Coverage of Care for Women and Newborns

There are a wide range of strategies and interventions used to save the lives of women and children during pregnancy, childbirth birth and in the neonatal period. These include:

• Reproductive health services such contraceptive services
• Antenatal care
• Skilled obstetrical care and emergency services
• Post natal care

The provision of contraceptives as a reproductive health measure appears to be in slight decline globally, most likely as a result of reduction in prioritization and funding. Almost a third of women worldwide have an unmet need for family planning measures.

However, antenatal care has been hugely successful especially in low income economies. Coverage is quite high with even the destitute able to access antenatal services in most countries. There is concern however, on the quality of care and the effectiveness of antenatal care provided. Interventions especially low income economies are not always appropriate at the antenatal level. This represents a missed opportunity to save the lives of mothers and children.

As regards to obstetrical care and emergency services at birth, less than 40% of women in low income countries have access to a skilled attendant at birth. Many countries have made great strides in this area since the inception of the Millennium Development Goals but much still remains to be done especially in 50 least developed countries.

Postnatal care leaves much to be desired in many countries including middle and high income countries. The level of skilled care at the post natal level is much worse than that found at the obstetrical stage in most low income countries. This is despite the fact that research has shown that a high level of care during the first two days of an infant's life can make all the difference. The majority of neonatal deaths are caused by infections, complications of pre-term birth and birth asphyxia.

The former two causes contribute to about two thirds of all neonatal deaths. The shocking bit is that half of these deaths can be prevented with simple and cost effective interventions, most notably, Kangaroo Mother Care. Kangaroo Mother Care is a method of care whereby a pre-term infant, able to breathe on its own, is held in a skin-to-skin breastfeeding position. Skin-to-skin contact has been shown to stabilize breathing, pulse rate and temperature. Babies are able to feed better and hence gain weight faster. The ability to breastfeed strengthens the immune system and helps the infant fight infections. Despite this well researched and documented method of care, Kangaroo Mother Care is yet to go into widespread use in many medical facilities and clinics around the world.