The Opportunity and the Challenge Delivering More for Mothers and Newborns on the Day of Birth Koki Agarwal, M.D. Dr. PH Director Maternal and Child Survival Program / Jhpiego, USA
The Opportunity and the Challenge Delivering More for Mothers and Newborns on the Day of Birth
Koki Agarwal, M.D. Dr. PH Director Maternal and Child Survival Program / Jhpiego, USA
Outline • Why focus on the day of
birth? • Opportunities for
achieving better care on the day of birth
• Challenges for delivering integrated services for mother and newborn
• Aligning with global initiatives
Almost half of all newborn occur on the day of birth
Source: 2005 Lancet Every Newborn Series
When Do Newborn Deaths Occur?
Birth is the Time of Greatest
Risk of Death and Disability
for Mothers and Newborns
Photo Credit: John Healey /ACCESS
40% of all maternal and newborn deaths occur within 24 hours of birth
1.2 million intrapartum stillbirths 1 million neonatal deaths 113,000 maternal deaths
Day of Birth…
Source: Lancet Every Newborn: progress, priorities, and potential beyond survival
The Opportunity: Better Care on the Day of Birth
Pregnancy
• Focused ANC • IPTp • GBV screening • Immunizations • Messages on danger signs for mother and newborn • Messages on healthy life
conditions • Emergency & delivery plans • FP counseling • Post abortion care • Management of preterm
labor
Day of Birth Infection prevention
Respectful care at birth Effective labor care
AMSTL Immediate newborn care Neonatal resuscitation
Immediate postnatal care Vacuum extraction Early postnatal care Management of PPH Early detection and
management of complications PPFP
Postnatal
• Essential newborn care • Management of newborn and maternal sepsis • KMC • Nutrition messages • FP counseling and services:
IUD & implants • Messages on health life
conditions • Immunizations • Messages on danger signs for
mother and newborn • Emergency plan
Challenges for Achieving: Better Care on the Day of Birth
• Vertical policy, programming, measurement, and funding (e.g. ENAP, EPMM)
• Poor alignment of maternal and newborn interventions
• Compartmentalized provider training/capacity-building strategies
Photo Credit: Karen Kasmauski/MCSP
Bringing the pieces together: Opportunities To Improve Care on the Day of Birth
Better Health Outcomes
ANC PNC Better Care
on the Day of Birth
Commodities
Quality Improvement
Measurement
Capacity- building
Health Systems Strengthening
Maternal and Child Survival Program
(MCSP)
Well Positioned to Strengthen Day of Birth Services for Mothers and
Newborns
FAMILY PLANNING
MATERNAL HEALTH
NEWBORN HEALTH
CHILD HEALTH
IMMUNIZATION
NUTRITION HIV/TB
MALARIA
WASH MCSP
MCSP’s Commitment to Implementing at Scale
• Strengthening local health systems (e.g. district) • Integrated capacity building • Ensuring commodities for mothers and newborns • Continuous measurement of core DoB indicators • Delivery of high-impact maternal & newborn
interventions • Supporting health workers and managers
Photo Credit: Kate Holt/MCSP
Con$nuous quality improvement to achieve effec$ve, safe and people-‐centered care for
mothers, newborns and families around the day of birth
Moving the Needle on the Day of Birth:
MCSP working in 22 of USAID 24 priority countries Commitment to continuous shared learning across countries
Contextual learning from Bangladesh, Pakistan and Tanzania
For more information, please visit www.mcsprogram.org
This presentation was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of the authors and do not
necessarily reflect the views of USAID or the United States Government.
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