New commentary shares WHO vision
1 May 2015: In a new commentary published in the BJOG: An International Journal of Obstetrics and Gynaecology, WHO states that quality of care must improve if the world is to end preventable deaths of mothers and newborn babies globally.
The BJOG commentary sets out WHO’s priority thematic areas and framework for quality of care, which must be ensured in order to help reduce preventable maternal and newborn mortality and morbidity. WHO “envisions a world where every pregnant woman and newborn receives quality care throughout pregnancy, childbirth and the postnatal period”.
Beyond essential interventions, beyond coverage
WHO underlines the importance for the world’s health community to move beyond focusing on the provision of essential health-care interventions, and coverage of populations with health information and services; In addition to the provision of care, the commentary calls for health systems to include processes which ensure quality of care for both mothers and newborns throughout the entire pregnancy, childbirth, and post-natal periods.
Focus on childbirth
WHO calls for a focus on the crucial time of childbirth and the period immediately following birth. The authors of the WHO commentary state that “globally, over 70% of maternal deaths occur as a result of complications of pregnancy and childbirth such as haemorrhage, hypertensive disorders, sepsis, and abortion”, and that “complications of preterm birth, birth asphyxia, intrapartum-related neonatal death and neonatal infections together account for more than 85% of newborn mortality.”
WHO therefore underlines that a focus on the time of childbirth and the period immediately following birth is critical to ensure a significant impact on reducing preventable maternal deaths, stillbirths and the early deaths of newborns.
Provision plus experience
According to the WHO Quality of Care Framework for maternal and newborn health, which is highlighted in the BJOG commentary, health system processes must include a dialogue between provision of care and people’s experience of care. This means that to ensure better outcomes, the experience of care – effective communication, respect and dignity, and emotional support – must be prioritised and implemented in addition to provision of care, which is ensured through evidence based practices for routine care and management of complications, actionable information systems and functional referral systems.
The framework also includes ‘competent and motivated human resources’ and ‘essential physical resources available’ as essential parts of both the provision and the experience of care. This reflects how better outcomes are ensured when provision and experience of care processes within health services function as one.
With the end of the Millennium Development Goals this year in 2015, WHO underlines that such a vision and approach is crucial as the world develops the new Global Strategy for Women’s, Children’s and Adolescents’ Health, to ensure that sexual and reproductive health and rights are included within the post-2015 sustainable development agenda.