Maternal, Newborn, and Child Health
MNCH Health Systems Strengthening Interventions
Maternal, Newborn, and Child Health
MNCH Health Systems Strengthening Interventions
Supplies
Ensuring reliable supply chains for MNCH commodities
Supplies
Ensuring reliable supply chains for MNCH commodities
A reliable supply of maternal, newborn, and child health (MNCH) commodities is essential for delivering high-quality health services and improving health outcomes. Stockouts of essential medicines, contraceptives, and life-saving interventions can lead to service disruptions, reduced client trust, and preventable maternal and child deaths. Strengthening supply chain management within health systems ensures that facility-based providers and community health workers (CHWs) have continuous access to the supplies they need to provide effective care.
Effective supply chain management involves forecasting demand, procuring quality-assured commodities, ensuring timely distribution, and maintaining proper storage and inventory management. Local governments play a key role in ensuring that MNCH supplies are adequately funded, tracked, and replenished. Leveraging digital tools, strengthening procurement systems, and integrating community-level reporting can help prevent stockouts and reduce wastage.
This section of the HSS toolkit provides practical guidance, tools, and best practices for improving supply chain resilience and ensuring an uninterrupted flow of essential MNCH commodities. By investing in stronger supply systems and fostering coordination across all levels of the health system, countries can enhance service delivery, improve maternal and child health outcomes, and sustain the impact of high-impact practices at scale.
Essential Supplies for Effective MNCH Service Delivery
Maternal Health Supplies
Newborn Health Supplies
Child Health Supplies
Basic Infection Prevention and Hygiene Supplies
Family Planning & Reproductive Health Supplies
- Oxytocin & Misoprostol (for preventing and managing postpartum hemorrhage)
- Magnesium sulfate (for managing eclampsia and pre-eclampsia)
- Iron and folic acid supplements (for preventing anemia)
- Blood pressure monitors
- Delivery kits (gloves, sterile blades, umbilical cord clamps, etc.)
- Neonatal resuscitation equipment (bag and mask, suction devices)
- Thermal care items (skin-to-skin wraps, warmers, hats)
- Chlorhexidine (for umbilical cord care)
- Injectable antibiotics (for treating infections like sepsis)
- Kangaroo mother care wraps (for preterm or low-birth-weight babies)
- Oral rehydration salts (ORS) and zinc (for diarrhea management)
- Vaccines (BCG, Polio, DTP, Measles, etc.)
- Antibiotics (for pneumonia and other infections)
- Vitamin A supplements (for immune support)
- Growth monitoring tools (weighing scales, MUAC tapes for malnutrition assessment)
- Hand sanitizers and gloves
- Disinfectants (for sterilization)
- Safe delivery kits
- Water purification tablets
- Contraceptives (oral pills, injectables, condoms, IUDs)
- Pregnancy test kits
- Postpartum IUD insertion kits
How to Implement
Implementing an effective supply chain for MNCH involves several key steps:
1. Assess Needs
- Organize a needs assessment to ascertain gaps in supplies and prioritize essential commodities.
- Use tools like the WHO Essential Medicines List and the UNICEF Supply Catalogue.
2. Strengthen Supply Chain Management
- Plan a robust supply chain system to ensure the availability of supplies at all levels of the health system.
- Predicting and Quantification: While taking seasonal variations and consumption rates into account, clearly define how much of each supply will be required over a given time frame
- Procurement Planning: Develop a procurement plan that includes supplier selection, budgeting, and timelines.
- Quality Assurance: Make sure that all purchased supplies fulfill established quality standards to ensure safety and effectiveness. The Manual for Procurement and Supply of Quality-Assured Maternal, Newborn, and Child Health Commodities provides comprehensive guidelines for establishing a quality assurance system in the MNCH supply chain.
- Storage and Inventory Management: Strictly put in place appropriate storage conditions and inventory control systems to maintain supply integrity and prevent stockouts or overstocking.
- Distribution and Logistics: To guarantee prompt supply delivery to medical facilities, set up effective distribution networks.
- Use digital tools like mSupply or OpenLMIS for inventory management.
3. Train Healthcare Workers
- Provide training on the use of supplies, such as neonatal resuscitation or infection prevention.
- Take advantage of resources such as the Helping Babies Breathe (HBB) training curriculum.
4. Monitor and Evaluate
- Implement a monitoring system to track the supply’s usage and availability.
- Use key indicators (see below) to regularly assess supply chain performance and identify areas for improvement.
- Use metrics such as supply utilization rates and stockout rates, for instance.
5. Engage Stakeholders
- Collaborate with governments, NGOs, and private sector partners to ensure sustainable funding and procurement.
- Use available resources, such as the UNICEF Supply Division.
6. Advocate for Policy Change
- Advocate for policies that prioritize MNCH supplies and allocate sufficient funding.
- Take advantage of resources, such as the PMNCH Advocacy Toolkit and TCI’s Advocacy Toolkit.
MNCH Supply Considerations Across the Continuum of Care
Preconception Care
Antenatal Care
Labor & Delivery
Newborn Care
Postpartum Care
Children under 5
Preconception Care
Preconception care helps ensure individuals are healthy prior to pregnancy, reducing complications and improving outcomes.
Examples of Preconception Care Supplies
- Iron and folic acid supplements
- Multivitamins
- Condoms
- STI testing kits
- Educational materials for counseling
Benefits of Maintaining Adequate Preconception Care Supplies
- Reduces the incidence of anemia
- Improves nutritional status
- Prevents unplanned pregnancies and sexually transmitted infections.
Illustrative Indicators
- Number of individuals receiving iron-folic acid before pregnancy
- Preconception counseling sessions held.
Helpful Tips
- Integrate preconception care into family planning and youth-friendly health services.
Antenatal Care
ANC supplies are vital to monitoring maternal and fetal health and preventing complications during pregnancy.
Examples of Antenatal Care Supplies
- Blood pressure monitors
- Hemoglobin meters
- Urine dipsticks
- Ultrasound machines
- ANC cards
- Iron/folic acid tablets
- Tetanus vaccines
- Malaria test kits
- SP for IPTp
- Vitamin supplements
Benefits of Maintaining Adequate Antenatal Care Supplies
- Detect and manage anemia
- Hypertension
- Infections
- Other conditions
Illustrative Indicators
- Percentage of ANC visits with complete supply kits
- Stock-out rate of ANC supplements.
Helpful Tips
- Bundle services with supplies to ensure each visit is comprehensive.
Labor & Delivery
This life stage requires rapid response and clean conditions to ensure safe childbirth and address complications.
Examples of Labor & Delivery Supplies
- Delivery kits
- Sterile gloves
- Oxytocin
- Misoprostol
- Magnesium sulfate
- IV fluids
- Catheters
- Clean birth sheets
- Newborn suction devices
- Partographs
Benefits of Maintaining Adequate Labor & Delivery Supplies
- Prevents postpartum hemorrhage, eclampsia, and birth-related infections
Illustrative Indicators
- Number of births attended with complete kits
- PPH and maternal complication rates
Helpful Tips
- Train traditional birth attendants or CHWs on sterile practices when skilled care isn’t available.
Newborn Care
Immediate and essential newborn care can reduce neonatal mortality.
Examples of Newborn Care Supplies
- Resuscitation bags and masks
- Thermal blankets
- Chlorhexidine for cord care
- Vitamin K
- Tetracycline eye ointment
- Infant scales
- BCG/Hepatitis B vaccines
Benefits of Maintaining Adequate Newborn Care Supplies
- Prevents sepsis, hypothermia, eye infections, and respiratory failure.
Illustrative Indicators
- Percentage of newborns receiving essential care
- Neonatal sepsis and mortality rates
Helpful Tips
- Encourage skin-to-skin contact and early breastfeeding with supply-ready support.
Postpartum Care
These supplies support recovery of the mother and health of the newborn during the postnatal period.
Examples of Postpartum Care Supplies
- Contraceptives
- Iron/folic acid,
- Vitamin A
- Maternal hygiene kits
- Clean pads
- Supplies for PNC exams
Benefits of Maintaining Adequate Postpartum Care Supplies
- Prevents anemia, postpartum depression, infection, and unplanned pregnancy.
Illustrative Indicators
- Percentage of women receiving postpartum iron or contraceptives
- Follow-up visit rates
Helpful Tips
- Provide maternal and newborn care supplies together to increase uptake.
Children under 5
Children under five are vulnerable to malnutrition, infections, and vaccine-preventable diseases.
Examples of Supplies for Children under 5
- Vaccines (measles, polio, DPT)
- Cold chain equipment
- Growth monitoring tools
- ORS and zinc
- Deworming tablets
- Ready-to-use therapeutic foods (RUTF).
Benefits of Maintaining Adequate Postpartum Care Supplies
- Prevents diarrhea, pneumonia, measles, and stunting.
Illustrative Indicators
- Immunization coverage rates
- Percentage of children dewormed or receiving vitamin A
Helpful Tips
- Involve CHWs to reach zero-dose children and promote health campaigns.
What’s the Evidence
Strong evidence demonstrates that access to essential MNCH supplies leads to improved health outcomes for mothers, newborns, and children. Programs with well-managed supply chains not only strengthen service delivery but also save lives and reduce health disparities.
Key Indicators
- Stockout Rate: Percentage of health facilities with stockouts of essential MNCH supplies.
- Lead Time: Average time taken to replenish supplies.
- Wastage Rate: Percentage of supplies expired or unused.
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Tips
- Analyze Context: Understand the local healthcare environment, including infrastructure, cultural practices, and available resources.
- Engage Stakeholders: Involve communities, health workers, and policymakers in planning and decision-making to ensure buy-in and sustainability.
- Build Capacity: Invest in training healthcare workers and supply chain managers to improve MNCH supply management.
- Use Technology: Leverage digital tools for inventory tracking, forecasting, and data collection to improve efficiency.
- Align with Policy: Ensure supply strategies comply with national and international health policies and standards.
Challenges
- Supply Chain Disruptions: Prepare for political instability, natural disasters, or pandemics by developing contingency plans, maintaining buffer stocks, and working with multiple suppliers.
- Funding Gaps: Address limited procurement and distribution funding by advocating for increased investment, forming public-private partnerships, and prioritizing cost-effective interventions.
- Logistical Barriers: Overcome poor storage and transport infrastructure by investing in vehicles, improving delivery systems, and exploring innovations like drone deliveries.
- Quality Assurance Issues: Ensure the safety and effectiveness of supplies by implementing strong quality control protocols based on global standards.
- Training Gaps: Improve the use of MNCH supplies through regular healthcare worker training, coaching, and mentorship programs.
- Data Gaps: Enhance planning and monitoring by strengthening health information systems and improving supply data collection and usage tracking.
Key Resources
- Procurement and Supply of Quality-Assured Maternal, Newborn, and Child Health Commodities. USAID 2022
- Improving the Quality of Care for Maternal, Newborn and Child Health: Implementation Guide. WHO 2022
- MNCH Resources. AAP 2021
- Quality of Care – Maternal, Newborn, Child and Adolescent Health. WHO
- Data & Measurement. TCI University
- Planning & Management of MNCH Equipment & Commodities. Newborn Toolkit. WHO & UNICEF
- Best Practices in Subnational Procurement of MNCH Commodities. MTaPS 2023
- Helping Babies Breathe. American Academy of Pediatrics 2016
