Published in:
Open Access 01-12-2017 | Editorial
Improving implementation of health promotion interventions for maternal and newborn health
Published in: BMC Pregnancy and Childbirth | Issue 1/2017
Login to get accessExcerpt
Recently published guidance from the World Health Organization (WHO) on health promotion interventions for maternal and newborn health (MNH) recommends a series of interrelated interventions to improve access to and use of skilled care during pregnancy, childbirth and after birth [1]. The recommendations are based on systematic reviews of available evidence on the effect of the interventions on maternal and newborn health outcomes, primarily care seeking outcomes. The recommendations can be grouped into different categories according to the strength of the recommendation as determined by an expert group and the applicability of the interventions to different contexts:-
Interventions which are strongly recommended that could be implemented in different contexts: including birth preparedness and complication readiness, male involvement, partnership with traditional birth attendants, culturally-appropriate skilled maternity care, companion of choice at birth, and community participation in quality improvement processes and in programme planning and evaluation interventions.
-
Community mobilization through facilitated participatory learning and action cycles is strongly recommended and was studied through randomized controlled trials, which is a higher level of evidence than the other interventions. Its effect has been mainly studied in rural settings where access to health services is poor.
-
One intervention, maternity waiting homes, was recommended to be implemented in contexts with limited access to services or for populations living in remote areas.
-
Community-organised transport schemes were recommended only when it is not possible to organize more sustainable and reliable sources of transport.
-
Two final interventions were considered research recommendations, because of the paucity of evidence found in the searches on care-seeking outcomes. However, the interventions are supported because of their potential to inform women about rights and because of their link to important human rights principles. Additional research and documentation is recommended to better understand how the promotion of awareness of human, sexual and reproductive rights/rights to access quality care and community participation in Maternal Death Surveillance and Response (MDSR) can affect care-seeking outcomes.