Improving the quality of care for mothers, newborns and children in health facilities: facilitator manual. Version 3

Overview

For reducing maternal, newborn and child mortality the focus has been on reaching higher coverage with key RMNCH interventions2. It has been observed that the evidence-based interventions are often delivered with insufficient quality3. A number of studies over the past years have documented poor quality of care provided to neonates and children4,5,6. Similarly deficiencies in maternal health care, for both routine and emergency care, have also been described7. Poor quality of care may even be harmful for the health of the individual and lead to adverse effects on future health-seeking behaviour by communities8. Low utilization of health care services by the population and lack of progress towards achieving MDG 4 and 5 can be partially attributed to the poor quality of the services. Issues of quality of care for maternal, newborn, child and adolescent health have been deliberated in several Regional Meetings. Member States have urged WHO-SEARO to provide support for establishing quality of care improvement in a systematic manner.

The Global Strategy for women’s children’s and adolescents’ health (2016-2030) and SDG framework provide further impetus towards ending preventable mortality among mothers, newborns and children. Universal health care is a center piece for SDG3 wherein the quality of health care is a crucial element. Quality of care is embedded in the recently developed global frameworks like ENAP (Every Newborn Action Plan) and EPMM (Ending preventable maternal mortality). It is therefore mandatory that interventions are delivered with sufficient quality, meeting appropriate standards of care. WHO-HQ with partners has put forth a Global vision for improving quality of MNH care that emphasizes provision of quality of care as well as improved experience of care at the time of childbirth. WHO has worked with partners to finalize the MNH standards9 for good quality and respectful care, implementation guidelines and a measurement framework.