The maternal mortality ratio (MMR) has been identified as one of the most important indicators of overall health status of women in a region, since the majority of maternal deaths (and injuries) are preventable with an adequately-equipped health system. Recent reports from the World Health Organization (WHO) and the Institute for Health Metrics and Evaluation estimate that approximately 800 women die from preventable causes related to pregnancy and childbirth every day, with 99% of these maternal deaths taking place in developing countries. In order to address these preventable causes, high quality care during pregnancy, birth, and postpartum are essential components of the reproductive, maternal, newborn, and child health continuum of care.
For care during pregnancy, the WHO currently recommends a model called Focused Antenatal Care (FANC), which delivers a series of evidence-based interventions, preventative care, and health promotion across four individualized visits. Given the complexities of delivering quality antenatal care (ANC) and the need for continuous evaluation and improvement, the WHO is currently revisiting its ANC guidelines, a process scheduled to complete at the end of 2015. The WHO also recently released similar guidelines which cover care for the mother and newborn after birth, or postnatal care (PNC), but the evidence for these recommendations is quite limited.
A new blog series, the Continuum of Care Series: Providing for Mom and Baby through Antenatal and Postnatal care, with contributions from a variety of settings, aims to highlight successful models for delivering ANC and PNC and explore the factors associated with quality of and access to care. Creating a forum for these topics is especially important since access to care is far from universal: in low-income countries, only 38% of pregnant women attended the recommended four or more ANC visits during 2006-2013. Access to PNC is even more difficult; a study of 23 sub-Saharan African countries found that two-thirds of women give birth at home, with just 13% of those women receive PNC within two days of birth.
While we have guidelines on the care that should be provided during the antenatal and postnatal periods, the information we have on the care that is actually delivered during these times is inadequate. For example, the most common measure of adequate ANC is whether or not a woman received four or more ANC visits; however, information on how care was delivered and what those visits contained is often not collected. Without this information, it can be difficult to ensure that quality care is delivered—that women receive the interventions and health education they need to lead healthy lives. Through upcoming blog posts, we hope to examine ways to measure quality of ANC and PNC more effectively.
Our goal for the Continuum of Care Series is to increase collaboration in order to explore barriers, challenges, and facilitators of successful ANC and PNC delivery models. This blog series aims to foster a conversation about successful implementation of and ways to address barriers to evidence-based, quality-driven programs, particularly in resource-limited settings. In addition to guest posts, we will highlight several innovative models which were included as part of the Women & Health Initiative’s Adding Content to Contact project.
Questions and topics for potential guest posts:
- Women—What are the needs of pregnant women and new mothers that need to be considered when designing ANC and PNC programs?
- Providers—What do maternal health care providers need in order to be able to deliver effective, comprehensive ANC and PNC? How can task-shifting be applied to antenatal and postnatal care delivery?
- Care delivery models for antenatal and postnatal care—Which delivery model is used in your facility or health system? What, in your opinion, contributes to the success/challenges related to the model? What is needed to deliver high-quality ANC and PNC?
- Integration—Have you seen ANC and PNC be integrated with other health programs (or with each other) in your region? What have the consequences been, for users and providers? Can services be integrated in a way that benefits both users and providers? How so?
- Health systems—How can ANC and PNC programs be sustainably integrated into and standardized at the health systems level? How can health systems be strengthened to support ANC and PNC programs?
- Measurement—How can quality of ANC and PNC be accurately measured? Which indicators should be included and how should a monitoring and evaluation plan be developed?
You may also feel free to suggest your own topic to our editors.
General guidelines for guest blog posts:
- Please include the author name, title, and photo (optional)
- Goal: Guest posts should raise questions, discuss lessons learned, analyze programs, describe research, offer recommendations, share resources, or offer critical insight.
- Audience: The audience for this series is health and development professionals working in maternal and newborn health around the world, primarily in resource-constrained settings
- Tone: Conversational. Doesn’t need to meet professional publication standards
- Feel free to choose your own style or approach. Q/A as well as lists (eg. top ten lessons) can often be effective ways of organizing blog posts.
- Length: 400-600 words
- No institutional promotion, please
- Please include links to sources such as websites and/or publications
- May also include photos and videos, please include a caption and a credit for the photo
Submissions to this series will be reviewed and accepted on a rolling basis, but preference will be given to posts received by August 11th, 2014.
Posts in this series will be shared on the MHTF blog and may be cross-posted on other leading global health and development blogs.