A research agenda to improve incidence and outcomes of assisted vaginal birth.

Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low- and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth.

Developing measures for WHO recommendations on antenatal care for a positive pregnancy experience: a conceptual framework and scoping review.

Objectives: In response to the newest WHO recommendations on routine antenatal care (ANC) for pregnant women and adolescent girls, this paper identifies the literature on existing ANC measures, presents a conceptual framework for quality ANC, maps existing measures to specific WHO recommendations, identifies gaps where new measures are needed to monitor the implementation and impact of routine ANC and prioritises measures for capture.

Methods: We conducted searches in four databases and five websites. Searches and application of inclusion/exclusion criteria followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow approach for scoping reviews.

Integrated Person-Centered Health Care for All Women During Pregnancy: Implementing World Health Organization Recommendations on Antenatal Care for a Positive Pregnancy Experience.

The 2016 WHO guideline on routine antenatal care (ANC) recommends several health systems interventions to improve quality of care and increase use of services including: Midwife-led continuity of care throughout the antenatal, intrapartum, and postnatal periods. Task shifting components of ANC, including promotion of health-related behaviors and distribution of nutrition supplements. Recruitment and retention of health workers in rural and remote areas.

Quality of care in women's, children's, and adolescent health. Methods for assessing evaluation and implementation in West Africa. Experience in the Côte d'Ivoire.

A tool developed by WHO was used to assess the quality of care for mothers, newborns, and children in some healthcare facilities in French-speaking Africa; this study led to the development of recommendations for the implementation of actions intended to resolve the problems observed and to optimize patient management. We report here the experience of the maternity units of the university hospital center of Treichville, in Abidjan, discuss the presentation of the results of the assessment, and make some recommendations as part of an action program. The experience of the monthly review of referred cases is also reported.

Elimination of mother-to-child transmission of HIV and syphilis: A dual approach in the African Region to improve quality of antenatal care and integrated disease control.

The World Health Organization's (WHO) Strategic Framework for the Elimination of New HIV Infections among Children in Africa by 2015 identifies important synergies for the elimination of mother-to-child transmission of HIV and syphilis in terms of prevention interventions, implementation logistics and service delivery, monitoring and evaluation systems, and need for sustained political commitment. The WHO advocates the use of an integrated, rights-based dual approach with partnerships and collaboration to make the best use of available resources. Through a consultative approach, six countries in the African Region committed to dual elimination and developed and implemented action plans for this purpose.

Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000-2010: a systematic review.

From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the literature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda's progress in expanding the coverage of four key women's health services. Progress took place in 2000-2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up.

Identifying barriers to emergency care services.

Objective: This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers.

Method: With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article.

Results: Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care.

Skilled birth attendant competence: an initial assessment in four countries, and implications for the Safe Motherhood movement.

Objectives: Percentage of deliveries assisted by a skilled birth attendant (SBA) has become a proxy indicator for reducing maternal mortality in developing countries, but there is little data on SBA competence. Our objective was to evaluate the competence of health professionals who typically attend hospital and clinic-based births in Benin, Ecuador, Jamaica, and Rwanda.

Methods: We measured competence against World Health Organization's (WHO) Integrated Management of Pregnancy and Childbirth guidelines.