This training package introduces Peace Corps Volunteers to the fundamentals of maternal and newborn health and exposes them to key concepts and global trends. The training package highlights the latest evidence-based practices that can be implemented by Volunteers and their counterparts at the community level to improve maternal and newborn health outcomes. These modules were developed with support from APC.
Session 1: Introduction to Maternal and Newborn Health
This session introduces maternal and newborn health (MNH), including the global situation, progress toward global goals, the country-specific situation, national program objectives, the Peace Corps country framework, and Volunteer contributions. The continuum of care, a core principle and schema for understanding MNH over time and at different levels, serves as an advance organizer to enhance learning, helping participants to visualize Volunteer roles and activities. This session introduces other key definitions and concepts, such as the “three delays model,” and provides a foundation for more detailed information in subsequent sessions.
Session 2: Conducting a Maternal and Newborn Health Community Assessment
Having been introduced to maternal and newborn health basics (Session 1), participants plan how to explore and assess MNH issues specific to their community using PACA methods, along with identifying barriers that affect behavior change.
Session 3: Healthy Timing and Spacing of Pregnancy
Healthy timing and spacing of pregnancy is a key maternal and newborn health (MNH) intervention that helps women and their families plan for wanted pregnancies at the healthiest times in their lives, resulting in greater survival and better health outcomes of mothers, newborns, and infants. This session links healthy timing and spacing of pregnancy, as well as family planning services, counseling, and education, with the MNH continuum of care.
Session 4: Pregnancy and Antenatal Care
Good antenatal care (ANC) contributes to the health of the mother, the unborn baby, and a better overall outcome for both mother and infant. ANC includes four or more ANC visits, healthy home behaviors, and a supportive household and community.
Session 5: Preparing for Labor and Delivery
Ideally, pregnant women deliver in well-equipped health facilities with the assistance of a skilled birth attendant. This, along with birth spacing and access to modern contraceptives and timely ANC visits, saves women’s and babies’ lives.[i] Efforts to reach this goal face a reality that nearly 50 million births in developing countries still take place at home without skilled care.[ii] Volunteers can help address delays that affect safe births by improving pregnant women’s and their families’ knowledge of signs indicating labor and the need to seek care; danger signs requiring transport to an emergency obstetric and newborn care facility; and by helping families to develop birth and emergency plans. Note that essential newborn care is addressed in Session 7.
Session 6: Community Mobilization for Maternal and Newborn Health
Communities play a critical role in the maternal and newborn health continuum of care. Poor and vulnerable communities with high newborn and maternal mortality have demonstrated that they can lead efforts to carry out culturally appropriate solutions to improve the health of mothers and newborns. These communities have reduced maternal and newborn mortality and also strengthened their own capacities to achieve results (Howard-Grabman, 2007).
Session 7: Postpartum Care for the Mother and Essential Newborn Care
The postpartum and postnatal period is critical to the health and survival of a mother and her newborn; they are most vulnerable in labor, delivery, and the first week of life. Paradoxically, the postpartum and postnatal period is the most neglected in terms of quality care and services. It is crucial that families are able to identify danger signs in the mother and newborn that indicate the need to urgently seek care, that families can provide postpartum care for the mother and essential newborn care, and that the mother and newborn are supported by a trained health worker through postnatal facility or home visits following a recommended schedule.
Session 8: Breastfeeding
Breastfeeding has immense benefits for both the mother and newborn. Breastfeeding protects newborn babies and infants; it saves lives and has profound impact on a child’s health, nutrition and development (Unicef, 2014). If every baby was exclusively breastfed from birth, about 1.5 million lives would be saved each year (Save the Children, 2005). Breastfeeding has short- and long-term health, psychosocial, and economic benefits for the mother. Breastfeeding benefits families and countries as a whole, for example, by reducing costs of treating illness and protecting the environment. Virtually all mothers can breastfeed if given appropriate advice, encouragement, and support, as well as practical assistance to resolve any problems.
Session 9: Engaging Influential Actors
The continuum of care visualizes and recognizes the influence of households, communities, and outreach and facilities on maternal and newborn health outcomes. All sessions to date include some discussion of opportunities and barriers that affect women’s practices and behaviors, for example: to practice family planning, to attend antenatal care, to make a birth and emergency plan, to deliver with a skilled attendant, to seek care urgently when danger signs present themselves either in the woman or in the newborn, to initiate breastfeeding immediately, and to exclusively breastfeed. A deeper understanding of culture and social influence will help participants to think critically about their own cultural lens and how they identify and then engage influential actors in their activities to promote MNH.
Session 10: Respectful Maternity Care
This session discusses disrespect and abuse of women receiving maternity care, an important contributing factor to underutilization of skilled care at delivery. Volunteers often play a role in strengthening the links between communities, families, and individuals with health care service providers in facilities and can thus help to increase understanding and communication regarding respectful maternity care.
Session 11: HIV and Maternal & Newborn Care
This session focuses on maternal and newborn health issues relevant to posts implementing HIV/AIDS and Prevention of Mother to Child Transmission (PMTCT) activities. Beginning with a review of a comprehensive PMTCT approach, the session highlights HIV prevention, care, and treatment across the MNH continuum of care and Volunteer roles and activities to help pregnant women and their families prevent, care, support, and treat HIV/AIDS in themselves and their newborns.
Session 12: Systems Strengthening, Integration, and Maternal and Newborn Health
This session provides basic information on health systems (including supply chain management, as an example), why this is important for MNH, and what Volunteers are doing to strengthen health systems in the context of MNH. Participants also review different types of integration within MNH care and services. Participants develop and share innovative ways to integrate care and services and strengthen health systems relevant to their work.
Session 13: Action Planning for Maternal and Newborn Health
In this final session of the Maternal and Newborn Health Training Package, participants make an action plan for implementing evidence-based activities in light of the knowledge, skills, and attitudes gained over the course of training.