Maternal and Neonatal Health Programs
USAID's approach to maternal and neonatal health includes community involvement, the promotion of evidence-based policies, and compassionate, high-quality services. Promoting the attendance of skilled personnel at birth is central to USAID's approach. Skilled attendance is essential for recognizing and treating unpredictable maternal and newborn complications. USAID also promotes good nutrition and control of infectious diseases to improve pregnancy outcomes.
Maternal health and nutrition profoundly affect newborn survival and health, and regional trends in neonatal mortality (death during the first 28 days of life) parallel trends in maternal mortality. Countries in USAID’s Asia/Near East and Latin America/Caribbean regions, for example, have seen declines in neonatal mortality as maternal health has improved. In sub-Saharan Africa, however, some countries are experiencing increases in neonatal mortality as HIV/AIDS and other factors adversely affect maternal health and survival.
USAID supports quality health services delivered by medically trained providers. These services target vulnerable, high-mortality populations in areas with weak health services but a strong commitment to improving maternal and neonatal health. Programs prepare communities for births through improved maternal care, recognition of complications, and transportation and payment arrangements. USAID helps policymakers develop practical evidence-based care standards and quality assurance systems to ensure satisfaction and positive results. Key evidence-based interventions emphasize:
- Iron-folate supplementation
- Tetanus toxoid immunization
- Syphilis control
- Intermittent presumptive malaria treatment and use of bednets for malaria prevention
- Prevention of mother-to-child transmission of HIV
- Counseling on safe health practices and birth planning
- Safe, clean delivery
- Treatment of obstetric and newborn complications
- Early, exclusive breastfeeding and birth spacing
USAID will soon launch a special initiative to spotlight prevention of postpartum hemorrhage, the greatest cause of maternal mortality, in the context of maternal and neonatal health services. The initiative will address the critical issues of scientific standards of care and availability of essential drugs and supplies. The initiative's goal is to equip birth attendants – including home birth attendants and attendants in health centers and hospitals – with the skills, drugs, and supplies to deliver lifesaving care and reduce the toll of preventable maternal mortality.
USAID's Key Achievements in Maternal and Neonatal Health Programs:
- A number of USAID-assisted countries have achieved significant reductions in maternal deaths from pregnancy-related causes. In Egypt, maternal mortality has declined by 52 percent since the late 1980s. Honduras (41 percent), Bangladesh (22 percent), and Morocco (8 percent) have also had substantial decreases.
- In South Africa, a USAID-supported project helped reduce neonatal mortality in one hospital from over 30 deaths per 1,000 live births to less than 15. Stillbirths decreased from 20 per 1,000 births to less than 10.
- A comprehensive neonatal care program in Tver oblast, Russia, contributed to a decrease in hypothermia at one neonatal intensive care unit from 63 percent of admissions to occasional rare cases. The unit achieved a 64 percent reduction in deaths due to respiratory distress syndrome.
- In Bangladesh, a maternal mortality reduction program contributed to an 11 percent increase in use of antenatal care services at health facilities and a 42 percent increase in hospital deliveries in 17 program communities between 2000 and 2001.
- In Afghanistan, a USAID-supported training program for midwives has reopened and a new training program for auxiliary midwives has been initiated. Training curricula have been developed and training sites upgraded with equipment, water and sanitation, and essential supplies.
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