Regional Workshop for Improving Quality of Hospital Care for Maternal and Newborn Health
10-13 May 2016, New Delhi, India
Distinguished participants, Esteemed partners on the stage and in the audience,
A very good morning to you!
It is with great pleasure that I welcome you to Delhi, and to this Regional meeting on Quality of Hospital Care for Maternal and Newborns.
When the Millennium Development Goals were launched in 2000, ambitious goals were set for the reduction of maternal and child mortality. In the last decade significant progress was achieved in the SEA Region, where maternal mortality declined by about 64%, and a similar reduction in child mortality as well.
However, progress was insufficient for the Region as a whole to have achieved the MDG 5 target of a reduction of maternal mortality ratio (MMR) by three fourths, and under-five mortality by two-thirds, between 1990 and 2015.
Nevertheless, I must commend our Member States for the tremendous efforts put in pursuing these goals and the significant progress in both the areas.
As we look to the future, we must take into consideration the lessons learnt from the MDG era. It is clear that although there are a slew of evidence-based interventions, that are being implemented, such interventions have often been delivered with insufficient quality. A number of studies over the past years have reported that the quality of care provided to mothers, newborns and children was sub-optimal.
For example, some Member States have reported that, though there has been a significant increase in coverage of skilled birth attendance, maternal and newborn mortality has failed to decline to the levels expected. High coverage by skilled attendants will have an impact only when the basic clinical and life-saving procedures are performed while ensuring good quality of care. Coverage of interventions alone is not likely to yield results unless these are delivered with good quality to make coverage effective. Moreover, poor quality of health-care services may even be harmful to the health of individuals seeking care. In addition, such quality dissuades people from utilizing health-care services, to the extent that they should, and increases out-of-pocket expenditure.
In the Sustainable Development Goals framework, universal coverage of health-care services is the centerpiece, and quality of health care has received well-deserved attention in addition to the need for expanded availability of essential services. The Global Strategy for Women's, Children's and Adolescents' Health, 2016–2030, released by the UN Secretary-General, also emphasized quality of health services as an essential and important element of the strategy.
Member States in our Region have also identified poor quality of care as a predominant threat for reproductive-maternal-newborn-child and adolescent health (RMNCAH). They have expressed the need to urgently address deficiencies in the quality of care by embarking on national quality improvement processes, and they have requested WHO and partners to provide technical support and guidance.
The South-East Asia Region is taking concrete steps in this direction. The Regional Office has prepared a Regional Framework for Improving Quality of Care for RMNCAH in consultation with Member States and in collaboration with partner agencies. The vision of the framework is that all countries of the South-East Asia Region provide universal access to quality care for every woman, newborn, child and adolescent at all levels of the health system. The Regional Framework provides guidance for Member States to develop national mechanisms for improving quality of care by establishing leadership at the national level in the ministries of health. We hope that countries will adopt the Regional Framework to their national systems to ensure an enabling and supportive environment for continuous quality improvement in line with global standards of RMNCAH care.
The Regional Framework puts the focus for Improving Quality of Care for RMNCAH at the health care facility level, and emphasizes the importance of collaborative team work of health-care providers. I understand that one of the key objectives of this meeting is to build capacity of health-care providers at health facilities, and to ensure that the focus will be on care provided to the mother and newborn around the time of childbirth.
I believe it is a good plan to initiate quality improvement processes at the point of care by involving the potential champions from selected hospitals in the Member States. Such champions will play a key role during the national roll-out of the quality improvement process within the national framework for improving quality of care. It is vital that strong support is available from the highest level in this endeavor, and the presence of responsible persons from ministries of health at this workshop is encouraging, as it would ensure that support from the senior management in health ministries as countries roll out national plans for strengthening national health systems for quality improvement across all levels of health care system.
Ladies and gentlemen,
Whatever we do, we cannot do it alone. Partnership is vital, both at national, regional and global levels for us to succeed. And I want to acknowledge and appreciate the strong collaboration we have with several partner agencies in this endeavour. We recently had a Regional Leadership Summit of H6 agencies, including WHO, UNICEF, UNFPA, World Bank, UNAIDS and UN WOMEN, to discuss a collaborative approach for the region and express joint support for the Global Strategy for Women’s, Children’s and Adolescents’ Health.
We have a joint statement for ending preventable maternal, newborn and child mortality.
If not for partnership this meeting itself would not have been possible. It is through the partnership of USAID, the WHO Collaborating Centre at All India Institute of Medical Sciences, New Delhi, and the Regional Office that the package for quality improvement at the hospital level to be introduced in this meeting was developed. I have no doubt that the deliberations and the sharing of experiences among Member States would be useful in shaping our future strategies for the improvement of quality of care at health care facilities. I encourage you all to prepare country-specific action plans to improve the quality of maternal and newborn care based on the understanding reached here and keeping in mind your existing country context. We will follow the progress closely. You can count on technical support from WHO and partner agencies in moving this agenda forward.
I wish you all a very successful and productive meeting as well as an enjoyable stay in New Delhi.