Credit: MamaYe!/Sierra Leone

Maternal, neonatal and child health

The establishment of the Millennium Development Goals saw the international community commit to reducing maternal mortality by three-quarters between 1990 and 2015. Since 1990, maternal deaths worldwide have dropped by 45 per cent. Nonetheless, maternal mortality remains unacceptably high. Every day, about 800 women die from pregnancy- or childbirth-related complications. In 2013, 289,000 women died during and following pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings and most could have been prevented.

Maternal and newborn deaths vary between and even within countries. All countries have been called on to commit to ending the unequal spread of maternal mortality and to reach the poorest, most underserved populations. Interventions and actions must be scaled up to save lives. We work to support this by:

  • Designing and supporting the implementation of Safe Motherhood programmes to improve access to and quality of care
  • Promoting preventive care by raising awareness in women and their families of danger signs and of the need to seek care from a skilled birth attendant at the right time
  • Supporting the training of health staff on clinical practice, on how to provide reliable long-term contraceptives for women, and how to advise on the prevention of unwanted pregnancies
  • Advocating for the provision of quality maternal health services through campaigns that promote maternal survival
  • Improving access to data and evidence in usable formats so that planners and civil society can hold decision-makers to account.

In Nepal, we have worked with the Ministry of Health and Population (MoHP) for over 15 years to improve the quality and accessibility of maternal and neonatal health services. Our work includes rolling out a demand-side financing programme, Aama, which gives women free access to delivery services at all public health facilities. We have strengthened district hospitals’ ability to provide 24/7 Comprehensive Emergency Obstetric and Newborn Care (CEmONC), and we have trained skilled birth attendants, family planning providers and medical abortion providers at strategically located Birthing Centres.

In Nigeria, we package evidence on the quality of maternal and neonatal care to enable government to make informed decisions on how to improve access to and quality of health services. We work with citizens’ Facility Health Committees to support them in holding decision-makers to account. We also influence change at state level by involving media, civil society organisations and professional healthcare bodies to track progress and ensure that commitments are met.

In Ethiopia, the Federal Ministry of Health launched Ethiopia’s Maternal Death Surveillance and Response system in May 2013, as part of its drive to tackle maternal mortality. 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.

The Quality of Institutional Care (QuIC) pilot introduced a rapid low-cost approach to collecting Emergency Obstetric and Newborn Care (EmONC) service readiness data in five African countries. In Sierra Leone, QuIC gathered data from 44 facilities across four districts to complement more resource-intensive Facility Improvement Team (FIT) assessments, which are conducted by the Ministry of Health and Sanitation (MoHS) twice-yearly. QuIC comprises 58 largely yes/no questions to provide a snapshot of EmONC readiness. Data are collected quarterly by phone and inputted directly into a mobile-based application. This automatically analyses data and generates traffic-light scores.


Maternal mortality in Nepal has dropped from 790 per 100,000 live births to 190 per 100,000 live births between 1990 and 2013

Deliveries assisted by skilled birth attendants in remote mountain districts in Nepal increased from 19% in 2011 to 32% in 2014

Our experts

  • Sara Bandali, DrPH
    Sara Bandali has over 15 years’ experience in health sector development, including research, policy development and programme design and implementation. She has worked within government, for implementing organisations and the UN. Sara has expertise in maternal and child health, HIV/AIDS, malaria, community health, health systems strengthening, and water supply and sanitation. She has facilitated policy dialogue on cross-sectorial initiatives including HIV/AIDS and gender and early childhood development. Sara is a leading expert on use of evidence and development of accountability mechanisms to advocate for better maternal and newborn health services.
  • Sara Nam, PhD
    Sara Nam is a public health professional with close to 20 years’ experience providing technical assistance to and implementing health programmes and conducting research and programme evaluations. Sara is a qualified midwife, bringing technical expertise in the design and delivery of maternal and newborn health services, health planning and management, strengthening human resources and improving quality of care. Sara has supported health programmes in a variety of development and emergency situations and fragile states, most recently in Sierra Leone during the Ebola outbreak.
  • Nicole Sijenyi Fulton
    Nicole is passionate about improving women’s health and well-being, and building high performing organisations and teams. Her career has spanned 18 years in Kenya, Canada, and several other African countries. Nicole was Team Leader for the UKAid-funded Maternal and Newborn Improvement (MANI) project in Kenya, and led Options’ work to strengthen county-level health system performance, as well as the County Innovation Challenge Fund for maternal and newborn health. Prior to joining Options she was the Country Representative for mothers2mothers in Kenya, leading the organisation’s growth strategy and the national scale-up of the Mentor Mother model.
  • Dr Maureen Dar Iang
    Dr Maureen Dar Iang has over 20 years experience in the planning and delivery of maternal and newborn, reproductive and child health programmes. She has played a key role in strengthening district health systems in Nepal, building capacity of service providers, and supporting national policy discussions on safe motherhood and family planning. She is coordinating our support to recovery of essential health care services in earthquake affected districts.

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More about Options
Established in 1992, Options has worked in over 50 countries. We lead and manage health sector programmes on behalf of international donors and national governments.
Established in 1992, Options has worked in over 50 countries. We lead and manage health sector programmes on behalf of international donors and national governments.

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