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Local Systems and Service Delivery

MCSP applies a health systems lens to work with national, regional, district and facility managers — as well as frontline health workers — to strengthen essential health system functions, and improve utilization and quality of maternal and newborn care across the system and life cycle continuums of care. We work with regional and district counterparts to strengthen:

  • Management, supervision and capacity-building for health workers (facility and community-based);
  • Quality, safety and person-centeredness of routine and complications maternal health care;
  • Actionable information systems in which priority health care indicators are tracked and used by distinct actors across the system;
  • Management of essential commodities such as magnesium sulfate for management of pre-eclampsia;
  • Improvements in respectful maternity care and reductions in mistreatment in childbirth, including improved engagement and trust of community members in facility services;
  • Referral protocols and processes for women and newborns who develop complications that cannot be managed at primary level; and
  • Healthy behaviors, early enrollment in antenatal care, birth preparedness and complication readiness, institutional delivery, and early recognition and prompt care seeking for complications during the prenatal and postnatal periods.

We seek innovative approaches to strengthen referral systems, with linkages to community and civil society organization and, where appropriate, eHealth applications.

The Program works with government counterparts and partners to support facility health worker teams and community health workers to identify and overcome local obstacles to provision of evidence-based respectful care and to regularly calculate and analyze quality of care process and health outcome measures to assess their progress. In collaboration with country government counterparts, we promote regular shared learning across sites to increase health worker engagement, instill confidence of managers and health workers, and to accelerate progress through shared learning about “what works” in a specific context.

MCSP works with country counterparts to prioritize and promote core packages of evidence-based high-impact antenatal, childbirth and postnatal care and a small number of associated quality of care process and outcome measures. These packages focus on integrated routine care best practices needed by every mother and newborn as well as prevention, early detection, and management of maternal and newborn complications including:

  • Postpartum hemorrhage (PPH);
  • Pre-eclampsia / eclampsia (PE/E) and hypertensive disorders of pregnancy;
  • Maternal/newborn infection;
  • Obstructed labor;
  • Birth asphyxia; and
  • Preterm birth.

MCSP has developed job aids, checklists and other implementation materials to assist providers to adhere to new World Health Organization guidelines within their routine and complication care practices. The Program promotes improved prevention and case management of PPH and PE/E in line with guidelines in the updated 2nd edition WHO Managing Complications in Pregnancy and Childbirth manual published in 2017.

We assist country counterparts to promote client-centered respectful maternity care and reduction of mistreatment in childbirth, working through local participatory processes to strengthen women’s and families’ engagement in and experience of care and to strengthen caring for women, newborns, families and health workers.

In addition to our work to strengthen the prevention and management of direct causes of maternal mortality, we also emphasize the prevention and management of indirect causes of maternal mortality (such as chronic hypertension) incorporating nutrition (such as iron supplementation), family planning, immunization, infection prevention (such as intermittent preventive treatment of malaria in pregnancy), and treatment interventions into antenatal, childbirth and postnatal care.

Maternal and Child Survival Program