Healthy Mother, Healthy Newborn: An Interconnected Continuum

Journal of Maternal-Fetal and Neonatal Medicine, 2013

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.

2001

The causes of stillbirths are inseparable from the causes of maternal and neonatal deaths. This report focuses on prevention of stillbirths by scale-up of care for mothers and babies at the health-system level, with consideration for eff ects and cost. In countries with high mortality rates, emergency obstetric care has the greatest eff ect on maternal and neonatal deaths, and on stillbirths. Syphilis detection and treatment is of moderate eff ect but of lower cost and is highly feasible. Advanced antenatal care, including induction for post-term pregnancies, and detection and management of hypertensive disease, fetal growth restriction, and gestational diabetes, will further reduce mortality, but at higher cost. These interventions are best packaged and provided through linked service delivery methods tailored to suit existing health-care systems. If 99% coverage is reached in 68 priority countries by 2015, up to 1•1 million (45%) third-trimester stillbirths, 201 000 (54%) maternal deaths, and 1•4 million (43%) neonatal deaths could be saved per year at an additional total cost of US$10•9 billion or $2•32 per person, which is in the range of $0•96-2•32 for other ingredients-based intervention packages with only recurrent costs.

IJSR, 2020

Health is a foundational investment in human capital and economic growth without which children are unable to go to school and adults can't be productive. Over 500 million people do not have access to a dependable health facility for quick diagnosis of disease and its proper treatment. Around 800 women die each day due to complications during pregnancy and childbirth. Every day, 16,000 children under the age of 5 die from mainly preventable or treatable causes; that is 5.9 million children a year. Close to half of these under-5 deaths occur within the first month of life. One million children die on the day they are born, 2 million within the first week. Many lives can be saved with packages for maternal preventive care and childcare, packages for newborn resuscitation and care, and packages related to community-based case detection and management. The effect of several intervention packages is considerably enhanced by innovations for scaling up coverage. Most innovations relate to low-cost interventions and diagnostic tools in the hands of health workers and to communication and information-technology platforms. The integration of new maternal and child health interventions with existing programs for maternal, newborn, and child health is critical. Health insurance is emerging as an important financing mechanism to meet the health care needs of the poor and disadvantaged. by managing risks, those who have micro-insurance policies are in a better position to protect the meagre wealth they accumulate and generate more income to look after their families. Community-based insurance is widely acknowledged an appropriate way of reaching the outreach. There is a strong need to strengthen public health system to ensure access to quality care at an affordable cost. Disease prevention and health promotion are critical to success of any secondary and tertiary care facility. Countries must consider establishing a National Health Service will go a long way to provide accessible, affordable, cost-effective, quality care to most, if not all, the population.

Disease Control Priorities, Third Edition (Volume 2): Reproductive, Maternal, Newborn, and Child Health, 2016

Best Practice & Research Clinical Obstetrics & Gynaecology, 2016

Despite the impressive progress gains for maternal and child health during the Millennium Development Goals era, over 5.6 million women and babies died in 2015 due to complications during pregnancy, birth and in the first month of life. In order to achieve the new mortality targets set out in the Sustainable Development Goals, there needs to be intentional efforts to maintain and accelerate efforts to end preventable maternal and newborn deaths and stillbirths. This paper outlines what progress is required to meet these new 2030 targets based on patters of progress in the recent past; where the burden is the greatest; when to focus attention along the continuum of care; and what causes of death require concerted efforts. Priority actions include intentional and intensified political attention and investment in maternalnewborn health with particular focus on improving quality and experience of care around the time of birth with implementation at scale of integrated maternal-newborn health interventions across the continuum of care with commensurate investment targeted at the most vulnerable populations. Looking forward, improved data for decision making and accountability will required. The health and survival of babies and their mothers are inextricably linked, and calls for coordinated efforts and innovation before and during pregnancy, in childbirth, and postnatally, in order to end preventable maternal, neonatal deaths and stillbirths.

2001

2009

Background: Care during pregnancy and labour is of great importance in every culture. Studies show that people of migrant origin have barriers to obtaining accessible and good quality care compared to people in the host society. The aim of this study is to compare the access to and use of maternity services, and their outcomes among ethnic minority women having a singleton birth in Finland.

Journal of Public Health and Emergency

2014

Objective To quantify maternal, fetal and neonatal mortality in low-and middle-income countries, to identify when deaths occur and to identify relationships between maternal deaths and stillbirths and neonatal deaths. Methods A prospective study of pregnancy outcomes was performed in 106 communities at seven sites in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. Pregnant women were enrolled and followed until six weeks postpartum. Findings Between 2010 and 2012, 214 070 of 220 235 enrolled women (97.2%) completed follow-up. The maternal mortality ratio was 168 per 100 000 live births, ranging from 69 per 100 000 in Argentina to 316 per 100 000 in Pakistan. Overall, 29% (98/336) of maternal deaths occurred around the time of delivery: most were attributed to haemorrhage (86/336), pre-eclampsia or eclampsia (55/336) or sepsis (39/336). Around 70% (4349/6213) of stillbirths were probably intrapartum; 34% (1804/5230) of neonates died on the day of delivery and 14% (755/5230) died the day after. Stillbirths were more common in women who died than in those alive six weeks postpartum (risk ratio, RR: 9.48; 95% confidence interval, CI: 7.97-11.27), as were perinatal deaths (RR: 4.30; 95% CI: 3.26-5.67) and 7-day (RR: 3.94; 95% CI: 2.74-5.65) and 28-day neonatal deaths (RR: 7.36; 95% CI: 5.54-9.77). Conclusion Most maternal, fetal and neonatal deaths occurred at or around delivery and were attributed to preventable causes. Maternal death increased the risk of perinatal and neonatal death. Improving obstetric and neonatal care around the time of birth offers the greatest chance of reducing mortality.

International Journal of Gynecology & Obstetrics, 2009