Maternal, Newborn, and Child Health

Mother with baby

In the last 20 years, great strides have been made in reducing child and maternal deaths.  However, child and maternal deaths still remain unacceptably high. In 2013, 6.3 million children died before their fifth birthday, and even now some 800 women and girls die each day in the process of giving life, largely from preventable causes. Strengthening essential system functions to reliably deliver high quality, life-saving interventions for leading causes of maternal, newborn, and child mortality is a major part of USAID’s Ending Preventable Child and Maternal Deaths (EPCMD) strategy. The USAID ASSIST Project supports the global EPCMD agenda by:

  • Testing and implementing innovative, cutting-edge quality improvement and service delivery approaches in maternal, newborn, and child health (MNCH), such as collaborative improvement, process redesign, and integrating routine and complications care across system levels
  • Developing, testing, and disseminating technical frameworks, approaches, and tools that can increase the efficiency, effectiveness, cost-effectiveness and sustainability of health system strengthening and quality improvement initiatives in support of the USAID EPCMD strategy, including strategies to integrate gender considerations in care delivery
  • Building government and implementing partner capacity to apply improvement methods across health system levels (community, clinic, hospital, district, regional, central) to improve, scale up, and sustain high-impact, low-cost, people-centered MNCH and family planning (FP) services for leading causes of maternal newborn and child morbidity and mortality in USAID priority countries
  • Strengthening frontline health worker and manager skills, motivation, and performance through integrated clinical and quality improvement (QI) capacity building and through engagement of health workers in making improvements in their local health care systems and processes
  • Supporting the development and testing of MNCH quality of care indicators, strengthening routine health information systems to enable regular tracking of quality measures at service delivery level, and promoting accountability at global, national, and sub-national levels

Drawing on extensive experience support the planning, implementation and evaluation of MNCH improvement programs in different countries and regions, USAID ASSIST also contributes to global learning about gaps in care processes and how to best support health system functions to deliver high-impact, cost-effective MNCH services to decrease preventable maternal and child deaths.

Scaling up a quality improvement initiative under the Government of India’s RMNCH+A program: Lessons from Chamba District

Praveen Sharma

Head of Programs, India, USAID ASSIST Project/URC

From December 2013, ASSIST’s India team started providing support for quality improvement (QI) initiatives to improve services at health facilities in Chamba District in Himachal Pradesh State. Within a few months, the district government saw good, sustained results from QI initiatives for the Government of India’s RMNCH+A program and with ASSIST’s support, the district government has been very active at all levels (facility, district, state) in scaling up QI.

International Day to End Obstetric Fistula

Elizabeth Romanoff Silva


May 23rd marked the International Day to End Obstetric Fistula. This year’s theme “End fistula, restore women’s dignity,” emphasizes that high rates of fistula continue to debilitate women and girls and deny them equal opportunities around the world.

Engaging health workers in improving quality of care key to reduce maternal mortality in Uganda

Mirwais Rahimzai

Regional Director for East Africa, USAID ASSIST/URC

I returned to Kampala inspired after an excellent gathering organized in Fort Portal, Uganda, by the Saving Mothers Giving Life (SMGL) initiative, where participants from Zambia, Uganda and Nigeria came together to review the progress, share learning and discuss the future course of action. The meeting was inaugurated by inspiring speeches from the Fort Portal District Leader, the USAID Mission Director, and the global SMGL coordinator in Washington.

International Day of the Midwife: Need for midwives is more than ever

Annie Clark

Senior QI Advisor MNCH, USAID ASSIST Project/URC

May 5 is the internationally recognized day for highlighting the work of midwives. The International Confederation of Midwives (ICM) established the idea of the 'International Day of the Midwife' (IDM) following suggestions and discussion among midwives associations in the late 1980s, then launched the initiative formally in 1992. 

Improving the quality of maternal and child health services in Latin America: past, present, and future

Jorge Hermida

Senior QI Advisor, MNCH, and Latin America Regional Director, USAID ASSIST Project/URC

In September, I had the pleasure of attending two international maternal and newborn health meetings: the “Integration of Maternal and Newborn Health: In Pursuit of Quality” technical meeting, convening global leaders on promising approaches to integration of care in Boston, Massachusetts, and the Latin America and the Caribbean Newborn Health Alliance Annual Meeting in Bogotá, Colombia. At both conferences, I presented about our work through the USAID ASISST Project to reduce maternal and newborn mortality through increasing access to and quality of care -focusing on high-impact, evidence based maternal and newborn care globally.

While many international organizations have been focused on recommending to countries and health systems the “best” interventions to put in place, the actual process of making it happen in those health systems has not always been a priority. What is needed, in my opinion, is implementation effectiveness- to focus more on the process of actually implementing those best practices, including identifying the main barriers and facilitating factors and the best ways to achieve large scale implementation with an effective level of quality.

Integration of maternal and newborn health care: A technical meeting and blog series

The following blog was originally featured on the Healthy Newborn Network and was written by Katie Millar. The post follows a conference in Boston that focused on integrating MNCH approaches across the continuum of care. ASSIST's Jorge Hermida and Kathleen Hill attended and presented at the conference.

On September 9th and 10th, the Maternal Health Task Force and Save the Children’s Saving Newborn Lives program convened experts in Boston to discuss maternal and newborn health integration. The meeting, “Integration of Maternal and Newborn Health Care: In Pursuit of Quality,” hosted about 50 global leaders—researchers, program implementers and funders—in maternal and newborn health to accomplish the following three objectives:

  1. Review the knowledge base on integration of maternal and newborn health care and the promising approaches, models and tools that exist for moving this agenda forward
  2. Identify the barriers to and opportunities for integrating maternal and newborn care across the continuum
  3. Develop a list of actions the global maternal and newborn health communities can take to ensure greater programmatic coherence and effectiveness

Improving the quality of tobacco and alcohol cessation services for pregnant women

Elena Novichkova

Chief of Party, Ukraine, USAID ASSIST Project/URC

Alcohol and tobacco use during pregnancy poses serious risks to the health and welfare of mothers and unborn babies. Preterm birth, developmental disabilities such as fetal alcohol syndrome, mental and growth retardation, low birth weight, and asthma and sudden infant death are some of the effects that drinking and smoking while pregnant have on babies.

The value of virtual forums: Promoting Kangaroo Mother Care in Latin America

Ivonne Gómez Pasquier

Chief of Party, Nicaragua, USAID ASSIST/URC

In June, the USAID ASSIST-supported Salud Materno Infantil (Maternal and Infant Health) Kangaroo Mother Care (KMC) Community of Practice hosted its second virtual discussion forum in Spanish on "Experiences in startup and early consolidation of Kangaroo Mother Care (KMC) activities in hospitals in Latin America: favorable aspects, constraints and lessons learned.” As a pediatrician and director of the USAID ASSIST Project in Nicaragua, I was honored to moderate the forum.

A ‘sabbatical’ for pregnant women in Turkana, Kenya

Doreen Bwisa

Improvement Advisor, Kenya, USAID ASSIST Project/URC

It was a hot and sunny day in mid-June when I was having my lunchtime meal at the restaurant in St. Theresa Pastoral Center in Lodwar, Turkana County when a middle aged lady joined me at the table. She told me her name is Ann*, one of the participants for the Quality Improvement training that we were conducting there. Ann added that she was a nurse at the Kakuma refugee camp in the maternity ward, and went ahead to share with me this story.

Distress on a wooden bench – explaining health care improvement and patient outcomes in Nakuru, Kenya

Faith Mwangi-Powell

Chief of Party, Kenya, USAID ASSIST Project/URC

Sitting on a hard wooden bench in Nakuru district hospital’s outpatient department, an eight-month pregnant Nyambura (not her real name) and her husband Julius were very anxious for many reasons.  Since her pregnancy started, she had never been seen by a medical practitioner and never attended any antenatal appointments.  This morning Nyambura had decided to visit the clinic as her normally active fetus had not kicked for several days. She was worried if all was well.