the registration of every child
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
"This document reports the outcomes of a technical consultation on the full range of issues relevant to the postpartum period for the mother and the newborn. The report takes a comprehensive view of maternal and newborn needs at a time which is decisive for the life and health both of the mother and her newborn. Taking women's own perceptions of their own needs during this period as its point of departure, the text examines the major maternal and neonatal health challenges, nutrition and breastfeeding, birth spacing, immunization and HIV/AIDS before concluding with a discussion of the crucial elements of care and service provision in the postpartum. The text ends with a series of recommendations for this critical but under-researched and under-served period of the life of the woman and her newborn, together with a classification of common practices in the postpartum into four categories: those which are useful, those which are harmful, those for which insufficient evidence exists and those which are frequently used inappropriately."
The Indigenous Knowledge and Development Monitor was a journal that served the international development community and all scientists who share a professional interest in indigenous knowledge systems and practices. Publication ceased in 2001. The author describes the indigenous postpartum maternal and child health care rites and observances among the Igbo of South Eastern Nigeria. Next he examines these practices against the background of the Igbo conception of health and recommends that Igbo health practices be adapted and incorporated into the primary healthcare plan
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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