Maternal, neonatal and child health
Pregnancy-related issues are the key cause of death and illness among newborns and adolescent girls.
Many women, children, and adolescents risk being left behind in global improvements in health, especially in fragile and resource-poor contexts. Although global coverage of interventions such as skilled birth attendance and child vaccination have steadily increased, progress is uneven and major gaps persist both between and within countries – and progress that has been made is being threatened by COVID-19.
We support and accelerate the delivery of maternal, neonatal, child and adolescent health by:
- Contributing to government policy, designing strategies and strengthening financing to create an enabling environment for safe motherhood, newborn health and adolescent empowerment programmes that improve access to services and quality of care.
- Catalysing grassroots change and advocating for the appropriate financing and provision of quality health services through partnerships, coalitions and campaigns that promote maternal and newborn survival.
- Strengthening human resources for health by supporting training and mentorship on specific clinical practices to deliver high quality maternity services, strengthen emergency care, provide reliable contraception, prevent unwanted pregnancies and undertake safe abortion care.
- Building evidence and enabling access to data in formats that help decision-making processes within government, and advocacy and accountability mechanisms among civil society.
- Promoting preventive care by empowering women, adolescents, and their families with the knowledge to seek the right care at the right time.
In Nepal, we have worked with the Federal Ministry of Health and Population (MoHP) for over 20 years to improve the quality and accessibility of maternal and neonatal health services. We designed and helped roll-out the government’s flagship results-based financing programme, Aama, which gives women free access to delivery services at all public health facilities. We worked closely with the Family Welfare Division to draft the Safe Motherhood and Newborn Health Roadmap 2030 – which is now the defining strategy for country’s MNH related work.
We also helped develop the Strategy for Skilled Health Personnel and Skilled Birth Attendants 2020-2025 and the National Nursing and Midwifery Strategy and Action Plan 2020-2030. Adopting a cross-sectoral approach we have supported the MoHP to introduce and roll-out One Stop Crisis Management Centres at district hospitals that offer multiple services to survivors of violence, many of whom are pregnant women and adolescents.
In Kenya, our Maternal and Newborn Improvement (MANI) project in Bungoma country worked to improve mothers and newborn survival by:
- Strengthening maternal and perinatal death surveillance and response systems (MPDSR)
- Using quality of institutional care (QuIC) assessments to strengthen emergency obstetric and newborn care services
- Helping overcome staff shortages and weak clinical skills through a mentorship programme.
We improve local-level accountability by supporting and strengthening Facility Health Committees in Nigeria, and Health Centre Advisory Committees in Malawi. We assess the roles and functions of the members and support them to hold decision-makers to account. We have also influenced change at a national level by involving media, civil society organisations and professional healthcare bodies to track progress and ensure that commitments are met, through our Evidence for Action programme.
Working with the WHO country office, Options played an instrumental role in developing the national tools and guidelines and designing the package of training materials for Ethiopia’s Maternal Death Surveillance and Response system in May 2013. Building on this, we have helped to digitise the MPDSR system in Nigeria, an improvement in patient record keeping in Kenya and have also looked at how it has been adapted during the COVID-19 pandemic.
We have supported evidence-informed decision-making for policy and programmes in innovative ways including:
- The Quality of Institutional Care (QuIC) which uses a rapid low-cost approach to collecting Emergency Obstetric and Newborn Care (EmONC) service readiness data
- The MPDSR Action Tracker, which helps MPDSR Committee members to analyse the problem that caused a maternal or perinatal death and to specify a proposed action
- Data dashboards, such as those in Nepal and Malawi or scorecards, such as in Kenya and Nigeria.
- Scaled public comprehensive emergency obstetric and newborn care (CEONC) sites in Nepal with functional caesarean section services to nearly 100 facilities
- Over 94% of eligible pregnant women receive free childbirth services and transport incentives in Nepal
- Skilled birth attendance rate improved by 13 percentage points in Kenya across the counties that have Options programmes
- Blood transfusion centres increased from 2 to 9 in one county in Kenya
Shanti MahendraShanti is a health systems specialist with over 20 years’ experience in South Asia and sub-Saharan Africa, particularly in maternal and newborn health and survival. This includes complex sector-wide budget support programmes, cutting-edge research and multi-country monitoring/evaluation projects. Shanti applies her grassroots experience to provide strategic technical direction, supporting programmes to be both evidence-driven and locally-rooted.