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Q1: What are the effective maternal mental health interventions to prevent developmental problems in early infancy?
Bettercare Learning Programmes.
Nearly 800 women die every day from preventable maternal causes, and in 2022 alone, an estimated 2.3 million newborns died. For every maternal death, countless more women endure life-altering injuri
...
es, infections, and disabilities related to childbirth.
Maternal deaths are concentrated in the poorest regions and conflict-affected areas. In 2020, sub-Saharan Africa accounted for nearly 70% of all maternal deaths, with just 22 countries responsible for 81% of the global total. Humanitarian crises and fragile health systems exacerbate these challenges, with maternal mortality rates in crisis-affected areas often double the global average. The barriers to progress are multifaceted, including inadequate funding, poor-quality healthcare, harmful gender and social norms, and critical gaps in data and accountability.
more
WHO/UNICEF/UNFPA joint statement
As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and susta
...
ined reduction
in institutional maternal mortality (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
more
Climate hazards, including extreme heat, are associated with increased risks of developing complications that lead to adverse maternal and perinatal outcomes. These may include multiple causes of maternal
...
and neonatal morbidity and mortality such as gestational diabetes, hyper tensive disorders of pregnancy, preterm birth, low birth weight and stillbirth. In addition to the health risks related to poor nutrition, water, hygiene and sanitation, the effects of exposure to climate hazards and their aftermath during and after pregnancy can affect mental health and contribute to intergenerational trauma. They may increase stress, anxiety and depression – known risk factors for adverse perinatal outcomes.
more
The guide for integration of perinatal mental health in maternal and child health services outlines an evidence-informed approach describing how pr
...
ogram managers, health service administrators and policy-makers responsible of planning and managing maternal and child health services can develop and sustain high-quality, integrated mental health services for women during the perinatal period.
more
Implementation guide for national, district and facility levels.
This implementation guide contains practical guidance for policy-makers,
programme managers, health practitioners and other actors working to
establish and implement quality of care
...
(QoC) programmes for maternal,
newborn and child health (MNCH) at national, district and facility levels.
It is intended to help anyone, throughout the health system, who wants
to take action to improve the QoC for MNCH.
more
Since 2002 the distribution of external funding to reproductive, maternal, newborn, and child health (RMNCH) has become more equitable and better targeted at the poorest countries and those experien
...
cing the highest mortality. The aid envelope is not large enough or well enough concentrated to close gaps in domestic government fund ing between the poorest and middle income countries. Donors and governments of low and middle income countries should increase their investments for RMNCH . Donors should further concentrate their funds on the poorest countries and those with the highest maternal, newborn, and child mortality. Investment is also needed to close serious data and methodological gaps for assessing equity of financing between and within countries
more
Background:Tracking aid fl ows helps to hold donors accountable and to compare the allocation of resources in relation to health need. With the use of data reported by donors in 2015, we provided estimates of offi cial development assistance and gr
...
ants from the Bill & Melinda Gates Foundation (collectively termed ODA+) to reproductive, maternal, newborn, and child health for 2013 and complete trends in reproductive, maternal, newborn, and child health support for the period 2003–13. Methods: We coded and analysed fi nancial disbursements to reproductive, maternal, newborn, and child health to all recipient countries from all donors reporting to the creditor reporting system database for the year 2013. We also revisited disbursement records for the years 2003–08 and coded disbursements relating to reproductive and sexual health activities resulting in the Countdown dataset for 2003–13. We matched this dataset to the 2015 creditor reporting system dataset and coded any unmatched creditor reporting system records. We analysed trends in ODA+ to reproductive, maternal, newborn, and child health for the period 2003–13, trends in donor contributions, disbursements to recipient countries, and targeting to need.
more
Background: Worldwide, maternal hypertensive disorders complicate one in ten pregnancies. As a result of changes in the life styles of society, currently, it is becoming a common public life encounter. However, Ethiopia lacks comprehensive and compa
...
rable maternal hypertensive disorders, causing burden and health loss to inform policy and practice.
Objective: To describe the incidence and prevalence of maternal hypertensive disorders and deaths, Disability Adjusted Life Years, and Years Life Lost attributable to maternal hypertensive disorders in Ethiopia and its regional distributions from 1990 to 2019 as part of a collaborative Global Burden of Diseases, (2019) Study.
Methods: The data for this study were collected from surveys, demographic surveillances, medical record reviews, health facility observations and interviews socio-demographic, health care service utilization, and other data sources such as case notifications, scientific literature, and unpublished data as per the Global Burden of Disease protocol and analysis techniques to produce national and regional estimates of maternal hypertensive disorders in Ethiopia. Cause of death ensemble modeling and Bayesian meta-regression disease modeling was employed to ascertain cause of death and morbidity. Each metric was estimated per 100,000 populations with a 95% uncertainty interval (UI).
Results: In the last thirty years, in Ethiopia, , the incidence of maternal hypertensive disorders among young women was raised by 52,596 cases per 100,000 population [199,707 (95% UI 150,261-267,221) to 252,303 (95% UI 191,335-332,524)], while decreased among adolescent women from 67,206 (95% UI 46,887-90,883) to 64, 622 (95% UI; 47,587-84,664) per 100,000 population. The prevalence among women of reproductive age had increased from 94, 818 (95% UI 59,434-135,332) in 1990 to 138, 263 (95% UI 88,447-196,029) in 2019. Between 1990 and 2019, deaths attributable to maternal hypertensive disorders among adolescents and young women had increased by 1.5 and 1.17 times, respectively. In 2019, disability adjusted life years among adolescent, young women and women of reproductive age due to maternal hypertensive disorders was 8,493 (UI 95% 5,370-12,849), 21,812 (UI 95% 14,682-32,139) and 57,867 (UI 95% 41,751-79,165) respectively. The highest daily adjusted life years due to maternal hypertensive disorders had occurred among young women, 13,319 (UI 95% 8,592-19,931) which was higher than 1990 whereas the young women years of life lost had increased.
Conclusions: Based on the finding, increasingly high new cases, prevalence and burden of maternal hypertensive disorders and significant health loss were observed in the last three decades in Ethiopia. Hence, prevention of cases, disabilities, deaths and health losses caused by maternal hypertensive disorders can be prevented by properly advocating lifestyle modifications with specifically designed age-specific interventions. On the top of continuing prevention efforts with newly devised magnesium sulphate administration in the new ANC initiative of the ministry, contextualized, need based, localized, and targeted interventions could be reconstituted. [Ethiop. J. Health Dev. 2023;37 (SI-2)]
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The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality
...
maternal, newborn and child health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing segments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.
more
In Latin America and the Caribbean (LAC), one maternal death was registered every hour in 2020. That same year, the trend in the maternal mortality ratio (MMR) for the Region of the Americas regress
...
ed alarmingly and unprecedentedly to the levels seen two decades ago. In addition to indicating a worsening of health outcomes, these figures also signal a deepening of inequalities, representing thousands of individual, unacceptable tragedies that in most cases could have been preventable. Maternal death is the result of a multifactorial process in which structural elements such as the economic system, environmental conditions, and culture interact. Other factors related to social inequality are also present, such as racism, poverty, gender inequality, and lack of access to the education system. The current situation calls for urgent mobilization of the health systems of LAC countries in order to strengthen efforts to combat maternal mortality, especially in countries that are still far from achieving the SHAA2030 regional target. For this reason, a preventive, health-promoting, life-course-based approach is needed, with models of care centered on women, families, and the community Scientific evidence shows that health systems with a solid foundation in primary health care (PHC) achieve better outcomes, greater equity, and reduced health expenditures. To address this, PAHO proposes a strategy, aimed primarily at women who are in the most vulnerable situation, who are the ones who represent the greatest burden of maternal mortality, to accelerate the reduction of maternal mortality in the Region of the Americas, based on the expansion and strengthening of PHC.
more
This document provides a list of key WHO-recommended maternal and newborn health commodities and aims to accelerate progress towards the SDGs. It consolidates the key and enabling commodities from e
...
xisting WHO guidelines on maternal and newborn health.
more
Guidelines approved by the WHO Guidelines -Review Committee; second edition
Practical considerations
It provides more detailed and practical guidance for continuing services for each life stage across the life-course continuum. As such, both documents should be read and used together. The countries in South-East Asia and the Pacific regions would like to adapt the guidance
...
within the national and sub-national continuity plans, based on the local situation of COVID-19 transmission, containment response and health system capacity.
more
Community Discussion Guide for Maternal and Newborn Health Care
Mobilising Access to Maternal Health Services in Zambia Programme, District Health Management Teams
UK Aid; Health Partner International, MOH Zambia
(2012)
C1
A training manual for safe motherhood action groups (MAMaZ)
