Maternal & Child Health

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 purpose of this toolkit, consisting of 7 booklets, is to provide nurses and midwives with tools to effectively participate in and influence health care planning and policy-making. This tool-kit has been designed for use by any nurse or midwife who has an interest in advocating for change in their work environment. [from publisher]

The regional guidelines for implementing the SDNM in the African Region are to accelerate action at country level. The guidelines also provide both a framework for WHO action to support countries in improving the quality of nursing and midwifery services, and a guide for action at national and local levels. Possible priority actions have been proposed to countries to facilitate strengthening of nursing and midwifery services at national and local levels. [from foreword]

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]

This report discusses ways and means of improving the capacities of nurses and midwives and building consensus on a regional agenda to strengthen the contribution of nursing and midwifery services to rapidly scale up health services delivery and health outcomes in the African region. [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]

The aims of this publication are to encourage midwives and student midwives to make the most of supervision by working in partnership with their supervisor; provide clear information about the supervisory process and the interface between supervision and midwifery practice; and inform midwives and student midwives about the changing role of the supervisor of midwives. [from introduction]

Prevention of Mother-to-Child Transmission of HIV is among the key HIV prevention strategies in Zimbabwe. The main objective of this study was to evaluate acceptability and feasibility of reinforcing the role of traditional birth attendants (TBAs) in family and child health services through their participation in PMTCT programmes in Zimbabwe. [from abstract]

Increasing access to safe delivery and family planning services within rural communities increases the opportunities for women to have positive outcomes for their pregnancies as well as to plan and achieve their desired family size. This paper examines the scaling up of a community-based model in Kenya that enabled women to give birth safely at home or to be referred to a hospital when attended by a self-employed skilled midwife living in the community. [adapted from summary]

This document details the specific hiring criteria for clinical, nursing & midwifery and pharmacy staff as established by the Health Services division of the Ghana Ministry of Health.

Since the early 1990s Indonesia has attempted to increase the level of skilled attendance at birth by placing rural midwives in every village in an effort to reduce persistently high levels of maternal mortality. Yet evidence suggests that there remains insufficient incentive to ensure an equal distribution across areas while the poor in all areas continue to access skilled attendance much less than those in richer groups.

Through an analysis of focus group discussion data, we examine Kenyan traditional birth attendants’ accounts of the persistence of homebirths and the key challenges they present. [from abstract]

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]

This document reviews the issues around midwives and others with midwifery skills: who they are, what they do and how to scale up professional attendance at all births. It also includes case studies of midwifery initiatives. [adapted from summary]

This report documents experiences and lessons from the First International Forum on Midwifery in the Community related to training and scaling-up the midwifery workforce.

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]

This article suggests that India’s maternal mortality rate is so high due to political, administrative and managerial issues such as the lack of exclusive midwifery training and professional midwives. [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]