Maternal & Child Health

Excitement is rapidly growing concerning the potential for community- based primary health care (CBPHC) to accelerate progress in reducing the tragedy of millions of children dying world-wide each year from readily preventable or treatable conditions. This report summarizes the current research findings concerning the effectiveness of CBPHC in improving the health of children in high-mortality, resource-poor settings. [from summary]

This report documents some of the processes undertaken to integrate gender and sexuality factors into a maternal health project in Uttar Pradesh, India from 2007-2009. [from foreword]

This document reviews the ISOFI program. The iterative steps of this system focus on building staff and organisational capacity to critically analyse the social construction of gender and explore how gender influences personal values and beliefs and programmatic designs and choices. In turn, through the analysis-reflection-action cycle of the ISOFI Innovation System, staff can help community health providers and other stakeholders to analyse gender issues, reflect on local barriers and opportunities, and make implementation plans to catalyze change. [from author]

This document describes the key effective interventions organized in packages across the continuum of care through pre-pregnancy, pregnancy, childbirth, postpartum, newborn care and care of the child. The packages are defined for community and/or facility levels in developing countries and provide guidance on the essential components needed to assure adequacy and quality of care. [from publisher]

This is the eleventh annual State of the World’s Mothers report. The focus is on the critical shortage of health workers in the developing world and the urgent need for more female health workers to save the lives of mothers, newborn babies and young children. There is a video, and executive summary, the full report and an interactive version of the report. [from publisher]

This case study thus describes an example of a private sector pay for performance voucher program targeting reproductive health and offers lessons for countries that are considering implementing similar schemes. [from author]

Each country profile presents the most recent available information on selected demographic measures of maternal, newborn and child survival and nutritional status, coverage rates for priority interventions, and selected indicators of equity, policy support, human resources and financial flows. [from publisher]

This article outlines a project that deployed short videos on mobile phones designed to motivate health workers and persuade pregnant village women to use health services. The project also asked health workers to record their own videos. The results show evidence that the creation and use of videos helped engage village women in dialogue, showed positive effects toward health worker motivation and learning, and motivated key community influencers to participate in promoting the health workers. [adapted from abstract]

Ensuring skilled attendant at birth is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assesses a community-based safe motherhood intervention in Mtwara rural District of Tanzania. [from abstract]

This study contends that increasing coverage of skilled delivery care and achieving the full implementation of Tanzania’s Focused Antenatal Care Package in Ngorongoro depends upon improved training and monitoring of health care providers, and greater family participation in antenatal care visits. [adapted from abstract]

Increasing interest has been shown in the use of lay health workers (LHWs) for the delivery of a wide range of maternal and child health (MCH) services in low and middle income countries. However, robust evidence of the effects of LHW interventions in improving MCH delivery is limited. The objective of this document is to review evidence from randomized controlled trials on the effects of LHW interventions in improving MCH and addressing key high burden diseases. [adapted from abstract]

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]