The interconnections between maternal and newborn health – evidence and implications for policy

Abstract

The past decade has witnessed increasing global attention and political support for maternal, newborn and child health. Despite this increased attention, actual progress has been slow and sporadic: coverage of key maternal and newborn health interventions remains low and there are wide disparities in access to care, within and across countries. Strategies for improving maternal and newborn health are closely linked, and can be delivered most effectively through a continuum of care approach. While these interventions are largely known, there is little information on which interventions have a positive health impact for both women and newborns. This supplement identifies the interventions during the preconception, pregnancy, intrapartum and postnatal periods found to have a positive, synergistic effect on maternal and neonatal outcomes. These interventions are then grouped into packages of care for delivery at the community, health center or hospital levels.

A prospective study of maternal, fetal and neonatal deaths in low- and middle-income countries

“…Previous research has suggested that infants who have lost their mothers have significantly higher risks of death and disease well into childhood and that maternal death also has an adverse effect on other siblings and on the extended family. 15,[28][29][30]32,33 Our study is a prospective, international, population-based research to assess the relationship between maternal and perinatal deaths. This study has several strengths.…”

Characteristics and mortality of neonates in an emergency obstetric and neonatal care facility, rural Burundi

“…It may have resulted from the high proportion (24%) of women with prolonged or obstructed labour, as many of these neonates may have suffered from prolonged asphyxia in utero, complicating effective resuscitation. Referral delays may also be implicated, 26,27 as 70% of all women delivering at CURGO were out-of-district referrals. However, extant evidence suggests that delays in the ambulance networks were minimal.…”

“…While caesarean sections for breech improve perinatal mortality, 27 only 69% of neonates in breech position were delivered by caesarean section. Birth resuscitation may also not have been performed effectively or in a timely fashion in all cases.…”

A Review of Initiatives that Link Provider Payment with Quality Measurement of Maternal Health Services in Low- and Middle-Income Countries

“…1 Maternal morbidities such as anemia, fistula, uterine rupture and scarring, and genital and uterine prolapse also represent significant global burdens. 2 To reduce maternal and newborn morbidity and mortality, high coverage of maternal health interventions needs to be matched with overall improvements in quality of maternal health care. Health facilities and their staff play a key role in this effort.…”