Quality of care in maternal, newborn and child health (MNCH) and sexual and reproductive health (SRH)

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Helpdesk Query:

Which interventions in promoting quality of care in MNCH and SRH are likely to have the best impact on service outputs and health outcomes?

Summary:

This helpdesk query looks at interventions to improve the quality of care in maternal, newborn, and child health (MNCH) and sexual and reproductive health (SRH). It includes evidence assessing which interventions are likely to have the best impact on service outputs and health outcomes, with an emphasis on cost effectiveness.

The MNCH focus is on the importance of continuum of care interventions. Continuity of care is necessary throughout the lifecycle (adolescence, pregnancy, childbirth, the postnatal period, and childhood) and also between places of caregiving (including households and communities, outpatient and outreach services, and clinical-care settings). Several high quality studies have reviewed the literature and assessed different interventions and their outcomes, and provide an excellent overview of which are likely to have the greatest effects on health outcomes and service delivery.

A section of this report is dedicated to the issue of cost effectiveness and includes several diagrams which can be used to assess this issue as well as a study showing key ways to improve cost effectiveness including increasing spending, efficiency, equity and ensuring there are incentives and integration.

The report then looks at SRH. Health and rights in sexuality and reproduction are an integrated package, which includes SRH services comprehensive sexuality education; and protection of SRH and rights. People cannot be healthy if they have one element of the package but miss others. Progress on the components of SRH and rights has been uneven. While acknowledging that certain components may be more difficult or more costly to implement, progress in many instances has been hindered on ideological, rather than scientific, public health and cost-effectiveness grounds. There have been many accomplishments but aggregate gains mask stark inequalities, with low coverage of services for the poorest women.

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