HOME INTRODUCTION BENEFITS STRATEGIES RECOMMENDATIONS

Global Maternal and Child

Health Strategy:
Strengthen Public Health System
for MCH

Arif Ramli (Arra)

Nur Anis Izzati Che Mut
HOME INTRODUCTION BENEFITS STRATEGIES RECOMMENDATIONS

TABLE OF CONTENTS

01 INTRODUCTION 02 BENEFITS
You can describe the topic of the
section here

IMPLEMENTED
03 04 RECOMMENDATIONS
STRATEGIES
 HOME INTRODUCTION BENEFITS STRATEGIES RECOMMENDATIONS

INTRODUCTION

• In a world where the well-being of mothers and children is a universal concern, the imperative
to strengthen the public health system for MCH has gained unprecedented recognition.

• As we strive to achieve global health goals, it becomes increasingly evident that a resilient and
effective public health system is the cornerstone of progress.

• By focusing our efforts on fortifying this vital infrastructure, we can unlock a world of
possibilities for improving MCH outcomes worldwide.

• This strategic approach holds the power to revolutionize access to essential healthcare
services, empower preventive measures, and provide comprehensive care that ensures a
brighter future for mothers and children everywhere.
 HOME INTRODUCTION BENEFITS STRATEGIES RECOMMENDATIONS

WHY IT IS IMPORTANT TO STRENGTHEN THE SYSTEM?

Ensures better
Enhances the Promotes
access to essential
capacity and preventive
healthcare
effectiveness of measures to
services for
the public health reduce MCH
mothers and
system. problems.
children.

Focuses on equity Utilizes health Contributes to

and addresses information better health
social systems for data outcomes and
determinants of collection and improved overall
health. monitoring. MCH well-being.
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KEY STRENGTHS/ BENEFITS

01 CONVENIENCE FOR FAMILIES

• Integrating services within the MCH clinics can reduce travel

time and streamline services for families, which can lead to
increased attendance and better health outcomes (Berlacher
et al., 2021)
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02 REDUCE HIV STIGMA

• Integrating prevention of mother-to-child transmission of

HIV care into general MCH care can reduce HIV stigma,
which can encourage more women to seek care and treatment
(Berlacher te al., 2021)
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03 IMPROVED INFANT HEALTH

• Exclusive breastfeeding in the first six months of life

stimulates babies' immune systems and protects them from
diarrhea and acute respiratory infections, two of the major
causes of infant mortality in the developing world (Asoh,
2019)
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INCREASED KNOWLEDGE AND PRACTICE OF

04 FAMILY PLANNING

• Public health education activities, such as those implemented

in the Integrated FP/MCH/Parasite Control project can
increase knowledge and practice of family planning and lead
to improved maternal and child care (Wang, 1985)
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STRENGTHENED PUBLIC HEALTH WORKFORCE

05
• Building and sustaining a MCH public health workforce that
is well-trained, diverse, adequate in size, and prepared to lead
complex public health challenges is essential to achieving a
vision of an integrated, coordinated, and comprehensive
system of services for the health of all MCH populations
(Ramos et al., 2022)
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INTERVENTIONS IMPLEMENTED BY COUNTRIES TO IMPROVE

MATERNAL AND CHILD HEALTHCARE
Standard Based Management and Recpgnition (SBM-
R)

To strengthen routine maternal and newborn health

(MNH) services.

It improved MNH providers' performance of routine

antenatal care (ANC), uncomplicated labor and delivery,
and immediate postnatal care (PNC) services (Ayalew et
al., 2017)
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INTERVENTIONS IMPLEMENTED BY COUNTRIES TO IMPROVE

MATERNAL AND CHILD HEALTHCARE

Community Quality Improvement Intervention

To reduce maternal and infant mortality through community-based

initiatives.

It was more cost-effective compared to standard community

healthcare, with incremental cost per disability-adjusted life year
(DALY) averted of $249 under the deterministic analysis and 76%
likelihood of cost-effectiveness under the probabilistic sensitivity
analysis using a standard threshold (Kumar et al., 2021)
HOME INTRODUCTION BENEFITS STRATEGIES RECOMMENDATIONS

INTERVENTIONS IMPLEMENTED BY COUNTRIES TO IMPROVE

MATERNAL AND CHILD HEALTHCARE
Quality improvement (QI)

Used to improve the quality of care were identified through

programs implemented supported by the German
development organization.

These methodologies were capacity-building and

supervision, governance and regulation, systemic QI at
facility level, support to infrastructures, and community
support (Goyet et al., 2019)
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INTERVENTIONS IMPLEMENTED BY COUNTRIES TO IMPROVE

MATERNAL AND CHILD HEALTHCARE

Locally Developed Package of Intervention

To reduce maternal and newborn mortality. The interventions included

training health providers, strengthening the data information system,
and providing catalytic equipment and medicines to establish newborn
care units (NCUs) within the existing infrastructure (Waiswa et al.,
2021)

This has led to improvements in maternal and newborn outcomes and

the institutionalization and scale-up of the quality improvement process
at both hospitals and high-volume health centers.
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Can these intervention implemented in Malaysia?

These specific implementation strategies may need to be tailored to

the Malaysian context, the interventions mentioned can be adapted
and implemented in Malaysia to strengthen routine maternal and
newborn health services, reduce maternal and infant mortality, and
improve the quality of care provided to mothers and newborns.
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01 RECOMMENDATIONS

Build capacity in state and local MCH agencies to

address long-standing, systemic health and social
inequities for MCH populations.

• A competent MCH workforce acknowledges and under-stands the impact of

long-standing, systemic inequities and racism on communities
• equipped with the tools to work upstream to address those in partnership with diverse
stakeholders.
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02 RECOMMENDATIONS
Develop and support pathways to entry-level career
positions in state and local MCH public health, and
support career trajectories for MCH staff to enhance job
satisfaction and retention
• Developing a range of pathways to recruit and retain a skilled MCH PH
workforce into governmental public health is essential.
• Strategies can include expanded academic-practice partnerships that lead to
employment upon successful completion of an internship, competency-based
fellowships, and other public health service opportunities, such as job-sharing
with local community organizations
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03 RECOMMENDATIONS

Develop and offer accessible, high-quality training,

capacity-building, and professional development
opportunities for the practicing MCH workforce

• The MCH PH workforce needs ongoing access to tailored training and

capacity building that develops skills aligned to the MCH leadership
competencies.
• Strategies should also be tailored to practicing professionals, consider the
learning needs and styles of non-traditional students
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04 RECOMMENDATIONS
Strengthen recruitment and preparation of an MCH
public health workforce that is racially and ethnically
diverse, and is reflective of the changing demographics
across the nation
• Achieving health equity requires expanded strategies to recruit a diverse
MCH PH workforce.
• Expanding MCH PH training in minority-serving institutions (MSIs), including
Historically Black Colleges and Universities, Hispanic Serving Institutions,
Tribal Colleges and Universities, and Asian American and Pacific Islander
Serving Institutions has the potential to increase the number of students from
racially and ethnically diverse backgrounds that enter the MCH PH workforce
and that practice in areas that are historically underserved
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05 RECOMMENDATIONS

Ensure equity and antiracism trainings are

foundational, grounding concepts in the continuum of
MCH training opportunities

• MCH PH students and practicing professionals require foundational training in

equity, the historical roots of inequity, antiracism and cultural responsiveness
to effectively work with diverse populations to achieve more equitable
outcomes for MCH populations.
• MCH training and professional development programs have been at the
forefront of preparing the MCH PH workforce to tackle complex health
challenges, and should continue to develop the workforce to be able to apply
upstream approaches that address structural and social determinants that
drive inequities in MCH out-comes.
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06 RECOMMENDATIONS

Increase exposure to careers in MCH governmental

public health for diverse students and professionals

• Exposure to MCH PH careers that reach students from diverse backgrounds

can occur at the high school, under-graduate and graduate levels.
• Such exposures, which can include a continuum of formal education,
mentoring, life skills coaching, cohort-based learning, and paid practica and
internship experiences in state and local public health agencies, can have
significant impact on the career trajectories and success of students from
diverse backgrounds.
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07 RECOMMENDATIONS

Strengthen engagement with MCH-related community

organizations, community members, and families as
vital members of the MCH workforce

• The MCH workforce has long recognized the value of partnerships with
families, community members and youth to build community capacity to lead
and engage as members of the MCH PH workforce.
• We must continue to amplify the role of families, youth and the community-
based workforce(e.g. doulas, home visiting paraprofessionals, community
health workers) as part of the MCH PH workforce.
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08 RECOMMENDATIONS

Align and aggregate MCH and public health data

sources to understand current workforce composition
and highlight current and emerging workforce needs.

• MCH programs in academic, governmental and community contexts draw on

available data sources to understand workforce trends and needs, but these
sources, when considered individually, lack the nuanced perspective needed
to inform a robust understanding of MCH workforce composition and needs.
• Data sources include enrollment, graduation, and faculty data from academic
MCH programs in SPPH, state- and local-based data sources (e.g. PH
Workforce Interests and Needs Survey), and data collected through MCHB
grant funding (e.g. Title V Information System, MCH Training Programs).
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09 RECOMMENDATIONS
Develop measurement frameworks that strengthen the
link between training and workforce development
activities, sustained career pathways in MCH-related
fields, and health outcomes for MCH populations.
• There is a need to look beyond current measurement frameworks in order to
sustain and increase workforce development investments and effectively
communicate the impact of MCH PH training.
• Multiple methods, including quantitative and qualitative, are needed to
formally track graduates of public health education programs to understand
the long-term impact of MCH training experiences on career choices and
community health outcomes.
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10 RECOMMENDATIONS

Expand opportunities for MCH public health faculty

and trainees to pursue applied, practice and policy
focused research

• MCH PH faculty face challenges in pursuing practice-based research (PBR)

including lack of funding and limited institutional support/recognition for PBR
as part of the career ladder.
• To elevate the prestige of PBR, we must fund and incentivize faculty to
pursue research aligned to community-identified MCH needs and that
promotes shared power between academia, health departments, and
community members.
 CONCLUSION

The global maternal and child health strategy to strengthen the public
health system for maternal and child health (MCH) is a critical and
multifaceted approach aimed at improving the well-being and
survival of mothers and children worldwide.

By prioritizing and enhancing the public health system, we can make

substantial strides towards achieving the goals related to maternal
and child health, ensuring that every mother and child can thrive and
reach their full potential.