Why is maternal and child health (MCH) an important focus for HAI?
The health of mothers and children is a key indicator of general health in any setting. Pregnant women, infants and small children are more susceptible to infections and many other causes of illness than others. But they are also typically the most dependent and least powerful members of any society, and thus in need of greater care and attention than other groups. HAI’s programs aim to strengthen the ability of women to receive quality care for themselves and their children, as well as to improve the social and other living conditions that promote health. Even specialized programs such as those addressing HIV/AIDS and tuberculosis provide extra attention to mothers and children, as they are among the most vulnerable to developing those conditions.
What are we doing to address MCH problems?
HAI partners with Ministries of Health to strengthen the quality of their MCH services through activities such as training of midwives and nurses, supportive supervision of MCH staff, and strengthening the health care system itself. In every country where we work, HAI staff are seen as trusted advisors to national or regional Ministries of Health in our program areas. HAI does not provide direct services, because our aim is to support improved capacity of local staff and systems.
The spectrum of interventions to support MCH is substantial; care before, during and after delivery is a key to assuring healthy mothers and infants. Family planning helps mothers space and time their pregnancies to promote both their own wellbeing and that of their children. Attention to sick children, particularly conditions such as malaria and diarrhea that are important causes of illness and death, is essential.
Promoting effective antenatal care for pregnant women has been an emphasis since the beginning of our work. Depending on the setting, antenatal care includes screening and treatment for a wide range of potential conditions, such as anemia, syphilis, malaria, HIV/AIDS, and specific complications of pregnancy. HAI works with Ministries of Health to assess the quality and accessibility of their services, and assists in testing and implementing measures to solve problems encountered. For example, in Mozambique, screening antenatal women for syphilis was MOH policy but was often not done because the test used took several days to deliver results. HAI evaluated the use of a rapid test for syphilis that was done by the antenatal care midwives, so results were available while the patient was still in the clinic. As a result, screening rates increased dramatically and the system eventually was adapted for national use.
Providing skilled care for deliveries is another MCH challenge for many resource-strapped Ministries of Health. In Timor-Leste, HAI developed a system of in-service education for midwives who had taken part in a national training on essential skills, reinforcing what they had learned and providing them the opportunity to practice in a structured setting. A careful evaluation found that those participating in the “follow-up after training” program attained competence to practice their new skills, whereas most of those not participating did not. As a result, the program has expanded to support midwife skills in new areas.
In many countries of sub-Saharan Africa, HIV infection of mothers is a major threat to the health of their infants. In Cote d’Ivoire, HAI has worked with the Ministry of Health to scale up accessible, integrated HIV services in public health clinics. This means when a woman comes in for her routine prenatal care visit, she is also offered counseling and testing for HIV. If she tests positive, she is then offered a continuum of care services, including treatment, follow up services, psychosocial support, and care and testing services for her infant – all from the same health facility.