{"id":25368,"date":"2017-04-25T15:09:09","date_gmt":"2017-04-25T19:09:09","guid":{"rendered":"http:\/\/www.healthynewbornnetwork.org\/?p=25368"},"modified":"2017-04-25T15:18:14","modified_gmt":"2017-04-25T19:18:14","slug":"postnatal-care-with-a-focus-on-home-visitation","status":"publish","type":"post","link":"https:\/\/www.healthynewbornnetwork.org\/blog\/postnatal-care-with-a-focus-on-home-visitation\/","title":{"rendered":"Postnatal care strategies must pay more attention to feasibility and context"},"content":{"rendered":"
\"\"
A home visit with a mother and newborn in the Patna district of Bihar, India. Photo:\u00a0Bill & Melinda Gates Foundation<\/figcaption><\/figure>\n

Current maternal\u2013newborn program efforts direct considerable attention to the critical period around the time of birth. While this is an appropriate focus, the days and weeks that follow birth are also vitally important. Good care practices, timely medical care, and other services that address a variety of health issues also improve the likelihood of survival and better health and development outcomes.<\/p>\n

Home visitation has been proposed as a way to achieve better outcomes during the postnatal period. While successful programs have been implemented in middle- and high-income countries for many decades, the current global effort to increase use of postnatal home visitation originated in a demonstration project in rural India in the 1990s. Several follow-up cluster randomized control trials tested variations on this model. The published trials found that under certain conditions such approaches can reduce the risk of newborn death. On the strength of these findings, WHO and UNICEF issued a joint statement<\/a> in 2009 endorsing this approach.<\/p>\n

While there is reason to anticipate considerable benefit from conscientiously delivered postnatal home visitation, what is feasible and what constitutes an optimal strategy will vary enormously by setting. Those responsible for such programs and services have a duty to ensure that the needs of the populations they serve are well met, working with the real-world opportunities and constraints they face. As much as we may prefer otherwise, there are no off-the-shelf strategies that fully address these needs in all settings.<\/p>\n

\"\"<\/a>
Postnatal Care, with a Focus on Home Visitation: A Design Decision-Aid For Policymakers And Program Managers<\/figcaption><\/figure>\n

Save the Children\u2019s Saving Newborn Lives program<\/a> and USAID\u2019s Maternal and Child Survival Program<\/a> have published a guidance document, Postnatal Care, with a Focus on Home Visitation<\/a><\/strong>, (developed with inputs from colleagues at WHO, UNICEF and USAID). This document offers some initial considerations for ministries of heath, national policymakers, and program managers to take into account as they design appropriate, strategic mixes of service delivery components to improve outcomes during the postnatal period and beyond. These considerations are intended to help them tailor their strategies to the needs and conditions particular to their setting, so that they may achieve the greatest impact that is feasible.<\/p>\n

The overarching conclusion is that a country considering what may be the most appropriate strategies to improve postnatal outcomes should give serious attention to both feasibility and context.<\/em><\/p>\n

We encourage countries to view programming holistically and to seek methods and tools that allow them to develop a flexible, tailored approach as they consider the incorporation of home visitation or other strategies into their health services.<\/p>\n

Download Postnatal Care, with a Focus on Home Visitation >><\/strong><\/a><\/p>\n

\n

\"steve\"
\n\u00a0Blog by Stephen Hodgins,\u00a0<\/em><\/strong>MD<\/em><\/strong><\/p>\n

Senior technical advisor, Saving Newborn Lives, Save the Children\u00a0<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

The days and weeks that follow birth are also vitally important. 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He is also Editor-in-Chief: Global Health: Science & Practice.\r\n\r\nPreviously, Steve was Senior Technical Advisor for Newborn Health providing technical leadership and Support for Save the Children's Saving Newborn Lives program. He is a public health physician who trained at McGill and UNC-Chapel Hill. He has broad public health and health services interests but his focus has been on public health practice. Through most of his career CHWs have been an important element of his work, beginning when he was a volunteer in north India almost 30 years ago. Together with Claire Glenton, Simon Lewin and others, he has published on community health worker motivation in Nepal.","user_avatar":"<img alt='' src='https:\/\/secure.gravatar.com\/avatar\/194e93f544a182139f01834f2125cd4a?s=96&d=mm&r=g' srcset='https:\/\/secure.gravatar.com\/avatar\/194e93f544a182139f01834f2125cd4a?s=192&d=mm&r=g 2x' class='avatar avatar-96 photo' height='96' width='96' decoding='async'\/>"}],"additional_authors":"","partners":[{"ID":646,"post_author":"4388","post_date":"2014-10-23 00:42:05","post_date_gmt":"2014-10-23 00:42:05","post_content":"The Maternal and Child Survival Program is a global, USAID Cooperative Agreement to introduce and support high-impact health interventions with a focus on 24 high-priority countries* with the ultimate goal of ending preventable maternal and child deaths (EPMCD) within a generation. This new program will build on the successes of the six-year Maternal and Child Health Integrated Program (MCHIP).\r\n\r\n \r\n\r\nThe Maternal and Child Survival Program supports programming in maternal, newborn and child health, immunization, family planning and reproductive health, nutrition, health systems strengthening, water\/sanitation\/hygiene, malaria, prevention of mother-to-child transmission of HIV, and pediatric HIV care and treatment.\r\n\r\n \r\n\r\nThe Program is focused on ensuring that all women, newborns and children most in need have equitable access to quality health care services to save lives.\r\n\r\n \r\n\r\n* USAID's high-priority countries are Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia, Ghana, Haiti, India, Indonesia, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Nepal, Nigeria, Pakistan, Rwanda, Senegal, South Sudan, Tanzania, Uganda, Yemen, and Zambia.\r\n<h2>What we do<\/h2>\r\nAwarded in the spring of 2014, the Maternal and Child Survival Program engages governments, policymakers, private sector leaders, health care providers, civil society, faith-based organizations and communities in adopting and accelerating proven approaches to address the major causes of maternal, newborn and child mortality such as postpartum hemorrhage, birth asphyxia, and diarrhea, respectively, and improve the quality of health services from household to hospital. The Program will tackle these issues through approaches that also focus on health systems strengthening, household and community mobilization, gender integration and eHealth, among others.\r\n\r\n \r\n\r\nWith approaches tailored to meet individual country needs, the Program seeks to empower countries to design effective approaches, develop technical skills, apply analytical tools, manage workforce capacity and devote resources to reduce inequities in care and build sustainable health systems to keep mothers, newborns and children alive and healthy.","post_title":"Maternal and Child Survival Program (MCSP)","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"maternal-and-child-survival-program-mcsp","to_ping":"","pinged":"","post_modified":"2016-04-05 12:01:50","post_modified_gmt":"2016-04-05 16:01:50","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=partner&p=646","menu_order":0,"post_type":"partner","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":834,"post_author":"2613","post_date":"2010-10-25 19:41:46","post_date_gmt":"2010-10-25 19:41:46","post_content":"<p>The U.S. Agency for International Development (USAID) is an independent agency that provides economic, development and humanitarian assistance around the world in support of the foreign policy goals of the United States.<\/p>\r\n<p>U.S. foreign assistance has always had the twofold purpose of furthering America's foreign policy interests in expanding democracy and free markets while improving the lives of the citizens of the developing world. Spending less than one-half of 1 percent of the federal budget, USAID works around the world to achieve these goals.<\/p>\r\n<p>USAID's history goes back to the Marshall Plan reconstruction of Europe after World War Two and the Truman Administration's Point Four Program. In 1961, the Foreign Assistance Act was signed into law and USAID was created by executive order.<\/p>\r\n<p>Since that time, USAID has been the principal U.S. agency to extend assistance to countries recovering from disaster, trying to escape poverty, and engaging in democratic reforms.<\/p>\r\n<p>USAID is an independent federal government agency that receives overall foreign policy guidance from the Secretary of State. <a href=\"http:\/\/www.usaid.gov\/our_work\/\">Our Work <\/a>supports long-term and equitable economic growth and advances U.S. foreign policy objectives by supporting:<\/p>\r\n<ul>\r\n <li>  economic growth, agriculture and trade;<\/li>\r\n <li>  global health; and,<\/li>\r\n <li>  democracy, conflict prevention and humanitarian assistance. <\/li>\r\n<\/ul>\r\n<p>We provide assistance in five regions of the world:<\/p>\r\n<ul>\r\n <li>  <a href=\"http:\/\/www.usaid.gov\/locations\/sub-saharan_africa\/\">Sub-Saharan Africa<\/a>;<\/li>\r\n <li>  <a href=\"http:\/\/www.usaid.gov\/locations\/asia\/\">Asia<\/a>;<\/li>\r\n <li> <a href=\"http:\/\/www.usaid.gov\/locations\/latin_america_caribbean\/\"> Latin America and the Caribbean<\/a>,<\/li>\r\n <li> <a href=\"http:\/\/www.usaid.gov\/locations\/europe_eurasia\/\"> Europe and Eurasia<\/a>; and<\/li>\r\n <li>  <a href=\"http:\/\/www.usaid.gov\/locations\/middle_east\/\">The Middle East<\/a>. <\/li>\r\n<\/ul>\r\n<p>With headquarters in Washington, D.C., USAID's strength is its field offices around the world. We work in close partnership with private voluntary organizations, indigenous organizations, universities, American businesses, international agencies, other governments, and other U.S. government agencies. USAID has working relationships with more than 3,500 American companies and over 300 U.S.-based private voluntary organizations.<\/p>\r\n<h2>What we do<\/h2>\r\n<p>The objective of USAID’s neonatal program is to reduce neonatal mortality by building on and strengthening neonatal interventions within existing maternal and child health programs and linking with prevention of mother-to-child transmission (PMTCT) in high HIV\/AIDS prevalence countries.<\/p>\r\n<p>Key program strategies include treating the mother and baby as a dyad by integrating maternal and newborn programs to support the full continuum of care during pregnancy, labor and birth, and after the birth of the baby with evidence-based perinatal and newborn interventions. USAID programs strengthen community-based approaches and empower families and communities to care for the newborn with simple preventive interventions such as warmth, hygienic cord care, early and exclusive breastfeeding, and to recognize and refer for complications such as infection. The program links communities to facilities, strengthens health systems, trains health providers, and improves quality of care in health facilities.<\/p>\r\n<p>By putting a spotlight on postpartum care, USAID has renewed its program efforts to strengthen the weakest link in the continuum of care to reach new mothers and their newborns for health services and information when most maternal and neonatal deaths occur. In a relatively new and evolving field, USAID’s newborn care program supports operations research to guide the identification, bundling, and scaling up of interventions and emphasizes the support of global and regional leadership and advocacy.<\/p>","post_title":"U.S. Agency for International Development","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"us-agency-international-development","to_ping":"","pinged":"","post_modified":"2016-01-21 19:44:00","post_modified_gmt":"2016-01-21 19:44:00","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=partner&p=834","menu_order":0,"post_type":"partner","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":793,"post_author":"7211","post_date":"2009-11-18 19:01:52","post_date_gmt":"2009-11-18 19:01:52","post_content":"Save the Children is the world's leading independent organization for children. Our vision is a world in which every child attains the right to survival, protection, development and participation. Our mission is to inspire breakthroughs in the way the world treats children and to achieve immediate and lasting change in their lives.\r\n<h2>What we do<\/h2>\r\n<img class=\"aligncenter size-full wp-image-795\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/2.-Parth-Sanyal.jpg\" alt=\"2. Parth Sanyal\" width=\"800\" height=\"533\" \/>\r\n\r\n \r\n\r\nPhoto: Parth Sanyal\/ Save the Children\r\n\r\n<strong>Saving Newborn Lives (SNL) Program:<\/strong>\r\n\r\nSave the Children's Saving Newborn Lives (SNL) program, supported by the Bill & Melinda Gates Foundation, is a globally recognized leader in newborn health and a respected voice in many low-resource countries. Since 2000, Save the Children\u2019s SNL program has worked as a catalyst towards ensuring that newborn health and survival is on global and national agendas. SNL seeks to achieve equitable and effective coverage of high-impact newborn services and practices institutionalized at scale.\r\n\r\nSNL currently works in partnership with 7 countries to reduce newborn mortality, improve newborn health and bring high-impact interventions to scale. In 4 countries \u2013 Bangladesh, Malawi, Nepal, and Uganda - the program works through partnerships with government and stakeholders to achieve and document the scale-up of newborn health interventions. These countries have achieved substantial policy and system readiness for scale-up and are positioned for accelerated change in service delivery and health outcomes. In 3 additional countries \u2013 Ethiopia, India, and Nigeria \u2013 SNL coordinates with government and partners to develop policies, program experience, and evidence in order to promote the effective and sustainable scale-up of key interventions. SNL collaborates closely with governments and implementing partners, and provides direct support to the design, development and implementation of national strategies and policies to improve the quality and availability of care for mothers and newborns. For more information on Save the Children\u2019s Newborn Health program, <a href=\"http:\/\/www.savethechildren.org\/site\/c.8rKLIXMGIpI4E\/b.6234293\/k.7FC1\/Newborn_Health.htm\">visit our website<\/a>.\r\n\r\nSNL currently maintains the Healthy Newborn Network and strives to establish the site as the \u201cgo-to\u201d resource for newborn health information, data and resources.\r\n\r\nSave the Children also offers technical assistance and support as the newborn health leading partner under USAID\u2019s Maternal and Child Survival Program (MCSP). MCSP is a global, USAID Cooperative Agreement to introduce and support high-impact health interventions with a focus on 24 high-priority countries with the ultimate goal of ending preventable maternal and child deaths within a generation. The Program is focused on ensuring that all women, newborns and children most in need have equitable access to quality health care services to save lives.\r\n\r\n<strong>Save the Children Campaigns:<\/strong>\r\n\r\nAs an independent and global organization, Save the Children has a powerful voice in campaigning for long-term change, and a track record of success. Save the Children encourages its supporters to put pressure on decision makers and opinion formers to change policies and practices, locally and globally, to ensure children's rights become reality.\r\n\r\n<strong><img class=\"alignleft size-full wp-image-796\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/EveryOne-Thumb.jpg\" alt=\"EveryOne - Thumb\" width=\"160\" height=\"160\" \/>The EveryOne Campaign<\/strong>: Save the Children has launched a global campaign to ensure governments provide basic health and nutrition services to millions of children who might not otherwise live to see their fifth birthday. EVERY ONE is Save the Children\u2019s global campaign to ensure no child under the age of five dies from preventable causes, and that public attitudes do not tolerate a return to high levels of child deaths. By 2015, the campaign aims to have catalyzed a breakthrough in governments' policies and practices that dramatically accelerates sustainable progress towards MDG 4. Follow the <a href=\"http:\/\/everyone.savethechildren.net\/news\">Every One campaign via their blog. <\/a>\r\n\r\n<strong><img class=\"alignleft size-full wp-image-797\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/EveryBeatMatters-Thumb.jpg\" alt=\"EveryBeatMatters - Thumb\" width=\"160\" height=\"160\" \/>Every Beat Matters<\/strong>: Through this campaign, Save the Children aims to raise awareness among the American public of the key issues related to child survival, engage and foster champions who are willing to raise their voices for children in need around the world, and create a movement which demands that we increase access to lifesaving care so that no parent suffers the unnecessary loss of a child. Every child deserves the chance to grow up healthy, happy and able to reach their potential. Take a look at <a href=\"http:\/\/www.everybeatmatters.org\/\">Save the Children\u2019s Action Network <\/a>for more information.","post_title":"Save the Children","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"save-the-children","to_ping":"","pinged":"","post_modified":"2016-12-12 10:03:13","post_modified_gmt":"2016-12-12 15:03:13","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=partner&p=793","menu_order":0,"post_type":"partner","post_mime_type":"","comment_count":"0","filter":"raw"}],"issues":[{"ID":134,"post_author":"7211","post_date":"2015-10-21 15:20:44","post_date_gmt":"2015-10-21 15:20:44","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>The first hours and days after birth are the riskiest for both mothers and newborns.<\/h2>\r\nThere are important interventions and practices during this period that can reduce these risks. There are also\u00a0opportunities at multiple points in time to help ensure high coverage for these interventions and practices. For example, contacts during pregnancy can be used for counseling and health education on newborn care and care-seeking for danger signs in the postnatal period. This support may be especially important in settings where births still take place at home.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">75<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456333677270{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of newborn deaths that occur in the first week of life<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">48<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456333713404{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of hours after birth when a newborn is at highest risk of death<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][vc_column_text]Postnatal care can also include assessment and counseling provided to the mother before discharge after giving birth in a health facility, as well as later contacts during home visits by community health workers or postnatal visits to a health facility. Broadly, the major elements of postnatal care include:\r\n<ul>\r\n \t<li>counseling and health education on recognition of danger signs and appropriate care-seeking (for both mother and newborn)<\/li>\r\n \t<li>counseling and health education on routine care practices such as exclusive breastfeeding and good thermal care practices<\/li>\r\n \t<li>dispensing and related counseling for routine preventive interventions (such as chlorhexidine for cord-stump care and postnatal iron supplementation)<\/li>\r\n \t<li>assessment and case-management and referral for any identified complications or risk conditions<\/li>\r\n<\/ul>\r\nIt is through the same contacts that we have opportunities to improve outcomes for both mother and newborn, so programs and services\u00a0should focus on needed care for both. This more integrated perspective is reflected in the most recent guidance from\u00a0the World Health Organization\u00a0(see Resources below).\r\n\r\nHome visitation by community health workers has been promoted as a postnatal care strategy based on promising pilots in South Asia that demonstrated potential for reducing newborn deaths. However, it has proven difficult to achieve comparable benefits under more routine conditions at scale.\r\n\r\nWith the marked increases in institutional deliveries seen in many settings in recent years, there is increasing attention being given to taking better advantage of the time before discharge to ensure delivery of key aspects of postnatal care. Challenges to taking optimal advantage of this contact include the very high volume of births in some centers and the common practice of early discharge.\r\n\r\nFollow-up visits to the health facility for postnatal care can provide an important opportunity to ensure assessment, care, and provision of important counseling. Suitable timing and content of such care will depend on the overall configuration of postnatal care services specific to the setting.[\/vc_column_text][vc_text_separator title=\"Key Resources\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/who-recommendations-on-maternal-and-newborn-care-for-a-positive-postnatal-experience\/\">WHO recommendations on maternal and newborn care for a positive postnatal experience (2022)<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Postnatal care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"postnatal-care","to_ping":"","pinged":"","post_modified":"2022-10-17 18:49:11","post_modified_gmt":"2022-10-17 22:49:11","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=134","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[],"countries":[],"featured_image":25370},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/25368"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=25368"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/25368\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/25370"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=25368"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/categories?post=25368"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/tags?post=25368"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}