With funding from Takeda’s Global CSR Program through the Global Fund, the Liverpool School of Tropical Medicine (LSTM) Emergency Obstetric Care and Quality of Care Unit hosted its 3rd and final Knowledge Management and Learning (KML) event of the “Quality Improvement of Integrated HIV, TB, and Malaria Services in Antenatal Care (ANC) and Postnatal Care (PNC) Programme in October 2024.
The KML event is a knowledge-sharing forum where programme implementers share best practices and knowledge from implementation to influence policy and practice in providing quality maternal and child health services in Kenya, Tanzania and Nigeria.
The third KML panel discussed designing future programs to accelerate maternal and newborn health improvements. Moderated by LSTM’s Dr Helen Allott, the session explored innovative strategies, pre-service and in-service capacity building, community engagement, and leveraging partnerships. The panel included Dr Henry Jumbo from Nigeria’s Federal Ministry of Health and Dr Mwajuma Gumbo from Tanzania’s University of Dodoma, with additional contributions from KML participants.
The panellists emphasised scaling up successful interventions to accelerate maternal and newborn health improvements while addressing systemic challenges. Dr Mwajuma Gumbo advocated for scaling successful programs to other health facilities, citing improvements in quality indicators. “Reaching the community level is essential; we must work with community healthcare workers to engage mothers early and educate them on seeking care,” she said.
Training healthcare workers on respectful maternity care and addressing attitudinal issues were highlighted as critical areas for improvement. “Continuous education ensures that the skills and attitudes taught are retained and applied consistently,” Dr Gumbo noted.
Role of Partnerships in Programme Design
Dr Henry Jumbo underscored the importance of aligning partner objectives with national health priorities. “We encourage partners to contribute to our operational plans while ensuring they address broader issues, like integrating syphilis interventions into the wider STI context,” he explained.
Key recommendations included:
- Aligning targets and indicators to avoid duplication and streamline data collection.
- Strengthening national collaboration for measurable and sustainable interventions.
- Emphasising mentorship and capacity building across all levels of healthcare.
Strengthening Pre-Service and In-Service Training
A recurring theme was the importance of pre-service and in-service training in building healthcare worker capacity, and discussions focused on making the most of these training opportunities.
Pre-Service Training
Panellists noted gaps in clinical teaching and curriculum relevance.
- Skill Development: “Midwives must develop practical skills during training, from abdominal examinations to respectful care practices,” highlighted Dr Gumbo.
- Local Content: Audience members emphasised the need for tailoring curricula to address local health challenges, with a call to integrate current, region-specific content.
- Harmonised Curriculum: In Tanzania, efforts are underway to standardise training across universities, ensuring consistency in healthcare education.
In-Service Training
Though seen as essential, in-service training was identified as costly and disruptive to healthcare service delivery. The programme's implementation of innovative solutions, such as blended learning models, was lauded as one cost-effective solution.
- Blended Training: Combining online theory modules with practical sessions reduces costs and ensures healthcare workers remain in facilities during training.
- Continuous Professional Development (CPD): Panellists suggested targeted CPD programs for educators to enhance teaching effectiveness.
Community Engagement for Health Impact
Community approaches emerged as a cornerstone for reducing maternal and newborn mortality, with specific recommendations related to:
- Male Involvement: Audience members stressed engaging men, as key decision-makers, to influence family health positively.
- Demand Generation: Leveraging community health workers to educate and mobilise communities was essential for addressing delays in care-seeking behaviour.
- Behaviour Change Communication: Utilising media and local gatherings to educate communities on maternal and newborn health issues was highlighted as a cost-effective strategy.
Policy Alignment and Advocacy
Panellists and audience members called for robust policy frameworks to ensure sustainable impact by:
- Addressing Gaps in Human Resources: Employing qualified healthcare professionals and optimising existing human resources were cited as critical for improving service delivery.
- Streamlining Curricula Updates: Adopting interim addendums to policies ensures new guidelines are integrated into training and practice more rapidly.
- Universal Health Coverage (UHC): Strengthening primary healthcare networks and integrating maternal health services within UHC frameworks were crucial recommendations.
Ideas for Future Programming
Participants proposed several forward-looking strategies as highlighted below:
- Optimising Costs and Efficiency: Reducing healthcare costs for pregnant women by addressing hidden expenses and scaling efficient interventions.
- Girls’ Education: Promoting girls’ education to improve knowledge and access to healthcare services.
- Post-Abortion Care: Expanding access to high-quality post-abortion care to reduce complications and mortality.
- Teenage Pregnancy: Addressing teenage pregnancy through sensitisation and education campaigns.
Takeaways for Policy and Practice
- Scale High-Impact Interventions: Extend proven programs to underserved areas to maximise impact.
- Enhance Pre-Service Training: Ensure curricula reflect local needs and equip educators with updated teaching methods.
- Foster Community Engagement: Mobilise communities through education, demand generation, and male involvement.
- Align Policies with Practice: Streamline policy updates to integrate best practices rapidly into healthcare systems, including training curricula.
- Leverage Partnerships: Strengthen collaborations with partners to align goals and maximise resources.
Future Direction
The session concluded with a shared vision of innovative program designs, strengthened healthcare worker capacity, and empowered communities. Future programs can deliver lasting improvements in maternal and newborn health by focusing on collaboration, scaling interventions, and addressing systemic challenges.