{"id":36557,"date":"2019-06-11T12:43:25","date_gmt":"2019-06-11T16:43:25","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=resource&p=36557"},"modified":"2019-06-10T12:55:43","modified_gmt":"2019-06-10T16:55:43","slug":"mcsps-contribution-to-critical-policies-ensuring-effective-reproductive-maternal-newborn-child-and-adolescent-health","status":"publish","type":"resource","link":"https:\/\/www.healthynewbornnetwork.org\/resource\/mcsps-contribution-to-critical-policies-ensuring-effective-reproductive-maternal-newborn-child-and-adolescent-health\/","title":{"rendered":"MCSP\u2019s Contribution to Critical Policies Ensuring Effective Reproductive, Maternal, Newborn, Child, and Adolescent Health"},"content":{"rendered":"

The US Agency for International Development (USAID)<\/a> flagship Maternal and Child Survival Program (MCSP)<\/a> focuses on 27 countries, with the ultimate goal of ensuring that all women, newborns and children most in need have equitable access to quality health care services. Over the life of the program, MCSP has supported the development and adoption of over 100 policies. In an effort to move beyond reporting the number of policies supported, MCSP did an analysis to place this contribution within the larger reproductive, maternal, newborn, child and adolescent health (RMNCAH) policy environment in USAID priority countries, analyzing how the program addressed some of the policy gaps identified.<\/p>\n

Having a policy aligned with the latest evidence is not sufficient to ensure its implementation with consistency and quality. On the other hand, without a policy in place, coherent and sustained action is difficult. Policies based on the latest global and country evidence provide a framework upon which to build resilient, accountable and responsive health systems. As the pace of evidence generation on technical and implementation issues accelerates, the need for agile and effective policy development processes become more urgent, bringing together various actors to ensure technical rigor, effective rollout and accountability.<\/p>\n

It has been difficult to firmly establish the link between policies and health outcomes because policy analyses have traditionally been descriptive and systematic country-level information has been lacking. Recently, there have been efforts to fill this information gap with systematic analyses of the content and state of development of policies related to RMNCAH. Countdown to 2015 undertook a notable effort to analyze country progress toward achieving Millennium Development Goals 4 and 5 in the 75 countries where more than 95% of all maternal, newborn, and child deaths occur, including systematically describing policies and their specific content elements that relate to evidence-based RMNCAH interventions. This and similar analyses have begun to offer a better understanding of the link between policies and health outcomes.<\/p>\n

The interactive policy dashboard, which provides specific findings from this study, is available here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

The US Agency for International Development (USAID) flagship Maternal and Child Survival Program (MCSP) focuses on 27 countries, with the ultimate goal of ensuring that all women, newborns and children most in need have equitable access to quality health care services. Over the life of the program, MCSP has supported the development and adoption of … Continued<\/a><\/p>\n","protected":false},"author":7211,"featured_media":36559,"comment_status":"open","ping_status":"closed","template":"","toolkit":[],"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\/resource\/mcsps-contribution-to-critical-policies-ensuring-effective-reproductive-maternal-newborn-child-and-adolescent-health\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"MCSP\u2019s Contribution to Critical Policies Ensuring Effective Reproductive, Maternal, Newborn, Child, and Adolescent Health - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"The US Agency for International Development (USAID) flagship Maternal and Child Survival Program (MCSP) focuses on 27 countries, with the ultimate goal of ensuring that all women, newborns and children most in need have equitable access to quality health care services. 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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"}],"other_organizations":"","issues":[{"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"},{"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":119,"post_author":"7211","post_date":"2015-10-21 15:18:12","post_date_gmt":"2015-10-21 15:18:12","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>Working closely with local leaders, civil society members, and existing structures is a core principle of community engagement.<\/h2>\r\nEngagement strengthens citizens' voices by involving them in the decisions that affect them. Community engagement can increase the impact of health programs and contribute to long-term sustainability. Women\u2019s groups convened for participatory learning and action is a methodology that has been tested across Latin America, Asia, and Sub-Saharan Africa. When certain key conditions are met, this approach has been shown to reduce maternal and newborn mortality risk.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_single_image image=\"13787\"][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_empty_space][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][vc_column_text]There are a wide range of community-level actions that can make a difference for maternal and newborn health; these include:\r\n<ul>\r\n \t<li>Mobilizing local resources, including municipal governments, to expand service access (e.g., by hiring <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/midwifery\/\" target=\"_blank\" rel=\"noopener\">nurse-midwives<\/a>)<\/li>\r\n \t<li>Having local health committees or development committees prioritize maternal-newborn health (e.g., by developing local provisions for emergency transport)<\/li>\r\n<\/ul>\r\nLocal government, community-based organizations, local religious communities, and others all potentially can mobilize to ensure better outcomes for mothers and newborns.\r\n\r\nOne methodology specifically developed to encourage effective community mobilization for maternal-newborn health is facilitated women\u2019s groups with cycles of participatory learning and action. Experiences with this method have been comparatively small scale and under controlled study conditions so far. The women\u2019s groups have been demonstrated as effective in reducing mortality in rural (but not urban) settings, when there is sufficiently intensive implementation to ensure that at least a third of pregnant women participate in the group meetings. The usual pattern has been to work through the specific content in a series of monthly meetings over a period of 24 months or more, under the facilitation of a trained animator. In most of the documented cases, these animators have been paid by a non-governmental organization or research project, although there has been experience using existing cadres of community health workers, such as Accredited Social Health Activists (ASHAs) in India. Because of the design of these studies, it is not possible to clearly separate out the relative contributions to mortality reduction that can be attributed to community action versus behavior change by individual participating pregnant women.[\/vc_column_text][vc_column_text]<strong>Key resources<\/strong>\r\n<ul>\r\n \t<li><a href=\"http:\/\/apps.who.int\/iris\/bitstream\/10665\/127939\/1\/9789241507271_eng.pdf?ua=1\" target=\"_blank\" rel=\"noopener\">WHO recommendation on community mobilization through facilitated participatory learning and action cycles with women\u2019s groups for maternal and newborn health (2014).<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Community engagement","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"community-engagement","to_ping":"","pinged":"","post_modified":"2022-10-19 17:49:45","post_modified_gmt":"2022-10-19 21:49:45","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=119","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[],"countries":[],"views":"1176"},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/36557"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/resource"}],"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=36557"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/36557\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/36559"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=36557"}],"wp:term":[{"taxonomy":"toolkit","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/toolkit?post=36557"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}