Maternal, Newborn, and Child Health
- Exclusive breastfeeding: aligning the indicator with the goal
While the global objective is exclusive breastfeeding (EBF) for a full 6 months duration, the standard indicator is a “prevalence” indicator, that is, the percentage of all children under age 6 months who are exclusively breastfed at a point in time. That yields a higher percentage than a more direct indicator of duration and can be easily misunderstood, exaggerating the amount of EBF. A measurement of actual percentage of children exclusively breastfeeding for a full 6 months can be easily calculated from standard DHS and MICS data.
- The quality–coverage gap in antenatal care: toward better measurement of effective coverage
The proportion of pregnant women receiving 4 or more antenatal care (ANC) visits has no necessary relationship with the actual content of those visits. We propose a simple alternative to measure program performance that aggregates key services that are common across countries and measured in Demographic and Health Surveys, such as blood pressure measurement, tetanus toxoid vaccination, first ANC visit before 4 months gestation, urine testing, counseling about pregnancy danger signs, and iron–folate supplementation.
- Rising cesarean deliveries among apparently low-risk mothers at university teaching hospitals in Jordan: analysis of population survey data, 2002–2012
Cesarean deliveries nationally in Jordan have increased to 30%, including substantial increases among births that are likely low risk for cesarean delivery for the most part. This level is double the threshold that WHO considers reasonable.
- It's about time: WHO and partners release programming strategies for postpartum family planning
The postpartum period is a critical time to address high unmet family planning need and to reduce the risks of closely spaced pregnancies. Practical tools are included in the new resource for integrating postpartum family planning at points when women have frequent health system contact, including during antenatal care, labor and delivery, postnatal care, immunization, and child health care.
- Moving malaria in pregnancy programs from neglect to priority: experience from Malawi, Senegal, and Zambia
Program areas that were generally working well in malaria in pregnancy programs (MIP) included: (1) integration of MIP interventions into antenatal care; (2) development of up-to-date policies; (3) active involvement of communities; and (4) development of capacity-building materials for training. Challenges remain in the areas of: (1) commodities; (2) quality assurance; (3) monitoring and evaluation; and (4) financing.
- Understanding where parents take their sick children and why it matters: a multi-country analysis
To effectively reach children with potentially life-threatening illness with needed treatment, it is important to understand where parents seek care. Data from 42 DHS and MICS surveys conducted since 2005 show that a majority of care in Africa is sought from the public sector; in South Asia, from the private sector; and in Southeast Asia, from a public-private mix. We recommend that such data be made available in standard DHS and MICS reports.
- Dedicated inserter facilitates immediate postpartum IUD insertion
A specially designed inserter aims at facilitating IUD insertion within 10 minutes to 48 hours after delivery during the postpartum period when demand for, and health benefits of, contraception are high.
- Making the most of food aid to help prevent child and maternal deaths
Advances in child nutrition over the last several decades are creating momentum for a programmatic push to reduce undernutrition worldwide. The contribution of food aid may be small, but, nonetheless, U.S. food aid policy should be revamped to benefit more effectively and more efficiently the children and mothers in need.
- Achieving better maternal and newborn outcomes: coherent strategy and pragmatic, tailored implementation
Maternal and newborn health program effort needs to: shift from mere contact to the actual content or substance of care; respond better to local context; ensure delivery of all key interventions needed during pregnancy, labor and delivery, and postnatally; and actively monitor performance to manage and improve programs.
- Forest cover associated with improved child health and nutrition: evidence from the Malawi Demographic and Health Survey and satellite data
In Malawi, net forest cover loss over time is associated with reduced dietary diversity and consumption of vitamin A-rich foods among children. Greater forest cover is associated with reduced risk of diarrheal disease. These preliminary findings suggest that protection of natural ecosystems could play an important role in improving health outcomes.