Background: The recent WHO report on health promotion interventions for maternal and newborn health recommends birth preparedness and complications readiness interventions to increase the use of skilled care at birth and to increase timely use of facility care for obstetric and newborn complications. However, these interventions are complex and relate strongly to the context in which they are implemented. In this article we explore factors to consider when implementing these interventions.
Childbirth and Postpartum care
Growth monitoring and regular developmental assessments are key components of what all parents need in order to rest assured that their infants and toddlers are on track or, if not, so that they can intervene early on, before any deviations affect the child's future.
Building upon the successes of Countdown to 2015, Countdown to 2030 aims to support the monitoring and measurement of women's, children's, and adolescents' health in the 81 countries that account for 95% of maternal and 90% of all child deaths worldwide. To achieve the Sustainable Development Goals by 2030, the rate of decline in prevalence of maternal and child mortality, stillbirths, and stunting among children younger than 5 years of age needs to accelerate considerably compared with progress since 2000.
We have lots of studies here but the challenge is that they are not driven by country-level needs but donor interest. This has caused the challenge of having too many studies done on one area while another area, that is equally a health need suffers paucity of evidence. If donors are passionate about helping Africa they they have to let us look into the local need driven issues.
I do indeed have some more to contribute to this discussion on safe deliveries and I would like to add to more names to this list...one is dr, coke (colin) mc cord many of you know him... who worked in africa and taught many young 10th or 12th grade pass students caesarians as well as many other emergency surgeries with a very good outcome which my late father, raj arole followed years later in the same countries in africa and the good work was still continuing where there were no skilled surgeons or obstetricians...
Even though I am an advocate of task shifting, I just want to add that while it may be easy to teach a carpenter to conduct a common Caesar, the decision making process leading to that Caesar is more important than the operation itself.
The recent WHO recommendations on optimizing health worker roles for maternal and newborn health (OptimizeMNH: http://www.optimizemnh.org/) include a number of recommendations for lay or community health workers (which was defined to encompass trained TBAs), including misoprostol administration to prevent PPH, continuous support for women during labour and a range of health promotion activities (see http://www.optimizemnh.org/intervention.php ).
if smart lay persons can be trained to correct vesico- and recto- vaginal fistulae safely, and they have been, then clearly they can be trained to do relatively simpler "Caesars" (Caesarian sections). And they should be! So why the omission?