The 'Missed Opportunities in Maternal and Infant Health' research project is based on the hypothesis that there are significant missed opportunities for improving maternal and child health which could be prevented and that an improved configuration of, and emphasis on, postpartum services will reduce maternal and newborn morbidity and mortality. The research will examine how postpartum services could best be organised to reduce maternal and newborn morbidity and mortality and be provided within existing health systems and constraints.

Three assumptions underlie the proposed study:

  1. Postpartum care is a neglected element of maternal and newborn health, particularly in relation to maternal health. We assume that better postpartum care has the potential to improve maternal and newborn health outcomes.
  2. The integration of maternal, newborn and reproductive health care during the postpartum period is a missed opportunity for expanding the coverage of essential services and strengthening postpartum care for mothers and newborns. In particular, coverage of postpartum maternal and reproductive health care services could be increased through integrating these services within child health clinics.
  3. Interventions need to be appropriate, sustainable, effective and replicable.


The aim of the study is to strengthen integrated postpartum health care delivery by conducting health system research in a district (or sub-district) of four sub-Saharan Africa countries: Burkina Faso, Kenya, Malawi and Mozambique. Studies will be conducted to investigate the impact of postpartum health care delivery as well as the determinants of effective and sustainable improvements of health care delivery at scale. This implies a greater research focus on health systems and services rather than on the clinical interventions per se.

Research concept to improve maternal and newborn health

Momi Concept 1

Conceptually, the study aims to examine how postpartum services could be organised and what effect different configurations of postpartum health care delivery might have on maternal and child health. To optimise the potential for sustainability and wider scale-up, the study will explicitly assess the effectiveness (as opposed to efficacy) of interventions tailored to local conditions and provided within existing health systems.

Flow diagram of study processes and the research activities that occur in each phase of the study

Momi Concept 1