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Childbirth: A Global Perspective

This course will review challenges for maternal and newborn health in the developing world, where a great many women and babies are suffering from complications during pregnancy, childbirth, and the days following birth. Themes covered include the epidemiology of maternal and newborn mortality and morbidity, relevant issues for the global health workforce, community-based interventions to improve maternal and newborn health and survival, and sociocultural dynamics surrounding birth.


Course at a Glance

About the Course

This course provides a broad overview of maternal and newborn health issues facing low-income and transitional countries, where more than 2.6 million babies are stillborn and nearly 500,000 women die during childbirth or from pregnancy-related complications each year. In the developing world, many women deliver at home without a skilled care provider, drugs, or technological supports. Maternal and newborn survival can be improved by mobilizing communities and improving access to skilled care.

 Through lectures, case studies and readings, course participants will learn about delivery challenges for maternal and newborn health services and how to utilize community-based strategies to improve the health and survival of mothers and babies.

Course Syllabus

Week One: Introduction to Maternal Mortality and Morbidity in the Global Context

Child mortality has decreased rapidly in recent decades, while maternal mortality has declined at a much slower pace; in some places, little improvement has been made at all. In this module, we’ll explore the scope of the maternal health crisis, the timing and major physiological causes of death and disability and the inequalities and inequities between and within countries.

Week Two: Introduction to Maternal Mortality and Morbidity in the US Context

While maternal in the United States is relatively low compared with that in the developing countries, it is much higher than it should be. In this module, we’ll explore the scope of the maternal mortality and morbidity in the United States, the inequalities and inequities between and within subpopulations of the country.

Week Three: The Impact of the Health Care Workforce Shortage on Maternal and Newborn Care

The global health care workforce shortage is leading to understaffed hospitals and shuttered health clinics across the world. Because of this dangerous shortage, patients are left without the critical care they need for survival. This shortage is exceptionally acute in developing countries such as Sub-Saharan Africa, which carries nearly 25% of the world’s disease burden but only 3% of the world’s health care workforce. This module will cover strategies to alleviate the shortage and maldistribution of the health care workforce in developing countries—particularly among nurses, midwives, and other skilled providers of maternal and newborn care.

Week Four: Emergency Obstetric Care: Health Facility Services that Support Maternal Health and Survival

In conjunction with increasing the global maternal health workforce, health systems must be strengthened to enable the provision of life-saving interventions that cannot be delivered at the community level. The primary means of achieving this goal is through the implementation of emergency obstetric care (EmOC) in health facilities. The main objectives of this lecture are to: review the rationale for EmOC, identify its “signal functions,” understand the United Nations process indicators for monitoring EmOC, describe monitoring and quality improvement approaches, and recognize key challenges to effective implementation of EmOC in developing country contexts.

Week Five: Improving Maternal and Newborn Care through Community-Based Interventions

Community mobilization is a promising strategy for improving access to/use of maternal and newborn health services. This module provides an understanding of how delivery of maternal and newborn care might be improved through community-based interventions that effectively include and engage the community in identifying and implementing sustainable solutions. 

Week Six: Case Study in Ethiopia: Educating the Community and Training Front-Line Community Health Workers to Deliver Maternal and Newborn Care

In Ethiopia about 90% of births occur at home, and an estimated 22,000 women and 100,000 newborns die annually from childbirth-related complications. This module describes a project that uses an innovative community-based strategy to ensure that more women and newborns in this country receive effective and timely care. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) educates pregnant women and families on safe birth and postnatal care practices, and trains frontline health workers to deliver a basic package of life-saving maternal and newborn care that can significantly improve health and survival (including referral to higher levels of the health care system).