Community-based intervention packages for reducing maternal morbidity and mortality and improving neonatal outcomes1

Abstract

A large proportion of maternal and newborn deaths and diseases can be addressed by developing a community-based approach to improved maternal care during pregnancy, delivery and after delivery, as well as care of the newborn. A systematic review found 27 experimental and non-experimental trials evaluating the health impacts of community-based intervention packages, in which health workers received additional training in maternal and newborn care. Women in areas assigned to receive a community-based intervention package had fewer illnesses and complications during pregnancy and birth, and their babies were more likely to survive. Referrals rates to health facilities for pregnancy-related complications and initiation of breastfeeding within an hour of birth also improved. This review offers encouraging evidence of the value of integrating maternal and newborn care in community settings through a range of strategies, many of which can be packaged effectively for delivery through community health workers.