What does it take to improve maternal and newborn health?

In May, we joined the global maternal newborn health community at the International Maternal Newborn Health Conference (IMNHC) 2023 in Cape town. The conference marked a pivotal moment as we get closer to 2030, the end date of globally agreed upon goals for maternal and newborn health and prevention of stillbirths.

A cross-cutting theme at the conference was on the Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortalities (EPMM) targets, in line with Sustainable Development Goal (SDG) 3- Health For All by 2030.  Options’ work in Asia and Africa promotes realisation of these targets working in collaboration with governments, both at national and sub-national level, grassroots civil society organisations and health service providers.

Our team of delegates share four things they learnt on what is needed to accelerate progress for maternal and newborn health:

1. Climate change has a big impact on health, and especially on women and girls

Are we still underestimating climate change and the impact it has on health? In our world today, we should boldly face causes of climate change as they pose significant global health challenges and put vulnerable populations, such as pregnant women and newborns, at risk of mortality and other lifelong morbidities.

“Is the global health community working in silos and not partnering enough with climate health experts?” asks Federica Signoriello, Options Technical Consultant.

“To effectively address the impacts of climate change on maternal and newborn mortality, a multi-stakeholder collaboration between the health sector and climate change initiatives is crucial.”

“We now recognise climate change as a challenge that requires a holistic approach and collaboration across different sectors. By combining expertise, we can develop comprehensive strategies, implement systems, influence policies, build capacity and mobilise resources.”

       2. Approaches to improving quality of care should be holistic and include women and girls’ mental health

The World Health Organisation (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. So when we think about how to improve quality of care, are we looking at it from a holistic perspective?

“Many global health projects have successfully demonstrated results on providing better and improved health for women and girls during pregnancy and childbirth. Yet still, we have done so little to ensure mothers who lose babies due to still birth are supported and get the dignity they deserve,” highlights Meshack Acholla, Advocacy Communications Advisor at Options’ Evidence for Action (E4A)-MamaYe) project.

“A key question is how can we effectively provide mental health support for mothers who have experienced stillbirths and perinatal deaths? We partner with governments to strengthen their Maternal Perinatal Death Surveillance and Response (MPDSR) systems. This has encouraged MPDSR committees to focus more on the ‘P’ for perinatal deaths by expanding their focus on still births, and recommending actions to ensure that healthcare workers, nurses and midwives are able to offer mental health support for mothers.”

3. Advocacy at all levels is important to institutionalise proven quality of care approaches

Several sessions at the IMNHC highlighted critical quality of care components. But government uptake of these is slow even though evidence shows they have significantly contributed to improved maternal and newborn health (MHH).

“There is little uptake by national and sub-national governments to scale life-saving best practices. Lessons from the past show how advocacy efforts for a component like Kangaroo Mother Care (KMC) ensured that it was incorporated into training curricula for health practitioners and midwives,” shares Stephen Yambi, MPDSR and County Advisor for E4A-MamaYe in Kenya.

“As MNH actors, we have many opportunities to undertake evidence-based advocacy to engage governments and promote the institutionalisation of proven quality of care components. Governments, on the other hand, should be willing to scale approaches that are working in their contexts to meet their 2030 commitments.”

    4. Political commitment and increased domestic investment is a driver to achieving Sustainable Development Goal (SDGs) 3 of health and wellbeing for all

During the conference, Exemplars in Global Health countries shared success stories on improving MNH outcomes. These proven lessons can be drawn on by other countries to adapt to difference contexts. However, although there have been significant declines in maternal and newborn mortality in some countries since 2000, more recent data has shown that this trend has stagnated in many countries since 2016.

“If we are to achieve the 2030 SDG targets, a concerted acceleration of efforts is needed, including donor investments and domestic resource mobilisation. Governments have to be in the driving seat and partner support has to be designed in a way that it contributes to national priorities, and is planned with the governments from the very outset,” outlines Shanti Mahendra, Team Leader for the Options’ managed Nepal Health Sector Support programme (NHSSP).

“Options’ work on health financing and accountability with governments and civil society is important towards increasing domestic resource allocation to deliver quality health care in lower middle-income countries. Our team continues to provide technical assistance and support governments to improve health outcomes. With only seven years left to achieve the SDG targets, the time for action to improve maternal and newborn health is now.”

This piece was written by Meshack Ian Acholla, Advocacy Communications Advisor, Evidence for Action (E4A) – MamaYe, Options.