Strategic Directions of the Department of Maternal, Newborn, Child and Adolescent Health ppt

Strategic Directions
of the Department of
Maternal, Newborn, Child
and Adolescent Health
For further information and publications please contact:
Department of Maternal, Newborn, Child and Adolescent
Health and Development (MNCAH)
World Health Organization
20 Avenue Appia, 1211 Geneva 27, Switzerland
Tel +41 22 791-3281
Fax +41 22 791-4853
Email

© World Health Organization 2011

Strategic Directions
of the Department of
Maternal, Newborn, Child
and Adolescent Health

Contents iii

Contents
1. Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
2. Vision, mission, goals, targets and indicators. . . . . . . . . . . . . . . . . . . . . . . . .3
3. Improving health along the continuum of care. . . . . . . . . . . . . . . . . . . . . . . .6
4. Strategic directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
5. Working across the three levels of the Organization. . . . . . . . . . . . . . . . . . . . 13
6. Working with other depart ments and with partners. . . . . . . . . . . . . . . . . . . . 14
7. Structure of the Department of Maternal, Newborn, Child and Adolescent Health . . 16
Annex: Functions of the teams and cross-cutting groups . . . . . . . . . . . . . . . . . . 18

Introduction 1

Introduction
Maternal, newborn, child and adolescent health are central to the agenda of
Primary Health Care. Healthy mothers can bear and raise healthy children who, when ena-
bled to grow into healthy adolescents, are the foundation of future generations. Investment in
one age group benets the other, and coordinated investment in all of these groups maximizes
the intergenerational benets. Fostering a continuum of care that spans from pre-pregnancy,
through pregnancy, childhood and adolescence not only makes programmatic sense, it is also
imperative to address emerging health priorities.
In pursuit of national and international goals and targets, the World Health Organization
(WHO) is committed to contributing to the achievement of universal access to maternal,
newborn, child and adolescent health services. Much has already been achieved in countries
with the support of WHO, and since 1990, signicant progress has been made in reducing
maternal and child deaths. In 2008, the global annual number of maternal deaths was esti-
mated at 358,000, down 34% from 546,000 in 1990.
1
In 2009, the global number of child
deaths fell to 8.1 million, down from 12.3 million in 1990.
2
In addition, 15 countries of the
African Region have seen declines in HIV prevalence, much of it due to reductions in young
people.
3
For maternal health, the greatest progress was made in countries of the South-East
Asia and Western Pacic Regions, while for child survival, the greatest progress was made
in countries of the European Region and the Region of the Americas. e overall progress
in maternal and child mortality reduction was least in sub-Saharan Africa and the East-
ern Mediterranean Region.

4
Despite good progress overall, the rates are not fast enough to
reach Millennium Development Goals (MDGs) 4 & 5, unless greatly accelerated reductions
are seen.
Important challenges remain. First, median coverage of life-saving interventions remains
low in most high burden countries.
5
Moreover, progress in national coverage levels does
not always indicate progress in reaching the poorest and most vulnerable women, children
and adolescents. Second, improving quality of care is essential for realizing the benets of
improved coverage. For example, women and children oen do not receive the interventions
1
Trends in maternal mortality: 1990 to 2008, Estimates developed by WHO, UNICEF, UNFPA, and the World Bank
( />2
World Health Statistics 2010 ( />3
e International Group on Analysis of Trends in HIV Prevalence and Behaviours in Young People in Countries most
Aected by HIV, “Trends in HIV prevalence and sexual behaviour among young people aged 15–24 years in countries
most aected by HIV”, Sex Transm Infect 2010;86(Suppl 2):ii72eii83 ( />4
Countdown to 2015 Decade Report: Taking stock of maternal, newborn and child survival (www.
countdown2015mnch.org/documents/2010report/CountdownReportAndProles.pdf).
5
EB128/7 “Health-related Millennium Development Goals: Report by the Secretariat”, 30 December 2010 (http://apps.
who.int/gb/ebwha/pdf_les/EB128/B128_7-en.pdf).
1
2 Introduction

they need when they need them, whether that be access to antenatal care, care during and
aer childbirth, or services for eectively managing childhood illness. ere are major gaps
in the continuum of care, in particular in the post-natal period, when the risk of mortality
is high for the mother and her newborn. ird, adolescent health needs are still neglected.

While many countries have included adolescents in national health policies and strategies,
large scale programmatic action is limited. Pregnancy in young adolescents is associated with
a higher risk of mortality and morbidity to the mother and her child, yet more than 2 mil-
lion girls aged 10–14 years and around 16 million girls aged 15–19 years give birth every year.
Also, there are currently 5.7 million young people aged 15–24 years living with HIV and an
estimated 900,000 more infected with the virus each year.
e slow progress in improving reproductive, maternal and newborn health is underpinned
by the many burdens of gender discrimination, poverty and inequity, lack of economic
opportunities, lack of education and other forms of exclusion that prevent women in poor
countries from exercising their right to health.
Five years remain to achieve MDG 4: Reduce the child mortality and MDG 5: Improve mater-
nal health. Opportunities exist as never before. e UN Secretary General’s Global Strategy
for Women’s and Children’s Health provides the platform for joint action. Governments and
partners have committed to its implementation.
is paper presents the strategic directions through which WHO’s Department of Maternal,
Newborn, Child and Adolescent Health (MNCAH) will address the key challenges and take
the lead in formulating the Organization’s contributions to attaining MDGs 4 and 5. It high-
lights the linkages of MNCAH with other health areas, goals and targets, in particular those
related to: reproductive health goals; MDG 1: Eradicate extreme hunger and poverty; MDG
3 Promote gender equality and empower women; MDG 6: Combat HIV/AIDS, malaria and
other diseases; and the broader agenda for women, children and adolescents beyond 2015.
MNCAH will act as the platform for the equitable delivery of quality, integrated health serv-
ices for mothers, newborns, children and adolescents.
Vision, mission, goals, targets and indicators 3

Vision, mission, goals,
targets and indicators
Vision: A world where every pregnant woman, newborn, child and adolescent enjoys the
highest attainable standard of health and development.
Mission: e Department of Maternal, Newborn, Child and Adolescent Health will work

closely with other technical units in HQ, WHO Regional and Country Oces and partners to:
• Generate and synthesize evidence and dene norms and standards for maternal, new-
born, child and adolescent health;
• Support the adoption of evidence-based policies and strategies which conform to interna-
tional human rights standards, including universal access to health care;
• Build capacity for high quality, integrated health services for pregnant women, newborns,
children and adolescents;
6
and
• Monitor and measure progress in implementation and the impact of those strategies on
survival, health, growth and development.
Goals and targets:
Departmental goals and targets (up to 2015)
In line with the Medium Term Strategic Plan, and recognising the importance of the Secre-
tary General’s Global Strategy for Women’s and Children’s Health which prioritises action in
the 49 highest burden, low-income countries. e department has set the following goals and
targets:
• High-burden countries are supported to ensure evidence-based policies and strategies are
in place to achieve universal access to high quality health services for MNCAH;
• High-burden countries to increase coverage and quality of eective MNCAH interven-
tions among pregnant women, newborns, children and adolescents;
– 25 high burden countries have an integrated policy and costed strategy on universal
access to eective interventions for maternal, newborn, child and adolescent health;
– e 25 countries with highest maternal mortality burden will have increased coverage
of skilled care at childbirth to >50%;
6
WHO Packages of interventions for family planning, safe abortion care, maternal, newborn and child health. Geneva:
World Health Organization, 2010.
2
4 Vision, mission, goals, targets and indicators

– e 25 countries with highest neonatal mortality will have introduced home visits in
the postnatal period for mothers and their newborns;
– Linkages between HIV and MNCAH services will have been systematically made in
the 20 highest HIV burden countries;
– Access to treatment of major childhood illness will have increased in the 68 high-bur-
den countries that account for 95% of maternal and child mortality
7
through expansion
of IMCI to more than 75% of districts, and community case management of childhood
illness; and,
– e 68 Countdown countries and those countries which have been identied through
interagency initiatives (e.g. UNAIDS group on HIV and young people, UN Adolescent
Girls Task Force) will have functioning adolescent health programmes.
7
Identied by the Countdown to 2015: Afghanistan, Angola, Azerbaijan, Bangladesh, Benin, Bolivia, Botswana,
Brazil, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic, Chad, China, Congo, Democratic
Republic of the Congo, Côte d’Ivoire, Djibouti, Egypt, Equatorial Guinea, Eritrea, Ethiopia, Gabon, e Gambia,
Ghana, Guatemala, Guinea, Guinea-Bissau, Haiti, India, Indonesia, Iraq, Kenya, Democratic People’s Republic of
Korea, Lao People’s Democratic Republic, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mexico, Morocco,
Mozambique, Myanmar, Nepal, Niger, Nigeria, Pakistan, Papua New Guinea, Peru, Philippines, Rwanda, Senegal, Sierra
Leone, Somalia, South Africa, Sudan, Swaziland, Tajikistan, United Republic of Tanzania, Togo, Turkmenistan, Uganda,
Yemen, Zambia, and Zimbabwe.
Vision, mission, goals, targets and indicators 5

Millennium Development Goals:
Targets directly related to MNCAH
Target 1.C: Halve, between 1990 and 2015, the proportion of people who suffer
from hunger
indicator 1.8: prevalence of underweight children under five years of age.

Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
indicator 4.1: under-five mortality rate;
indicator 4.2: infant mortality rate.
Target 5.A: Reduce by three-quarters, between 1990 and 2015, the maternal mortality
ratio
indicator 5.1: maternal mortality ratio;
indicator 5.2: proportion of births attended by skilled health personnel.
Target 5.B: Achieve, by 2015, universal access to reproductive health
indicator 5.4: adolescent birth rate;
indicator 5.5: antenatal care coverage (at least one visit and at least
four visits).
Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS
indicator 6.1: HIV prevalence among population aged 15-24 years;
indicator 6.3: proportion of population aged 15-24 years with
comprehensive correct knowledge of HIV/AIDS.
Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and
other major diseases
indicator 6.8: proportion of children under five with fever who are treated
with appropriate anti-malarial drugs.
indicator 5.4: adolescent birth rate;
indicator 5.5: antenatal care coverage (at least one visit and at least
four visits).
Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS
indicator 6.1: HIV prevalence among population aged 15–24 years;
indicator 6.3: proportion of population aged 15–24 years with
comprehensive correct knowledge of HIV/AIDS.
Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and
other major diseases
indicator 6.8: proportion of children under five with fever who are treated
with appropriate anti-malarial drugs.

6 Improving health along the continuum of care

Improving health along
the continuum of care
e Department of MNCAH is committed to working with countries to
improve access to, coverage and quality of health services for MNCAH, as specied below.
Care during pregnancy, child birth and the postnatal period: e
majority of maternal and perinatal deaths are caused by preventable and treatable condi-
tions which can be addressed by ensuring universal access to skilled care at birth. Even at
current levels of coverage, improving the quality of care in health facilities would prevent
a large number of maternal and perinatal deaths. e Department will focus on promoting
appropriate standards for maternal and perinatal health and strengthening health service
delivery. is will include supporting governments in building the capacity and availabil-
ity of health professionals in rst- and referral-level facilities to provide quality care during
pregnancy, childbirth and the post-natal period, with special attention to the needs of ado-
lescent mothers and vulnerable groups. e provision of essential care for every baby and
the management of problems that can occur immediately aer birth are important elements
of quality services. Particular emphasis will be given to the promotion of integrated service
delivery aligning with disease specic programmes such as HIV, malaria and nutrition. e
capacity of health services to work with women, families and communities will be strength-
ened to ensure improved care and support in the home and that services respond to their
needs. Community health workers, where they exist, will be encouraged to promote skilled
care in pregnancy, childbirth and the post-natal period and appropriate home care for moth-
ers and babies.
Care in the newborn period and in childhood: Care and support for health,
growth and development and prompt treatment of common newborn and childhood illness
are essential. A child’s rst days and months of life are critical, as this is the period when the
risk of mortality is highest and decits in growth and development are dicult to reverse.
Adequate nutrition, starting with exclusive breastfeeding, followed by adequate and appropri-
ate complementary feeding, preventive interventions and access to treatment when required

are essential. Data show clearly that too few children are reached with eective interventions
to protect and promote health and manage illness (such as ORS and zinc for diarrhoea, anti-
biotics for pneumonia and insecticide-treated nets and antimalarials). In addition, currently
too few children have access to early diagnosis and treatment for HIV, or receive prophylac-
tic co-trimoxazole when HIV positive. e Department will work with countries to build
capacity of health workers in communities and rst- and referral-level facilities to promote
health, ensure adequate nutrition and integrated care for sick children. It will also promote
the engagement and development of capacity of community health workers to support fam-
ilies in the adoption of good care practices such as for infant and young child feeding, play
and communication as part of early childhood development.
3
Improving health along the continuum of care 7

Care during adolescence: Adolescents aged 10–19 years make up an increasing pro-
portion of the population in many countries. Adolescents complete their physical, emotional
and social transition into adulthood in a world that contains both opportunities and risks.
Many do so in good health. Many others do not. ey face sexual and reproductive health
problems such as those resulting from too-early and unprotected sexual activity, including
pregnancy and HIV infection. ey also face injuries resulting from accidents and violence,
mental health problems, problems resulting from substance use, problems resulting from
under nutrition and over nutrition, and endemic diseases (e.g. tuberculosis and malaria).
Some of these health problems aect the individual during adolescence (e.g. death caused by
a road trac crash, suicide resulting from a premarital pregnancy, or the consequences of an
unsafe abortion). Others aect the individual later in life (e.g. cardiovascular disease result-
ing from unhealthy eating and lack of physical exercise, smoking and other habits initiated
during adolescence). Competent and caring health workers in responsive and friendly health
services and systems can help those adolescents who are well to stay well, and help those who
are ill or injured to get back to good health. e focus of the Department’s work will be to
systemize and standardize eorts to improve the quality and expand the coverage of health
services for all adolescents, with a special focus on those who are at higher risk of health and

social problems.
8 Strategic directions


Strategic directions
e following three strategic directions will guide the work of the Depart-
ment. ey are in line with the mission statement and goals stated earlier in this document.
4.1 Develop evidence-based norms and standards to support policies and
strategies, for maternal, newborn, child and adolescent health
WHO has a unique mandate to generate evidence, and to lead processes to synthesize and
interpret evidence in order to develop norms, standards, policies, guidelines and tools. Evi-
dence is best put in practice when it is generated as part of a cycle that links research and
development of policies, norms, standards and tools with implementation, monitoring and
evaluation. Such an approach will ensure that research and development are focused and
relevant; that countries are supported in their eorts to implement evidence-based and prag-
matic policies and strategies; and that monitoring and evaluation stimulate and dene the
future research and development agenda.
is model of programme development meets the need for WHO norms and standards to be
based on the best available scientic evidence from a wide range of disciplines. Epidemiolog-
ical data on the incidence and prevalence of health problems, and protective and risk factors
are needed to estimate disease burden, to develop appropriate interventions, and to evaluate
their outcomes and impact. Evidence about the safety, ecacy and cost-eectiveness of inter-
ventions are prerequisites for successful implementation at population level. Both qualitative
and quantitative data contribute to an understanding of the needs of pregnant women, chil-
dren and adolescents, and the types of interventions that will result in the highest possible
gains in health, growth and development.
erefore, the Department will play a leading role in promoting and supporting research and
development that will inform policy, guide norms and standards and improve delivery strate-
gies, relevant to the needs of pregnant women, children and adolescents. For research related
to maternal and perinatal health the Department will work closely with the Department of

Reproductive Health and Research. e focus will not only be on identication of cost-eec-
tive interventions and delivery approaches, but as a member of the Implementation Research
Platform (IRP, APHSR, HRP, TDR, MCH) also examine implementation factors that deter-
mine the success of scaling-up intervention packages and programmes, and how they can be
applied in various contexts.
Specically, the Department will:
• Identify research priorities for MNCAH and work with RHR, other departments and part-
ners to promote and support their investigation, e.g. evidence for best ways of scaling up,
4
Strategic directions 9

and the most appropriate delivery channels;
• Build capacity for implementation research on MNCAH in regions and countries in part-
nership with ministries of health through leading institutes and collaborating centres;
• Systematically review and assess evidence on the eectiveness of interventions and delivery
approaches, and use and share the knowledge base for formulation of policies, guidelines
and tools for MNCAH; and
• Work with countries and partners on the dissemination and implementation of these evi-
dence-based policies, guidelines and tools.
4.2 Support action to achieve universal access to quality, integrated
health services for women, children and adolescents
Universal coverage of a limited set of cost-eective health interventions will have a major
impact on averting deaths among pregnant women, newborns, children and adolescents and
improve their health and development. However governments and partners face a major
challenge to improve both access to and the quality of health services. WHO’s health sys-
tems framework species the multiple functions that must be harnessed in order to create
a responsive health sector that can meet needs, including those of the most vulnerable and
hard to reach. e MNCAH Department can be a catalyst for the equitable delivery of qual-
ity, integrated health services for women, newborns, children and adolescents. e functions
include supporting countries to: adopt eective laws and policies; adopt equitable nanc-

ing options; develop a competent and adequately distributed health workforce; and provide
the necessary infrastructure, medicines and equipment. Integration of services – particu-
larly those related to nutrition, HIV and malaria – are crucial in the highest burden and oen
poorest countries.
e Department will facilitate strategic planning and programming, ensuring national
MNCAH plans include key eective interventions, are costed and are explicitly guided by
international human rights standards, and that they address the social determinants of health.
To achieve the key outcomes strengthening health systems, particularly having well qualied
midwives, and health workers with midwifery skills to provide skilled care during pregnancy
and birth, having skilled health workers to care for babies in the newborn period and sick
children, and to have health workers who are sensitive to the needs of adolescents requires
collaboration. While the Department has a clear mandate to assist governments and part-
ners to develop evidence-based policies and strategies to improve maternal, newborn, child
and adolescent health, it will work with the Health Systems and Services (HSS) cluster and
other relevant departments in WHO to address critical health system functions and inte-
grate crucial services. For example, the MNCAH Department will work with the Department
of Human Resources for Health (HSS/HRH) in projecting human resources requirements
for MNCAH, and actively promoting task shiing, where appropriate. It will work with the
Department of Health System Financing (HSS/HSF) to contribute to the costing of MNCAH
strategies as well as monitoring of innovative health nancing mechanisms, such as demand-
and results-based nancing. It will work with the Department of Health Policy Development
10 Strategic directions

and Services (HSS/HDS) to ensure MNCAH plans are integrated into national health plans.
e Department will also work with the HIV Department to ensure integration of HIV and
MNCAH services, particularly for PMTCT.
Four integrated approaches form the mainstay around which the Department will organize
its support to governments and partners. ese are:
1. e Integrated Management of Pregnancy and Childbirth (IMPAC);
2. e Integrated Management of Childhood Illness (IMCI), and improving care of children

in hospitals;
3. Increasing access to care and support in the community (IFC,
8
iCCM
9
); and
4. Strengthening the health sector response to adolescent health and development through
the “4-S” framework.
10
ese approaches are built around:
i) gathering and using strategic information;
ii) developing supportive, evidence-informed policies;
iii) scaling up the provision and utilization of health services and commodities; and
iv) strengthening action and linkages with communities, key partners and other sectors.
Together with approaches promoted by RHR for sexual and reproductive health, they facil-
itate the creation of a continuum of care that spans across the life course as well as across the
various levels of service provision. Furthermore, they promote integration of health inter-
ventions in cost-eective packages and implementation through multiple programme areas,
such as HIV/AIDS, malaria, nutrition and immunization. IMPAC and IMCI approaches
integrate HIV and are supported by clinical and programmatic guidelines and tools to facil-
itate their implementation.
e Department will work with key departments in FCH and other clusters, the Regional
and Country oces of WHO and in collaboration with development partners to build capac-
ity for:
• Policy, planning and programme management:
– Support countries to make the economic case for investment in MNCAH, particularly
linking targets and investment to lives saved.
– Support the development of costed strategies and plans for MNCAH as part of overall
national health plans; and
– Assist countries in the assessment, formulation and implementation of laws, regula-

tions and policies related to the health of mothers, children and adolescents.
– Build capacity of national and district programme managers in eective programme
planning and management, ensuring the use of available information and focused on
8
Individuals, Families and Communities (www.who.int/making_pregnancy_safer/documents/who_fch_rhr_0311)
9
Integrated Community Case Management
10
Outlined in “Strengthening the health sector response to adolescent health and development” (www.who.int/child_
adolescent_health/documents/cah_adh_yer_2010).
Strategic directions 11

increasing coverage of eective interventions for maternal, newborn, child and adoles-
cent health; and
– Build the capacity of national and district programme managers to work with other
sectors and other partners, including communities, to address the dierent determi-
nants of MNCAH and the barriers to accessing care.
• Health system support for implementation, such as:
– Eective human resource strategies for improved MNCH outcomes and application of
innovative approaches for continued education, and scaling up quality improvement
processes, including health system requirements for delivering quality of care, forecast-
ing medicine and equipment needs, and integrating key age- and sex-disaggregated
indicators in health information systems.
• Improving the quality of care at health facilities:
– Build capacity of health workers in rst- and referral-level facilities to deliver qual-
ity, integrated care during pregnancy, childbirth and aer birth; to manage childhood
illnesses and support caregivers; to work with women, families and communities to
improve care-seeking behaviour, appropriate care in the home and community support;
and to provide services that respond to the needs of adolescents and young people; and
– Support mechanisms to improve the quality of care, including the use of maternal and

perinatal death audits and service availability assessments, quality assessments for “ado-
lescent friendliness”, and mechanisms to ensure women and provider input in quality
processes.
• Improving access to quality health services and care in the home:
– Support mechanisms to increase timely access to care, including through community
health workers;
– Help to build health workers skills and improve implementation of interventions to
improve key family practices for healthy pregnancy, healthy growth and development
of infants and young children and treatment of common childhood illnesses including
diarrhoea, pneumonia and malaria; and
– Support countries in integrating key interventions to address women’s, families’ and
communities’ capacity to contribute to MNCAH, and strengthen skills to engage com-
munities and other sectors to address MNCAH needs.
4.3 Monitor and evaluate progress to inform planning and
implementation, and promote accountability
Documenting progress and collecting evidence to ensure that interventions, strategies and
tools are feasible and eective in reducing the burden of ill health in countries are essen-
tial. Ongoing monitoring of implementation with feedback to programme managers, as well
as periodic evaluations of process, outcomes and impact contribute to sound planning and
management of public health programmes.
e Department is guided by a systematic framework for monitoring and evaluation that
links inputs to outputs, outcomes and impact. It recognizes the important role that other
12 Strategic directions

partners play in improving health information systems (CHeSS) and in assessing mortal-
ity and intervention coverage (e.g. Multiple Indicator Cluster Surveys and Demographic and
Health Surveys).
e MNCAH Department will work closely with RHR and IER to assess and disseminate epi-
demiological information on the causes of maternal, newborn, child and adolescent mortality
and morbidity through the (Maternal and) Child Health Epidemiology Reference Group. e

Department will develop mechanisms to better monitor the implementation of health pol-
icies and track key health system indicators relevant for scaling up MNCAH interventions.
It will work with governments to increase the prole of data on quality of care, promote
age- and sex-disaggregation of data and produce comparative information periodically, as a
complement to data on intervention coverage. In this respect, the Department will be a key
contributor to the Countdown to 2015: Tracking progress in maternal, newborn and child sur-
vival; and the accountability framework that will be designed in line with the UN Secretary
General’s Global Strategy for Women’s and Children’s health.
e Department will:
• Develop and maintain an epidemiological database on causes of death for mothers, new-
borns, children and adolescents, develop perinatal mortality estimates, further build on
the work of the Child Health Epidemiology Reference Group (CHERG) and the adolescent
epidemiology reference group, and collaborate with RHR on the causes of maternal death;
• In partnership with WHO Regional Oces, maintain and further develop MNCAH coun-
try proles as a critical, synthesized source of strategic information;
• Collect, analyse and disseminate information on MNCAH health policy and systems
indicators;
• Develop valid and reliable indicators for assessing the quality and coverage of maternal,
newborn, child and adolescent health services and interventions;
• Strengthen systems for monitoring MNCAH programme implementation, and monitor
progress in the implementation and use of results for prioritization and re-planning;
• Promote and support countries to conduct MNCAH programme reviews, periodic health
facility and household surveys, Service Availability Readiness Assessments (SARA), and
innovative approaches such as establishing pregnancy registries;
• Contribute to global initiatives to assess progress and increase accountability including
the Countdown to 2015: Tracking progress in maternal, newborn and child survival and the
accountability framework being developed in line with the UN Secretary General’s Global
Strategy for Women’s and Children’s Health;
• Provide guidance in the development and application of indicators which are disaggre-
gated by age, sex and socio-economic category and sensitive to human rights standards

and principles, e.g. non-discrimination and equality, participation and inclusion, account-
ability and rule of law; and
• Facilitate the use of human rights mechanisms for enhanced monitoring and evaluation of
stakeholders’ commitments and legal obligations.
Working across the three levels of the Organization 13

Working across the three
levels of the Organization
e Department will take full advantage of WHO’s three-tiered structure to support coun-
tries in translating knowledge into eective action for the achievement of maternal, newborn,
child and adolescent health goals.
• Headquarters is responsible for ensuring WHO technical guidance on maternal, newborn,
child and adolescent health. is includes planning and monitoring implementation of
the global programme of work, advocacy and resource mobilisation; normative functions
including establishing and updating evidence-based policies; strategies, norms and guide-
lines; monitoring and evaluation and coordination with partners.
• Regional oces are responsible for dening local priorities, supporting country imple-
mentation through capacity building, supporting health systems integration, ensuring
linkages across programmes and monitoring results;
• Country oces are responsible for providing programmatic and technical support to Min-
istries of Health for programme implementation monitoring and evaluation. Ensuring
engagement and teamwork with partners.
5
14 Working with other depart ments and with partners

Working with other
depart ments and
with partners
No single actor is equipped to face the global challenge alone. e Department of MNCAH
will contribute to building broad-based partnerships within and outside the Organization,

and work collaboratively with them to achieve its goals.
Within the FCH cluster, the Department will work closely with RHR on maternal and peri-
natal health issues, particularly in relation to research and norms; with IVB on pneumonia,
diarrhoea and HPV; and with GWH and ALC on cross-cutting gender and ageing issues.
e Department will work with other clusters, particularly:
• HTM, with the HIV Department on PMTCT, the integration of HIV and MNCAH serv-
ices, and issues around HIV and young people, and with the GMP on malaria in pregnancy
and childhood;
• HSS on health nancing, human resources, health planning, and essential medicines;
• IER on health information, research and ethics, and human rights;
• NMH on health promotion, nutrition, mental health, violence and injury prevention in
children and adolescents;
• HSE on environmental issues; and
• HAC on humanitarian crises.
e Department collaborates closely with UNICEF, UNFPA, the World Bank and UNAIDS
as a key partner in the group of H4+ agencies working together to improve maternal and
newborn health. It is a member of relevant UNAIDS Task Teams, the UN Adolescent Girls
Task Force and other partnerships working to consolidate evidence, advocate for investment,
and facilitate the harmonization and alignment of inputs and resources. e Department is
and will continue to lead the eective interventions area of work and be an active member of
the Partnership for Maternal Newborn and Child Health (PMNCH).
Globally, large-scale funding initiatives and partnerships are instrumental in raising
resources and creating coordinated action for the achievement of the health-related MDGs.
e Department will collaborate with the GFATM, GAVI and other initiatives and contribute
to strengthening MNCAH specic elements within their operations. It will strengthen capac-
ity in countries to enhance eective planning and for accessing increased nancial resources,
and provide technical assistance to ensure ecient implementation.
6
Working with other depart ments and with partners 15

Improved health outcomes are not solely the result of interventions delivered through the
health sector. Social protection, education, economic and social welfare, and food security
are all important determinants of MNCAH outcomes as well. To build on these multiple
and cross-cutting inuences, the Department will not only maintain close collaboration with
health-related partners, but also coordinate eorts as appropriate with partners in other rel-
evant sectors.
16 Structure of the Department of Maternal, Newborn, Child and Adolescent Health

Structure of the Department
of Maternal, Newborn, Child
and Adolescent Health
a. In order to deliver on the above priority actions, the department needs to be t for pur-
pose. In consideration of the key strategic directions it is proposed that the department will
be managed as a matrix. e work of the department will be managed by three functional
teams:
1. Research and Development for MNCAH
2. Policy, Planning and Programmes.
3. Epidemiology, Monitoring and Evaluation
b. To complement the teams in order to ensure visibility of the key population groups
addressed in the continuum of care, four cross-cutting groups will be established. ese will
be lead by a Lead Specialist, who will be a member of the above teams.
1. Maternal and Perinatal Health,
2. Newborn Health,
3. Child Health
4. Adolescent Health
c. In addition for key areas of work with other departments and clusters Task Teams will be
established.
d. Stang implications.
Given the current funding situation of the department a minimum stang scenario to achieve
the strategic work of the department is proposed. is includes:

i) Director’s oce, Director, plus 3 P sta and one G sta assistant.
ii) Research and development team, Coordinator plus 7 P sta,
iii) Policy, planning and programmes team, Coordinator plus 7 P sta,
iv) Epidemiology, Monitoring and Evaluation team, Coordinator plus 6 P sta.
e teams will be supported by 5 G sta.
is makes a total of 33 sta.
7
Structure of the Department of Maternal, Newborn, Child and Adolescent Health 17

MNCAH department structure
Director’s office
Research and
Development
Policy,
Planning and
Programming
Epidemiology,
Monitoring and
Evaluation
Maternal and Perinatal Health
Newborn Health
Child Health
Adolescent Health
Finance, advocacy
and programme
management
18 Annex: Functions of the teams and cross-cutting groups

Annex:
Functions of the teams

and cross-cutting groups
Research and Development for MNCAH
Collect, review and assess evidence to develop evidence based norms and standards to inform
policy, guide norms and standards and improve delivery strategies, relevant to the needs of
pregnant women, newborns, children and adolescents.
Policy, Planning and Programmes.
Promote adoption of evidence based policies, which conform to human rights standards.
Promote integrated service delivery across the continuum of care. Build capacity for policy
and strategy development, planning and programme management, and strengthen health
system support for improved quality of care at health facilities and in the community.
Epidemiology, Monitoring and Evaluation
Improve the epidemiologic information available for maternal, newborns, children and
adolescents. Monitor and evaluate progress to inform planning and implementation, and
promote accountability.
Lead specialist Maternal and Perinatal Health
Lead and promote visibility of Maternal/Perinatal health in the work of the department.
Ensure Maternal/Perinatal specic issues reected in cross-cutting guidelines. Lead the work
on maternal/perinatal specic guidelines, coordinate work with RHR in this respect.
Lead specialist Newborn Health
Lead and promote visibility of Newborn health in the work of the department. Ensure New-
born specic issues reected in cross-cutting guidelines. Lead the work on newborn specic
guidelines. Coordinate with other departments as appropriate.
Lead specialist Child Health
Lead and promote visibility of Child health in the work of the department. Ensure Child specic
issues reected in cross-cutting guidelines. Lead the work on child specic guidelines. Coordi-
nate with other departments on collaborative work related to child health e.g. NHD, HIV.
Lead specialist Adolescent Health
Lead and promote visibility of Adolescent health in the work of the department. Ensure
Adolescent specic issues reected in cross-cutting guidelines. Lead the work on adolescent
specic guidelines. Coordinate with other departments on collaborative work related to ado-

lescent health e.g. HIV, RHR, NMH.
28/02/11