Integrated Maternal and Child Health Care


The interface with women at child-health clinics offers a critical opportunity to expand the provision of sexual and reproductive health services, and to encourage their long-term use. Yet this strategy is rarely used to its full effect. The potential benefits of extending postpartum services beyond the conventional six-week period after childbirth are considerable but they will be especially enhanced through integration of maternal and reproductive care within child health services. This is an innovative approach, potentially alleviating much of the burden of disease women experience during this time. Synchronized with local immunization schedules, an early visit could be offered around four to six weeks postpartum, a second visit about three months after childbirth and a final visit at six to nine months. Some indication of the feasibility of this approach is evident from research in East Africa, where integration of services for postpartum women within child health services was successfully piloted. The optimum package of services would need to be tailored to local disease priorities and health policies.

Concerns have often been raised about the breakdown in the continuum of care provided during what has been called the "the two-year postnatal period" in one report, when opportunities to deliver essential services are being lost. Integration of maternal care within child health services will begin to address this gap by enhancing the continuity of care for the mother as she transitions back to reproductive potential. The MOMI research project will provide comparative data across four country sites on the impact of such an integration initiative on health processes and outcomes and will generate lessons learned during implementation.