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Integrating maternal and neonatal care in resource-poor settings


Improving facility-based outcomes for mothers and newborns is achievable

Of the patients Médecins Sans Frontières (MSF) and other organisations treat in settings affected by conflict, neglect or disaster, most are women and children. In MSF’s facilities, they present against a backdrop of unacceptably high maternal and under-5 child mortality rates worldwide. Neonatal death in particular is seemingly intractable, growing to comprise 44% of all deaths of children aged under 5 years, or about three million deaths annually.1 Additionally, there are an estimated 2.7 million stillbirths each year, a large proportion occurring in the intrapartum period.2

Maternal mortality and its risk factors are well documented. Infection, low birthweight or prematurity, and asphyxia are the main reasons for newborns’ high risk of dying. The highest loss of life occurs during birth or within the subsequent 24 hours.3 Most of these deaths are preventable. Relatively low-tech interventions have the potential to substantially improve the survival and health of newborns, but there are clear challenges to implementing them. Nonetheless, the experience of MSF highlights the importance and achievability of improving…