In a significant stride towards enhancing maternal and newborn health, WHO/Europe is producing a comprehensive Pocketbook designed to serve health-care providers as they improve care for newborns and mothers across the WHO European Region.

This initiative underscores the ongoing commitment to improving health outcomes for mothers and their babies, a vital goal for health-care systems across the Region.

In the Region, the current newborn mortality rate is 4 per 1000 live births, down from 10 in the year 2000. Despite advancements in recent decades, mothers and newborns remain at risk during the encompassing pregnancy, delivery, postpartum and perinatal periods.

Babies born prematurely or with severe congenital anomalies face heightened risks of mortality and long-term health issues. Also, stillbirth rates have not declined as significantly as neonatal deaths – the current rate of 4 per 1000 live births has been stable since 2018, with many causes still unidentified. Maternal deaths, often linked to substandard care, also present a persistent challenge, with the current rate in the Region standing at 13 per 100 000 live births (2020 data).

Recognizing these issues, WHO/Europe is prioritizing the development of standardized, evidence-based guidelines to improve maternal and newborn care.

Tackling the “three delays” to improve quality of care

The new initiative draws on the "three delays" model, which identifies three critical delays as key factors contributing to pregnancy complications and maternal mortality:

1. seeking medical help
2. reaching appropriate facilities
3. receiving adequate care.

Addressing these delays through international standards in maternal care is essential for improving outcomes.

The development of the Pocketbook aligns with WHO/Europe's broader mission to enhance the quality of care and patient safety across the Region. The urgent need for the Pocketbook emerged from a regional consultation in Trieste, Italy, in May 2019.

Stakeholders from across the Region underscored the importance of technical guidelines tailored to the needs of local health-care providers. The Pocketbook, to be available in both paper and digital formats, aims to meet this need by providing a practical, accessible reference for doctors, midwives, nurses, and other health-care professionals.

The development of the Pocketbook is based on existing WHO guidelines but is adapted to the specific requirements and realities of the Region. Drawing inspiration from the WHO Regional Office for South-East Asia's 2017 Pocketbook of Hospital Care for Mothers, the new publication will incorporate the latest evidence and best practices. An editorial committee has been identified to oversee the project, ensuring that the content is comprehensive, accurate, and user-friendly.

The development process includes several key steps. These include setting up the editorial committee, agreeing on the Pocketbook's scope and outline, identifying lead authors, and developing chapters on 10 main areas of maternal and newborn health. These areas range from preconception care to emergency newborn care and postpartum support.

The Pocketbook will be available in English and Russian, with the potential for translations into local languages. An accompanying mobile app will provide an easily accessible, regularly updated digital version.

This initiative marks a crucial development in maternal and newborn health care in the Region. By providing standardized, evidence-based guidelines, the Pocketbook aims to improve care quality, reduce risks, and ultimately save lives.