Alma-Ata: Rebirth and Revision 6 Interventions to address maternal, newborn, and child survival: what difference can integrated primary health care strategies make?

Zulfiqar A. Bhutta, Samana Ali, Simon Cousens, Talaha M. Ali, Batool Azra Haider, Arjumand Rizvi, Pius Okong, Shereen Z. Bhutta, Robert E Black

Research output: Contribution to journalArticle

Abstract

Several recent reviews of maternal, newborn, and child health (MNCH) and mortality have emphasised that a large range of interventions are available with the potential to reduce deaths and disability. The emphasis within MNCH varies, with skilled care at facility levels recommended for saving maternal lives and scale-up of community and household care for improving newborn and child survival. Systematic review of new evidence on potentially useful interventions and delivery strategies identifies 37 key promotional, preventive, and treatment interventions and strategies for delivery in primary health care. Some are especially suitable for delivery through community support groups and health workers, whereas others can only be delivered by linking community-based strategies with functional first-level referral facilities. Case studies of MNCH indicators in Pakistan and Uganda show how primary health-care interventions can be used effectively. Inclusion of evidence-based interventions in MNCH programmes in primary health care at pragmatic coverage in these two countries could prevent 20-30% of all maternal deaths (up to 32% with capability for caesarean section at first-level facilities), 20-21% of newborn deaths, and 29-40% of all postneonatal deaths in children aged less than 5 years. Strengthening MNCH at the primary health-care level should be a priority for countries to reach their Millennium Development Goal targets for reducing maternal and child mortality.

Original languageEnglish (US)
Pages (from-to)972-989
Number of pages18
JournalThe Lancet
Volume372
Issue number9642
DOIs
StatePublished - 2008

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Primary Health Care
Mothers
Newborn Infant
Child Mortality
Maternal Death
Uganda
Maternal Mortality
Self-Help Groups
Pakistan
Cesarean Section
Referral and Consultation
Infant Health
Maternal Health
Child Health
Health
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

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Alma-Ata : Rebirth and Revision 6 Interventions to address maternal, newborn, and child survival: what difference can integrated primary health care strategies make? / Bhutta, Zulfiqar A.; Ali, Samana; Cousens, Simon; Ali, Talaha M.; Haider, Batool Azra; Rizvi, Arjumand; Okong, Pius; Bhutta, Shereen Z.; Black, Robert E.

In: The Lancet, Vol. 372, No. 9642, 2008, p. 972-989.

Research output: Contribution to journalArticle

Bhutta, Zulfiqar A. ; Ali, Samana ; Cousens, Simon ; Ali, Talaha M. ; Haider, Batool Azra ; Rizvi, Arjumand ; Okong, Pius ; Bhutta, Shereen Z. ; Black, Robert E. / Alma-Ata : Rebirth and Revision 6 Interventions to address maternal, newborn, and child survival: what difference can integrated primary health care strategies make?. In: The Lancet. 2008 ; Vol. 372, No. 9642. pp. 972-989.
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