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This Roadmap represents a significant milestone in the global pursuit of enhanced maternal and perinatal health during epidemics and pandemics. It describes collaborative means to address the most pressing challenges that hinder the generation of high-quality evidence on the direct and indirect effects of epidemics on maternal and perinatal health.

The Roadmap is relevant to multiple types of stakeholders working in the areas of maternal and perinatal health, global health security and surveillance, and medical products development.

Maternal and perinatal death surveillance and response (MPDSR) is an approach promoted by the World Health Organization (WHO) and partners to reduce maternal and perinatal mortality. MPDSR involves stakeholders in the processes of identifying and reporting maternal and newborn deaths and stillbirths, understanding why the deaths occurred, taking actions to prevent similar deaths occurring in the future, monitoring implementation of actions and resulting changes, and promoting accountability for maternal and perinatal deaths.

The aim of this report is to describe progress on strengthening MPDSR over the last 10 years, as a follow up to the WHO and UNFPA Time to respond: a report on the global implementation of maternal death surveillance and response, published in 2016. The report describes improvements in policies, implementation and tracking of MPDSR implementation, and highlights how MPDSR can be successful in various contexts, such as humanitarian and fragile settings. Eight country case studies highlight examples of addressing barriers to MPDSR implementation by using the MPDSR approach to reduce maternal and perinatal mortality and increase accountability for maternal and perinatal deaths. Finally, the report outlines progress on MPDSR implementation since 2016, improvements in barriers to implementation, and highlights focus areas to further strengthen to 2030.

This report takes a systematic approach investigating in-depth the practice of using MPDSR in eight countries around the world with more than 160 semi-structured interviews. Through case studies from countries at different levels of progress in MPDSR implementation, it also reports on gaps and challenges in MPDSR implementation and shares experiences from countries on how these have been addressed. It is expected that this report will encourage the global health community of policy-makers, programme managers, health workers, civil society organizations (CSOs), professional societies, academic institutions, bilateral and multilateral agencies and foundations working in maternal, perinatal and newborn health to continue to strengthen MPDSR implementation and mobilize efforts and funding to overcome gaps and challenges that adversely affect maternal and perinatal survival.

The Global Burden of Disease Study 2021 reveals a significant yet uneven decline in stillbirths worldwide from 1990 to 2021, with the global stillbirth rate at 20 weeks’ gestation or longer decreasing by 39.8%, from 5.08 million in 1990 to 3.04 million in 2021. Despite this progress, the reduction in stillbirths lagged behind the 45.6% decline in neonatal deaths over the same period. The study highlights stark regional disparities, with South Asia and sub-Saharan Africa accounting for 77.4% of global stillbirths in 2021, up from 60.3% in 1990.

The findings underscore the need for targeted interventions in these regions to address the persistent high rates of stillbirths, particularly those occurring between 20 and 28 weeks’ gestation, which constituted 30.5% of the global total in 2021. The study emphasizes the importance of improving access to quality maternal healthcare, addressing socioeconomic disparities, and enhancing data collection and reporting systems to better monitor and prevent stillbirths.

This document provides a list of key WHO-recommended maternal and newborn health commodities and aims to accelerate progress towards the SDGs. It consolidates the key and enabling commodities from existing WHO guidelines on maternal and newborn health. 

The commodities included in the list are either critical for reducing maternal, fetal, and/or newborn deaths, or are essential for providing high-quality care.  

Poor perinatal mental health (PMH) affects 13-30% of women globally, with higher rates in low- and middle-income countries. Biological, socioeconomic, and sociocultural factors, as well as gender inequalities, increase the risk of poor PMH, especially for marginalized groups like non-binary people, trans men, and women with disabilities. Poor PMH has severe consequences for both mothers and infants, including increased risk of maternal mortality, obstetric complications, self-harm, and adverse infant outcomes.

Addressing PMH is crucial for improving maternal and child health, reducing poverty, and strengthening societies. USAID is committed to optimizing PMH through evidence-based interventions, addressing systemic barriers, and fostering collaboration with diverse stakeholders. This collective effort can improve maternal and child health, reduce maternal mortality, and break the cycle of intergenerational trauma associated with poor mental health.

Climate change is exacerbating health risks worldwide, from extreme heat events to flooding and hurricanes. Strengthening primary health care (PHC) is crucial for building climate-resilient health systems. PHC can address climate-related health impacts like non-communicable diseases, malnutrition, and infectious diseases. Key strategies include investing in PHC workforce capacity, integrating climate and health data, and promoting integrated models of service delivery. While adaptation is essential, rapid reductions in greenhouse gas emissions are equally important. PHC professionals can play a role in both climate adaptation and mitigation by promoting healthy behaviors and advocating for sustainable policies. The World Health Organization’s Fourteenth Global Programme of Work provides a framework for these efforts, emphasizing multisectoral action and the importance of health in all policies.

The “Transitioning to Midwifery Models of Care: Global Position Paper” is a comprehensive document produced by the World Health Organization (WHO) Department of Maternal, Newborn, Child and Adolescent health and ageing, under the Strategic Technical Advisory Group of Experts for Maternal, Newborn, Child and Adolescent health and nutrition (STAGE), in collaboration with WHO technical departments, regional offices and numerous stakeholders.

In the pursuit of providing high-quality health services to improve health and well-being for all in the context of Universal Health Coverage, transitioning to midwifery models of care represents a cost-effective strategy to optimize outcomes for women and newborns with minimal use of unnecessary interventions. This position paper offers an international definition, describes the guiding principles of midwifery models of care and reviews the advantages of adopting these models of care. It highlights the significant role and impact that midwives can have within health systems, while recognizing the importance of collaborative and integrated care where various professionals jointly contribute to providing high-quality maternal and newborn health services.

This study reveals that small-quantity lipid-based nutrient supplements (SQ-LNS) significantly improve birth outcomes. Compared to standard iron and folic acid or multiple micronutrient supplements, SQ-LNS increased birth weight by an average of 49 grams and improved all birth anthropometric z-scores. The supplements also reduced the risk of low birth weight by 11%, newborn stunting by 17%, newborn wasting by 11%, and small head size by 15%. These findings underscore the potential of SQ-LNS to address multiple nutritional deficiencies during pregnancy, thereby enhancing maternal and infant health outcomes in low- and middle-income countries

Overview

The purpose of the Maternal, newborn, child, adolescent health, and ageing and quality of care indicator metadata toolkit: Indicator validation guide is to provide Maternal Newborn Child and Adolescent and Healthy Ageing programme managers with information to understand the basic concepts of indicator validation.

This document provides some examples of methods for research on indicator validation and testing. It also includes recommendations on the following:

• Providing information on defining, designing and conducting indicator validation studies for MNCAH and healthy ageing populations, as well as QoC indicators for these groups.
• Offering instructions on interpreting and applying available evidence to evaluate whether given indicators meet desired standards of validity.
• Highlighting the importance and value of assessing the validity of different types of indicators specific to MNCAH, healthy ageing and quality of care.
• Offering specific recommendations on methods for conducting indicator validation studies.

This document is part of Maternal, newborn, child, adolescent health and ageing and quality of care indicator metadata toolkit that has been developed to facilitate monitoring at various levels and can be found here https://platform.who.int/data/maternal-newborn-child-adolescent-ageing/indicator-toolkit/adolescent-health-indicators.  The toolkit includes functionality to search for metadata information for priority indicators.

The Summit of the Future in September 2024 produced an inter-governmentally negotiated, action-oriented Pact for the Future (Resolution A/RES/79/1) with chapters on:

• Sustainable development and financing for development;
• International peace and security;
• Science, technology and innovation and digital cooperation;
• Youth and future generations; and
• Transforming global governance.

This Pact for the Future is global political recommitment to the Sustainable Development Goals and to an inclusive, equitable future where all people can live healthy, productive, and safe lives on a planet free from the shocks of conflict and climate change.

At the September 2024 High-Level Meeting on Antimicrobial Resistance (AMR), global leaders approved this political declaration on AMR, committing to a clear set of targets and actions, including reducing the estimated 4.95 million human deaths associated with bacterial antimicrobial resistance (AMR) annually by 10% by 2030.

If effectively implemented, these commitments will help AMR, slow its progression, prioritize access to appropriate antimicrobial treatments when not available, drive the development of new treatments and enhance infection prevention measures in healthcare settings.

This guide aims to equip USAID Missions and partners with tools to monitor and evaluate programs that enhance person-centered care across the sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) spectrum in low- and middle-income countries, ensuring that the perspectives of clients and caretakers are central to these efforts. The guide compiles measures that can be used to track client-reported experiences of care (EOC) in facility- and community-based health service delivery settings across the spectrum of SRMNCAH, including family planning, HIV, sexually transmitted infections, and care of the sick child. It compiles measures of self-reported data on EOC for the client and caretaker (for newborns and children).