TAILIEUCHUNG - Continuum of care for maternal, newborn, and child health: from slogan to service delivery

It is not only that poor people are in ill-health: ill-health causes poverty. In Voices of the poor, a recent World Bank study, ill-health emerged as one of the principal reasons why households become poor and remain poor (23). Explanations are numerous: they include the burden of health care expenditures incurred by caring for sick household members (24), the lost income of the sick, and the lost income of other household members who care for the sick. Nationally, although data relating the impact of health indicators to poverty rates are scarce, evidence is emerging about the impact of health on economic growth. One study estimated that health and demographic variables accounted for half. | Review Continuum of care for maternal newborn and child health from slogan to service delivery Kate J Kerber Joseph E de Graft-Johnson Zulfiqar A Bhutta Pius Okong Ann Starrs Joy E Lawn Lancet 2007 370 1358-69 See Editorial page 1283 See Comment page 1285 Saving Newborn Lives Save the Children Washington DC USA K J Kerber MPH J E de Graft-Johnson MD J E Lawn MRCP ACCESS Program Baltimore MD USA J E de Graft-Johnson Department of Pediatrics and Child Health Aga Khan University Pakistan Prof Z A Bhutta PhD Department of Obstetrics and Gynaecology Nsambya Hospital Uganda and International Federation of Gynecology and Obstetrics Committee on Maternal and Newborn Health London UK P Okong MD Family Care International New York USA A Starrs MPA and Partnership for Maternal Newborn and Child Health Geneva Switzerland A Starrs Correspondence to Dr Joy E Lawn Saving Newborn Lives Save the Children-US 11 South Way Pinelands Cape Town 7405 South Africa joylawn@ The continuum of care has become a rallying call to reduce the yearly toll of half a million maternal deaths 4 million neonatal deaths and 6 million child deaths. The continuum for maternal newborn and child health usually refers to continuity of individual care. Continuity of care is necessary throughout the lifecycle adolescence pregnancy childbirth the postnatal period and childhood and also between places of caregiving including households and communities outpatient and outreach services and clinical-care settings . We define a population-level or public-health framework based on integrated service delivery throughout the lifecycle and propose eight packages to promote health for mothers babies and children. These packages can be used to deliver more than 190 separate interventions which would be difficult to scale up one by one. The packages encompass three which are delivered through clinical care reproductive health obstetric care and care of sick newborn babies and children four through outpatient and

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