|© UNICEF/HQ06-0550/Shehzad Noorani|
Just as community partnerships in health can help increase the reach of essential services while inspiring greater inclusion within health systems, outreach and outpatient services can create bridges between home and community care and facility-based care. Outreach and outpatient services are important means for delivering antenatal and post-natal care, as well as sexual and reproductive health programmes.
Antenatal and post-natal check-ups for both newborns and mothers can effectively be conducted as outreach or outpatient services. Key services include recognizing and checking the danger signs for mothers and newborns, guidance on feeding – particularly early and exclusive breastfeeding – and caring for the newborn, referral for treatment of mother or baby if appropriate, and support and counselling on healthy practices.
Health facilities usually provide the most number of preventive and curative treatments for maternal and newborn care and possibly the most skilled group of health-care workers. Medical facilities are either clinics or hospitals. Staff in the clinic, the facility closest to the community, can assist with uncomplicated births and some of the key complications. It is important, however, that the staff in clinics, as well as those engaged in outreach, need the knowledge to recognize delivery complications or neonatal conditions that are beyond their capacity and require referral to a higher level.
That next level is likely to be a district hospital where doctors can offer medical diagnosis, treatment, care, counselling and rehabilitation services. In some health systems there may be a referral hospital providing complex clinical care, but in most developing countries the facility-based health needs of mothers and infants are met by clinics or the district hospital, if at all.