Maternal, Newborn, and Child Health
- Where Do Caregivers Take Their Sick Children for Care? An Analysis of Care Seeking and Equity in 24 USAID Priority Countries
Understanding whether and where parents take sick children for care is critical to improve child health and survival. Stakeholders should use this information to ensure that resources are programmed effectively and that sectors complement one another to increase equitable access to high quality integrated management approaches for sick child care.
- A Qualitative Comparative Analysis of the Drivers of HIV Status Knowledge in Orphans and Vulnerable Children in Mozambique
We identified combinations of modifiable factors that HIV programs supporting orphans, vulnerable children, and their families may be able to act on to increase the proportion of beneficiaries who know their HIV status.
- It Takes a System: Magnesium Sulfate for Prevention of Eclampsia in a Resource-Limited Community Setting
Magnesium sulfate is not a silver bullet to reduce maternal mortality associated with preeclampsia/eclampsia. We believe a well-functioning health care system, especially at the hospital level, with competent well-trained providers, adequate equipment, and medications will likely be necessary.
- Management of Preeclampsia, Severe Preeclampsia, and Eclampsia at Primary Care Facilities in Bangladesh
Program introduction, including cascade training, to screen for severe preeclampsia and eclampsia and initiate treatment with magnesium sulfate was somewhat successful. Challenges included inconsistent adherence to the national protocol, data quality, and some issues with supplies and equipment.
- Healthy Timing and Spacing of Pregnancy: Reducing Mortality Among Women and Their Children
Accessible, affordable, and high-quality postabortion care (PAC) can prevent maternal death and disability and provides an important opportunity to prevent future unintended pregnancies. This supplement offers learnings on PAC provision from the community of partners around the world, including service delivery and community engagement models, approaches to support facility-based providers, best practices in pre- and post-procedure counseling, and approaches to institutionalize PAC in public- and private-sector health systems.
- Evaluating WHO-Recommended Interventions for Preterm Birth: A Mathematical Model of the Potential Reduction of Preterm Mortality in Sub-Saharan Africa
Using the Maternal and Neonatal Directed Assessment of Technology (MANDATE) model, we estimate that WHO-recommended interventions could have saved nearly 300,000 lives in 2015. Combined interventions had the greatest impact. MANDATE can allow health officials to prioritize implementation strategies.
- Scaling Up Misoprostol to Prevent Postpartum Hemorrhage at Home Births in Mozambique: A Case Study Applying the ExpandNet/WHO Framework
Facilitating factors for this community-level scale up in 35 districts included strong government support, local champions, and a national policy on preventing postpartum hemorrhage (PPH). Challenges included a lack of a systematic scale-up strategy, limited communication of the PPH policy, a shift from a universal distribution policy to application of eligibility criteria, difficulties engaging remote traditional birth attendants, and implementation of a parallel M&E system.
- Saving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and Zambia
The 5-year public-private partnership boldly addressed maternal mortality in Uganda and Zambia using a systems approach at the district level to avoid delays in women seeking, reaching, and receiving timely, quality services. This supplement provides details on the Saving Mothers, Giving Life partnership and approach, including the model, impact, costs, and sustainability.
- The Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and Zambia
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
- Saving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private Partnership
Overall, the Saving Mothers, Giving Life partnership was praised as a successful model for interagency coordination. Key strengths included diversity in partner expertise, high-quality monitoring and evaluation, strong leadership, and country ownership. Uncertainty about partner roles and responsibilities, perceived power inequities between partners, bureaucratic processes, and limited Ministry of Health representation in the governance structure were some challenges that, if addressed by similar public-private partnerships under development, may improve long-term partnership success.