The period around birth constitutes a critical window of opportunity for prevention and management of maternal and newborn complications, which can otherwise prove fatal. Availability and accessibility of skilled birth attendants, basic and comprehensive emergency obstetric care, around the time of birth is therefore critical. A large proportion of newborn illnesses and deaths can also be prevented using simple, low-cost interventions during delivery and during the week following birth partum, provided both in the facility and at home (where currently 50 per cent of newborn deaths occur). Regular visits by community health workers at the time of delivery and following birth can be instrumental in preventing complications and post-natal mortality.
Essential life-saving interventions include immediately drying the newborn and keeping the baby warm, skin to skin contact, delayed cord clamping, initiating breastfeeding as soon as possible after delivery, supporting the mother to breastfeed exclusively, giving special care to low-birth weight infants, and diagnosing and treating newborn complications such as asphyxia and sepsis.
Strengthening referral mechanisms and linkages between different levels of facility-based care, and between health facilities and the community, must be a top priority. Empowering women, families and communities by supporting their involvement and proactive care-seeking for pregnancy care, nutrition, birth preparedness, use of a skilled attendant at birth, recognition of maternal and newborn danger signs, early initiation and exclusive breastfeeding, postnatal care and support for optimal birth spacing is important. In addition, identification of pregnant women by community health workers and continued follow-up and support during antenatal and postnatal period can promote healthy practices and timely care-seeking in case of complications.