1. Office of Global Health and HIV (OGHH) Office of Overseas Programming & Training Support (OPATS) Maternal and Newborn Health Training Package Session 1: Introduction to Maternal and Newborn Health

2. Meet Saro from Nepal

3. Meet Lorenzo from Peru

4. Meet Nathi from Uganda

5. These deaths and disabilities are preventable. You can play a part.

6. Maternal deaths, illness, and disability  In 2013, 289,000 women died from complications of pregnancy and childbirth each year  15 million women suffer from long-term illnesses or disability due to complications of pregnancy and childbirth

8. Newborn deaths Each year, worldwide  2.6 million babies are stillborn  2.9 million babies die in the first month of life

9. Causes of newborn deaths

10. Causes of newborn deaths + proportion of child (U5) deaths

11. Inextricable link  In developing countries, a mother’s death in childbirth means that her newborn will almost certainly die  When mothers are malnourished, ill, or receive inadequate care, their newborns face a higher risk of disease and premature death  Improved practices for one benefit the other  “A baby on its mother’s back does not know the way is long” (proverb from Nigeria)

12. Post adaptation  [Share maternal and newborn death and disability data for the country. See the document below with country-specific information if needed.]  countdown2015mnch.org/documents/2013Re port/Countdown_2013- Update_withprofiles.pdf countdown2015mnch.org/documents/2013Re port/Countdown_2013- Update_withprofiles.pdf

13. Period of greatest risk for mothers and newborns The 24 hours around childbirth and the first day of a baby’s life carry the greatest risk for neonatal and maternal mortality.

14. The “3 delays model”:  Delay in deciding to seek care  Delay in reaching appropriate care  Delay in receiving adequate and appropriate care and treatment Model highlights the barriers women face in getting timely and effective care to prevent deaths in pregnancy and childbirth.

15. Inequity and gaps  Stark disparities in coverage of MNH interventions between and within countries – Babies born to poor mothers in rural and remote areas face great challenges to survival – Women in Sub-Saharan Africa face greatest risks – Mothers and babies in South Asia die in great numbers  What about maternal and newborn mortality in the United States?

16. Post adaptation  [Share relevant information on maternal and newborn health inequity and gaps within the country, or among countries within the region, as appropriate.]

17. The good news  Most maternal and newborn deaths are preventable – Prepregnancy: Preventing unwanted pregnancies and promoting healthy spacing and timing of births; preventing anemia – Pregnancy: Antenatal care in pregnancy and healthy home behaviors, including good nutrition and rest – Birth: Skilled care during childbirth and access to emergency obstetric care – Postnatal: Care and support in the immediate days and weeks after childbirth; universal coverage of 16 proven newborn health interventions, including optimal breastfeeding in the first six months

18. MNH & MDG Goals  Goal 4: Reduce child mortality – Target 4A: Reduce by two-thirds, between 1990 and 2015, the under-5 mortality rate Indicator 4.1 Under-5 mortality rate Indicator 4.2 Infant mortality rate Indicator 4.3 Proportion of 1-year-old children immunized against measles  Goal 5: Improve maternal health – Target 5A: Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio Indicator 5.1 Maternal mortality ratio Indicator 5.2 Proportion of births attended by skilled health personnel Indicator 5.3 Contraceptive prevalence rate Indicator 5.4 Adolescent birth rate Indicator 5.5 Antenatal care coverage (at least one visit and at least four visits) Indicator 5.6 Unmet need for family planning

19. Trends in maternal mortality

20. Trends in neonatal mortality  Remarkable progress to reduce child mortality has been made over recent decades. However… – Progress toward reducing perinatal and neonatal mortality has been far slower  From 1990 to 2012 – Child mortality declined by 50% – Neonatal mortality declined by only 36%

21. MNH research, initiatives, and programs over time

22. Post adaptation  [Share information on current national and/or Ministry of Health MNH goals, initiatives, and frameworks.]

23. Peace Corps is playing an important role.

24. Post adaptation  Briefly describe the MNH components of your post’s health project framework (goal, objectives, activities, targets, and indicators) along with current Volunteer work in MNH.  Show how Volunteers’ roles and work and the health project framework for MNH fits within national MNH initiatives and frameworks. It may help to make a sketch or diagram illustrating the intersection of Volunteer work and national MNH programs and how Volunteers contribute to national goals.  As appropriate, and time permitting, invite a seasoned Volunteer to briefly share his or her MNH activities.

25. The continuum of care