Strategies and systems to improve women’s and children’s health
The health of women, newborns and children is closely linked and calls for systems and strategies that address care in an integrated way.
The ‘Continuum of Care’ is a framework that facilitates delivery of an integrated and comprehensive package of interventions. The concept of ‘Continuum of Care’ has two dimensions to it: time and place. The time dimension refers to linking-up care from pre-pregnancy, through childbirth, the immediate post-natal period and childhood. The place dimension refers to linking-up care that is provided across different levels such as the home and community; clinical care at primary and tertiary health centres; and outpatient and outreach services. The PMNCH Knowledge Summary – Enable the Continuum of Care discusses this in further detail.
The Global Strategy for Women’s and Children’s Health (www.everywomaneverychild.org) which was launched on the 22nd September 2010, emphasised the need for care provision throughout the ‘Continuum’ and called for improvements through more money, stronger policies and better health services. The Global Strategy specifically emphasises the need for stronger health systems; a larger and better skilled health workforce; research, innovative technologies and mechanisms which can help speed-up progress; accountability mechanisms; and country level ownership of plans. Universal access to high quality and evidence-based interventions and health services is necessary to achieve the Global Strategy aim of saving 16 million lives by 2015. Additional resources and contributions from all stakeholders, such as donors, governments, civil society, etc., and accountability mechanisms to monitor progress, review and act, can make it happen
Integrated health care delivery is very much dependent on stronger health systems for care to be effective and equitable. The WHO Framework of Action (www.who.int/healthsystems/strategy/everybodys_business.pdf ) includes six building blocks which lay down the essential components and functions of a health system.
Better access, good quality care and ultimately better health for women and children are a result of a health system that has adequate skilled workers and well-equipped facilities. Built on a foundation of sound policies, funding and leadership national health systems can deliver such care. A recent paper - The Global Health System: Strengthening National Health Systems as the Next Step for Global Progress talks about how the inter-relationships of these ‘component elements’ of the health system, demand-side issues and other ‘enabling’ functions such as financing, resource generation, building the health workforce are important.