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Destaques das diretrizes de 2013 da Organização Mundial da Saúde
Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last
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three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implemented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Integrating community engagement and accountability into disaster risk reduction activities of the Maternal, Newborn and
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Child Healthcare programme in rural Myanmar
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Improving the quality of care for mothers and newborns in health facilities: learner's manual. Version 02.
World Health Organization (WHO), Regional Office for South-East Asia
WHOCC AIIMS, UNICEF, UNFPA and USAID
(2017)
C_WHO
A training package for building capacity of healthcare teams in health facilities for continous quality improvement of maternal and newborn healthcare. The focus is on the care of mothers
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and newborns at the time of child birth since a large proportion of maternal deaths, newborn deaths and stillbirths happen around that time.
The 4-Step POCQI (Point of care Quality Improvement) package includes Coaching manual and Learner manual that present a demystified and simple model of quality improvement at the level of health facilities using local data to identify quality gaps, analyse underlying causes and improve health care practices in their own specific context without much additional resources.
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Breastfeeding is the cornerstone of infant and young child survival, nutrition and development and
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maternal health. The World Health Organization recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond.1 Early and uninterrupted skin-toskin contact, rooming-in2 and kangaroo mother care3 also significantly improve neonatal survival and reduce morbidity and are recommended by WHO.
Corrigendum 23 June 2020
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These standards for the quality of paediatric care in health facilities form part of normative
guidance for improving the quality of maternal, newborn, child
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and adolescent health care.
In view of the importance of the continuum of both the life-course and service delivery (1),
these standards build on the Standards for improving the quality of maternal and newborn
care in health facilities (2), during labour, childbirth and the early postnatal period.
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For health care providers.
Sub-Saharan Africa has the highest maternal mortality in the world. According to estimates by the United Nations Maternal
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Mortality Estimation Inter-Agency Group (UN MMEIG)1 in September 2017, while the African Region had recorded a significant decline in maternal mortality rate (MMR) of 37.8% between 2000 and 2017, 66% of the 295 000 maternal deaths reported globally occurred in sub-Saharan Africa. The African Region is also noted to have an extremely high MMR, estimated at 542 per 100000 livebirths, with an average annual rate of reduction of 2.9%.
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Birth defect has been an emerging major cause of child mortality in the region. Scarcity of the birth defects information hampers policy decisions and
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control measures at national level. In order to create evidence for action for birth defects prevention in the region, WHO-SEARO in collaboration with CDC, USA has developed and launched a regional electronic database on birth defects. This surveillance database allows data collection on newborn health, birth defects and stillbirths cases and provides real time information at hospitals and national level.
Training of the hospital health staffs and data managers in the birth defects surveillance network; at regional, national and at hospital levels is recognized as essential for expansion of this database and to assure quality of data. A two days training module for hospital based birth defects surveillance was developed using a guide for operation and facilitator guide. more
Training of the hospital health staffs and data managers in the birth defects surveillance network; at regional, national and at hospital levels is recognized as essential for expansion of this database and to assure quality of data. A two days training module for hospital based birth defects surveillance was developed using a guide for operation and facilitator guide. more
WHO-SEARO in partnership with WHOCC AIIMS, UNICEF, UNFPA and USAID has prepared a training package for building capacity of healthcare teams in health facilities for continous quality improvement of matern
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al and newborn healthcare. The focus is on the care of mothers and newborns at the time of child birth since a large proportion of maternal deaths, newborn deaths and stillbirths happen around that time.
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Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more
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likely to die than those from the safest places.
The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. more
The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. more
The 2015-16 MDHS is a national sample survey that provides up-to-date information on fertility levels; marriage; fertility preferences; awareness and use of family planning methods; child feeding pr
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actices; nutrition; adult and childhood mortality; awareness and attitudes regarding HIV/AIDS; women’s empowerment; and domestic violence. The target groups were women and men age 15-49 residing in randomly selected households across the country. In addition to national estimates, the report provides estimates of key indicators for both urban and rural areas in Myanmar and also for the 15 states and regions.
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The guidelines address timing, number and place of postnatal contacts, and content of postnatal care for all mothers and babies during the six week
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s after birth. The primary audience for these guidelines is health professionals who are responsible for providing postnatal care to women and newborns, primarily in areas where resources are limited. The guidelines are also expected to be used by policy-makers and managers of maternal and child health programmes, health facilities, and teaching institutions to set up and maintain maternity and newborn care services.
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WHO’s Ambition and Action in Nutrition 2016-2025 is anchored in the six global targets for improving maternal, infant and young
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child nutrition and the global diet-related NCD targets.
In support of the 2030 Agenda for Sustainable Development, particularly SDG2 and SDG3, and in concert with the 2016-2025 UN Decade of Action on Nutrition, WHO’s Ambition and Action in Nutrition 2016-2025 aims for “A world free from all forms of malnutrition where all people achieve health and well-being”. It defines the unique value of WHO for advancing nutrition: the provision of leadership, guidance and monitoring and proposes a theory of change. Finally, following a set of guiding principles, it proposes priority actions for WHO, the delivery model and a clear allocation of roles across the Organization. more
In support of the 2030 Agenda for Sustainable Development, particularly SDG2 and SDG3, and in concert with the 2016-2025 UN Decade of Action on Nutrition, WHO’s Ambition and Action in Nutrition 2016-2025 aims for “A world free from all forms of malnutrition where all people achieve health and well-being”. It defines the unique value of WHO for advancing nutrition: the provision of leadership, guidance and monitoring and proposes a theory of change. Finally, following a set of guiding principles, it proposes priority actions for WHO, the delivery model and a clear allocation of roles across the Organization. more
PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768
Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable
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maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to determine the impact of a community health worker (CHW) intervention on the proportion of women who visit ANC fewer than 4 times during their pregnancy and deliver at home.
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Healthy maternal nutrition, exclusive breastfeeding, and optimal infant and young child nutritio
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n are critical for appropriate growth and development, as well as reducing the risk of developing noncommunicable diseases (NCDs), for both mothers and children. On 7–8 November 2018 the WHO Regional Office for Europe convened an international conference of key stakeholders to discuss good practices and share experiences on these important issues.
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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
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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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The Relationship between the Health Service Environment and Service Utilization: Linking Population Data to Health Facilities Data in Haiti and Malawi.
Wenjuan Wang, Rebecca Winter, Lindsay Mallick, Lia Florey, Clara Burgert-Brucker, and Emily Carter
ICF International
(2015)
C2
DHS Analytical Studies No. 51
Child Health, Family Planning, Geographic Information, HIV, Malaria, Maternal Health
The DHS report itself explains the purpose was, “to obtain and provide information on basic indicators of social progress including fertility, childhood mortality, reproductive
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and child health, nutritional status of children, and awareness of HIV/AIDS and other health-related issues” in PNG. This is important because a DHS then provides the evidence base for PNG officials themselves to track progress in PNG over time, compare trends with other comparable countries, and then allocate financial and human resources to where they are needed most.
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Private health sector assessment: selected health products and services in Sénégal
Brunner B., J. Barnes, A. Carmona et. al.
United States Agency for International Development
(2016)
C2
USAID Senegal and Health in Africa (HIA) initiative of the World Bank Group engaged the Strengthening Health Outcomes through the Private Sector (SHOPS) project to conduct an assessment of the private health sector in Senegal. The assessment’s pri
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mary focus is family planning, and its secondary focus is maternal, neonatal and child health (MNCH), HIV and AIDS, malaria, and nutrition.
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Updated 17 April 2020
Improving care for women during pregnancy and around the time of childbirth to prevent and treat pre-eclampsia and eclampsia
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is a necessary step towards the achievement of the health targets of the Sustainable Development Goals (SDGs). Efforts to prevent and reduce morbidity and mortality due to these conditions can help address the profound inequities in maternal and perinatal health globally. To achieve this, healthcare providers, health managers, policy makers and other stakeholders need up-to-date and evidence-informed recommendations to guide clinical policies and practices.
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