Maternal, child and adolescent health (MCAH)
The country programme will focus on delivering quality maternal, newborn, child and adolescent health-care services, including birth registration.
Challenge
This programme component is aimed at achieving the following: “By 2025, parents and children, with a focus on the most vulnerable, have access to equitable, integrated, quality essential health, nutrition and HIV services, including during emergencies”. The country programme will focus on three priority areas, described as follows.
Solution
Priority 1. The country programme will focus on delivering quality maternal, newborn, child and adolescent health-care services, including birth registration. Working with the Ministry of Health as the lead partner, especially in the implementation and coordination of the newborn and child care agenda, UNICEF will adopt a two-pronged approach: (a) health-systems strengthening at all levels, including community systems, emphasizing evidence-based programming; and (b) awareness creation and community empowerment to demand services, including during emergencies.
UNICEF will build the capacity of health workers to deliver an essential maternal and newborn care package of interventions, neonatal intensive care services and the prevention of mother-to-child transmission (PMTCT) of HIV, including for pregnant adolescent girls. Emphasis will be placed on mentoring and supportive supervision for quality of care, the provision of essential equipment and strengthening postnatal care and follow-up. UNICEF will support the strengthening of leadership and accountability in maternal, newborn, child and adolescent health services as well as the planning and use of domestic resources for them. To ensure that birth registration is provided routinely in all facilities, UNICEF will advocate for the revision of related policies and support the interoperability of systems between the Ministry of Health and the Ministry of Home Affairs, while ensuring accessibility of records aimed at increased transparency and efficiency. UNICEF will support capacity-building for the roll-out of birth registration in all health facilities and empower communities with information on birth registration.
To effectively link the provision of services to demand, UNICEF will support community empowerment and involvement in the planning and implementation of services such as positive maternal, newborn, child and adolescent care practices, including mental health and psychosocial care. This will link systems of health facilities and the communities for, among other services, enhanced postnatal follow up, especially of women who are HIV positive and HIV-exposed children.
Priority 2. The nutrition programme will address supply- and demand-side barriers to achieving equitable and quality coverage of nutrition services. A systems- strengthening approach will be adopted to ensure that women and children access adequate diets; adequate health, nutrition and water, sanitation and hygiene services; and adopt appropriate practices. Focus areas will include (a) the prevention and management of wasting; (b) the prevention of micronutrient deficiencies; (c) improving the quality of young children’s diets; and (d) effective sectoral coordination, nutrition information management and procurement and supply-chain management for nutrition supplies.
UNICEF will raise awareness on the importance of nutrition, nurturing care and stimulation in the first 1,000 days of life, access to immunization and the elimination of open defecation. UNICEF will support the Ministry of Health to conduct an analysis of barriers to health-seeking behaviours and positive health, hygiene and nutrition practices, and will assist the Ministry to target one or two behaviours in its behaviour-change strategies that will have high impact on reducing stunting.
Priority 3. In the area of the provision of services to children and adolescents living with HIV, the programme aims to address high child and adolescent AIDS-related morbidity and mortality. This requires early identification, early antiretroviral therapy initiation and adherence to treatment to achieve viral suppression.
UNICEF will advocate for enhanced resource allocations for antiretroviral medicine, especially for children, to ensure non-interrupted supply. To improve the supportive environment that will enhance uptake and adherence to antiretroviral therapy, especially among adolescents, UNICEF will support the capacity-building of health workers, parents and caregivers, focusing on strengthening adolescent-targeted interventions, including youth-friendly services as part of the sexual reproductive health programme of the Ministry of Health, and the mentoring of adolescent-responsive services. Further support will be provided towards building the capacity of adolescents as peer educators and counsellors to provide peer support at health facilities, community centres and schools. Special attention will be given to helping pregnant and lactating adolescent girls to access PMTCT services. UNICEF will further support demand-creation for prevention and treatment using innovative ways relevant to adolescents, especially in communities.
Across the programme, UNICEF will support developing the capacity of the Government on emergency preparedness and response to health and nutrition emergencies, including pandemics, while ensuring that food and health systems are resilient to pandemics, chronic food insecurity and climate-related events.
The main partners of the programme are government ministries, CSOs, bilateral and multilateral organizations, such as United Nations agencies, the World Bank, the Foreign, Commonwealth and Development Office of the United Kingdom of Great Britain and Northern Ireland, the Taiwan International Cooperation and Development Fund and the United States President’s Emergency Plan for AIDS Relief as well as academic and research organizations, media and the private sector.