Maternal & Child Health

This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector’s influence on child health outcomes. [from abstract]

Thanks to a small cadre of village volunteers, trained in basic health-care concepts, western Uganda is beginning to see some promising improvements in child health. [from author]

In rural settings, the promotion of household and community health practices through community health workers (CHWs) is among the key strategies to improve child health. The objective of this study was to assess the performance of CHWs in the promotion of basic child health services in rural Mali. [from abstract]

This paper aims to describe the design, methods and approaches used to assess the effectiveness and cost-effectiveness of the skilled care initiative in reducing pregnancy-related and perinatal mortality in Ouargaye district, Burkina Faso. [from summary]

The aim of this paper is to assess to what extent a skilled care initiative was associated with pregnancy-related mortality in Ouargaye district, Burkina Faso. [from summary]

This paper assesses the development of maternal health services and policies in Bangladesh by reviewing policy and strategy documents since the country's independence in 1971, with primary focus on rural areas where three-fourths of the total population of reside. [adapted from abstract]

In resource-poor settings, the facility-based maternal death review or audit is one of the most promising strategies to improve health service performance. We aim to explore and describe health workers’ perceptions of facility-based maternal death reviews and to identify barriers to and facilitators of the implementation of this approach in pilot health facilities of Senegal. [from abstract]

This article discusses the role of traditional healers in pediatric care in South Africa. [adapted from introduction]

The Capacity Project partnered with the Ministry of Health and other organizations to perform a pilot study to demonstrate the efficiency and the safety of matrones using active management of the third stage of labor with skilled birth attendants who were authorized to perform the practice and assessed factors that could affect their ability. [from author]

Efforts to formalize the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. Continued attendance by TBAs at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. [adapted from abstract]

Nepal’s Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the intention of increasing utilisation of professional care at childbirth. It provided cash to women giving birth in a health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We explored early implementation of the programme at the district-level to understand the factors that have contributed to its low uptake. [from abstract]

The potential for traditional birth attendants (TBAs) to improve neonatal health outcomes has largely been overlooked during the current debate regarding the role of TBAs in improving maternal health. Randomly selected TBAs were interviewed to gain a more thorough understanding of their knowledge, attitudes, and practices regarding maternal and newborn care. [from abstract]

The objective was to provide a systematic review of the effectiveness of community-level interventions to reduce maternal mortality. Selection criteria were maternity or childbearing age women, comparative study designs with concurrent controls, community-level interventions and maternal death as an outcome. [from abstract]

This video resource details the social, economic and health care services disparities between urban and rural areas of Tajikistan and how women there struggle with their health and the role of men, or the lack thereof, in supporting them. [adapted from synopsis]

This video resource shows how midwives and community volunteers are helping more Cambodian women to increase the time between births, thereby contributing to healthier pregnancies, infants and families as well as to a better chance of escaping poverty. [adapted from synopsis]

This policy brief explores the major challenges facing Kenya in the implementation of their Integrated Management of Childhood Illness strategy and looks at why it is failing to fulfill its potential to improve health care and reduce child mortality. [adapted from introduction]

Tanzania is implementing the Integrated Management of Childhood Illness (IMCI), developed by the WHO and UNICEF to improve the management of child health at the primary care level in order to reduce child mortality in low and middle income countries. Workers in health facilities are trained in a structured IMCI case management course. IMCI also advocates the strengthening of the health system to facilitate practice of the skills acquired by health workers, as well as calling for improvement of household and community practices related to child health. [from executive summary]

Medical doctors and nurses in Bangladesh are concentrated in urban secondary and tertiary hospitals, while 70% of the population lives in rural areas. This situation has created a major challenge for the national health system, particularly for reducing the high maternal mortality rate, with fewer than 20% of births being attended by a skilled birth attendant. The Declaration of Safe Motherhood was desgined to address this issue, supportetd by a number of national programs and strategies. [from summary]

This report assesses progress on the Millennium Development Goals 4 and 5 on child mortality and maternal health and proposes best strategies for reaching them. Chapeter 3 (p.81) discusses the impact of skilled attendance and emergency obstetric care on maternal and child survival rates, and chapter 4 (p.119) outlines the broader importance of health workforce management to maternal and child health. [adapted from author]

This paper will use India as a lens to examine the broader issues surrounding human resources and public health. It will explore some of the HR strategies employed in a variety of settings with mixed results. Finally, it will look at several very contrasting approaches employed by two Indian states, Tamil Nadu and Gujarat, in dealing with human resource shortages as they struggle to reduce maternal mortality. [from author]

Given the worrying trends in infant and child mortality rates, there is a clear need to assess current practices in the management of childhood illnesses and to identify opportunities for intervention. The 2004 Kenya Service Provision Assessment Survey (KSPA) findings indicate that most health care providers are not taking care of sick children holistically, but rather are treating children only for the presenting illness.

The study had three objectives: to determine the current competency levels of the workforce attending women during labor, delivery, and the early postpartum period; examine conditions at the workplace to determine environmental and organizational factors that affect workforce productivity and performance; and assess implications for regional training and performance improvement at the workplace. [from author]

This report concludes that assigning nurses to community locations where they provide basic curative and preventive care substantially reduces childhood mortality and accelerates progress towards attainment of the child survival MDG. The research in Navrongo demonstrates that affordable and sustainable means of combining nurse services with volunteer action can accelerate attainment of both the International Conference on Population and Development agenda and the MDGs. [from summary]

Urgent support to increase the numbers and skills of midwives would save the lives of 5 million women, prevent 80 million illnesses and disabilities from pregnancy or childbirth and save the lives of countless newborns. The goal of this workshop is to contribute to that agenda, and respond to the global focus on human resources for health. [from executive summary]

This guidance note is designed for countries seeking to scale up midwifery services, especially at the community level. It outlines in detail the action required by policy-makers and program managers to effect change at country level and scale up midwifery capacity, specifically in poor and hard-to-reach areas.

This cross-sectional study assessed knowledge and utilization of the partograph, an effective tool for monitoring labour that can prevent prolonged or obstructed labour, among health care workers in southwestern Nigeria. [adapted from author]

Research has identified that skilled nurses working in rural and remote locations are crucial for the provision of maternity care to rural parturient women. This study considered the experiences of rural nurses and their contributions to maternity care in rural and remote settings and in the small towns where women might be referred for care surrounding childbirth. [from introduction]

The main objective of this study was to assess the role of traditional birth attendants and the quality of their services in contributing to the reduction of maternal deaths in Malawi. [from abstract]

In developing countries, postabortion care (PAC) programs are frequently available only in urban or regional health facilities, placing rural women at greater risk for mortality and morbidity from complications because they lack access to services. This technical brief evaluates efforts to decentralize PAC activities in Senegal and Tanzania that show PAC can be safely and successfully decentralized with services capably provided by mid-level personnel in health centers, dispensaries, and some health posts when providers are trained and supervised and equipment and supplies are available. [adap

In this paper we review the current situation of human resources for maternal health as well as the problems that they face. We propose seven key areas of work that must be addressed when planning for scaling up human resources for maternal health in light of MDG5, and finally we indicate some advances recently made in selected countries and the lessons learned from these experiences. [from abstract]