Abstract
Research is needed to understand why some countries succeed in greater improvements maternal, late fetal and newborn health and reducing mortality than others. Pathways towards these health outcomes operate at many levels, making it difficult to understand which factors contribute most to these health improvements. Conceptual frameworks provide a cognitive means of rendering order to these factors, and how they interrelate to positively influence maternal, late fetal and newborn health. We developed a conceptual framework by integrating theories and frameworks from different disciplines to encapsulate the range of factors that explain reductions in maternal, late fetal and newborn mortality and improvements in health. We developed our framework iteratively, combining our interdisciplinary research team’s knowledge, experience, and review of the literature. We present a framework that includes health policy and systems levers (or intentional actions that policy makers can implement) to improve maternal, late fetal and newborn health; service delivery and coverage of interventions across the continuum of care, and epidemiological and behavioural risk factors. The framework also considers the role of context in influencing for whom and where health and non-health efforts have the most impact, to recognise ‘the causes of the causes’ at play at the individual/household, community, national and transnational levels. Our framework holistically reflects the range of interrelated factors influencing improved maternal, late fetal and newborn health and survival. The framework lends itself to studying how different factors work together to influence these outcomes using an array of methods. Such research should inform future efforts to improve maternal, late fetal and newborn health and survival in different contexts. By re-orienting research in this way, we hope to equip policymakers and practitioners alike with the insight necessary to make the world a safer and fairer place for mothers and their babies.
Key Messages
- Integrated research on maternal, late fetal and newborn health (MNH) is lacking, and conceptual frameworks for MNH research are usually topic- and/or discipline-specific.
- This article presents a novel and holistic conceptual framework for MNH research reflecting a range of interrelated factors leading to improved MNH and survival.
- The framework aims to re-orient maternal and newborn health research and in turn equip policy-makers and practitioners alike with the insight necessary to improve maternal, late fetal and newborn outcomes.