Health Technical Elements
Maternal and Child Health
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| Click image above to download the PDF version of the Maternal and Child Health Fact Sheet (Adobe Acrobat PDF, 63kb) |
Overview
In many countries in Eastern Europe and Eurasia1 (E&E), maternal and child health (MCH) indicators lag well behind other European countries. However, much progress has been made and there is great potential for continued gains in the near future. The most pressing maternal and child health problems are largely preventable, the solutions are well-known, and there is a relatively high capacity for implementation and replication.
USAID’s Response
Helps by improving prenatal care and obstetric services through implementation of evidence-based practices. Community-level education programs have focused on safe motherhood practices such as breastfeeding and infection prevention.
Additional Information and Resources
Important MCH Issues in Europe and Eurasia
- While the majority of births in E&E take place in a medical facility with trained attendants, most
infant deaths in the regions still take place during the first month following birth. More
effective newborn care techniques including simple practices such as immediate breastfeeding,
skin-to-skin care, and “rooming in” could address problems such as hypothermia, which in some
E&E countries accounts for a large percentage of infant mortality.
- In WHO European region, smoking during pregnancy is the leading cause of poor pregnancy
outcomes and prenatal death. It can cause serious health problems including ectopic
pregnancy, increased risk of miscarriage, complications during labor, preterm birth, stillbirth, low
birth weight and sudden unexpected death in infancy.
- The over-medicalization of pregnancy, including the overuse of C-sections and unnecessary
medications, presents a threat to safe pregnancy. Post-partum hemorrhage also remains a
significant risk. By continuing to implement evidence-based obstetric practices in hospitals and
other health facilities, maternal and infant mortality could be dramatically improved.
- Abortion rates in the region remain very high. In some E&E countries, abortion is a leading
cause of maternal mortality. Promoting modern contraceptives as an alternative to abortion
leads to better health for women and children because it allows for proper birth spacing and
reduces unintended pregnancies and risks associated with abortion.
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| Figure 3. E&E MCH programs focus evidence-based practices, such as companion presence during birth. |
Examples of USAID MCH Programs
- The Maternal and Child Health Improvement Project in Armenia works to enhance the knowledge and skills of practicing healthcare providers, improve the physical infrastructure of healthcare facilities, institutionalize the quality assurance system, and strengthen overall management and supervision. Implementer: RTI
International.
- Project Sustain in Georgia will lay the foundation for long-term, sustainable maternal and neonatal health programs in the private sector, through private
insurance industry plans, existing health clinics and planned health training units. Implementer: John Snow, Inc.
- Ukraine focuses on the broad implementation of international evidence-based practices to strengthen infant delivery and care; the dissemination of clinical guidelines and training of health professionals; the development of centers of excellence to serve as models for training and education; and the implementation of communications activities to increase awareness of effective birthing and childcare practices. Implementer: John Snow, Inc.
- A regional E&E activity is examining the quality of maternal newborn care with a primary objective of assessing the degree to which a selected number of evidence-based, high-impact maternal newborn care practices are integrated into routine maternal newborn services. A second regional activity will study to what extent non-communicable diseases are screened for in women in of reproductive age. Implementer: University Research Corp.
USAID MCH Success Stories
- Among the most effective interventions for preventing postpartum hemorrhage is Active Management of Third Stage of Labor (AMTSL). AMSTL was not performed in Georgia before USAID project interventions. AMTSL is now performed in 98% of total vaginal deliveries in the 16 pilot maternities across the country, covering 61% of all deliveries in the country. As a result, the life threatening postpartum hemorrhage rate dropped down from 8% in 2003 to 1.2 %.
- By implementing AMTSL through USAID’s Maternal and Infant Health Project (MIHP) in Ukraine, postpartum hemorrhage decreased from 2.2% in 2002 to 0.6% in 2006 at the Lutsk Maternity Hospital.
- Since 2004 in targeted facilities in Armenia under Project NOVA, the still birth rate decreased from 1.5% to 0.3%, the incidence of post partum hemorrhage was reduced from 4% to 2%, and births covered by AMSTL increased from 0% to 97%.
- Practices promoted through USAID’s women and infant health initiative helped Russia achieve a dramatic 23% decline in infant mortality from 1996 – 2003, as well as effectively reduce hypertension in pregnant women, one of the major contributors to maternal death. Between 2003 and 2007, rates fell from 28 percent to 7 percent.
Maternal and Child Health Resources, Websites and Links
PUBLICATIONS
Two Decades of Progress: USAID’s Child Survival and Maternal Health Program (Adobe Acrobat PDF, 3.87mb)
Working Toward the Goal of Reducing Maternal and Child Mortality: USAID Programming and Response to FY08 Appropriations. Released on July 31, 2008 by USAID to Congress. The report focuses on USAID’s five-year targets, priority countries, and a strategic programming approach for maternal and child mortality reduction. Details on maternal and child programs in 30 priority countries, as well as FY08 funding levels, are also included.
Full Report (Adobe Acrobat PDF)
Section Pertaining to E&E Region (Adobe Acrobat PDF)
Project Nova Mid-Term Assessment (Armenia) (Adobe Acrobat PDF, 478kb)
Mercy Corps Azerbaijan Child Survival Project (Adobe Acrobat PDF, 711kb)
Georgia Reproductive Health and Maternal and Child Health Sector Assessment (Adobe Acrobat PDF, 815kb)
Mid-Project Evaluation of Russia’s Maternal and Child Health Initiative II Program (Adobe Acrobat PDF, 983kb)
Successful Implementation of Evidence-based Routines in Ukrainian Maternities (Adobe Acrobat PDF, 151kb)
Evaluation of the Impact of the Mother and Infant Health Project in Ukraine (Adobe Acrobat PDF, 413kb)
Child Nutrition in Central and Eastern Europe and Commonwealth of Independent States (UNICEF) (Adobe Acrobat PDF, 657kb)
Eliminating Iodine Deficiency in Central Eastern Europe Commonwealth Independent States (UNICEF) (Adobe Acrobat PDF, 575kb)
A Review of Progress in Maternal Health in Eastern Europe and Central Asia (UNFPA) (Adobe Acrobat PDF, 2.66mb)
WEBSITES
USAID Bureau for Global Health MCH Section
UNICEF – United Nations Children’s Fund
World Health Organization
Child Health
Multimedia Feature: 10 Facts on Child Health
Maternal Health
WHO “Making Pregnancy Safer” Program in the WHO European Region
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