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December 5, 2013

SickKids Centre for Global Child Health Addresses Global Maternal, Newborn and Child Health in the New England Journal of Medicine (NEJM)

New article outlines intervention packages and innovations to reduce maternal and child mortality

An article published today in leading medical journal, the New England Journal of Medicine (NEJ M) presents the need to maintain a focus on maternal, newborn and child health beyond the United Nations Millennium Development Goals (MDGs) targeted for 2015.  

The article is available online.

Dr. Zulfiqar Bhutta, Robert Harding Chair and Co-Director of the Centre for Global Child Health at SickKids and the co-author of the article says that even in the countries that will reach their MDG targets, many will still have high numbers of deaths, with much scope for improvement.

Much of the burden of maternal and child mortality and ill health is concentrated among the poorest populations in countries of sub-Saharan Africa and South Asia. Achieving sustained improvement to the global rate of reduction of maternal and child mortality would require the rapid scale-up of targeted interventions. Social determinants of health must also be addressed.

“There exist promising interventions that can benefit survival as well as human development, but there is a huge public health need to integrate the two issues. Linking maternal and child health and nutrition with the emerging issues of long-term development, human capital, and economic growth is key to ensuring that we stay the course in solving one of the most important moral dilemmas of our times,” said Dr. Bhutta.

The effect of intervention packages to improve maternal and child health is considerably enhanced by innovations for scaling up coverage – innovations that include improved ways of delivering interventions through the use of low-cost communication and information-technology, diagnostic tools to screen for biomarkers and improved methods of drug and vaccine delivery. Deploying low-cost interventions through community health workers, combined with use of mobile phones to reach difficult-to-reach populations, has enormous potential to improve access to care. The NEJM article outlines a series of intervention packages of care, innovations for delivery and to increase access to care; and estimated lives saved among mothers, newborns and children.

To achieve meaningful impact in the reduction of maternal, newborn and child mortality, these interventions, care packages and delivery innovations will need to be further supported by commitment at the policy level in addressing fundamental barriers to delivery; such as fragmented health care infrastructure, social and economic barriers affecting women’s empowerment, and a lack of attention and funding for reproductive health care and family planning globally.  

Knowledge of the major causes of maternal, newborn and child death has increased in parallel with improved global statistics on mortality burden and trends, and improved methods for allocating cause of death. Understanding the causes of child death allows for improved planning and the targeting of evidence-based interventions - a critical step toward achieving a reduction in the under-five mortality rate (MDG 4).  

Read more about Dr. Bhutta’s work