To support countries in adapting their response to different COVID-19 scenarios, the World Health
Organization (WHO) Department of Maternal, Newborn, Child and Adolescent Health and Ageing commissioned this scoping review of published and grey literature. The objective was to identify interventions... implemented to maintain the provision and use of essential services for MNCAAH during disruptive events and to summarize lessons learned during these interventions. The review included outbreaks of Ebola virus disease (EVD), severe acute respiratory syndrome (SARS), Zika virus disease (ZVD), the ongoing COVID-19 pandemic, and natural disasters and humanitarian emergencies that caused disruption to services, transport and other activities.
more
This statement presents the 2018 definition of skilled health personnel providing care during childbirth (also widely known as a “skilled birth attendants” or SBAs). It results from the recent review and revision of the 2004 joint statement by WHO, FIGO and ICM – Making pregnancy safe: the cri...tical role of the skilled attendant.
more
Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth - meaning that a woman dies around every two minutes.
Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100 000 live births by ...2030.
The United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG) – comprising WHO, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank Group and the United Nations Department of Economic and Social Affairs, Population Division (UNDESA/Population Division) has collaborated with external technical experts on a new round of estimates covering 2000 to 2020. The estimates represent the most up to date, internationally-comparable MMEIG estimates of maternal mortality, using refined input data and methods from previous rounds.
The report presents internationally comparable global, regional and country-level estimates and trends for maternal mortality between 2000 and 2020.
more
Nepal has performed exceptionally in improving reproductive, maternal and child health outcomes over the past two decades. In this article, we discuss these achievements and outline a vision for the future of maternal, newborn and child survival in Nepal after the era of the Millennium Development G...oals. On the pathway towards quality universal health care services for all, we propose strengthening of health information systems, gradual health system reforms, improvement of existing facility based services, development of integrated service delivery models, improved technical and managerial capacity at district and facility levels. Elimination of all preventable causes of maternal, newborn and child deaths in Nepal should be our collective aspirational goal.
more
Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
more
The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing seg...ments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.
more
Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP)..., which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes.
more
To examine how health aid is spent and channelled, including the distribution of resources across countries and between
subsectors. Our aim was to complement the many qualitative critiques of health aid with a quantitative review and to provide insights on the level of development assistance availa...ble to recipient countries to address their health and health development needs.
more
The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
more
Antibiotic resistant bacteria are spreading at an alarming rate and some bacterial infections may once again be untreatable. Antibiotic resistance (ABR), conservatively calculated, causes more than 500 000 deaths every year. This number is projected to rise dramatically if radical actions are not ta...ken. Lack of effective antibiotics, diagnostics and vaccines threatens the health of millions and hampers fulfilment of several of the Sustainable Development Goals. Access to effective antibiotics should be part of every adult and child’s right to health.
more
Ethiopia saw a six-fold increase in confirmed COVID-19 cases between June and August, with 5,689 cases by end June compared to 34,058 cases as of 19 August. Ethiopia also registered more than 13,000 recoveries and more than 600 deaths. As of the last week of August, Ethiopia was leading eastern Afri...can countries with the highest number of cases.
more
Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit...h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
more
Background:Neonatal mortality accounts for 43% of global under-five deaths and is decreasing more slowly than maternal or child mortality. Donor funding has increased for maternal, newborn, and child health (MNCH), but no analysis to date has disaggregated aid for newborns. We evaluated if and how a...id flows for newborn care can be tracked, examined changes in the last decade, and considered methodological implications for tracking funding for specific population groups or diseases. MethodsandFindings:We critically reviewed and categorised previous analyses of aid to specific populations, diseases, or types of activities. We then developed and refined key terms related to newborn survival in seven languages and searched titles and descriptions of donor disbursement records in the Organisation for Economic Co-operation and Development’s Creditor Reporting System database, 2002–2010. We compared results with the Countdown to 2015 database of aid for MNCH (2003–2008) and the search strategy used by the Institute for Health Metrics and Evaluation. Prior to 2005, key terms related to newborns were rare in disbursement records but their frequency increased markedly thereafter. Only two mentions were found of ‘‘stillbirth’’ and only nine references were found to ‘‘fetus’’ in any spelling variant or language
more
UNFPA aims to achieve three world-changing results by 2030, the deadline for achieving the Sustainable Development Goals. These are: Ending unmet need for family planning, ending gender-based violence including harmful practices such as female genital mutilation and child marriage, and ending all pr...eventable maternal deaths. COVID-19 pandemic could critically undermine progress made towards achieving these goals.
more
A Focus on the Journey to Self-Reliance for Preventing Child and Maternal Deaths . June 2018
The 2018 Acting on the Call report focuses on 25 countries’ journeys to self-reliance for preventing child and maternal deaths. Self-reliance is a country’s ability to finance and implement solution...s to its own development challenges. Understanding where countries lie on this effort - known as the journey to self-reliance - helps USAID to best partner with countries and support their efforts.
The report looks at the health status of 25 priority countries as well as the current capacity of the health system to meet the needs of women and children. In the report, we recount progress since the 2012 Call to Action as well as identify gaps in order to inform future programming and areas that need strengthening during the journey to self-reliance. For the first time ever, we’ve calculated the return on our investment to eliminate bottlenecks to improving health services.
more
Notable progress has also been made on other key health indicators such as reducing maternal, infant and child deaths and malnutrition, increasing immunization coverage, eliminating infectious diseases such as polio and reducing the incidence of malaria, tuberculosis and diarrhoeal diseases.
But ...despite such substantial progress, the country now faces new and emerging new challenges such as the rising burden of noncommunicable diseases, increased risks associated with disasters, environmental threats and health emergencies during disease outbreaks including the COVID-19 pandemic that is a serious public health threat to Bangladesh. To establish a resilience system for future potential pandemics, the national capacity for emergency preparedness and early response to health emergencies needs to be bolstered considerably.
more
Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35000 Nepali children die before their fifth birthday, with almost two-thirds of these deaths occurr...ing in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding.
more
For health care providers.
Sub-Saharan Africa has the highest maternal mortality in the world. According to estimates by the United Nations Maternal Mortality Estimation Inter-Agency Group (UN MMEIG)1 in September 2017, while the African Region had recorded a significant decline in maternal mortali...ty rate (MMR) of 37.8% between 2000 and 2017, 66% of the 295 000 maternal deaths reported globally occurred in sub-Saharan Africa. The African Region is also noted to have an extremely high MMR, estimated at 542 per 100000 livebirths, with an average annual rate of reduction of 2.9%.
more
A training package for building capacity of healthcare teams in health facilities for continous quality improvement of maternal and newborn healthcare. The focus is on the care of mothers and newborns at the time of child birth since a large proportion of maternal deaths, newborn deaths and stillbir...ths happen around that time.
The 4-Step POCQI (Point of care Quality Improvement) package includes Coaching manual and Learner manual that present a demystified and simple model of quality improvement at the level of health facilities using local data to identify quality gaps, analyse underlying causes and improve health care practices in their own specific context without much additional resources.
more