This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal care recommendations at the ...o-highlight medbox">health-care facility level. The careful design of this toolkit is based on a rigorous evidence-based approach that includes implementation strategies of proven effectiveness to help close the gap between WHO’s care recommendations and current policies and practices.
The primary target audience for the toolkit includes policy-makers, health-care facility managers, implementers and managers of maternal and child health programmes, nongovernmental organizations (NGOs) and professional societies involved in the planning and management of maternal and child health services.
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Objectives of the Study:
To understand the community needs, behaviors and perception for MNH in urban poor settings.
To explore various factors (both demand and supply side) affecting care seekin...g for MNH.
To assess the preparedness of the urban health system for providing MNH services at various levels of care in terms of infrastructures at various levels of care, HR availability and capacity, logistics, drugs & equipment, referral, recording & reporting, supervision, governance and financial modalities.
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It provides guidance on care for use in resource-limited settings or in settings where families with sick young infants do not accept or cannot access referral care, but can be managed in outpatient... settings by an appropriately trained health worker. The guideline seeks to provide programmatic guidance on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
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Levels and Inequities
DHS Further Analysis Reports No. 110
This study shows large variations in maternal health indicators across high-priority counties in Kenya. Nairobi exceeds the natio...nal average on all maternal health indicators in this study, while other highpriority counties consistently are disadvantaged compared with Kenya as a whole in most maternal health indicators. Kisumu exceeds the national average in use of antenatal care, delivery in a health facility, and postnatal care, but not other indicators. Nakuru has fewer women with fertility risk and fewer women who report that the distance they must travel to reach a health facility is a problem.
This study identifies a number of inequities in maternal health indicators across socio-demographic characteristics in the high-priority counties—most in the distribution of delivery care and least in antenatal care. Inequities are also observed in fertility risk and postnatal care.
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CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent compl...ications, caring for newborns and their mothers at home immediately after discharge from health care centers. CHW upskilling training on maternal-newborn services should be prioritized in the most affected areas.
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To improve the quality of care during labour and childbirth, facilitate effective implementation of the World ...edbox">Health Organization (WHO) recommendations: Intrapartum care for a positive childbirth experience, published in 2018, and promote a shift towards improving the experience of childbirth, WHO developed the WHO Labour Care Guide (LCG) and an accompanying WHO labour care guide: user's manual. The WHO LCG is a tool to facilitate implementation of quality, evidence-based, woman-centred care for a positive childbirth experience within the context of a broader, rights-based approach.
The goal of this policy brief is to provide maternal and newborn health stakeholders and decision-makers with an overview of the WHO LCG and its guiding principles, key advantages of making the shift from the WHO partograph to the WHO LCG, and what is required to ensure an enabling environment that will facilitate a sustainable introduction of the WHO LCG.
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This guideline aims to improve the quality of essential, routine postnatal care for women and newborns with the ultimate goal of improving ...ass="attribute-to-highlight medbox">maternal and newborn health and well-being. It recognizes a “positive postnatal experience” as a significant end point for all women giving birth and their newborns, laying the platform for improved short- and long-term health and well-being. A positive postnatal experience is defined as one in which women, newborns, partners, parents, caregivers and families receive information, reassurance and support in a consistent manner from motivated health workers; where a resourced and flexible health system recognizes the needs of women and babies, and respects their cultural context.
This is a consolidated guideline of new and existing recommendations on routine postnatal care for women and newborns receiving facility- or community-based postnatal care in any resource setting.
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This document puts forward the joint position and vision of an expert, global, multistakeholder working group on implementing Kangaroo Mother Care (KMC) for all preterm or low birth weight (LBW) inf...ants as the foundation for small and/or sick newborn care within maternal, newborn, and child health programmes, and spur collaborative global action. The document summarizes the background information, evidence, and rationale for making KMC available to every preterm or LBW newborn and seeks to galvanize the international maternal, newborn, and child health community and families to come together to support the implementation of KMC for all preterm or LBW infants to improve their and their mothers and families health and well-being.
This position paper is intended to be used by policy-makers (i.e. those responsible for national policy, guideline development and budget allocation), development partners, programme managers, health workforce leadership, practising clinicians, civil society leadership (e.g. parent and professional organizations) and researchers/research organizations involved in KMC implementation research.
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This brief summarizes current evidence and guidance for maintaining safe and effective care across the spectrum of maternal, newborn and infant ...an class="attribute-to-highlight medbox">care while protecting mother and child and health care providers during COVID-19. Furthermore, implications of the principle of “do no harm” are reviewed for maternal, newborn and infant care delivery during COVID-19, so that this information is conveniently and readily available to clinical and health system policy leaders and stakeholders in countries and communities. Additionally, considerations for safe oxygen delivery as well as key Infection Prevention and Control (IPC) measures at home and in healthcare facilities for pregnant women, newborns and children are described in detail in the brief.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting th...eir effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Background document to the 2018 joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA: definition of skilled health personnel providing care...> during childbirth
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BMJ Open2018;8:e020423. doi:10.1136/bmjopen-2017-02042
EC has been increasingly used in the evaluation of maternal and child health programmes.12...15 For instance, Nesbitt et al compared crude coverage and EC of pregnant women with facility-based obstetric services in Ghana and estimated that although 68% of the women studied had service access only 18% received high-quality care provided by a skilled birth attendant.16 Similarly, by comparing EC of young children receiving Strengths and limitation of this study. Using multiple data sources (direct observation, vignettes, facility inventories) this study comprehensively assessed under 5-year-old child service
performance of first-line health facilities. We conducted this study in around 500 primary-level health facilities and within 7000 households
across six regions in Burkina Faso.
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Women and Health Initiative Working Paper No. 1. Women and Health Initiative
Improving maternal heal...th in the context of the sub-Saharan African HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective responses by the health system, and a social context which promotes quality care and encourages use of MCH and HIV services. Advancing the proposed research agenda will make an invaluable contribution by generating needed evidence for policy and practice that improves the maternal health of women who are living with HIV, as well as those who are not. Bringing together maternal health and HIV researchers, policy-makers and program implementers to reduce HIV-related maternal morbidity and mortality and improve the HIV response for women represents an opportunity and a challenge.
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DHS Working Papers No. 86
Health Economics Review, 2016 6:7 -Published: 11 February 2016
The Report describes the evaluation of WHO's contribution to the Maternal Health Program in South-East Asia Region. This was an independent evaluat...ion conducted in 2015 by Amaltas, a Delhi based organization. The evaluation highlights the progress in five countries, namely Bangladesh, Indonesia, Myanmar, Nepal and Sri Lanka and provides specific recommendations for Organizational Learning and Development. This report will be useful for all those interested in WHO's work on Maternal Health Program in the Region.
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To support countries in adapting their response to different COVID-19 scenarios, the World Health
Organization (WHO) Department of Maternal, Newbo...rn, Child and Adolescent Health and Ageing commissioned this scoping review of published and grey literature. The objective was to identify interventions implemented to maintain the provision and use of essential services for MNCAAH during disruptive events and to summarize lessons learned during these interventions. The review included outbreaks of Ebola virus disease (EVD), severe acute respiratory syndrome (SARS), Zika virus disease (ZVD), the ongoing COVID-19 pandemic, and natural disasters and humanitarian emergencies that caused disruption to services, transport and other activities.
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