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MHTF Quarterly, Issue 5: Integration of Maternal and Newborn Health Care

 

The MHTF Quarterly shares resources, research and news in key maternal health areas.  Our focus here is on antenatal and postnatal care for improving maternal and newborn health.

From biological, genetic, cultural, and social perspectives, maternal and newborn health are inextricably linked. Pregnant women and mothers are critical to a newborn’s growth, social development, survival, and health and wellbeing throughout their childhood. Indeed, interventions to improve health during a girl’s adolescence—as well as preconception, pregnancy, labor and delivery, and the postnatal period—have positive effects on the health of both mothers and their newborns. Despite many shared goals, a persistent divide exists between the maternal and newborn health communities, at the expense of health system effectiveness and, most importantly, the health outcomes of the mothers and newborns they serve. Too often, maternal and newborn health programs, services, training schemes, monitoring and evaluation, and quality improvement systems are funded, planned, managed, and delivered separately. In addition to a myriad of barriers, there are also many opportunities to smartly integrate care that position both maternal and neonatal health outcomes at the center of clinical, administrative, and policy-related decision-making.
 
Those who favor an “integrated” approach to maternal and newborn health believe that greater coordination and unity between stakeholders at the global and national levels and at points of care is required to ensure that mothers and newborns have equitable access to the highest quality of care. An integrated approach at the policy level is key for change at all other levels, yet this type of coordination has not been achieved in most policies to date, failing to measure newborn indicators and leaving the newborn health as an orphan target. With the Sustainable Development Goals around the corner, there are new opportunities for the maternal and newborn health communities to establish a cohesive set of targets and articulate mutually acceptable strategies for achieving them. These strategies should be clearly linked to maternal and newborn health outcomes and indicators, be readily adaptable to fitting different contexts’ barriers and opportunities for care provision, including the financial realities of integration on the ground, and be planned around established platforms, such as antenatal care visits.

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Featured Resources


Integration of Maternal and Newborn Health Care: In pursuit of quality Technical Meeting Report
In September 2014, the Maternal Health Task Force and Save the Children’s Saving Newborn Lives program convened maternal and newborn health leaders and technical experts to increase collaboration between the two communities. This report reflects the objectives, themes, and conclusions of this meeting.

Recommended Actions for Integrating Maternal & Newborn Health Care
This list of Recommended Actions establishes global priorities for the effective integration of maternal and newborn health care and clarifies which organizations and projects are working to address them. The list was generated by 60 leaders and technical experts at the Integration of Maternal and Newborn Health Care meeting and is regularly updated to ensure it accurately reflects the organizations that are contributing to each priority item. Is your organization working in any of these areas? Let us know, and we’ll add you!

Browse more technical resources on our Maternal and Newborn Health topic page.

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Resources

  
Ending Preventable Maternal Mortality and Every Newborn Action Plan
These documents represent the latest consensus on post-2015 Sustainable Development Goal targets by the maternal and newborn health communities, respectively. Although each document highlights maternal and newborn health separately, they each describe the critical junction of maternal and newborn health and their intrinsic relationship.
 
MHTF-PLOS Collection on Integrating Health Care to Meet the Needs of the Mother-Infant Pair
This collection of evidence aims to contribute to a better understanding of how and when to comprehensively integrate maternal and infant health care. This includes conditions such as HIV, malaria, exposure to environmental risks, and other situations that have a significant impact on both maternal and newborn health.
 
Essential Interventions, Commodities and Guidelines for Reproductive, Maternal, Newborn and Child Health (RMNCH)
This global review, led by the World Health Organization, Aga Khan University, and the Partnership for Maternal, Newborn & Child Health, compiles existing evidence on the impact of different interventions on the main causes of maternal, newborn, and child deaths. By doing so, authors seek to develop consensus on the content of RMNCH packages of interventions at each level of the health system across the continuum of care, facilitate the scale-up of these interventions, and identify research gaps in the content of core intervention packages.
 
Integrated Management of Pregnancy and Childbirth (IMPAC)
This World Health Organization resource is a package of guidelines and tools which respond to key areas of maternal and perinatal health programs, offering a framework in which integrated policies, programs, and action plans can be elaborated at the national level. Particular attention is paid to health systems, health workers, and health promotion as they related to improving maternal and newborn access to skilled care before, during, and after pregnancy and childbirth.
 
Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes (Review)
This Cochrane review explores a number of community-based models that deliver interventions to improve maternal and newborn health outcomes. The review focused primarily on community health worker training packages and routine newborn care, and finds encouraging evidence for promoting integrated community-based interventions.

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Publications

Check out all the most recent publications on the integration of maternal and newborn health care.
 
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Videos


Performance gaps and the cost of inaction and Integration in pursuit of quality and equity
Participants discuss the negative consequences of disintegrated, vertical care with regards to public and private health systems, programs, and health outcomes. Mariam Claeson, from the Bill & Melinda Gates Foundation, reviews the evidence that supports a continuum of care approach and shares the Gates Foundation model of impact for integrated approaches to maternal and newborn health.
 
Promising approaches to integration of care
Panelists represent a diverse mix of promising approaches for effectively integrating maternal and newborn care in a variety of contexts, including Ecuador, Nigeria, and Zambia. Specific emphasis was placed on the theory of change and evidence base supporting these approaches and the contextual factors that enabled their success in practice.
 
What could integrated care look like? Areas for exploration
Jeff Smith, an OB/GYN from USAID’s flagship Maternal and Child Survival Program, and Rima Jolivet, a midwife from the Maternal Health Task Force, deliver a joint presentation of the opportunities during pregnancy, labor and delivery, and the postnatal period where effectively integrated maternal and newborn health care can improve health outcomes. The presentation is followed by a moderated discussion about implications.
 
Overview of the Integration of Maternal and Newborn Health Care technical meeting
Kathleen Hill reflects on the objectives, themes, and emerging conclusions of the convening, and what should be done to move the integration of maternal and newborn health care agenda forward.
 
More videos on this topic can be found on the MHTF’s Integration of Maternal and Newborn Health Care channel on Vimeo. 

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MHTF blog


A joint blog series by the MHTF and the Healthy Newborn Network follows up on participants’ perspectives about the ideas and knowledge exchanged by the maternal and newborn health communities at the September meeting, and shares examples of integrated approaches by other colleagues working in the field. Contact Katie Millar for more information on contributing to the MHTF Blog.

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More from the MHTF


Twitter

Join @MHTF and our partners in our discussion about the integration of maternal and newborn health care on Twitter, using #MNHIntegration.
 

Maternal and Newborn Health Topic Page

The MHTF’s Topic Page on Maternal and Newborn Health allows you to explore all the best resources on maternal and newborn health, including recent publications, blog posts, and videos.

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Contact us!


The MHTF is always looking for new resources, research, perspectives and news on this important issue. We invite your feedback and any resources you’d like to share! Please contact Katie Millar, kmillar@hsph.harvard.edu, with comments, suggestions and questions.

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Copyright © 2014 Maternal Health Task Force at the Harvard T.H. Chan School of Public Health, All rights reserved.


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