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Monitoring trends and refocusing efforts: The role of data in improving maternal and newborn health

At this year’s International Maternal and Newborn Health Conference (IMNHC) in Cape Town, South Africa, attendees issued a call for renewed intensity of purpose from the global health community to better identify effective interventions for advancing maternal and newborn health.

CHISU Deputy Project Director Dr. Stephanie Watson-Grant and Technical Director Derek Kunaka attended IMNHC in early May. During the sessions they participated in, both noticed the critical role data plays in advancing maternal and newborn health.

 

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Attendees at this year’s IMNH conference in Cape Town, South Africa, including CHISU leadership Derek Kunaka and Dr. Stephanie Watson-Grant.
Attendees at this year’s IMNHC in Cape Town, South Africa, including CHISU leadership Derek Kunaka and Dr. Stephanie Watson-Grant. Photo credit: Zoe Kaplan

 

According to a recent United Nations report, global progress toward reducing maternal and newborn mortality has flatlined since 2015. The report also indicates that maternal and newborn deaths remain extremely high worldwide, with a combined 4.5 million deaths per the latest published estimates. Surveillance data can help to monitor trends and focus efforts to reduce maternal and newborn morbidity and mortality—something that was widely discussed during the conference.

“Almost every single conversation came back to the data—either the lack of data or the use of data,” Dr. Watson-Grant said. She explained that during one session on climate change and maternal health, participants emphasized that there is not enough data available—and that much of the data being used is from the Global North. This means that although we can discuss the physiological effects of climate change and higher temperatures on pregnant women and their babies, there’s not a lot of supporting evidence from the world’s hottest places.

Mr. Kunaka recalled a session about how countries with large volumes of data can harness evidence for better decision making. One example given was how Nigeria is using publicly available data sources to understand why the urban advantage in health is disappearing. They’ve found that many women experience difficulties accessing health services where security and traffic is an issue, which can cause delays in decisions around care, transport to health facilities, and more.

“This is a good way of leveraging big data to get better outcomes for women, especially when it comes to emergencies,” Mr. Kunaka explained.

Dr. Watson-Grant and Mr. Kunaka identified several key takeaways from their IMNHC experience:

  • Countries are recognizing the importance of routine health information systems for improving maternal and newborn health outcomes. Dr. Watson-Grant noted that much of the data around maternal and newborn health is complex, and further complicated by factors like emergency contexts. Routine systems are more sensitive to (and thus more accurate for) collecting maternal and newborn health data. Mr. Kunaka reinforced these points, adding that stronger routine health information systems allow for more data availability and less duplication of efforts (which can happen when data is instead collected through multiple surveys). 
  • Connecting data from different sources is key to improving maternal and newborn health data overall. It’s not only important to have data systems that are interoperable, as Dr. Watson-Grant explained, but looking at data itself with that interoperability lens is crucial, too. That way, we can make sense of what the data is actually telling us. “An example of a central data analytics unit that the Western Cape Department of Health presented at IMNHC showed that this could be done,” Mr. Kunaka said, “albeit with years of deliberate investment in skills and infrastructure.” 
  • Fostering a diverse mix of partnerships is getting more attention, and IMNHC illustrated the benefits of bringing a broad stakeholder grouping together. Dr. Watson-Grant  mentioned that participation at the conference got her thinking about how such a stakeholder composition can be advanced at the country level going forward, and how it can be leveraged to improve health outcomes for women and babies.
  • Risk stratification and subnational tailoring of interventions are important pieces of the puzzle in advancing maternal and newborn health services, and are strategies that more countries need to be employing to use various data sources to identify populations most at risk and match interventions to their real needs. Mr. Kunaka noted that CHISU is embracing this in its work to increase data sources that feed into those approaches.

Both Dr. Watson-Grant and Mr. Kunaka came away from the conference having made numerous connections with CHISU’s present and future work. In particular, they noticed a shift in approach for many countries, which had previously focused on increasing the number of skilled birth attendants without much targeting of those increases. Now, there’s more awareness about the role of good data to inform those efforts. “If you really want to see improvement, you need to provide high quality care in the right places,” Mr. Kunaka concluded. “And for you to be able to do that, you need appropriate data, which is where we come in.”

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