Integration of Maternal and Newborn Health Services in Mozambique, Challenges and the Way Forward

By: Leonardo Chavane, National Senior Advisor for Mozambique, MCHIP & JHPIEGO

This post is part of the Maternal and Newborn Health Integration Blog Series, which shares themes of and reactions to the “Integration of Maternal and Newborn Health: In Pursuit of Quality” technical meeting.

Integration of maternal and newborn health care services is a constant topic in health communities in Mozambique. Since the foundation of the post-colonial health system, the notion that integrated care should be provided to mothers and their newborns has always been present.

One of the reasons why integration has been seen as the best way to deliver services is due to the lack of skilled human resources. The number of interventions included in the maternal and newborn care package has increased over time and poses a number of challenges for the organization and quality assurance of service provision. In many low resource settings, health workers must perform multiple tasks at once – caring for both the newborn and the baby. One of the major challenges has been ensuring quality care and client satisfaction while maintaining high efficiency in the use of available resources.

Two major challenges that Mozambique faces in its effort to integrate maternal and newborn health care services:

1. Lack of sufficient human resources with the right mixture of competencies

One of Mozambique’s high priorities is the acceleration of training of health workers. We need to ensure that health centers at the periphery, primary and facility levels are staffed with personnel that have the right mixture of skills to provide high quality of both maternal and newborn health care services. Not only should the number of service providers increase, but quality of care should not be compromised. Training and provision should take into account the very best practices based on evidence, meet the needs of the patient and respect the rights of the patient, families and community.

2. Need for improved health care delivery and organization

Although services offered in health facilities have grown over time, the overall organization of service delivery has only undergone minor changes. The current momentum represents an important opportunity for Mozambique to reflect on new innovative ways of delivering services. While integration of care can bring challenges, several approaches to integrated care have been taken to scale successfully in Mozambique. For example, in recent years, efforts to integrate the provision of disease control and prevention of malaria, tuberculosis and HIV by the Ministry of Health (MoH) led to a renovated, simplified and integrated health information system that was able to successfully measure all the interventions. A one stop strategy has its benefits and challenges and there is a need for all stakeholders to reflect on the interventions that make sense to integrate for improved health outcomes.

Maternal and newborn communities can make a difference in health outcomes for moms and babies by continuing to support countries at the level of health policy and service delivery. I remain convinced that integration of Maternal and Newborn care services is essential to scaling up efforts to ending preventable newborn and maternal deaths.

I recently attended a two-day technical meeting on the “Integration of Maternal and Newborn Health: In Pursuit of Quality” organized by theMaternal Health Task Force and Save the Children. The meeting brought together health care providers at the front line; policy makers; researchers and academics; civil society and donors to discuss the challenges and benefits to integrated care. The conversations not only highlighted the need to understand varying contexts within countries, but brought to bear the importance of including the client’s perspective in ensuring quality care. It was clear to me from the depth of discussion that to move integrated care forward we must continue the conversation with all stakeholders. I plan to engage with national efforts to improve integration in Mozambique, and will share lessons learned from this meeting with local stakeholders, keeping in mind the goal: integrate for better maternal and newborn outcomes!

This post originally appeared on The Healthy Newborn Network Blog

For more information on maternal and newborn health check out these resources: