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\u2018Dakshata\u2019 by Government of India proves mentorship is essential to achieve sustained success in maternal newborn health (MNH)<\/strong><\/a> –\u00a0 For sustained long-term impact, Dakshata incorporated continued learning mechanisms such as follow-ups and mentoring and support visits. This video infographic by Jhpiego and the Children’s Investment Fund Foundation shares the impact of mentoring and support visits on overall Dakshata success and sustainability.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"In 2015, the Government of India launched \u2018Dakshata\u2019, meaning adroitness, across the country, to reduce the maternal mortality ratio and stillbirth rate. The initiative aimed to strengthen the quality of care (QoC) during and immediately after childbirth through focused and customized trainings for strategic skill-building of providers on high-impact essential practices. The strategy transferred learning … Continued<\/a><\/p>\n","protected":false},"author":7211,"featured_media":52234,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"acf":[],"yoast_head":"\nHealthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/blog\/learnings-from-the-government-of-india-dakshata-initiative-to-improve-the-quality-of-maternal-and-newborn-care\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Learnings from the Government of India 'Dakshata' initiative to improve the quality of maternal and newborn care - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"In 2015, the Government of India launched \u2018Dakshata\u2019, meaning adroitness, across the country, to reduce the maternal mortality ratio and stillbirth rate. 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Jhpiego draws on its technical expertise and extensive experience in the field- as well as the creativity and science of The Johns Hopkins University- to prevent the needless deaths of women and their families. For more than 35 years, Jhpiego has empowered front-line health workers by designing and implementing effective, low-cost, hands-on solutions to strengthen the delivery of health care services for women and their families. With nearly 700 employees currently working in over 54 counties, Jhpiego puts evidence-based health innovations into everyday practice, breaking down barriers to high-quality health care for the world’s most vulnerable populations. Jhpiego's technical expertise lies in the areas of maternal and child health, family planning and reproductive health, cervical cancer prevention and treatment, and infectious disease.<\/p>","post_title":"Jhpiego","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"jhpiego","to_ping":"","pinged":"","post_modified":"2016-01-21 00:17:31","post_modified_gmt":"2016-01-21 00:17:31","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=partner&p=617","menu_order":0,"post_type":"partner","post_mime_type":"","comment_count":"0","filter":"raw"}],"issues":[{"ID":137,"post_author":"7211","post_date":"2015-10-21 15:21:12","post_date_gmt":"2015-10-21 15:21:12","post_content":"<p>[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]<\/p>\n<h2>More than 5,000 stillbirths occur each day, nearly half of which happen during labor and birth.<\/h2>\n<p>Stillbirths have been overlooked as a global public health crisis, in spite of the fact that often highly-preventable solutions overlap with maternal and newborn health interventions. Social taboos and stigma remain a challenge and are culturally variant. The stillbirth rate is a sensitive indicator of quality of care in pregnancy and at birth.[\/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]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">1.9<\/span>m<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690996796159{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of stillbirths that occurred in 2021<\/span><\/h3>\n<p>[\/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]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">20<\/span>m<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666119375673{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">projected stillbirths by 2030 <a href=\"https:\/\/data.unicef.org\/resources\/a-neglected-tragedy-stillbirth-estimates-report\/\">if no progress is made<\/a><\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">45<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690997040986{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of stillbirths that <a href=\"https:\/\/data.unicef.org\/topic\/child-survival\/stillbirths\/\">occurred during labor in 2021<\/a><\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_separator][vc_column_text]<\/p>\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>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_row_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>High number of preventable stillbirths<\/h4>\n<p>An estimated 1.9 million stillbirths occur annually, 89 percent of which occur in low- and lower-middle-income countries and 77 percent of which occur in sub-Saharan Africa and Southern Asia. Over <a href=\"https:\/\/data.unicef.org\/topic\/child-survival\/stillbirths\/\">45% of all stillbirths occur during labor and birth<\/a>. The most common causes of stillbirth are similar to those that also kill mothers and newborns, such as maternal infections (notably syphilis and malaria), non-communicable diseases, and obstetric complications. Only 7 percent are due to congenital disorders, but some of these are also preventable*.<\/p>\n<h6>*All data on this page represents the most recent data available. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further.<\/h6>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>Heavy burden of psychosocial and economic cost on families and nations<\/h4>\n<p>The burden of stillbirth affects women, families, caregivers, communities, and society. Parents experience various psychological symptoms that often persist long after the death of their baby but could be mitigated by respectful maternity services, including bereavement care. An estimated 4\u00b72 million women are living with depression associated with a previous stillbirth. Stigma and taboo further exacerbate trauma for families, and fatalism impedes stillbirth prevention.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text]<\/p>\n<h4>Most stillbirths are preventable with health system improvements<\/h4>\n<p>Stillbirths are preventable through high-quality antenatal and intrapartum care within the continuum of care for women and children. Such inputs result in a quadruple return on investment by preventing maternal and newborn deaths and stillbirths, plus improving child development. The stillbirth rate is a sensitive marker of quality and equity of health care.<\/p>\n<p>Opportunities to integrate stillbirths within women's and children's health programs must be seized more systematically. Some initiatives, such as the multi-stakeholder <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/every-newborn-action-plan\/\" target=\"_blank\" rel=\"noopener\">Every Newborn Action Plan<\/a>, within the <a href=\"https:\/\/www.everywomaneverychild.org\/\" target=\"_blank\" rel=\"noopener\">Every Woman Every Child<\/a> umbrella, have included stillbirths. Data for tracking stillbirths has increased. However, mentions of stillbirth remain limited in most relevant policies, research, and funding; these are missed opportunities to integrate and act to ensure progress.<\/p>\n<p>More information can be accessed in either the UNIGME 2023 Report - <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/never-forgotten-the-situation-of-stillbirth-around-the-globe\/\"><em>Never Forgotten - The situation of stillbirth around the globe<\/em> <\/a>or in <em>The Lancet\u00a0<\/em><a href=\"http:\/\/www.thelancet.com\/series\/ending-preventable-stillbirths\" target=\"_blank\" rel=\"noopener\">Ending Preventable Stillbirths Series<\/a>, published January 2016. The Series presents the state of stillbirths, highlights missed opportunities, and identifies actions for accelerated progress to end preventable stillbirths[\/vc_column_text][vc_row_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<strong>Key resources<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/never-forgotten-the-situation-of-stillbirth-around-the-globe\/\">UNIGME 2023 Report - Never Forgotten - The situation of stillbirth around the globe<\/a><\/li>\n<li><a href=\"https:\/\/data.unicef.org\/resources\/a-neglected-tragedy-stillbirth-estimates-report\/\">UNIGME 2020 Report - A Neglected Tragedy: The global burden of stillbirths<\/a><\/li>\n<li><a href=\"http:\/\/www.thelancet.com\/series\/ending-preventable-stillbirths\" target=\"_blank\" rel=\"noopener\">The Lancet Series \u201cEnding Preventable Stillbirths\u201d 2016<\/a><\/li>\n<li><a href=\"https:\/\/www.mamaye.org\/blog\/preventing-stillbirths-stronger-perinatal-death-review\" target=\"_blank\" rel=\"noopener\">Mamaye - Preventing Stillbirths with Stronger Perinatal Death Review<\/a><\/li>\n<li>The Lancet Ending Preventable Stillbirth <a href=\"http:\/\/stillbirthalliance.org\/news\/lancet-series-launch\/\" target=\"_blank\" rel=\"noopener\">Lay Summary<\/a> (in English, Spanish, French, Italian, Portuguese, Arabic, Hindi and Chinese)<\/li>\n<li>Ending Preventable Stillbirth <a href=\"https:\/\/www.youtube.com\/watch?v=ZGvMWnO1O08\" target=\"_blank\" rel=\"noopener\">Video<\/a><\/li>\n<li>The Lancet Ending Preventable Stillbirths <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(15)00954-X\/abstract\" target=\"_blank\" rel=\"noopener\">Campaign<\/a><\/li>\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=FRObOlP3M94\" target=\"_blank\" rel=\"noopener\">Video <\/a>of The Lancet Ending Preventable Stillbirths main launch event<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text] <\/p>\n<p><iframe src=\"https:\/\/www.youtube.com\/embed\/ZGvMWnO1O08?rel=0\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]<\/p>\n","post_title":"Stillbirths","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"stillbirths","to_ping":"","pinged":"","post_modified":"2023-08-02 13:32:12","post_modified_gmt":"2023-08-02 17:32:12","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=137","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":117,"post_author":"7211","post_date":"2015-10-21 15:17:43","post_date_gmt":"2015-10-21 15:17:43","post_content":"<p>[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]<\/p>\n<h2>Within the continuum of care, childbirth care is provided during labor and delivery. Interventions include skilled care at birth, basic and comprehensive obstetric care, and management of preterm births.<\/h2>\n<p>It is important that the childbirth care interventions for mother and newborn are seen as a functional unit delivered in a narrow time window by the same healthcare provider (or team) and in the same place, with referral for management of complications including mother and baby together.[\/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]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">1.3<\/span>m<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666029713081{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of intrapartum stillbirths globally in 2015<\/span><\/h3>\n<p>[\/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]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">66<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690994883939{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of births attended by a skilled health professional in least developed countries (2016-2023)<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">18<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690994111505{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of cesarean section deliveries globally (2016 - 2021)<br \/>\n<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/vc_column_inner][\/vc_row_inner][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]The interaction between skilled healthcare workers and mothers before, during, and just after labor is critical for saving lives and ensuring good, healthy birth outcomes. Best practices include ensuring mothers are involved in the decision-making (including where they will give birth) and are provided with supportive care at all stages and that the birth proceeds without intervention as long as labor progresses normally and the woman and baby are well. When complications arise, health workers must be ready to respond appropriately.[\/vc_column_text][vc_text_separator title=\"Key resources\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]<\/p>\n<ul>\n<li><a href=\"https:\/\/www.unfpa.org\/sowmy\">State of the World\u2019s Midwifery Report<\/a><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/MCPC-2nd-ed.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">\u00a0<\/a>(2021)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/MCPC-2nd-ed.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">WHO guidelines Managing complications in pregnancy and childbirth: A guide for midwives and doctors\u00a0<\/a>(2017)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/every-newborn-action-plan\/\" target=\"_blank\" rel=\"noopener\">Every Newborn Action Plan<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]<\/p>\n<ul>\n<li><a href=\"https:\/\/www.who.int\/tools\/essential-newborn-care-training-course\">Essential Newborn Care Course<\/a>\u00a0\u2013 interim version of the second edition (2022)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/blog\/ending-preventable-stillbirths-requires-improving-quality-of-care\/\" target=\"_blank\" rel=\"noopener\">Ending Preventable Stillbirths requires improving quality of care<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","post_title":"Childbirth care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"childbirth-care","to_ping":"","pinged":"","post_modified":"2023-08-02 12:48:31","post_modified_gmt":"2023-08-02 16:48:31","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=117","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"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"},{"ID":135,"post_author":"7211","post_date":"2015-10-21 15:20:52","post_date_gmt":"2015-10-21 15:20:52","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>Many countries, even those that have achieved improvements in the last 15 years, still experience high rates of maternal and newborn deaths due to poor quality services.<\/h2>\r\nPoor quality can affect the demand for care from communities. Accelerating reduction of preventable deaths and poor outcomes depends on service quality improvements, including addressing health system challenges such as infrastructure, supplies, skilled and appropriately deployed health providers, and management. Quality improvement systems that address both the content and standards as well as the process and experience of care should be an important area of investment during the period of the new <a href=\"http:\/\/www.un.org\/sustainabledevelopment\/sustainable-development-goals\/\" target=\"_blank\">Sustainable Development Goals<\/a>.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_single_image image=\"13784\"][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_empty_space height=\"16px\"][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]","post_title":"Quality improvement","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"quality-improvement","to_ping":"","pinged":"","post_modified":"2016-02-25 15:58:05","post_modified_gmt":"2016-02-25 20:58:05","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=135","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":124,"post_author":"7211","post_date":"2015-10-21 15:18:57","post_date_gmt":"2015-10-21 15:18:57","post_content":"<p>[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]<\/p>\n<h2>In order to meet our maternal and newborn health objectives, we need health professionals and community health workers that:<\/h2>\n<ul>\n<li>Are readily available where and when needed<\/li>\n<li>Have the necessary knowledge and skills for the services they are providing<\/li>\n<li>Are appropriately motivated to provide the needed service<\/li>\n<li>Are adequately supported and enabled with supervision, support systems (supply chain and\u00a0information systems), necessary infrastructure (space, water, electricity, and communications), and more<\/li>\n<\/ul>\n<p>Ensuring that this set of conditions is met depends on adequate human resources policy and management.[\/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]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">82<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1691004009799{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of global births that were assisted by suitably qualified health workers between 2016 and 2021<\/span><\/h3>\n<p>[\/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]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">66<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1691004076215{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of women in least developed countries that were assisted by suitably qualified health workers during birth between 2016 and 2021<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]Over the past decade and a half, considerable emphasis within global maternal-newborn health programs has been placed on \u201cskilled birth attendance,\u201d i.e., births assisted by suitably qualified health workers. This reflects the observation that for women delivering at home without ready access to emergency obstetrical care, support from traditional birth attendants proved inadequate to substantially reduce risk of death for the mother or newborn. Considerable effort has been expended in many settings to help ensure that women give birth with the assistance of qualified human resources, specifically a health worker, and generally in a health facility.<\/p>\n<p>However, in many instances there has not\u00a0been equal attention given to the actual substance of the care provided or the necessary supports to enable health workers to provide adequate care. In recent years, there has been increasing attention in program work to the quality and content of maternal-newborn services, particularly around the time of birth. This is reflected in current work at the World Health Organization on improving quality of maternal-newborn health care.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]Part of what is implied in the \u201cskilled birth attendance\u201d strategy is that assisting in childbirth does not necessarily require a physician. Many interventions related to maternal-newborn health can be competently delivered by categories of health workers with comparatively modest training.<\/p>\n<p>Accordingly, certain maternal-newborn services can be provided by categories of health workers labelled as \u201ccommunity health workers\u201d (CHWs). This is a broad designation that includes:<\/p>\n<ul>\n<li>Health auxiliaries with training sometimes approaching that of registered nurses<\/li>\n<li>Paid full-time workers with several months of basic training<\/li>\n<li>Non-salaried but financially \u201cincentivized\u201d workers, typically working less than full-time<\/li>\n<li>Volunteers providing services on a periodic or intermittent basis with little or no financial incentives<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_single_image image=\"13796\" add_caption=\"yes\" alignment=\"center\" css_animation=\"appear\"][vc_column_text]In some settings, there is more than one tier of CHWs.\u00a0When robustly supported (as they can be under project conditions), non-salaried and volunteer CHWs have been demonstrated as effective for various maternal- and newborn-related services. There are fewer examples of such work being effectively delivered at national scale, under non-project conditions. A very important but frequently neglected factor is the supports needed for effective programs.<\/p>\n<p>The issue is not so much,<\/p>\n<ul>\n<li><em><strong>can <\/strong>CHWs be effective for a particular service?<\/em><\/li>\n<\/ul>\n<p>But rather,<\/p>\n<ul>\n<li><em><strong>what supports are necessary<\/strong> for effectiveness?<\/em><\/li>\n<\/ul>\n<p>And,<\/p>\n<ul>\n<li><em><strong>are such supports feasible at scale<\/strong> under normal, non-project conditions?<\/em><\/li>\n<\/ul>\n<p>Program efforts commonly address health worker knowledge and skills. This is typically done primarily by training. Motivation is less often given focused attention. Certainly, some aspects of performance can be positively affected by financial incentives, although such incentives can also have unintended negative consequences. However, motivation is more than just a matter of incentives.<\/p>\n<p>In many settings, legitimate and illegitimate absences from work significantly undermine reliable access to services. This can be a consequence, for example, of frequent off-site trainings. There are also many settings where health workers are either frequently away from their posts without authorization or where they offer services only for very limited periods of time each day.<\/p>\n<p>Even when health workers are at their posts, their practices are affected not only by material they may have been exposed to in training but also by other influences on what they consider appropriate care. For example, health workers may be well aware of what treatments are recommended or authorized in national treatment guidelines but may -- for any number of reasons -- prefer to offer treatments not reflected in official protocols. For human resources program efforts to be effective in ensuring availability of appropriate care, they need to respond to the actual factors influencing health worker practices.<\/p>\n<p>Supervision is often mentioned as an important performance factor in health worker practices. Certainly under project conditions, there are numerous examples of \u201csupportive technical supervision\u201d or \u201cmentoring\u201d that appear to have made a positive contribution to quality of care. There are, however, far fewer examples of this function being effectively delivered under non-project conditions. Health-facility-level quality improvement efforts can serve a somewhat similar function, whereby groups of health staff work collectively to improve performance, holding each other accountable.[\/vc_column_text][vc_column_text]<strong>Key resources<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/77764\">WHO Recommendations: Optimizing health worker roles for maternal and newborn health<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","post_title":"Human resources for health","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"human-resources","to_ping":"","pinged":"","post_modified":"2023-08-02 15:22:01","post_modified_gmt":"2023-08-02 19:22:01","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=124","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":251,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Asia","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"asia","to_ping":"","pinged":"","post_modified":"2016-02-11 21:51:07","post_modified_gmt":"2016-02-11 21:51:07","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&p=251","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":184,"post_author":"7211","post_date":"2015-10-21 21:58:21","post_date_gmt":"2015-10-21 21:58:21","post_content":"[vc_row][vc_column css=\".vc_custom_1453305596740{padding-top: 30px !important;padding-bottom: 30px !important;}\"][vc_text_separator title=\"Leading causes of neonatal deaths in India (2020)\" el_class=\"transform:upperclass\"][vc_row_inner][vc_column_inner][vc_round_chart type=\"doughnut\" stroke_width=\"1\" stroke_color=\"custom\" values=\"%5B%7B%22title%22%3A%221%25%20Diarrhoea%22%2C%22value%22%3A%221%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%220%25%20Tetanus%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%23cec2ab%22%7D%2C%7B%22title%22%3A%227%25%20Pneumonia%22%2C%22value%22%3A%227%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2239%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2239%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2221%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2221%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%225%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%225%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%229%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%229%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2218%25%20Other%20conditions%22%2C%22value%22%3A%2218%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686158564827{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&source=gmail&ust=1551964625737000&usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158668744{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">19.1<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158653873{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">4<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158622111{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">62<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158639136{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">12.2<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158578078{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">89.4\r\n<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1651070613999{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">57<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698696298715{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">13<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births <37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158608753{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">103<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1453307990481{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"India","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"india","to_ping":"","pinged":"","post_modified":"2023-10-30 16:03:36","post_modified_gmt":"2023-10-30 20:03:36","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&p=184","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"about_the_author":"","author_image":false},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/52901"}],"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=52901"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/52901\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/52234"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=52901"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/categories?post=52901"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/tags?post=52901"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"\"](\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/1-6.png\")
Rajasthan, impresses with maternal mortality and stillbirth reduction by following \u2018Dakshata\u2019<\/strong><\/a> – In India, institutional deliveries have risen showing promising results, however, disparity prevails across the regions. Dakshata resulted in the stillbirth ratio declining by 15.3 points and maternal mortality ratio dropped by 22 points.<\/li>\n<\/ul>\n![\"\"](\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/2-4.png\")
Government of India helps mothers and their babies in Rajasthan with \u2018Dakshata\u2019: the journey<\/strong><\/a> – Dakshata implementation partners Jhpiego and the Children\u2019s Investment Fund Foundation documented their learnings backed by evidence in the form of video infographics.<\/li>\n<\/ul>\n