Maternal & Child Health

New Pardigm Old Thinking: the Case for Emergency Obstetric Care in the Prevention of Maternal Mortality in Nigeria

This study assessed the knowledge of maternity unit operatives at the primary and secondary levels of care about the concept of emergency obstetric care and investigated the contents of antenatal care counseling services they delivered to clients. It also described the operatives’ preferred strategies and practices for promoting safe motherhood and averting maternal mortality in south-west Nigeria. [from abstract]

Can Developing Countries Achieve Adequate Improvements in Child Health Outcomes without Engaging the Private Sector?

This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector’s influence on child health outcomes. [from abstract]

Uganda Registers Successes with Child-Health Volunteers

Thanks to a small cadre of village volunteers, trained in basic health-care concepts, western Uganda is beginning to see some promising improvements in child health. [from author]

Role of Community Health Workers in Improving Child Health Programmes in Mali

In rural settings, the promotion of household and community health practices through community health workers (CHWs) is among the key strategies to improve child health. The objective of this study was to assess the performance of CHWs in the promotion of basic child health services in rural Mali. [from abstract]

Use of Traditional and Complementary Health Practices in Prenatal, Delivery and Postnatal Care in the Context of HIV Transmission from Mother to Child (PMTCT) in the Eastern Cape, South Africa

The aim of this study was to provide a baseline assessment in PMTCT in the traditional health sector to determine the views of women who have used the services of traditional practitioners before, during and/or after pregnancy; and to conduct formative research with traditional health practitioners (THPs), i.e. herbalists, diviners and traditional birth attendants on HIV, pregnancy care, delivery and infant care. [adapted from abstract]

Role of Nurses and Midwives in Polio Eradication and Measles Control Activities: a Survey in Suday and Zambia

We conducted a survey among nurses and midwives working at district level in Sudan and Zambia to determine their roles and functions in polio eradication and measles elimination programs. [from abstract]

Methods for Evaluating Effectiveness and Cost-Effectiveness of a Skilled Care Initiative in Rural Burkino Faso

This paper aims to describe the design, methods and approaches used to assess the effectiveness and cost-effectiveness of the skilled care initiative in reducing pregnancy-related and perinatal mortality in Ouargaye district, Burkina Faso. [from summary]

Effects of a Skilled Care Initiative on Pregnancy-Related Mortality in Rural Burkina Faso

The aim of this paper is to assess to what extent a skilled care initiative was associated with pregnancy-related mortality in Ouargaye district, Burkina Faso. [from summary]

Task Shifting for Emergency Obstetric Surgery in District Hospitals in Senegal

This article discusses the issues facing the district training program for emergency obstetric surgery teams in Senegal. [adapted from abstract]

Community-Based Skilled Birth Attendants in Bangladesh: Attending Deliveries at Home

A program to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh Bangladesh in 2004. This article suggests that the task-shifting program can only serve as an interim measure rather than a long-term solution as more women decide to seek institutional delivery and professional midwifery care. [adapted from abstract]

Provision of Anesthesia Services for Emergency Obstetric Care Through Task Shifting in South Asia

This paper provides a literature review and documents existing programmes for task shifting anaesthesia services to mid-level providers in South Asia to increase access to emergency obstetric care and reduce maternal mortality. [adapted from abstract]

Public-Sector Maternal Health Programs and Services for Rural Bangladesh

This paper assesses the development of maternal health services and policies in Bangladesh by reviewing policy and strategy documents since the country's independence in 1971, with primary focus on rural areas where three-fourths of the total population of reside. [adapted from abstract]

Improving Obstetric Care in Low-Resource Settings: Implementation of Facility-Based Maternal Death Reviews in Five Pilot Hospitals in Senegal

In resource-poor settings, the facility-based maternal death review or audit is one of the most promising strategies to improve health service performance. We aim to explore and describe health workers’ perceptions of facility-based maternal death reviews and to identify barriers to and facilitators of the implementation of this approach in pilot health facilities of Senegal. [from abstract]

Traditional Healers and Pediatric Care

This article discusses the role of traditional healers in pediatric care in South Africa. [adapted from introduction]

Building Capacity to Save Women's Lives in Mali

The Capacity Project partnered with the Ministry of Health and other organizations to perform a pilot study to demonstrate the efficiency and the safety of matrones using active management of the third stage of labor with skilled birth attendants who were authorized to perform the practice and assessed factors that could affect their ability. [from author]

Traditional Birth Attendants in Rural Nepal: Knowledge, Attitudes and Practices about Maternal and Newborn Health

Efforts to formalize the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. Continued attendance by TBAs at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. [adapted from abstract]

Experiences of Districts in Implementing a National Incentive Programme to Promote Safe Delivery in Nepal

Nepal’s Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the intention of increasing utilisation of professional care at childbirth. It provided cash to women giving birth in a health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We explored early implementation of the programme at the district-level to understand the factors that have contributed to its low uptake. [from abstract]

Health Service Planning and Policy-Making: a Toolkit for Nurses and Midwives

The purpose of this toolkit, consisting of 7 booklets, is to provide nurses and midwives with tools to effectively participate in and influence health care planning and policy-making. This tool-kit has been designed for use by any nurse or midwife who has an interest in advocating for change in their work environment. [from publisher]

WHO Guidelines for Implementing Strategic Directions for Strengthening Nursing and Midwifery Services in the African Region 2007-2017

The regional guidelines for implementing the SDNM in the African Region are to accelerate action at country level. The guidelines also provide both a framework for WHO action to support countries in improving the quality of nursing and midwifery services, and a guide for action at national and local levels. Possible priority actions have been proposed to countries to facilitate strengthening of nursing and midwifery services at national and local levels. [from foreword]

Potential Role of Traditional Birth Attendants in Neonatal Healthcare in Rural Southern Nepal

The potential for traditional birth attendants (TBAs) to improve neonatal health outcomes has largely been overlooked during the current debate regarding the role of TBAs in improving maternal health. Randomly selected TBAs were interviewed to gain a more thorough understanding of their knowledge, attitudes, and practices regarding maternal and newborn care. [from abstract]

Systematic Review of Effect of Community-Level Interventions to Reduce Maternal Mortality

The objective was to provide a systematic review of the effectiveness of community-level interventions to reduce maternal mortality. Selection criteria were maternity or childbearing age women, comparative study designs with concurrent controls, community-level interventions and maternal death as an outcome. [from abstract]

Cost-Effectiveness Study of Caesarean-Section Deliveries by Clinical Officers, General Practitioners and Obstetricians in Burkina Faso

This paper evaluates the effectiveness and cost-effectiveness of alternative training strategies for increasing access to emergency obstetric care in Burkina Faso. [adapted from abstract]

Men's Partnership in Maternal Health (Tajikistan)

This video resource details the social, economic and health care services disparities between urban and rural areas of Tajikistan and how women there struggle with their health and the role of men, or the lack thereof, in supporting them. [adapted from synopsis]

Helping Cambodians Plan Their Families

This video resource shows how midwives and community volunteers are helping more Cambodian women to increase the time between births, thereby contributing to healthier pregnancies, infants and families as well as to a better chance of escaping poverty. [adapted from synopsis]

Implementing IMCI in Kenya: Challenges and Recommendations

This policy brief explores the major challenges facing Kenya in the implementation of their Integrated Management of Childhood Illness strategy and looks at why it is failing to fulfill its potential to improve health care and reduce child mortality. [adapted from introduction]

Strengthening Nursing and Midwifery Services in National Health Systems

This report discusses ways and means of improving the capacities of nurses and midwives and building consensus on a regional agenda to strengthen the contribution of nursing and midwifery services to rapidly scale up health services delivery and health outcomes in the African region. [adapted from introduction]

Implementation of Integrated Management of Childhood Illness in Tanzania: Success and Challenges

Tanzania is implementing the Integrated Management of Childhood Illness (IMCI), developed by the WHO and UNICEF to improve the management of child health at the primary care level in order to reduce child mortality in low and middle income countries. Workers in health facilities are trained in a structured IMCI case management course. IMCI also advocates the strengthening of the health system to facilitate practice of the skills acquired by health workers, as well as calling for improvement of household and community practices related to child health. [from executive summary]

Bangladesh Trains Health Workers to Reduce Maternal Mortality

Medical doctors and nurses in Bangladesh are concentrated in urban secondary and tertiary hospitals, while 70% of the population lives in rural areas. This situation has created a major challenge for the national health system, particularly for reducing the high maternal mortality rate, with fewer than 20% of births being attended by a skilled birth attendant. The Declaration of Safe Motherhood was desgined to address this issue, supportetd by a number of national programs and strategies. [from summary]

Who's Got the Power? Transforming Health Systems for Women and Children

This report assesses progress on the Millennium Development Goals 4 and 5 on child mortality and maternal health and proposes best strategies for reaching them. Chapeter 3 (p.81) discusses the impact of skilled attendance and emergency obstetric care on maternal and child survival rates, and chapter 4 (p.119) outlines the broader importance of health workforce management to maternal and child health. [adapted from author]

Leveraging Human Capital to Reduce Maternal Mortality in India: Enhanced Public Health System or Public-Private Partnership

This paper will use India as a lens to examine the broader issues surrounding human resources and public health. It will explore some of the HR strategies employed in a variety of settings with mixed results. Finally, it will look at several very contrasting approaches employed by two Indian states, Tamil Nadu and Gujarat, in dealing with human resource shortages as they struggle to reduce maternal mortality. [from author]