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.

Developing job aids to increase adherence to an antibiotic regimen in children with pneumonia in Niger

The development of antimicrobial resistance (AMR) has increased the worldwide threat of infectious disease. Strategies to curb the development of AMR include improving (1) patient counseling and (2) antibiotic regimen adherence. The...

Safe motherhood studies -- results from Jamaica. Competency of skilled birth attendants, enabling environment for skilled attendance

More than 500,000 women worldwide die each year from complications related to childbirth. With good quality obstetric care, approximately 90% of these deaths could be averted. The assistance of a skilled birth attendant during labor,...

Designing quality essential obstetric care services in Honduras

This case study describes how quality design methodology was applied by three waves of teams to improve the quality and accessibility of obstetric care in the Comayagua and La Paz regions of Honduras. As part of the Latin American and...

Developing evidence-based standards for pregnancy-induced hypertension in Russia

This case study describes how facility-level teams worked with department of health leaders in Tver Oblast, Russia, to create an evidence-based guideline as part of a larger quality improvement project to improve the system of healthcare...

Evaluation of an IMCI computer-based training course in Kenya

The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) developed the Integrated Management of Childhood Illness guidelines (IMCI) in the mid-1990s to enable a holistic approach to the care of children presenting at...

Improving the management of obstetric emergencies in Uganda through case management maps

In this study, Uganda's Jinja Hospital and the Quality Assurance Project developed and implemented case management maps (CMMs) for two distinct pregnancy-related conditions: pregnancy-induced hypertensive disorders (PIHD) and postpartum...

Redesigning hospital documentation systems to improve the quality of obstetric patient records in Ecuador.

This study tested whether a redesign methodology would improve the quality of medical records in the obstetric services of four Ecuadorian hospitals. Quality teams in each hospital implemented a redesign methodology, working in cooperation...

Assessing Health Worker Performance of IMCI in Kenya

Quality assessment is the measurement of the quality of healthcare services. A quality assessment measures the difference between expected and actual performance to identify opportunities for improvement. Performance standards can be...

Designing Obstetric Services to Reduce Maternal Mortality in Guatemala

In 1999, the Guatemala Ministry of Health and the Quality Assurance Project undertook a joint initiative, which applied quality design methodology at seven hospitals in the highlands of Guatemala. The goal of the quality design effort was...

Quantifying the economic impact of using evidence-based clinical guidelines for pregnancy-induced hypertension in two hospitals

In 1999, a demonstration project of evidence-based clinical guidelines for treating pregnancy-induced hypertension (PIH) was implemented in three hospitals in Tver Oblast under the Quality Assurance Project/Russia. In parallel, an...

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