WHO/Jerome Flayosc
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Maternal and newborn health

    Overview

    Maternal health refers to the health of women during pregnancy, childbirth, and the postnatal period. Newborn health refers to the babies' first month of life. A healthy start in life has significant repercussions for a person's health and well-being during infancy, childhood, and adulthood. Therefore, strong efforts are required from all countries to ensure quality of care in maternal and newborn health (MNH). Moreover, high-quality MNH care is integral to the right to health, route to equity, and preservation of dignity for women and their babies.

    The total fertility rate (average number of children born to women during their reproductive years) in the WHO European Region was relatively low at 1.7 live births per woman in 2021, ranging from 1.1 to 3.2 in different countries. The total fertility rate in the European Union (EU) was 1.53 live births per woman in 2021. In recent decades, generally, Europeans have been having fewer children and this pattern partly explains the slowdown in the EU's population growth. At the same time, the population of central Asia has been increasing by an average of one million people annually and further growth is predicted. The focus of future strategies and interventions will vary across countries in the Region, but it is clear that action is required from all sectors of society to address the growing need in MNH.  

    Impact

    New data released by WHO and other UN agencies warns that, despite progress tackling maternal mortality rates over the past 20 years, in some countries in Europe progress slowed or stopped between 2016 and 2020. In 2020, around 1000 women in the Region died due to complications related to pregnancy or childbirth. In those places where direct causes of maternal deaths prevail over indirect ones, this indicates poor-quality medical care. Most maternal deaths are preventable with timely management, using evidence-based interventions by a skilled health professional working in a supportive environment.

    Between 2000 and 2021, the newborn mortality rate in the Region halved (from 10 to 4 per 1000 live births). The first month of life is the most vulnerable period for child survival. Preterm birth, intrapartum-related complications (i.e. birth asphyxia or the inability to breathe at birth), infections, and birth defects are the leading causes of most neonatal deaths. A majority of children who die within the first 28 days of birth suffer from conditions and diseases associated with a lack of quality care at or immediately after birth and in the first days of life. 

    WHO response

    WHO provides targeted technical assistance and strategic support to countries to help reduce maternal and neonatal mortality and morbidity by improving the quality of primary and facility-based care for pregnant women and their newborns and reducing inequities in the access to MNH care. 

    WHO supports countries in reducing future preventable maternal and newborn mortality by:

    • developing and updating comprehensive, evidence-based national policies, strategies and guidelines related to MNH;
    • enhancing data collection, analysis, and use within the concept of continuous quality improvement;
    • understanding the underlying factors that impact the quality of maternal and neonatal services;
    • establishing a system of maternal and perinatal death surveillance and response (MPDSR), which includes clinical audits at hospital and national levels; and
    • improving the knowledge and skills of health-care providers on evidence-based interventions in different areas of maternal and newborn care, including emergency obstetric and neonatal care. 

    Our work

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    Caring for children and adolescents in hospitals

    Caring for children and adolescents in hospitals

    WHO/Malin Bring
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    Overview

    WHO advises and supports countries to ensure severely ill children and adolescents in hospital receive the care they need.

    In most parts of the WHO European Region, severely ill children have good access to hospitals, with established referral systems and skilled and committed nurses and doctors. Nevertheless, in some settings children remain in hospital and away from school and their families unnecessarily and for too long; receive excessive treatment with ineffective drugs and inappropriate therapies; and get inadequate support or monitoring.

    The reasons for this include:

    • a lack of evidence-based clinical guidelines;
    • links between hospitals’ reimbursement from health insurance schemes or government budgets and length of stay or number of therapies, regardless of need;
    • health regulations that do not always support a rational approach to laboratory services and testing;
    • little incentive for hospitals to comply with standards of good practice;
    • aggressive marketing from pharmaceutical companies;
    • low salaries and little information for staff; and
    • financial interests of physicians.

    WHO support to countries

    • Capacity building. WHO provides training and technical support to health professionals and decision-makers to strengthen child-friendly, high-quality hospital care. This includes workshops, country missions, supportive supervision and peer learning to promote best practices in neonatal and paediatric care.
    • Evidence-based research. WHO supports countries in generating and applying evidence to improve hospital care for children. For example, in Kyrgyzstan and Tajikistan, WHO has collaborated with national authorities to strengthen health systems and improve the quality of maternal, newborn and child health services. This initiative has applied research and quality assessments to guide targeted interventions and demonstrated how data-driven approaches can lead to measurable improvements in care.
    • Tools and guidelines. WHO has developed practical tools such as the Assessment Tool for Hospital Care for Children and the Standards for Improving the Quality of Care for Children and Young Adolescents in Health Facilities. These resources help countries evaluate and improve the quality of care in line with international standards. The WHO “Pocket book of hospital care for children” provides clinical guidelines for managing common childhood illnesses in hospital settings, supporting safe and effective care. The WHO “Pocket book of primary health care for children and adolescents” offers guidance for managing child and adolescent conditions at the primary care level, helping to prevent unnecessary and avoidable hospitalizations.
    • Advocacy and partnerships. WHO works with governments, professional associations and civil society to promote child-centred high-quality hospital care. By fostering collaboration and advocating for policy change, WHO helps ensure that children’s rights and needs are prioritized in hospital settings.

    Publications

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    Child and adolescent health in the WHO European Region: immunization factsheet
    Persistant gaps in immunization coverage leave children vulnerable to dangerous vaccine-preventable diseases. At least 95% of children should be vaccinated...
    WHO European Childhood Obesity Surveillance Initiative (‎COSI)‎ in Ukraine 2023–2024

    The WHO European COSI is the largest childhood obesity surveillance initiative, tracking trends in overweight and obesity among primary school-aged children....

    Policy brief on the association between sugar-sweetened beverage consumption and childhood overweight and obesity

    Childhood overweight and obesity represent a significant global health challenge. Alongside the rising prevalence of this issue is sugar-sweetened beverage...

    Related WHO collaborating centres

    WHO collaborating centres are institutions that form an international collaborative network carrying out activities to support WHO’s programmes at all levels. They provide an opportunity for WHO to utilize their inherent expertise for the benefit of all Member States.

    View the list of related collaborating centres

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