Harmonizing post-2015 Global Maternal and Newborn Frameworks

This blog was originally published in Impatient Optimists. Written by Alison Chatfield and Annie Kearns.  

A recent editorial in the Lancet highlighted the synergies between the maternal, newborn and child health movements, calling for an integrated approach to the way the international health community funds, plans and implements care. Translating the continuum of care from theory into practice is an enormous challenge; however, recent consensus-building around the post-2015 global health agenda constitutes a tremendous opportunity to harmonize international frameworks, intervention packages and tools for measurement and evaluation.  

The past year has seen a great deal of momentum around the Every Newborn Action Plan (ENAP), a framework establishing global targets and priority actions for ending preventable newborn deaths. In addition to a core set of recommendations for implementing essential newborn interventions, the draft Plan was opened for consultation from a wide range of stakeholder groups last month.

The Every Newborn Action Plan purposefully positions newborns along the continuum of care, and appropriate integration of newborn care with related health services is a key tenet of the document. As such, maternal health is woven in throughout the document:

  • Given that almost three-fourths of maternal and newborn deaths occur during labor, childbirth and the first day of newborn life, the Plan calls for strengthening and investing in care during the intrapartum period.
  • Understanding that mothers and newborns are often subject to poor-quality care, (disrespectful interpersonal care; lack of evidence-based clinical practice) seizing opportunities for training institutions, governmental bodies and other stakeholders to work together to improve quality for mothers and newborns is prioritized.
  • Despite important progress in reducing access inequality, this goal remains unrealized, and the ENAP highlights the need for the maternal and newborn health communities to leverage growing momentum around universal health coverage to increase access to high-quality health facilities for all women and children.
  • The Plan also brings attention to the reality that many maternal and newborn deaths happen at home without any health care having been sought, and calls for engagement with women’s participatory groups, community-based capacity-building activities, and mass media to shift social norms and foster community mobilization around maternal and newborn health.
  • The ENAP calls for countries to integrate core maternal and newborn health indicators like births and deaths into their health systems, as well as contribute to ongoing efforts to develop quality of care and outcome indicators.

The ENAP’s chosen priority areas reflect a need for a strengthened partnership between the newborn and maternal health communities  to translate these goals into reality.

Now, there is a new opportunity to put an integrated approach to care into practice. The WHO has convened a working group on Ending Preventable Maternal Mortality (EPMM) to build consensus on post-2015 maternal mortality goals. The Group recently released a draft communiqué proposing new global- and country-level targets for maternal mortality reduction over the next 20 years.

The EPMM Working Group members agree that the analytical basis for targets for ending preventable maternal mortality is well-established, and develops targets using the logic and lessons learned from MDG5. The Working Group proposes that all countries implement their plans for ending preventable maternal mortality with a rights-based approach, while simultaneously aiming for a set of 5-year milestones, which allow for the development and implementation of context-specific strategies and trajectories at the country-level. 

The communiqué is focused on maternal health, but implementation will require collaborative efforts with the newborn and child health communities at the global and national levels. As such, the EPMM Working Group will collaborate with partners to organize, solicit, and disseminate feedback from in-country technical, policy, advocacy, and civil society leaders; plan several virtual and face-to-face country and regional consultations to facilitate discussions on maternal mortality goals setting and to gather input; and work with country leaders and other partners to develop and refine the overall goal and individually-designed implementation plans.

These next steps are important opportunities for stakeholders from the newborn and child health communities as well as allied fields such as the HIV, TB, and malaria communities to contribute their perspectives. 

Updates on this consultative process and opportunities to add your opinion on can be found through the Maternal Health Task Force‘s topic page and blog series on post-2015 maternal mortality target setting.

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