What We Do

Maternal, Neonatal & Child Health

Strategy Overview

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An Ethiopian mother with her son, who received all of his required vaccinations from a health extension worker.

our goal:

to ensure that mothers and babies survive and remain healthy during pregnancy, childbirth, and early childhood.

The Challenge

At A Glance

In the developing world, millions of women and babies die unnecessarily during pregnancy, childbirth, and the first months after childbirth.

Most of these deaths could be prevented using proven and affordable tools and procedures that are commonly available in the developed world.

We invest in the development of tools, technologies, and treatments that can be readily used by families and frontline health workers to improve the health of mothers and infants.

We promote better, more frequent, and more affordable interactions between frontline health workers and families, and we advocate for better policies and increased funding to support maternal, neonatal, and child health.

Our Maternal, Neonatal & Child Health strategy, initially developed in 2009, is led by director Mariam Claeson, and is part of the foundation’s Global Development Division.

Every year, complications from pregnancy and childbirth claim the lives of nearly 300,000 women and permanently disable many more, mostly in developing countries. Mothers suffer primarily from hemorrhage, sepsis, obstructed labor, and disorders caused by high blood pressure.

In addition, more than 2.6 million babies are stillborn, another 2.9 million die before they are a month old, and many suffer neurodevelopmental disabilities and impairments. Most neonatal deaths are caused by preterm birth, asphyxia during birth, and infections such as sepsis, pneumonia, and meningitis.

Effective, low-cost interventions are available, but they are not reaching all of the women and babies who need them. In developing countries, many women deliver at home and rarely see a trained healthcare provider before or after the baby’s birth. Skilled providers in poor countries often lack access to current tools or do not use them. Families may not seek care or follow medical advice.

The Opportunity

Most maternal and neonatal deaths can be prevented using available tools and procedures: antibiotics, sterile blades for cutting umbilical cords, drugs that prevent and treat postpartum hemorrhage, antenatal corticosteroids to accelerate lung maturation in the fetus, and best practices such as kangaroo mother care, which includes exclusive breastfeeding and skin-to-skin contact to keep the baby warm and protect from infection.

Such low-cost interventions can significantly reduce deaths of mothers and newborns. Further improvements are also possible through the development of new tools and technologies that enable earlier and faster diagnosis and treatment of dangerous conditions.

Our Strategy

The Bill & Melinda Gates Foundation’s Maternal, Neonatal & Child Health program focuses on expanding the use of current solutions and developing new ones to ensure that mothers and infants survive and stay healthy during childbirth and early childhood, when services are most lacking and the majority of deaths occur.

A mother and child in rural Nepal, where aid organizations are promoting the use of skilled birth attendants to address the high maternal mortality rate.

We also work closely with governments, United Nations agencies, nongovernmental organizations, and the private sector, and we collaborate with other programs at the foundation in areas such as nutrition, family planning, and infectious diseases.

Our approach recognizes the central role of local healthcare providers. To support their work, we invest in efforts to adapt and develop innovative tools, technologies, and treatments; improve the counseling and negotiation skills of frontline health workers; encourage families to practice healthy behaviors and seek out quality maternal and neonatal care; strengthen frontline health workers’ skills and effectiveness; and advocate for targeted national and global policies, funding, and leadership.

We also support research efforts in many parts of the world that can lead to better ways to improve the health and save the lives of mothers and newborns. Our efforts are currently focused in northern India, Ethiopia, and northern Nigeria.

Areas of Focus

We focus our efforts in several areas:

Improving tools, technologies, and treatments.

To address the primary risk factors for maternal and neonatal deaths, we work to adapt current preventive and curative tools, technologies, and treatments as well as develop new ones that are more effective and affordable and will be more readily accepted by families and frontline health workers in rural and community clinics. These include managing postpartum hemorrhage with drugs such as oxytocin and misoprostol and preventing and treating newborn infections using simplified antibiotic treatment regimens and cleaning of the umbilical cord.

Improving health practices.

A health extension worker makes a home visit in Mojo, a town in Central Ethiopia.

We work to identify and reduce barriers to adoption of effective interventions, disseminate information about maternal and neonatal health, conduct large-scale educational campaigns, mobilize local networks to improve household and community practices and social norms, and reduce financial barriers to obtaining care.

Enhancing frontline health workers’ skills.

We work to help community-level healthcare providers—particularly in northern India, Ethiopia, and northern Nigeria—advance their knowledge, skills, and use of innovative tools.

Increasing funding and improving policies.

According to the World Health Organization, achieving the UN Millennium Development Goals for maternal and child health will require a substantial ongoing investment. We support efforts to increase funding and build on our partners efforts globally and at the country level. We also work to develop policies and strategies that enable countries to increase use of lifesaving health interventions, raise awareness of overlooked risk factors for neonatal and maternal mortality, and expand the use of essential medicines.

Extending benefits beyond the neonatal period.

We believe that strengthening the skills of frontline health workers can benefit children in the critical period between birth and age 2. For example, good health practices such as hand washing, immunization, postpartum family planning, and exclusive breastfeeding can lead to improved outcomes for mothers and children as well as mitigate childhood illnesses such as pneumonia, diarrhea, and undernutrition.

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