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:
- 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.
- 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
- Interventions need to be appropriate, sustainable, effective
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
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