Resource Library

This framework is for improving the quality of care for mothers and newborns around the time of childbirth, developed by WHO and released in 2016, encompasses both the provision and experience of care. It contains eight domains of quality of care that should be assessed, improved and monitored within the context of the health system building blocks. 

This report reviews the data elements related to maternal and newborn health (MNH) present in the health management and information (HMIS) systems in 24 low- and lower middle-income countries. The review’s purpose is to quantify the extent to which key data elements are available in the antenatal, delivery and postpartum registers and associated summary reporting of the 24 USAID priority countries for MNH. These findings have been used and will continue to be used to inform the development of global indicators and the revision of national HMIS systems.

This interim guidance from UNFPA, supports a 3-pronged approach to the COVID-19 pandemic within maternity care settings: 1) protect maternity care providers and the maternal health workforce, 2) provide safe and effective maternity care to women, and 3) maintain and protect health systems.

Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centered response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanized birth that prioritizes the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in an already strained health system. 

This article explores the contextual factors influencing maternal, neonatal, and child health (MNCH) in Bangladesh, Nigeria, and South African amidst the COVID-19 pandemic. It suggests a four-point contextualised mitigation plan to safeguard MNCH care during the pandemic using the observed countries as exemplars for low- and middle income country health system adaptations to maintain the trajectory of progress regarding the Sustainable Development Goals.

The harmonized health facility assessment (HHFA) represents a resource package for conducting standardized health facility surveys. The HHFA enables a comprehensive, external review of the availability of health facility services, the systems that facilities have in place to deliver services at required standards of quality, and the effectiveness of the services. Availability, quality and effectiveness of health services are integral to universal health coverage (UHC) and contribute to achieving the Sustainable Development Goals (SDGs). HHFA data can support health sector reviews, planning and policy-making, and enable evidence-based decision-making for strengthening country health services.

The HHFA builds upon the USAID/WHO Service Availability and Readiness Assessment (SARA) and incorporates components of other key global health facility surveys and indicator lists. It is based on global service standards and uses standardized indicators, questionnaires and data collection methodologies. Standardization of indicators and data collection promotes alignment of health facility survey approaches and enables comparability of results over time and across geographic areas.

PATH is cataloging and analyzing the policies that governments in low- and middle- income countries are making to adapt and maintain essential health services during the COVID-19 pandemic.

This module describes a core set of indicators for Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) that can be captured through routine health management information systems (HMIS). It includes possible analyses and visualizations of the indicators, references on how to assess the quality of the data, and considerations for using the data for decision-making. By the end of this module, participants will be able to:
1. Describe the core set of HMIS indicators for routine monitoring of RMNCAH programmes;
2. Conduct basic analyses and data visualizations of these indicators to help monitor RMNCAH programmes;
3. Interpret the indicator values and their implications for RMNCAH programme management.

Pregnancy is a time of great anticipation for all expectant parents and their families as they envision getting to know and love a healthy baby. The presence of a long-desired baby in a woman’s womb is accompanied by thoughts and dreams about what the child will look like and how his or her future will be.

Experiencing a stillbirth or the death of a baby in the final stages of pregnancy, during labour or soon after delivery is a silent tragedy for mothers, fathers and families globally. The day of birth is potentially the most dangerous day for both mothers and their babies. Significant reductions have been made in neonatal mortality during the last two decades, but there are still an estimated 2.7 million neonatal deaths and 2.6 million stillbirths every year. Most of these losses are preventable with high-quality, evidence-based interventions delivered before and during pregnancy, during labour and childbirth, and in the crucial hours and days after birth.

Countries are increasingly collecting data that will enable the burden of stillbirths and newborn deaths to be more accurately estimated. Yet in most countries, especially where the estimated burden is the highest, there is a need to strengthen the civil registration and vital statistics (CRVS) systems for counting all births and deaths and assigning cause of death. Most stillbirths and half of all neonatal deaths do not receive a birth certificate and are not registered. Improving systems for reporting births and neonatal deaths is a matter of human rights and a prerequisite for reducing stillbirths and neonatal mortality.

By counting the number of stillbirths and neonatal deaths, gathering information on where and why these deaths occurred and also by trying to understand the underlying contributing causes and avoidable factors, health-care providers, programme managers, administrators and policy-makers can help to prevent future deaths and grief for parents, and improve the quality of care provided throughout the health system. This guide shows the way forward for health-care facilities or whole countries to introduce a system to address the burden of stillbirths and neonatal deaths. Similar to the maternal death surveillance and response (MDSR) approach to ending preventable maternal mortality, this guide and related tools provide support for identifying cases, collecting information and analysing the data collected to recommend solutions to improve the quality of care and to implement the changes within a continuous evaluation and response cycle.

This guide does not suggest setting up a new system, but building on systems already in place. The approach is in line with two of the five objectives outlined in the Every Newborn Action Plan (ENAP): Strategic Objective 2 – Improve the quality of maternal and newborn care; and Strategic Objective 5 – Count every newborn through measurement, programme tracking and accountability to generate data for decision-making and action.

Global health researchers know that investing in maternal, neonatal, and child health (MNCH) is not just a moral good. At The Lancet Global Health, we often see work that shows both the fantastic value for money that these investments represent, and their substantial, often intergenerational, impacts. As such, the Venice Forum on “Why investing in MNCH is critical for sustainable recovery after COVID-19”—comprising online talks from and discussions among thought leaders from multilateral and non-governmental organisations, universities, and more—over March 22–24, 2021, might seem to be preaching to the choir. However, the Forum also delved into more complex questions around MNCH investment. Why do we struggle to get funding? How could we spend more efficiently? And how can we persuade those with money to spend that MNCH is a worthwhile target? We heard some illuminating perspectives. —More–

We present a set of indicators that could be used to measure the effects of programs on RMC. Integrating these indicators into programs to improve quality of care and other health system outcomes will facilitate routine monitoring and accountability around experience of care.

This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.