Resource Library

The “Transitioning to Midwifery Models of Care: Global Position Paper” is a comprehensive document produced by the World Health Organization (WHO) Department of Maternal, Newborn, Child and Adolescent health and ageing, under the Strategic Technical Advisory Group of Experts for Maternal, Newborn, Child and Adolescent health and nutrition (STAGE), in collaboration with WHO technical departments, regional offices and numerous stakeholders.

In the pursuit of providing high-quality health services to improve health and well-being for all in the context of Universal Health Coverage, transitioning to midwifery models of care represents a cost-effective strategy to optimize outcomes for women and newborns with minimal use of unnecessary interventions. This position paper offers an international definition, describes the guiding principles of midwifery models of care and reviews the advantages of adopting these models of care. It highlights the significant role and impact that midwives can have within health systems, while recognizing the importance of collaborative and integrated care where various professionals jointly contribute to providing high-quality maternal and newborn health services.

Overview

The purpose of the Maternal, newborn, child, adolescent health, and ageing and quality of care indicator metadata toolkit: Indicator validation guide is to provide Maternal Newborn Child and Adolescent and Healthy Ageing programme managers with information to understand the basic concepts of indicator validation.

This document provides some examples of methods for research on indicator validation and testing. It also includes recommendations on the following:

• Providing information on defining, designing and conducting indicator validation studies for MNCAH and healthy ageing populations, as well as QoC indicators for these groups.
• Offering instructions on interpreting and applying available evidence to evaluate whether given indicators meet desired standards of validity.
• Highlighting the importance and value of assessing the validity of different types of indicators specific to MNCAH, healthy ageing and quality of care.
• Offering specific recommendations on methods for conducting indicator validation studies.

This document is part of Maternal, newborn, child, adolescent health and ageing and quality of care indicator metadata toolkit that has been developed to facilitate monitoring at various levels and can be found here https://platform.who.int/data/maternal-newborn-child-adolescent-ageing/indicator-toolkit/adolescent-health-indicators.  The toolkit includes functionality to search for metadata information for priority indicators.

This guide aims to equip USAID Missions and partners with tools to monitor and evaluate programs that enhance person-centered care across the sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) spectrum in low- and middle-income countries, ensuring that the perspectives of clients and caretakers are central to these efforts. The guide compiles measures that can be used to track client-reported experiences of care (EOC) in facility- and community-based health service delivery settings across the spectrum of SRMNCAH, including family planning, HIV, sexually transmitted infections, and care of the sick child. It compiles measures of self-reported data on EOC for the client and caretaker (for newborns and children). 

AMDD’s Staha project systematically studies the types, prevalence, and root causes of disrespectful and abusive maternity care experiences and interventions to reduce D&A practices. Their website includes links to tools used in AMDD’s first study of disrespect and abuse (D&A) of women during facility birth. The tools have since been applied to research into the prevalence of D&A in other contexts.

This editorial highlights the alarming rates of maternal mortality in the country, emphasizing the urgent need for comprehensive reforms to improve healthcare access and quality for women.

Overview

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 segments 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.

The World Health Organization (WHO) and the UN’s Special Programme on Human Reproduction (HRP) launched a series on maternal and newborn care for a positive postnatal care experience in BMJ Global Health with six articles presenting evidence on the importance of understanding women’s, parents’, and health workers’ perspectives and rights-based approach to strengthen quality postnatal care, for every woman and newborn, everywhere.

The Healthy Newborn Network (HNN) is an online community dedicated to addressing critical knowledge gaps in newborn health. HNN brings together partner organizations and individuals working in newborn health to share key resources, data, experiences, and lessons and helps increase global commitment to the advancement of newborn health. It also provides a platform for stakeholders to engage in discussions and working group activities on the vast range of newborn and maternal health topics.

NEST360 is an international alliance united to end preventable newborn deaths in African hospitals. The alliance works to deliver a package of technologies and services that enable local governments to save newborn lives, improve newborn outcomes, and empower the medical workforce for the future. There are a number of resources available to support clinicians, engineers and administrators to implement an evidence-based model for sustainable, high-quality hospital-based newborn care in limited resource settings, including clinical and technical resources, technology resources, implementation resources, and COVID-19 related resources.

Bohren et al’s opinion piece in The Lancet series emphasizes the critical need to address the complex interplay of gender power dynamics and systemic inequities in maternal health. By employing an intersectional approach, the researchers highlight how factors such as racism, ethnic discrimination, and gendered power relations intersect to exacerbate health disparities. The study advocates for a shift from merely assessing healthcare coverage and usage to focusing on the quality of care, dignity, and justice experienced by women. It underscores the importance of integrating equity-informed interventions and policies that recognize and address these intersecting forms of oppression. The authors call for comprehensive strategies that not only improve maternal health outcomes but also promote social justice and equity, ensuring that all women receive respectful and high-quality care during childbirth.

The Modular Health Facility Assessment (HFA) and user guide provide the MOMENTUM suite of awards with a tool focusing on reproductive, maternal, newborn, child and adolescent health/family planning care and services, including seven modules that collect information on the following: service availability; service readiness; quality and safety of patient care; experience of care; availability of register; community services and mobilization; health facility oversight; quality improvement; and use of data.

Highlights

• The MOMENTUM Modular HFA draws from a number of existing tools, including those developed by MOMENTUM awards, and informs most of the quality of care indicators included in the MOMENTUM Measurement, Evaluation, and Learning (MEL) Framework.
• Guidance for how to construct these indicators is included in the HFA User Guide.
• The tool also includes new maternal health clinical vignettes (French version available) developed by MKA, a section focusing on readiness to provide services for small and sick newborn care as well as additional sections on nutrition, adolescent health and others.

How to Use

The assessment tool is designed to collect relevant information at various levels of health facilities, from community health centers to tertiary or national level referral hospitals. The tool is designed in a modular manner, which allows flexibility and adaptability to different country contexts to relate to the needs of the country and the specificities of its health system.

Summary

Implementation of KMC is central to achievement of the SDGs for the survival, health and well-being of preterm or LBW infants, both well and sick, through its successful scale-up at all levels of facility care and in the community. Based on the new evidence on successful scale-up of KMC in programmatic settings from several countries, complemented by the joint wisdom and experience of global stakeholders, this implementation strategy is intended to guide the way forward for universal coverage of KMC for all preterm or LBW infants, both well and sick. This implementation strategy is meant to inspire a renewed vision in which mothers and infants are kept and cared for together from birth, and where parents and families play a central role in the care of their infants, thus humanizing health care.

Highlights

Achieving KMC implementation at scale requires:

• A system-wide perspective and structural changes to place mothers and infants at the center of care by keeping and caring for them together after birth
• A commitment by political and program leadership to implement KMC as the foundation of small and/or sick newborn care
• A dedicated budget for implementing KMC as part of small and/or sick newborn care in national maternal, newborn and child health programs
• Developing and implementing a monitoring and evaluation framework to track progress.

How to Use

KMC has been shown to be an essential intervention superior to standard radiant warmer/incubator care in all settings. All countries, irrespective of their income setting and resource availability, should adapt this strategy to their health system contexts to realize the full impact of KMC in improving the survival, health and well-being of mothers and preterm or LBW infants alike.