Maternal, Newborn and Child H ealth

1. Maternal, Newborn and Child Health

2. IFRC • Membership organisation of Red Cross and Red Crescent National Societies • Network of 187, over 3 million volunteers • Auxillary role to national authorities • Secretariat, serves to provide technical guidance for national societies

3. RCRC and MNCH • Implementing programmes over 20 years through RCRC network and strategic alliances • Programmes range from comprehensive to community based activities eg. Serve to filling gaps in service delivery • Afghanistan Red Crescent supports network of clinics -part of the Government’s Basic Package of Health Service • Pakistan RC run mobile health units & programmes re-orientation of TBAs and immunisation • eg.Advancing national health agenda – India RC significant contribution to implementation of National Family Welfare Programme

4. RCRC MNCH FRAMEWORK • The framework provides guidance and direction to National Societies in the planning, design and implementation of programs and interventions In MNCH • Identifies MNCH Continuum of Care as the operational context for health programming • The Framework presents strategic objectives, cross-cutting principles and a structured approach to guide the efforts of the National Societies

6. Focus as RCRC and Added Value • The principal focus of NS in the MNCH activities is on interventions that can be delivered at the community/home level and the first /outreach or primary level • The main delivery channel is a network of trained RC/RC volunteers • The interventions must be context-specific and linked with the formal healthcare system, and they must have back-up support from facility-based services.

7. Considerations for MNCH programming in the Red Cross Red Crescent • Select interventions • That are evidence-based • Can be delivered by volunteers with training in coordination with primary health care • Are consistent with national/regional health priorities/health plans • Address identified gaps in coverage of key interventions across the continuum/improve the quality of their delivery • Incorporate gender and equity issues in design and implementation

8. Considerations for interventions that.. • Promote adoption of healthy behaviours, skilled care seeking • Empower communities to demand and access quality, skilled care through mobilisation of community resources • Consider balance of supply of services to match increase in demand • Encourage male involvement and responsibilities • Improve linkages between communities and their health facilities and strengthen referral systems

9. MNCH interventions suitable for delivery at the community/home level

10. Examples of MNCH in Community based health programming • Promotion of ANC/skilled birth attendance • in Afghanistan – women to women volunteers • linking vulnerable women in urban settings in Bangladesh to MCH centres. • Childhood continuum of care • promoting of vaccination through campaigns to routine immunisation and access to wider child health services in Pakistan

11. Community and Health systems strengthening for MNCH in Honduras • Honduran RC implemented integrated program focused on Maternal Child Health and strengthened community resilience. • by developing extensive partnerships • working with both the centralized and decentralized health providers Key elements: • community mobilization and empowerment • advocacy for strengthened community health resources at the local level • promotion of gender equality within family health • improved access to institutional health services both in terms of coverage and quality.

12. MNCH and Honduras Red Cross: Redes project • The project aimed to i) improve maternal-child health; ii) improve the quality and coverage of local health services; and iii) strengthen capacity and coordination among local health actors.  • The project targeted 80,000 beneficiaries in 229 communities in northwestern Honduras, in the Departments of Copan and Santa Barbara.

13. Gender equality, Engaging men in maternal and child health, 3 delays Intervention • increased community awareness of the roles of women and men • increased participation of men in maternal child health • family & community organisation to address 3 delays • increased capacity of municipal governments and partner institutions to promote gender equality.

14. WhyEngageMen in MNCH? To reduce delays in decision making through promotion of shared responsibility

15. Community-Based Volunteers Redes createdand trained “Networks of InfluentialLeaders” (bothmaleand female) tohaveconversationsand modelbehaviourswithneighbours and friendson: howmen can participateduringpregnancy, birth and post-partum,

16. Power of One Local Change Agent: Nurse Ana Began with her husband’s soccer team friends, talking to them about reproductive health and how to participate during pregnancy, birth and post-partum

17. Health Personnel Men were not allowed in the health centre during the prenatal control, birth or post-natal control Health Centre space was considered “female” Redes trainedmedical personnelusingthegender-basedmanuals: Invitedmentoaccompanytheirwivesto prenatal visits, Prepareda birthing plan together, Promotedaninstitutionalbirth, Supported post-natal visits

18. Impact on Maternal and Child health through Redes • improvement of mother and child health and increased access to local health services was demonstrated throughout the continuum of care eg. • Newborn deaths decreased from 40% to 29% • Attendance at ANC increased from 61% to 81% • Breastfeeding until 2 years increased from 47% to 71% • The project also built a solid platform for engagement on MNCH policy and programming between key national actors and partners committed to MNCH programming in Honduras. • Honduran Red Cross strengthened its capacity to deliver interventions across the continuum of care.

19. Challenges to implementing MNCH programmes in RCRC • Weak link to country/local health systems • Implementation of community programmes to scale • Volunteer skills

20. Going to scale, addressing volunteer skills and health system link RCRC Priorities moving forward • Taskshifting • Integrated community case management (iCCM) • eg.Kenya home management of malaria expands to management of pneumonia and diarrhoea and • Mobile technology/ICT to facilitate going to scale • Use of standardised indicators for monitoring and reporting impact (ref CoIA)