Programme material

This brief highlights the contribution of the E4A-MamaYe programme in Nigeria towards improving maternal and newborn health outcomes. It highlights outcomes on accountability in the health sector by holding those in power responsible for their commitments to women‘s and girls‘ health. The programme worked with stakeholders to make complex health data accessible and actionable. With the vision that everyone can be an advocate with the power of data, read how E4A-MamaYe has evolved across several phases.

E4A-Mama Ye supports Bungoma County to understand the importance of the RMNCAH scorecard. Amy Jackson, Technical Officer at E4A-MamaYe, interviewed two members of the County Health Management Team on how this tool is used to inform decision making on health.

E4A-MamaYe is currently supporting grassroots civil society organizations in engaging in the annual government planning and budgeting processes.

E4A-MamaYe is currently supporting civil society coalitions to engage in the GFF across sub-Saharan Africa.

E4A-MamaYe recently published a practice briefing on our pioneering Health Budget Transparency Assessment (HBTA) tool in Malawi. This briefing summarises what health budget transparency is, why it’s important and how it has vitally contributed to the local government reform health agenda in three northern districts in Malawi.

Is scaling-up community maternal verbal autopsies a viable approach to inform action to reduce maternal mortality? Dr Sarah Barnett considers this question and shares her opinion with us.

Breastfeeding is a human rights issue for babies and mothers, and should be protected and promoted for the benefit of both.

This briefing summarises the key findings from a review conducted Malawi understand how the “response” element of a community maternal death surveillance and response system is implemented in one district of Malawi. The briefing is for health providers to inform their efforts in improving quality of care in Malawi. The study was conducted by UCL and PACHI Malawi on behalf of MamaYe Malawi.

This briefing summarizes the key findings from a study of maternal death audits, which explored the quality of care offered to pregnant women arriving at a health facility in a stable condition compared to those who are critically ill. The briefing is for health providers to inform their efforts in improving quality of care in Malawi. The study was conducted by UCL and PACHI Malawi on behalf of MamaYe Malawi.

This report, published by the High-Level Working Group on the Health and Human Rights of Women, Children and Adolescents, is set to promote leadership to ensure all humans have the “right to health and through health”.

Adolescent mothers between the ages of 15 and 19 experience greater risks to their health in comparison with women aged 20 to 24 years old. This is mainly attributed to their biological and social disadvantages, such as post-partum bleeding and economic status, respectively.Babies born to adolescent mothers are also at a greater risk of suffering from complications like preterm delivery and infant mortality, compared to babies born to mothers in their early twenties.The authors of this paper advocate for there to be more research about how pregnant adolescents use maternal health services. This will complement strategies to prevent early marriage and early childbearing, and will help reach the sustainable development goals.The authors conducted a systematic review to explore the factors that affect adolescents’ use of maternal health services in low- and middle-income countries (LMICs).Here are the key findings:Through the literature search, it was found that there is limited available research about adolescents’ use maternal health services. This may be due to the difficulties in capturing information about adolescent mothers. Past surveys suggest that adolescents have lower fertility rates than older groups of women. Cultural barriers are also important to consider when approaching adolescent mothers in LMICs, in relation to issues with consent, shame and lack of power. The authors suggest an increase in qualitative research would complement quantitative studies and provide a more enabling environment to what can be a sensitive issue.Education of the adolescent mother was shown to be a significant factor that influences her use of maternal health services, making a case for a greater focus on strategies to improve their education. The spouse’s education was also seen to be a significant factor in the decision to attend maternal health services. It is, therefore, necessary to engage men in the demand for maternal services among adolescents.Other influencing factors that were found to be significant were economic status, media exposure and residence (urban versus rural). Greater emphasis should be given to removing financial barriers to access maternal health services. The authors also suggest that further research is needed about adolescents’ access to social media. Social media may also be a platform where adolescents would be more willing to share their stories than talking face to face with adults.The authors found that adolescents’ use of antenatal care (ANC) services was associated with delivery with skilled birth attendance. Using both these services was found to be associated with adolescent use of postnatal care services. ANC services present an opportunity for pregnant adolescents to learn about the benefits of using maternal health services and to prepare for childbirth. However, the integration of these services should not overburden already overstretched workforces. These services should also be approachable for unmarried adolescents.The evidence showed that there were gaps from when the data was collected to when it is analysed meaning adolescent groups from the data period are different from the adolescents that the plans and policies are being drawn for.The findings of this paper must be carefully interpreted as there were limitations in the search for literature (e.g. the authors only searched for English articles).Echoing the SDGs call to ‘leave no on behind’, the authors conclude with a call for more research on and efforts to improve access to maternal services for adolescents, including those such as unmarried adolescents who are harder to reach.To read the article for free, click here.Banke-Thomas, O.E., Banke-Thomas, A.O. & Ameh, C.A. (2017). Factors influencing utilisation of maternal health services by adolescent mothers in low- and middle-income countries: a systematic review. BMC Pregnancy and Childbirth, 17:65 

Adolescent mothers between the ages of 15 and 19 and their babies experience greater risks to their health in comparison with women aged 20 to 24 years old. In this paper, the authors explore the factors that affect adolescents’ use of maternal health services in low- and middle-income countries (LMICs).

This qualitative study in Nigeria explores the perceptions and experiences of mistreatment during childbirth, from the perspectives of women and health providers.

In this paper, the authors present their findings on the Newborn Cross-Sectional Study as part of the Intergrowth-21st Project. The study aimed to explore the risk factors related to antepartum stillbirth by examining foetal-growth and pregnancy outcomes of women who received ultrasounds and good antenatal care during pregnancy in eight urban settings worldwide.

This report collates findings from two multilingual workshops and a global online survey. It highlights the challenges faced by midwives globally and puts forward their recommendations for overcoming these barriers in order to help them provide quality care to women and newborns.

We asked five experts in maternal, newborn and child health from around the world to share their knowledge and experiences in perinatal death surveillance and response. Here is what they told us.

This is the sixth and last paper in a Lancet Series about maternal health. It focuses on outlining five priority actions for the next five years to improve maternal health, in light of the findings of the five previous papers in the series.

Paper 4 in the Lancet Maternal Series explores the main models used to deliver maternity care in high-income countries. It examines the drivers of these models, looks at case studies from the USA and Sweden, and discusses how the models influence the health of mothers and babies.

This second paper in the maternal health Lancet series discusses two extremes in antenatal, intrapartum and postnatal care associated with avoidable maternal morbidity and mortality: ‘too little, too late’ (TLTL) and ‘too much, too soon’ (TMTS).

This is the third paper in a Lancet Series of six papers about maternal health. It focuses on health care during childbirth, comparing different models of care across low- and middle-income countries. It argues that we need to focus on birth locations and capacity; staff skills; women’s access to routine and emergency care; and referral systems for emergency care.

Paper 1: This is the first article published in the 2016 Lancet Series on Maternal Health. The article provides an overview of the patterns and trends in maternal health worldwide. It focuses on the changing nature of maternal health problems, both between and within populations.

Paper five in the maternal health Lancet series discusses external factors that may affect pregnant women, their communities and health facilities over the next 15-20 years. These include social, political, environmental and demographic changes.

The Independent Accountability Panel issued the first annual report for the period of the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030). The panel provides insight on the progress towards the Global Strategy based on their review and feedback of monitoring results from others.

The ICD-PM helps health providers and others to standardise the classification of the causes and timing of deaths for babies that are stillborn or die within the first seven days after birth (the ‘perinatal period’). It also allows perinatal deaths to be linked to maternal ill health. It is recommended to be used by all countries across the world for comparable data of perinatal deaths.

This publication by the World Health Organization (WHO) gives guidance on conducting a mortality audit system to investigate the modifiable factors in perinatal deaths and prevent similar causes of events. This guide is intended to be used at various levels of a health system, from a small programme in a health facility to a national system.

This report describes the global status of implementation of maternal death surveillance and response (MDSR). It presents findings from the 2015 global survey of national MDSR systems, which was conducted by the World Health Organization in collaboration with United Nations Population Fund (UNFPA).

This World Health Organization (WHO) report outlines agreed standards of care and quality measure to ensure that every woman and newborn receives quality of care from pregnancy to after birth in health facilities.

We asked six experts from Malaysia, Ireland, Ethiopia and India about the importance of multi-disciplinary teams in maternal death surveillance and response (MDSR) systems. Read more about the insights they shared with us.

This literature review explores the factors affecting people’s willingness to donate blood voluntarily in sub-Saharan African settings. The review found that the main barriers to donation related to health concerns and a lack of knowledge. Important motivating factors included saving another person's life and access to adequate information.

This IDEAS report examines the interactions between families and frontline workers and coverage of key interventions for mothers and newborns in Gombe State, Nigeria. The study was conducted between June 2012 and June 2015.

This report presents analysis of data from 52 countries in Africa, Asia, and Latin America and the Caribbean where a Demographic and Health Survey was conducted between 2005 and 2014. It looks specifically at the reasons why sexually-active women who want to avoid pregnancy do not use contraceptives.

This knowledge brief summarises the key guiding principles on social accountability approaches in health in Tanzania. The review was conducted by Options Consultancy Services and commissioned by Irish Aid.

This study explores the factors influencing the effective delivery of demand-generation interventions among adolescents in Sierra Leone and other low-resource settings. The findings were summarised into lessons learned and a Framework for Action to guide future demand-generation interventions among adolescents.

In case you are beginning to lose track of all the GFF activities that have been going on lately, we've summarised the meetings in Kenya, Montreux and Washington, as well as links to related documents.

This Countdown Case Study examines Malawi’s success in improving child survival and achieving Millennium Development Goal (MDG) 4. The study finds that early adoption and effective implementation of evidence-based policies was central to Malawi’s success in improving child survival. There is now a need to focus on improving newborn survival.

Paper 5: This is the fifth and final article in the Lancet Series on Ending Preventable Stillbirths. The paper aims to increase global concern about stillbirths and identify actions to accelerate progress in ending preventable stillbirths.

This Lancet series focuses on ending preventable stillbirths globally. The series provides strong evidence that most stillbirths are preventable, and proposes actions to ensure successful integration of stillbirths into post-2015 initiatives for women’s and children’s health.

Paper 2: This is the second article published in the 2016 Lancet Series on Ending Preventable Stillbirths. The article reviews the rates and risk factors for stillbirths, and assesses the progress towards ending preventable stillbirths.

Paper 3: As part of the Lancet special series on Stillbirths, the authors of paper 3 present new data to highlight the impact of stillbirths on parents, families, healthcare providers, and wider society, as well as estimating some of the direct and indirect costs incurred.

Paper 1: This is the first article published in the 2016 Lancet Series on Ending Preventable Stillbirths. The article reviews progress in key areas. It aims to inform the integrated post-2015 agenda for maternal and newborn health.

Paper 4: This is the fourth article published in the 2016 Lancet Series on Ending Preventable Stillbirths. The article outlines the current scale of stillbirths in high-income countries and identifies strategies for decreasing stillbirths and meeting the needs of parents whose baby is stillborn.

The Making it Happen programme aims to improve the health of mothers and babies by improving skilled birth attendance and emergency obstetric and newborn care in Kagera and Pwani regions in Tanzania. This quarterly report sets out progress made between July and September 2015.

This report presents the latest internationally comparable maternal mortality ratio (MMR) estimates, including trends from 1990 to 2015. The estimates are important for measuring progress on the Sustainable Development Goals and working towards ending preventable maternal deaths.

This document compiles the new commitments in support of the Global Strategy for Women’s, Children’s and Adolescents’ Health. The document was published 30 October 2015, and contains political documents from over 40 countries, including Ethiopia, Malawi, and Sierra Leone.

This document describes the updated United Nation’s Global Strategy for Women’s, Children’s and Adolescents’ Health, 2016-2030. The Global Strategy is to be a roadmap to end all preventable deaths of women, children and adolescents by 2030 and improve their health.

This report is an in-depth review of accountability processes at the regional, national, and sub-national levels, particularly those related to maternal and newborn health. The report reviews key programmes and strategies and provides recommendations to strengthen accountability for maternal and newborn health.

This Evidence for Action study examines the extent to which maternal death reviews are implemented and how findings are used in Kano state in Nigeria.

The International Budget Partnership’s Open Budget Survey is a global assessment of transparency, participation, and oversight in budget processes. The survey assessed budget systems in 102 countries, including the MamaYe countries.

This Evidence for Action report investigates the allocation and use of financial resources for maternal and newborn health in Kano state. The findings reveal a number of areas of intervention to help strengthen financial resources for MNH, including key advocacy roles for civil society organisations.

These evidence-based World Health Organization (WHO) guidelines inform health professionals on the prevention and treatment of maternal bacterial infections (peripartum infections).

This Evidence for Action study evaluates the availability of lifesaving drugs and supplies to treat the major causes of maternal and newborn death in Kano State, Nigeria. The findings indicated that many facilities lacked the necessary quantities of lifesaving drugs and supplies.

In this video, the Speaker expresses the determination of the State Assembly to ensure 15 per cent budgetary allocation to the health sector.

Tanzania is on track to meet MDG 4 for child survival, but is making insufficient progress for newborn survival and maternal health and family planning. To understand this mixed progress and to identify priorities for the post-2015 era, Tanzania was selected as a Countdown to 2015 case study.

This report, produced by the World Health Organization, looks at the state of inequality in health in low- and middle-income countries. It presents some successes in reducing within-country inequalities but highlights that inequalities still persist in most reproductive, maternal, newborn and child health indicators.

This briefing note analyses planned government health spending across 21 African countries in 2014 and trends between 2008 and 2014.

This article presents an analysis of the impact of maternal death on infant and child survival, in Butajira Ethiopia. The findings indicate that children whose mothers survive childbirth have much greater chance of survival than those whose mothers die during childbirth.

This article by the World Health Organization (WHO) outlines their vision of quality of care for maternal and newborn health (MNH). This vision is informed by a framework and quality of care improvement strategy, which together will help the WHO to develop guidance for global and national stakeholders on how to implement the WHO’s vision of quality of care for MNH.

This article presents a checklist tool that aims to improve organisation, management and oversight at facilities that deliver comprehensive or basic emergency obstetric care.

This systematic review examines maternal and neonatal mortality in Tanzania.

This study assesses the impact of the Ebola outbreak on reproductive, maternal, neonatal, adolescent, and child health outcomes in Sierra Leone, as well as the factors affecting the demand and supply of these services. It was produced by UNFPA, with support from the Ministry of Health and Sanitation, UK Department for International Development, Irish Aid and Options.

This WHO report provides a global review of water, sanitation, and hygiene (WASH) services in health care facilities in 54 low- and middle-income countries. The report finds a lack of appropriate WASH services and highlights the need for urgent action at local, national, and global levels.

A cost-effectiveness study into the pay-for-performance pilot programme in Tanzania found that there were substantial costs in managing the programme, and generating and verifying performance data. It could also be diverting the attention of health service personnel from actual service delivery, especially at the lower levels of service provision. If it were scaled-up across Tanzania, each facility birth would incur an additional cost of between $94 and $261.

This brief outlines of government plans to accelerate progress towards Millennium Development Goals 4 and 5 (including the One Plan, the Sharpened One Plan, BRN, and the One Plan II). The document outlines the funding challenges of meeting the targets within the various initiatives and calls for more government and development partner donor support to ensure the targets are met.

This Letter to the Editor, published in the BMJ, draws attention to the possible neglect of essential health services in the face of an epidemic, such as the current Ebola virus outbreak.

This study reviews the data on the first 106 patients that were diagnosed with Ebola virus disease in Sierra Leone this year. The article presents findings on the common symptoms associated with the disease, as well as the incubation period and fatality rate identified in these patients.

The authors combine data from the Global Burden of Disease (GBD) Study 2013 with other datasets to estimate the global burden of HIV, tuberculosis and malaria. They find that progress has been made but these three diseases still pose a huge global health challenge. Some estimates also contrast with WHO and UNAIDS estimates.

The authors combine data from the Global Burden of Disease (GBD) Study 2013 with other datasets to estimate the global burden of HIV, tuberculosis and malaria. They find that progress has been made but these three diseases still pose a huge global health challenge. Data for Sierra Leone is also provided.

Using 2010 Demographic and Health Survey data and 2006 Service Provision Assessment survey data, home births and facility births were assessed on the adequacy of the water and sanitation environment at the time of delivery.

In highlighting the importance of improving quality of maternal and newborn care, the journal BJOG: An International Journal of Obstetrics & Gynaecology, has released this special supplement. The supplement includes review articles, country studies, and commentaries on the provision and accurate assessment of quality of care for maternal and newborn health.

This study assesses the knowledge and practices of women on maternal and child health in rural Sierra Leone. This study identifies inadequacies and recommends health education activities for maternal and child health improvements.

This article reviews the evidence on the cost-effectiveness of strategies to improve maternal and newborn health in low resource settings. The authors highlight a number of common supply- and demand-side strategies in this area but call for further high quality studies.

The Every Newborn Action Plan sets out goals, targets and actions to end preventable newborn deaths and stillbirths by 2035.

This is the third article in The Lancet’s series on Midwifery. It reviews four countries’ efforts to improve maternal and newborn survival through investments in midwifery.

Paper 2 of the Lancet Series on Midwifery models the life-saving impact of scaling up midwifery interventions on women and babies.

This article is part of the Lancet Midwifery Series. It argues that midwives have an important contribution to make towards meeting international goals for maternal and newborn health because they provide an essential level of care between less-skilled healthcare workers and obstetricians. In particular, midwives can make specific contributions to improving the quality of care for all women and newborns.

The Lancet Midwifery series, together with The State of the World’s Midwifery Report 2014, is the most important and wide-reaching engagement with midwifery to date, bringing together a range of clinical, health system and policy perspectives.

This research concludes the Lancet Series on Midwifery by summarising each of the three previous articles and demonstrating how investment in midwives can improve quality of care and save lives.

This article provides a comparative and historical analysis of the association between unmet need for family planning and fertility across four regions: Asia, Africa, and Latin America and the Caribbean. It is a part of a special series on Unmet Need for Family Planning published in the Population Council’s journal Studies in Family Planning.

This paper reviews the evidence regarding the impact of early and exclusive breastfeeding on the health and survival of infants in the first month of life. It finds that initiation of breastfeeding within the first hour of life, as well as exclusive breastfeeding, can reduce the risk of neonatal death.

This report describes the shortage of skilled health workers needed to deliver acceptable, accessible and quality care for every woman, mother and baby in 73 high-burden countries, including Malawi.

The State of the World’s Midwifery finds that midwives, when educated and supported to do so, can provide 90% of the essential care needed by women and infants in the 73 countries where progress in maternal and newborn survival is most urgently needed.

This series of articles, published in the Lancet, focuses on newborn babies, providing estimates of the numbers of newborns dying every year. The series highlights the scale of under-reporting of newborn births and deaths, analyses data on newborn survival for 195 countries, and outlines the interventions necessary to save lives.

This is the first of five articles published in the Lancet Every Newborn Series. This article assesses the progress made in the last decade on the integration of newborn care across the continuum of reproductive, maternal, newborn, and child health.

This article published in the Lancet Every Newborn Series estimates the potential maternal, newborn and stillborn lives saved and the costs of implementing evidence-based, interventions along the continuum of care.

This is the second article in the Lancet Every Newborn Series. The article reviews trends and progress in neonatal survival since 2005.

This article prioritises interventions and mechanisms needed to improve newborn survival and political will and leadership for maternal and newborn health

The fourth paper in the Every Newborn Lancet series analyses common health system problems that prevent newborn survival. It also describes effective strategies employed by countries to accelerate newborn mortality reduction.

A presentation outlining the process of generating the National Sharpened One Plan.

The rivalry of two politicians, who are also in-laws, and how their political ambitions affect survival of the citizens, especially pregnant women and newborns.

This is a policy brief developed by MamaYe Sierra Leone calling for policy makers to take action to ensure that clinics have clean water and good sanitation available.

This report presents internationally comparable maternal mortality ratio estimates, including trends from 1990 to 2013. It is the seventh in a series of analyses by the United Nations agencies, led by The Maternal Mortality Estimation Inter-Agency Group (MMEIG).

This report analyses the loss of government revenue in Sierra Leone due to tax incentives to foreign companies such as mining companies.

This literature review explores the effectiveness of global postpartum family planning programmes in terms of improving birth spacing and increased contraceptive use.

"The first day of a child’s life is the most dangerous and too many mothers give birth alone on the floor of their home or in the bush without any life-saving help. We hear horror stories of mothers walking for hours during labour to find trained help, all too often ending in tragedy," says Jasmine Whit Bread, CEO of Save the Children at the launch of their latest report.

This paper discusses methodological challenges experienced while conducting maternal death review research in Malawi.

Can the lack of water or sanitation facilities can be associated with maternal mortality?

The researchers wanted to discover which factors are associated with women who bypass primary clinics to deliver in a health centre of hospital, without being referred there.

This UNICEF report tracks progress and promotes accountability for global commitments made to children. The report also presents information on neonatal deaths making it an important report for those working with MamaYe. This year’s report presents:Figures of child mortality and causes of under-five deaths by country.Trends and levels in under-five mortality over the past two decades.Analysis of progress towards Millennium Development Goal 4.Causes of and interventions against child mortality.Highlights of national and global initiatives by governments, civil society and the private sector to accelerate progress on child survival.Great progress has been made but huge challenges remain: The global rate of under-five mortality has roughly halved, from 90 deaths per 1,000 live births in 1990 to 48 per 1,000 in 2012. And yet, since 1990, 216 million children have died before their fifth birthday.As under-five child mortality is reduced through increases coverage of some essential interventions, a greater share of deaths is occurring in the newborn period (first 28 days of life). If current trends continue in all countries, the world will not meet the MDG 4 target until 2028 instead of 2015.Despite a reduction of 29% of under-five deaths, Sierra Leone remains the country with the highest under-five mortality in the World, with 182 under-five deaths for every 1000 live births in 2012. The annual rate of reduction is remains low (1.6%) and there were 39 000  deaths in 2012 (estimates). The share of neonatal deaths  in under-five deaths has increased and  neonatal deaths accounted for 27% of under-five deaths in 2012. Among other causes of death, 19% of the under-five deaths were caused by pneumonia.To read the report, click here.If you want to find out more about the advocacy that supported this report:- Melinda Gates and other high-profile individuals have been engaged in this process; you can read Melinda Gates' blog entry on:  <http://www.impatientoptimists.org/Posts/2013/09/The-Most-Important-Statistic-in-the-World>- The Lancet has also commented on the report: <http://www.apromiserenewed.org/css/Lancet_Comment_Renewing_the_Promise_of_Suvival_for_Children_13_Sep_2013.pdf>- And it was published in light of post-2015 consultations <http://www.worldwewant2015.org/>  that are taking place in the UN General Assembly in Fall 2013.UNICEF (2013). Committing to Child Survival: A Promise Renewed - Progress Report 2013. New York: United Nations Children's Fund.

This paper sets out to quantify the risk of maternal death in adolescents in 144 countries and to compare these ratios with those for women in other five year age groups.

This report from the World Health Organization outlines six global nutrition targets for 2025. It emphasises the importance of a multidimensional approach to maternal, infant and young child nutrition, as well as coordinated but specific actions at both national and international levels.

This Guttmacher Institute report provides new estimates, for 2014, of the needs for and costs and benefits of sexual and reproductive health interventions. The key areas examined in this report are contraceptive services, maternal and newborn care, and HIV and other STI services.

This toolkit provides background information, tools and messages for advocates to help ensure improved and equitable access to life-commodities for women, children and newborns.

The World Health Organization and UNICEF have coordinated the development of an Every Newborn action plan to end preventable newborn deaths. As part of the development of the Every Newborn action plan, a Toolkit has been developed to provide support to those involved in promoting more action and accountability on newborn and maternal health.

This article reviews the epidemiology of preterm birth and its global burden, highlighting the fact that preterm birth rates appear to be increasing in all countries with available data as well as existing geographic disparities.The article is part of a Reproductive Health supplement published to mark World Prematurity Day 2013. The supplement's six articles explore the burden of and solutions to preterm birth based on the key WHO report “Born too Soon: the global action report on preterm birth”.To access the full article for free, click here>For links to access the full supplement for free, click here>Blencowe, H., Cousens, S., Chou, D., Oestergaard, M., Say, L., Moller, A.B., Kinney, M., & Lawn, J.E. (2013). Born Too Soon: The global epidemiology of 15 million preterm births. Reproductive Health, 10(Suppl 1:S2), 1–14.

Overview of the World Health Organization (WHO) guidelines for maternal death surveillance and response and a spotlight on Tanzania.

This study investigates the knowledge of safe motherhood among women in rural northern Nigeria. Findings aim to inform a new intervention, the Safe Motherhood Initiative Demand Side.

The reports titled Payment for maternal care and women’s experience of giving birth: evidence from four districts in Tanzania and Payment and quality of antenatal care in two rural districts of Tanzania, published by Research for Poverty Alleviation (REPOA) highlight the prevailing conditions in Tanzanian public health facilities as regards out of pocket payment for pregnancy, delivery and after delivery care services.Key findings from this survey include:Women in both rural and urban district still pay significantly for antenatal, delivery and postnatal care despite the national policy of free services, even in public health facilitiesOverall, payment for antenatal, delivery and postnatal care was common in public than in FBO facilities as 7% of women who delivered in FBO facilities got free services compared to only 4% in public facilities.Women were more likely to pay for delivery care services than for antenatal and postnatal care and postnatal care was the most likely services to be offered free of charge.Factors such as unavailability of services near women’s homes, unpredictable out of pocket payments, neglect by attendants while in labour and during delivery, lack of essential supplies at the health facilities, including for caesarean delivery, perceived quality of care and previous experience with the health care services still impact variously to shape women’s likelihood of accessing and utilizing delivery care at health facilities.Access and use of ANC services are largely determined by distance and ability to pay for transport and services.To read the full reports, click the titles below Payments for Maternal Care and Women’s Experiences of Giving Birth: Evidence from Four Districts in TanzaniaPayments and Quality of Ante-Natal Care in Two Rural Districts of Tanzania

The 2013 Ibrahim Index of African Governance evaluates African countries’ progress with regard to a range of governance indicators.

This study examines the determinants, barriers and enablers for use of skilled birth attendants in Northern Nigeria.

The goal of this WHO annual report is to identify the research questions that open the way to universal health coverage and to discuss how these questions can be answered.

This paper presents key findings and recommendations from a systematic review of qualitative literature on maternal emergency transport in low- and middle-income countries. It explores practices, barriers and facilitators in transport use.

These Notes for Discussion were developed for the Asia-Pacific Leadership and Policy Dialogue in Manila, November 2012. This event brought together Ministers and senior officials from nearly 20 countries in the Asia-Pacific region to discuss mutual strategies and principles in accelerating progress for women's and children's health in the region.They are useful evidence summaries with country case studies, focusing on five themes that are important to improving women’s and children’s health:  accountability, advocacy, implementation, innovation, investment and research. They were designed to further the dialogue between policymakers, programme managers, and other stakeholders to achieve “more, better, and faster” reproductive, maternal, newborn and child health in their region.They can now be used as helpful guides to support the development of women’s and children’s health in other regions.Effective Management of Decentralized Health SystemsFor links to all the summaries in the series, click here>The Partnership for Maternal Newborn & Child Health. (2012). Effective Management of Decentralized Health Systems: Notes for discussion. Geneva: WHO.

These Notes for Discussion were developed for the Asia-Pacific Leadership and Policy Dialogue in Manila, November 2012.

This research examines data from 35 countries to assess the equity in coverage of skilled birth attendants over time by wealth status of the population. It also explores coverage of measles vaccination and insecticide-treated bednets.

This paper analyses nine low-income and middle-income countries in Africa and Asia that have implemented reforms to move towards universal health coverage. The structure of Ghana and Nigeria’s national health insurance reforms are covered in this analysis.

This Lancet Series examines the evidence for universal health coverage. Universal health coverage is a system in which everyone in a society can get obtain the health-care services they need without suffering financial hardship.

The purpose of this policy briefing is to provide information on the importance of adopting a supportive legislative and policy framework for the effective implementation of maternal death reviews (MDRs) in Sierra Leone.

This report, produced by Guttmacher Institute and United Nations Population Fund, presents new 2012 estimates of the needs for and costs and benefits of contraceptive services. The report presents estimates for all low-income countries, including all MamaYe countries.

This is a special issue of the Journal of Health, Population, and Nutrition. It includes a group of studies from both Bangladesh and India that examine the long-and short-term consequences of maternal complications for mothers and newborns.

This is the first report to provide national, regional and global estimates of preterm births.To read the report, click here>To read an overview of The Lancet Born Too Soon Supplement, click here>March of Dimes, The Partnership for Maternal Newborn & Child Health, Save the Children, World Health Organization. (2012). Born Too Soon: The Global Action Report on Preterm Birth. (Eds) Howson, C.P., Kinney, M.V., & Lawn, J.L. WHO: Geneva.

This document describes the opportunities that mobile technology offers for training community health workers (CHWs)

The Ghana Atlas of Birth, published in 2012, presents data on key health indicators in an attractive and easy-to-understand way. It was produced by the Alliance for Reproductive Health in collaboration with the Universities of Ghana and Southampton, and Evidence for Action.

This research used data from national surveys in 54 countries to examine how inequalities in maternal, newborn and child health interventions differ for the people according to their level of wealth by intervention and country.

This study examines gender discrimination in relation to a woman registering the birth or passing on her nationality to her child. The research focuses on the contexts of Latin America and the Caribbean, Asia, East Africa and West Africa. The study was commissioned by Plan International.

A review of the existing evidence on the prevalence and determinants of non-psychotic common perinatal mental disorders among women living in low- and lower-middle-income countries.

This progress review, conducted by the African Union Commission in 2010, is intended to inform members of the African Union and other stakeholders of the progress made in the implementation of the Maputo Plan of Action.

How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania is a paper published in 2011. It describes a study that was conducted in a rural district in northern Tanzania to assess the quality of care women received during antenatal care consultations (ANC) in 2008.  The availability of essential items to support quality ANC services was also assessed as well as women provider interaction. Based on the findings, the authors make recommendations to ensure full implementation of Tanzania’s focused ANC model. To read this article, click here. No subscription or payment required.Magoma, M., Requejo, J., Merialdi, M., Campbell, O. M. R., Cousens, S., & Filippi, V. (2011). How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania. BMC pregnancy and childbirth, 11(1).

Malaria during pregnancy is a major global health problem. This article presents the findings of a literature review of qualitative research on social and cultural factors associated with the use of malaria during pregnancy prevention in sub-Saharan Africa.

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