Maternal, Newborn, and Child Health
MNCH Health Systems Strengthening Interventions
Maternal, Newborn, and Child Health
MNCH Health Systems Strengthening InterventionsImproving Quality: Newborn Care
Ensuring Quality in Newborn Care
Quality Newborn Care refers to the timely delivery of essential, evidence-based interventions that ensure every newborn receives a healthy start to life. It encompasses practices that support survival, prevent complications, and promote long-term well-being – beginning from the moment of birth. Central to this approach is the presence of skilled providers who can assess, manage, and respond to the needs of both healthy and at-risk newborns.
As part of strengthening service delivery for newborns, many local governments implement lifesaving interventions, such as Neonatal Resuscitation Programs (NRPs), which equip providers to manage birth asphyxia and improve survival in the critical first moments of life, and Maternal and Neonatal Tetanus Elimination (MNTE) strategies, which prevent deadly infections through immunization and hygienic cord care.
While these interventions address different risks, they both represent a commitment to scaling up high-impact, quality newborn services that reduce preventable deaths and align with global goals for improved neonatal outcomes.
What Are the Benefits of Delivering Quality Newborn Care?
How to Implement
1. Strengthen Maternal Immunization
- Provide tetanus toxoid (TT) vaccination to all women of reproductive age.
- Conduct mass campaigns in high-risk areas.
- Maintain a reliable vaccine supply at facilities and outreach points.
2. Promote Clean and Safe Birth Practices
- Train birth attendants on infection prevention and clean delivery techniques.
- Provide clean delivery kits for facility and home births.
- Encourage facility-based births and improved maternal care infrastructure.
3. Introduce Neonatal Resuscitation Training
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- Organize simulation-based NRP trainings for doctors, nurses, and midwives.
- Use WHO and national curricula to standardize content.
- Integrate refresher training into professional development cycles.
4. Equip Delivery Areas with Emergency Supplies
- Neonatal bag and mask (self- or flow-inflating).
- Suction devices and oxygen supply.
- Endotracheal tubes, laryngoscope, and warmers.
- Epinephrine and volume expanders for emergencies.
- Daily and weekly equipment checks for readiness.
5. Integrate into Facility Protocols
- Embed resuscitation algorithms into standard delivery room procedures.
- Establish rapid response systems for emergency neonatal care.
6. Conduct Community Awareness and Engagement
7. Implement Continuous Quality Improvement (CQI)
- Conduct regular emergency drills.
- Review neonatal outcomes post-resuscitation and identify improvement areas.
- Use debriefings and supportive supervision for learning.
8. Monitor and Scale-Up
- Track service coverage, outcomes, and staff performance.
- Advocate for integration into national MNCH policies.
- Build sustainability through local government ownership and training-of-trainers models.
What's the Evidence
- In Francophone West Africa, TCI-supported local governments saw a 275% increase in postpartum family planning use – a reflection of strengthened maternal and newborn care systems.
- WHO reports that access to oxytocin reduces postpartum hemorrhage, a leading cause of maternal death.
- Neonatal resuscitation devices can reduce newborn deaths by up to 30% (UNICEF, 2022).
Key Indicators
Key indicators for measuring the quality of newborn care service delivery:
- Percentage of pregnant women receiving two or more tetanus toxoid doses.
- Number of healthcare workers trained in neonatal resuscitation per facility.
- Availability of resuscitation equipment and medications in delivery rooms.
- Proportion of newborns receiving positive pressure ventilation within 1 minute.
- Rate of newborns successfully resuscitated and discharged without complications.
- Number of reported neonatal tetanus cases per 1,000 live births.
- Facility stock levels of chlorhexidine and clean delivery kits.
- Percentage of births attended by skilled providers.
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Quality of Care
Looking for practical guidance on delivering MNCH services? Visit the MNCH Service Delivery Toolkit for step-by-step instructions on Newborn Care. Â
Tips
- Use simulation-based training and emergency drills to reinforce provider skills.
- Build strong referral networks for advanced neonatal care.
- Engage families in birth preparedness and cord care practices.
- Conduct community education on antenatal care and safe delivery practices.
- Include newborn care in maternal health outreach campaigns.
Challenges
- Limited Resources: Address supply shortages with improved procurement planning and advocate for increased funding.
- Skill Gaps: Ensure regular refresher training, coaching, and supportive supervision.
- Data Deficiency: Strengthen data collection and feedback loops to monitor and improve outcomes.
- Cultural Barriers: Use local influencers and health workers to shift harmful cord care and delivery practices.
Key Resources
- Neonatal Resuscitation Guidelines. WHO 2012
- Helping Babies Breathe Training Manual. American Academy of Pediatrics
- NSSK Resource Manual. Ministry of Health and Family Welfare, Government of India 2020
- Neonatal Resuscitation Module. Ministry of Health and Family Welfare, Government of India 2014
