Abstract
BackgroundAchievement of Millennium Development Goal (MDG) 4 for child survival requires acceleration of gains in newborn survival, and current trends in improving maternal health will also fall short of reaching MDG 5 without more strategic actions. We present a Maternal Newborn and Child Health (MNCH) strategy for accelerating progress on MDGs 4 and 5, sustaining the gains beyond 2015, and further bringing down maternal and child mortality by two thirds by 2030.DiscussionThe strategy takes into account current trends in coverage and cause-specific mortality, builds on lessons learned about what works in large-scale implementation programs, and charts a course to reach those who do not yet access services. A central hypothesis of this strategy is that enhancing interactions between frontline workers and mothers and families is critical for increasing the effective coverage of life-saving interventions. We describe a framework for measuring and evaluating progress which enables continuous course correction and improvement in program performance and impact.SummaryEvidence for the hypothesis and impact of this strategy is being gathered and will be synthesized and disseminated in order to advance global learning and to maximise the potential to improve maternal and neonatal survival.
Highlights
Achievement of Millennium Development Goal (MDG) 4 for child survival requires acceleration of gains in newborn survival, and current trends in improving maternal health will fall short of reaching Millennium Development Goals (MDGs) 5 without more strategic actions
Newborns and mothers are both at the highest risk of dying around childbirth: about one-third of neonatal deaths occur in the first 24 hours after birth [14], and the risk of maternal death is highest within 48 hours of delivery, not accounting for the estimated 13% of maternal deaths related to abortion [15,16]. To address this unfinished agenda, we present a strategy for accelerating progress on MDG 4 and 5 leading up to the 2015 target date, sustaining the gains beyond 2015, and further bringing down maternal, neonatal and child mortality by two thirds by 2030
The Maternal Newborn and Child Health (MNCH) strategy takes into account current trends in coverage and cause-specific mortality, builds on implementation lessons learned of what works to date, and will help to reach out to those who do not yet access services
Summary
Towards an MNCH strategy for scale up A limited number of conditions account for the majority of maternal deaths [6] (haemorrhage, hypertensive disorders, sepsis/infections, and obstructed labour), which contribute to the highest burden of newborn conditions [17] (preterm birth, severe infections (sepsis, meningitis), and intrapartum-related complications known as “birth asphyxia”). The strategy proposes innovative potential solutions (Additional file 1: Web annex 2) to mitigate those risks, with a focus on enhancing interactions between frontline workers and mothers and families as a critical lever in increasing the effective coverage of life-saving interventions. To take forward innovative local solutions to achieve impact at scale, strategic and catalytic partnerships are essential, and increasingly such partnerships are formed with governments providing the leadership and with other development partners engaged, for example, in the states of Bihar and UP in India, and in Nigeria, Malawi and Ethiopia This strategy, strengthened by its measurement framework, should contribute to the overall global efforts to improve maternal and newborn survival, reducing deaths by two thirds by 2030.
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