“The thing about stillbirth – in my experience with moms who have also experienced this – is that as a mom, nine months leading up to when you give birth, you are looking forward to being your child’s mother. At stillbirth, you only get that moment.”

At the International Maternal Newborn Health Conference (IMNHC) 2023, Treasure Lwatale, a patient advocate from Malawi, recounted her experience of delivering her stillborn child and the trauma she experienced from a health system that was not geared to support her. Treasure’s story prompted important questions: How can we improve the care experience for mothers and newborns worldwide? Why should women and children die from preventable causes? What are the various ways we can empower health workers and communities?

In May 2023, The Antara Foundation (TAF) joined the global maternal and newborn health community to discuss, debate, and deliberate on precisely these questions. TAF was selected to showcase our AAA platform at the Technical Marketplace session amongst other promising maternal and newborn health innovations. The AAA platform is a convergence platform aimed at bringing together India’s three community health workers to empower them to coordinate service delivery and provide comprehensive care. At TAF, we work in rural Madhya Pradesh in partnership with the government and communities to strengthen the health system and improve maternal and child health outcomes. This was a remarkable opportunity for us to engage with the global public health community, which showed interest in the simplicity of our tools and the platform’s potential for adaptation to different contexts.

We also had the opportunity to contribute to discussions on emerging maternal and child health topics. Here are our five main insights from the conference:

1. Scaling Known Solutions: Several solutions are effective, but the challenge lies in them succeeding at scale. Although only a few countries have effectively scaled up interventions for sick newborns, an analysis of their scale-up strategies reveals ten critical components, including—having a committed national plan for improving the quality of care for newborns, involving families and communities, and linking maternal and newborn care.

2. A Data-Driven Approach is Critical: In the maternal and child health field, we currently face a syndrome known as DRIP (Data Rich Information Poor). Improving and utilizing data is crucial to improve the quality of our decisions. Ways to achieve this include increasing the use of data from all collection platforms, tracking subnational data for equity, measuring care quality for local improvement, counting every stillbirth, tracking women’s and newborns’ care experiences, and following up with those at risk.

3. Leveraging Communities: Many countries have some policies or frameworks around community engagement in maternal and newborn care but often lack a comprehensive national strategy to address this in a systematic manner. Effective community engagement requires a national leadership approach focused on developing long-term agendas, building community trust, involving communities in plan and guideline design, conducting assessments, and creating a two-way feedback mechanism.

4. Respectful Maternity Care as a Core Aspect of Quality: Treasure’s experience highlighted the issue of disrespectful care. Patient-centred care is crucial to quality. While research and literature discuss the disrespectful, abusive, and neglectful treatment of women in healthcare facilities during childbirth, there is limited research on effective interventions for person-centred maternal care (PCMC). Some solutions discussed during the conference include creative storytelling to increase patient involvement, creating culturally competent facilities, and providing training to reduce stress and bias among health providers.

5. The Importance of Strengthening Referral Systems: Referral systems extend beyond transportation and have multiple dimensions: transport readiness, referral efficiency and care coordination, care during transport, financial accessibility, family-centred referrals, and inter-facility dynamics. Investing in and strengthening these components of the referral system is essential.

The conference also witnessed the pivotal launch of Every Newborn Action Plan (ENAPP) and Ending Preventable Maternal Mortality (EPMM) progress reports.[2] They outline our progress in achieving Sustainable Development Goals and have helped us align on the objectives, priorities, and ways to end preventable maternal and newborn deaths.

Much remains to be done and considered until we reconvene at the next chapter of the International Maternal Newborn Health Conference in two years. In the meantime, at The Antara Foundation, we remain committed to sharing our implementation experience, learning from other practitioners, and contributing to the maternal and child health community.

TAF’s team at the International Maternal Newborn Health Conference

^[1] International Maternal Newborn Health Conference 2023 Opening Plenary. AlignMNH, 2023. https://www.youtube.com/watch?v=7l7EZ8UKw-8&t=515s.

[2] Grear, K. (2023) Improving maternal and newborn health and survival and reducing stillbirth – progress report 2023, AlignMNH. Available at: https://www.alignmnh.org/resource/improving-maternal-and-newborn-health-and-survival-and-reducing-stillbirth-progress-report-2023/ (Accessed: 15 September 2023).