FACT SHEET Maternal, Newborn and Child Health Interventions The Reality About 8 million children die each year – greater than the number of adults who will die from AIDS, malaria and tuberculosis combined.1, 2 Approximately 350,000 women die every year as a result of childbirth and 15 million more suffer life-long complications.2, 3 The vast majority of these deaths occur in developing countries and most are preventable.
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Mothers and their children need access to a variety of health services throughout their lifespan. Interventions should be linked across time (pre-pregnancy, pregnancy, childbirth and postpartum) and space (home, community and health facilities) to meet mothers’ and children’s changing needs. Linking interventions can reduce cost and increase uptake; no single intervention alone has the potential to achieve all of the desired outcomes.4 Pre-pregnancy ! Access to family planning helps women time and space their pregnancies. Globally, 818 million women want to avoid or delay pregnancy, but just over 600 million are using modern contraceptives.6 More than half of women with unmet family planning needs live in sub-Saharan Africa and South Central Asia.
Key Interventions for MNCH5
Comprehensive family planning Skilled care during pregnancy and childbirth Safe abortion services, where legal Breastfeeding Improved child nutrition Prevention and treatment of major childhood diseases
Pregnancy ! Routine antenatal care includes the detection of complications, tetanus immunization, micronutrient supplementation, syphilis testing, and counseling on pregnancy and post-pregnancy issues.7 In developing countries, about 75 percent of women access at least one antenatal care visit, but only about 50 percent access all four recommended visits. ! Prevention of mother-to-child transmission of HIV is an essential component of antenatal care, including testing and counseling, and antiretroviral prophylaxis and treatment.8 Birth ! In developing countries, only 62 percent of deliveries are assisted by a skilled birth attendant (SBA), and in five countries this coverage plummets to less than 20 percent.9 SBAs can monitor labor, identify complications for mother and newborn, and provide referrals to a facility. ! Unpredictable complications, including hemorrhage (the leading cause of maternal death), sepsis, and birth asphyxia may arise at the time of birth; about 15 percent of all births will require emergency obstetric care (EmOC).8 Postpartum and Newborn ! Postnatal maternal care includes the prevention and detection of complications, prevention and control of anemia, information and counseling on nutrition, information on family planning and birth spacing, and provision of contraceptive methods. ! Newborn care includes hygienic cord/skin care, thermal care (such as kangaroo care), extra care for low birthweight babies, and community case management for pneumonia. ! Breastfeeding is extremely beneficial to the health and wellness of mothers and their newborns.
Exclusive breastfeeding for the first six months of life, followed by complementary feeding and breastfeeding for up to two years, would save the lives of 1.5 million children.10 Infancy and Childhood ! Developed by WHO and UNICEF in the early 1990s, the Integrated Management of Childhood Illness (IMCI) strategy promotes an integrated approach to child health that includes a range of preventive and curative childhood interventions linked across the household, community and referral levels. ! Immunization is one of the most cost-effective health interventions, especially for reducing child morality. Routine vaccinations against tuberculosis, pneumonia diphtheria, tetanus, pertussis, polio, measles, hepatitis B, and Haemophilus influenzae infections prevent the deaths of 2.5 million children per year.11 Outcomes of Selected MNCH Interventions12 ,QWHUYHQWLRQ 2XWFRPH 7HWDQXV LPPXQL]DWLRQ 5HGXFHV ULVN RI QHRQDWDO WHWDQXV GHDWK E\ SHUFHQW 6FUHHQLQJ IRU SUH HFODPSVLD 5HGXFHV ULVN RI PDWHUQDO GHDWK GXH WR K\SHUWHQVLRQ E\ SHUFHQW UHGXFHV ULVN RI QHRQDWDO GHDWKV GXH WR SUHPDWXULW\ E\ SHUFHQW &DUH GXULQJ FKLOGELUWK 5HGXFH PDWHUQDO PRUWDOLW\ DQG PRUELGLW\ GXH WR ODERU UHODWHG FRPSOLFDWLRQV E\ SHUFHQW UHGXFH DVSK\[LD UHODWHG QHZERUQ GHDWKV E\ SHUFHQW UHGXFH ULVN RI SRVWSDUWXP KHPRUUKDJH E\ SHUFHQW
Challenges ! Access to services does not necessarily guarantee quality of services. Achieving Millennium Development Goals 4 and 5 (to reduce child and maternal health, respectively) will require not only improved coverage rates but also trained health personnel, strong health systems and better quality services. ! Progress in providing maternal, newborn and child health interventions that respond to acute needs, such as EmOC or skilled birth attendance, has been slower than addressing those that can be prearranged, such as antenatal care and immunizations.13 14 ! Economic, social and cultural barriers are additional obstacles for women and children to overcome in order to access health services.6
NOVEMBER 2010
References 1. You D, Jones G, Wardlaw T, United Nations Inter-agency Group for Child Mortality Estimation. Levels & trends in child mortality: estimated developed by the UN Inter-agency Group for Child Mortality Estimation. New York: UNICEF; 2010. 2. Hogan MC, Lopez AD, Lozan R, Murray CJ, Naghavi M, Rajaratnam JK. Building momentum: global progress toward reducing maternal and child mortality. Seattle: Institute for Health Metrics and Evaluation; 2010. 3. WHO, UNICEF, UNFPA, World Bank. Trends in maternal mortality: 1990 to 2008. Geneva; 2010. 4. Kerber KJ, de Graft-Johnson JE, Bhutta ZA, Okong P, Starrs A, Lawn JE. Continuum of care for maternal, newborn, and child health: from slogan to service delivery. Lancet. 2007;370:1358-69. 5. Partnership for Maternal Newborn & Child Health. Consensus for maternal, newborn and child health. [cited April 8, 2010]; Available from: http://www.who.int/pmnch/topics/maternal/consensus_12_09.pdf 6. Singh S, Darroch JE, Ashford LS, Vlassoff M. Adding it up: the costs and benefits of investing in family planning and maternal and newborn health New York: Guttmacher Institute and United Nations Population Fund; 2009. 7. WHO. WHO recommended interventions for improving maternal and newborn health. 2009 [cited August 2010]; Available from: http:// whqlibdoc.who.int/hq/2007/WHO_MPS_07.05_eng.pdf 8. UNICEF. Progress for children: a report card on maternal mortality. New York: UNICEF; 2008. 9. WHO. Proportion of births attended by a skilled health worker: 2008 update; 2008. 10. WHO. 10 facts on breastfeeding. 2009 [cited 23 August 2010]; Available from: http://www.who.int/features/factfiles/breastfeeding/en/ index.html 11. WHO, UNICEF, Bank W. State of the world’s vaccines and immunizations, 3rd ed. Geneva WHO; 2009. 12. WHO. Packages of interventions for family planning, safe abortion care, maternal, newborn and child health. Geneva: WHO, World Bank, UNICEF, UNFPA; 2010. 13. Bhutta ZA, Chopra M, Axelson H, Berman P, Boerma T, Bryce J, et al. Countdown to 2015 decade report (2000-10): taking stock of maternal, newborn and child survival. Lancet. 2010;375:2032-44. 14. Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, Coovadia H, et al. Sub-Saharan Africa’s mothers, newborns, and children: where and why do they die? PLoS Medicine. 2010;7(6).
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