Continuum of care
A continuum of care which integrates maternal, newborn and child health care will help reduce maternal and newborn mortality and morbidity.
Essential services for mothers, newborns and children are most effective when they are delivered in integrated packages at critical points in the life cycle of mothers and children, in a dynamic health system that spans key locations, underpinned by an environment supportive of the rights of women and children.
The critical points for service delivery are adolescence, pre-pregnancy, pregnancy, birth, post-partum, neonatal, infancy and childhood.
Quality family planning services
The World Health Organisation (WHO) has identified five key priorities for action on reproductive health-care services: strengthening health systems capacity; improving information for setting priorities; mobilising political will; creating supportive legislative and regulatory frameworks; and strengthening monitoring, evaluation and accountability.
Enhancing nutrition for mothers and newborns
Gaining the confidence of pregnant women through such programs of micronutrient supplementation can be a useful way to encourage their continued attendance for other forms of professional antenatal care.
UNICEF, the United Nations Population Fund (UNFPA) and WHO recommend a minimum of four antenatal care visits during pregnancy, the minimum needed to provide the most important services, which can include treatment of hypertension to prevent eclampsia, tetanus immunisation, intermittent preventive treatment for malaria and distribution of insecticide-treated nets, prevention of mother-to-child transmission of HIV, micronutrient supplementation, and birth preparedness, including information about danger signs during pregnancy and childbirth.
HIV prevention services
Skilled health personnel
Particularly when complications occur, skilled personnel need access to essential drugs, supplies, equipment and emergency obstetric care. They should receive training on required competencies. And they need supervision that helps ensure high standards of care, which is vitally important. When emergency-care referrals are needed, these skilled personnel must have access to a well-functioning health system.
Emergency obstetric care
Comprehensive emergency obstetric care should be available at a minimum of one facility in every district or one per 500,000 population.
Post natal visits
These visits can provide essential information and guidance on maternal and newborn health – especially on the care and feeding of babies, the danger signs of illness, referral processes and improved hygiene practices. Studies show that fewer neonatal deaths occur when mother and baby are visited within 48 hours of birth. Mothers who are HIV-positive and babies born prematurely need particular attention. Low birthweight infants require special attention, particularly for temperature management.
Healthy practices for newborn care
The state of the health system, social context and local practices matter just as much as epidemiological risks. Neonatal health can be improved, for example, by practices that do not have high costs attached, such as clean delivery conditions and the promotion of early and exclusive breastfeeding, and by ensuring that the mother is healthy when she gives birth.
It must be highlighted that many women in the developing world – and most women in the world’s least developed countries – do give birth at home without skilled attendants, yet their newborns are usually healthy and survive past their first few weeks of life until their fifth birthday and beyond. Despite the multitude of risks associated with pregnancy and childbirth, the majority of mothers also survive.
SOWC 2009 Video: Reducing mortality
Dr Peter Salama
VIDEO: Interventions to reduce maternal and neonatal mortality. View
SOWC 2009 - Special Guests Essays
Creating a supportive environment for mothers and newborns
H. M. Queen Rania Al Abdullah of Jordan
Eminent Advocate for Children, UNICEF
Working together for maternal and newborn health
Wife of Prime Minister United Kingdom
SOWC 2009 - In Focus