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.

A clear guide to improving care of mothers and babies in low-resource settings

By: Tamar Chitashvili, Silvia Holschneider, Jorge Hermida, and Nigel Livesley 

There is growing recognition that clinical training and health infrastructure — while essential—are insufficient for improving and sustaining life-saving maternal and newborn health care services in low-resource settings. Instead, broader systems strengthening and continuous quality improvement efforts at the service delivery level are needed to continuously assess gaps in processes and content of care and to plan, test, implement, regularly monitor, refine and institute changes to deliver services correctly and consistently. To respond to this need and help frontline care providers in their continuous quality improvement journey, “Improving Care for Mothers and Babies: A Guide for Improvement Teams” was recently developed through collaborative efforts of the Survive & Thrive Global Development Alliance (S&T GDA).

VIDEO: Cost-effectiveness of an intervention to increase immunization coverage in Pakistan

This is a presentation of the results of a cost-effectiveness study to improve immunization uptake among children under 2 years of age and pregnant women in Sindh province in Pakistan.

Guía de Consejería: Consejería preconcepcional, prenatal y posparto en el contexto de la epidemia de Zika

This Spanish language counseling guide focuses on family planning, prenatal and post-partum care in the context of Zika. Based on national and international counseling norms, it has been designed specifically to assist health care practitioners who provide care to women of reproductive age in the regions affected by the Zika virus.

Evaluation of an Intervention to Improve Essential Obstetric and Newborn Care Access and Quality in Cotopaxi, Ecuador

Despite improvements in health-care utilization, disadvantages persist among rural, less educated, and indigenous populations in Ecuador. The United States Agency for International Development-funded Cotopaxi Project created a provincial-level network of health services, including community agents to improve access, quality, and coordination of essential obstetric and newborn care.

Gender integration in quality improvement: Increasing access to health services for women in rural Mali

Anemia is one of the leading contributors to infant and maternal mortality and morbidity in Mali. The causes of anemia are many and complex, but are influenced by social norms and cultural beliefs as well as lack of access to health and social services. It is in this context that USAID, through the USAID ASSIST Project in Mali, is supporting sites and communities in the Bougouni Health District in the Sikasso Region to reduce the incidence of anemia among pregnant women and children under five years old.

Improving hand washing among parent attendants entering the new-born intensive care unit of Ram Manohar Lohia Hospital, New Delhi, India

In its new-born intensive care unit (NICU), Ram Manohar Lohia Hospital (a central government hospital) provides specialised care to sick new-borns. Running low on staff, the hospital staff encouraged parents and attendants of sick new-borns to be involved in care for their babies. This, however, also posed a high risk of infections being carried into the unit by caregiving attendants. Staff found that that handwashing behaviours were poor among parent attendants.

Assessment of the quality of basic resuscitation services in Uganda

To guide future efforts to reduce preventable newborn mortality and stillbirth in Uganda, the USAID ASSIST Project carried out an assessment of the quality of newborn resuscitation services as part of integrated newborn care in 26 health facilities sampled from eight districts of Northern, Eastern, Central and Western regions.

Responding to gender issues to improve outcomes in nutrition assessment, counseling, and support services

Nutrition assessment, counseling, and support (NACS) is an approach to integrate evidence-based nutrition interventions into health services, including the prevention, categorization, and treatment of malnutrition and sustained improved nutritional status. This technical brief describes gender issues in NACS services as well as suggestions for how to address them. Gender issues discussed include:

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