Presentation at the Global Maternal Newborn Health Conference, October 19, 2015
Background: Humanized and respectful maternal and newborn health services are increasingly being recognized as central to quality of health care. The Government of Mozambique has made a systematic investment in quality and humanized health services through the national Model Maternity Initiative (MMI), which was launched in 2009.
Methods: MMI aims to “transform maternities into centers of quality and humanized care and teaching”, using the Standards-Based Management and Recognition quality improvement approach to measure progress in nine clinical and programmatic areas. This process includes the development of standards; dissemination of information on client rights; training and supportive supervision; implementation of respectful maternity care practices; and scaling-up MNH high-impact interventions.
Results: By December 2014, the MMI was implemented in 125 maternities covering about 36% of all country institutional deliveries. Performance on quality standards increased on average across all facilities from 36.6% in 2009 to 67.7% in 2014, and improvements were seen in key indicators of respectful care and high-impact practices that were not the national norm prior to the MMI: women with companion during labor/delivery; women who delivered in vertical/semi-vertical positions; newborns with immediate skin-to-skin contact with the mother ; newborns breastfed within 1 hour after birth; deliveries with partograph completed; deliveries with active management of the 3rd stage of labor; and women with eclampsia treated with Magnesium Sulfate. These practices contributed to a decrease in the Institutional Maternal Mortality Ratio across all MMI facilities from 2009 to 2014 (416 to 218/100.000 live births).
Conclusions: At selected maternities, respectful care principles have been successfully incorporated into services. Paired with other high-impact practices, facilities have achieved MNH services better quality and improved health outcomes. The results achieved by Mozambique show that is possible in resource-poor countries to improve quality of care for mothers, newborns, and families through the implementation of humanized health care approach.