A continuum of care to save newborn lives

This commentary from The Lancet argues that investment in maternal, newborn and child health remains seriously inadequate, despite its crucial importance not only for saving lives but also for achieving poverty reduction, equity and other human development goals. The authors point out that the most effective package of interventions for reducing mortality in both women and newborns – female education, family planning, community-based maternity care, and referral services for women with obstetric complications – has received little attention from policymakers. The interventions most likely to reduce child deaths have also failed to reach those most in need. In particular, the authors note the absence of newborn health from policies, programmes and research in the developing world, despite the 4 million neonatal deaths that occur each year.

The authors conclude that maternal and child health advocates, by competing with one another, have weakened their collective voice. Instead, the authors recommend the integration of maternal, newborn and child health programmes, alongside their strengthening and expansion. They advocate the delivery of proven cost-effective interventions through a continuum-of-care approach, spanning pregnancy, delivery, the immediate postnatal period and childhood. They also recommend a related continuum that links households to hospitals by improving home-based practices, care-seeking, and access to good quality care at health facilities.