Women Deliver 2016: It’s time to take action


Maternal-newborn health - Quality, equity and dignity for all


Speakers (from left): Dr. Anthony Costello, Clementina Elukil, Aparajita Gogoi, Dr. Gloria Quansah Asare, Robin Gorna

A powerful new integrated maternal-newborn health advocacy campaign focused on quality, equity and dignity of care for all mothers and babies was launched at the Women Deliver conference. The Global Strategy for Women’s, Children’s and Adolescents’ Health (Global Strategy) calls for ending all preventable maternal and newborn mortality and stillbirths. Greater quality of care is needed to preserve and protect the health of both mothers and babies, especially for those hardest to reach and where crisis prevails.

This advocacy campaign supports the technical efforts by UN agencies to lay the groundwork for a strong country-focused drive for quality maternal and newborn care. The World Health Organization (WHO) has developed a set of quality of care standards for maternal and newborn health and is preparing a roadmap for implementation and scale up. Successful implementation of this roadmap requires an intentionally linked advocacy movement to support country implementation, influence supportive global and national policies and investments, and to unify all stakeholders in joint action through a strong communications campaign. This new maternal-newborn health advocacy effort emphasizes the human rights-based goals of equity, universal coverage, access to quality care services, and dignity and respect for all women and babies. The effort takes forward the implementation of the Every Newborn Action Plan (ENAP) and Strategies towards Ending Preventable Maternal Mortality (EPMM) to achieve the goals of Global Strategy.

The launch took place during a side event on Tuesday, 17 May, 2016. The event shared information about the new quality of care framework for maternal and newborn health led by WHO as well as to learned from different country experiences of successful improvements for quality, equity, and dignity for mothers and babies.

Betsy McCallon, White Ribbon Alliance, and Mary Kinney, Save the Children, opened the event providing the background to the purpose of the session on behalf of the ENAP and EPMM advocacy working groups. The moderator of the session, Robin Gorna, Executive Director of the Partnership for Maternal, Newborn and Child Health (PMNCH), started the session by emphasizing the value of partnership in delivering on the agenda for the Global Strategy.

The first speaker, Dr. Anthony Costello, Director Maternal, Child and Adolescent Health, WHO, presented the WHO vision of the Quality of Care Framework for maternal and newborn health, which includes both supply and demand components.

Dr. Costello agreed to take on the “Kangaroo Mother Care challenge” – practicing KMC with a baby doll for 24 hours – to demonstrate the challenges that mothers face when practicing KMC. Quality of care includes ensuring support from communities and trained health workers to new mothers to care for their babies, especially if they are born too soon.

Dr. Costello proposed that a related advocacy campaign on quality, equity and dignity for all mothers and babies, linked to WHO’s framework, would improve measurable commitment by all stakeholders and drive greater access to care among those who need it most. He called for ‘Half in Five' – a target of cutting facility deaths of mothers and newborns in half in the next five years by improving quality of services.

Speakers addressed the importance of ensuring quality, equity and dignity from three different viewpoints of the health system: 1) health care providers; 2) policy makers; and 3) civil society. First, Clementina Elukil, a young midwife providing care in a community clinic in rural Uganda, spoke passionately about the realities facing health workers with constrained resources. As the only midwife at her facility, she delivers 30 babies per month, works 7am to 10pm and through the night if needed and may up for up to six kilometres just to get water to clean her delivery area. She is dependent on generators for light, and often delivers by torchlight. Without transportation providing the access to the district hospital in cases of emergency, she often pays out of pocket for a private taxi service when a woman in labour needs higher level care. While she represents dedicated care to the families in her community, the health system needs to be strengthened to support midwives like Clementina to be appropriately supported to provide high quality care at rural, primary care facilities.

Clementina speaks about the challenges of working in the understaffed, under-resourced facility.

Providing the policy maker perspective, Dr. Gloria Quansah Asare, Deputy Director-General of the Ghana Health Services, underscored the importance of focusing on the full continuum of care and ensuring that advocacy is part of the Health Sector strategy. Dr. Anisa Omar, Program Manager, Adolescent Health in the Neonatal, Child and Adolescent Health Unit, Kenya Ministry of Health, reflected on her journey through the health sector, from a clinician to the Director of Adolescent Health for the MOH. She stressed that reproductive, maternal, newborn , child and adolescent health (RMNCAH) is a health system issue requiring improved access to commodities, health worker capacity and retention, as well as strong leadership, management and governance skills.

From civil society, Aparajita Gogoi, the National Coordinator for White Ribbon Alliance, India and Executive Director of Center for Catalyzing Change, highlighted the inherent connection of quality and respectful care, which is brought together in the Respectful Maternity Care charter in India. She shared findings from the pilot study of the Mobile Monitor for Quality of Maternal Care model, which uses basic mobile phone technology to both inform expecting mothers and to allow them to provide feedback if they have experienced disrespectful care. The study revealed that women equate quality of care with access to what many would consider basic supplies and services, such as having their own bed during and after delivery, rather than having to share a bed with another new mother, which is part of respectful care.

Participants attending the side event shared priorities for joint maternal-newborn advocacy in their country or area of focus and these ideas will be incorporated into the design of the advocacy plan going forward.

The session was organized by the World Health Organization (WHO), the Partnership for Maternal, Newborn and Child Health (PMNCH), the FCI Program of Management Sciences for Health, Save the Children, White Ribbon Alliance on behalf of Every Newborn and Ending Preventable Maternal Mortality management teams.

To learn more about this campaign, contact Kadi Toure at tourek@who.int