Safeguarding maternal, newborn and child health

Decades of investment has seen Lao People’s Democratic Republic (PDR) experience significant improvements in maternal, newborn and child health. Between 2000 and 2020, Lao PDR was among the top 10 countries with the largest rate of reduction in maternal mortality in the world. However, death rates remain higher than most countries in the WHO Western Pacific Region.

The quality of healthcare remains the greatest challenge. Most maternal, newborn and child deaths are preventable with timely management by a skilled health professional working in a supportive environment.

Efforts are required to sustain past progress, overcome the setbacks of the COVID-19 pandemic, and ensure women, babies and children reach their full potential for health and well-being.

To tackle this challenge, the Ministry of Health, with support from WHO and other partners, is implementing the National Strategy and Action Plan for Integrated Services on Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) 2021–2025 under the leadership of the national RMNCAH Committee.

 

Our support

WHO’s support for the development, implementation, monitoring and evaluation of the National Strategy and Action Plan has been spearheading improvements of the broader health system, using the reproductive, maternal, and newborn program as an entry point. Its support to the National RMNCAH Committee has led to collaboration among the health authorities and about 20 development partners to jointly develop, fund, implement and monitor the five-year National Strategy and Action Plan on RMNCAH 2021-2025.

To improve the quality of health care in all provinces and districts, WHO has applied evidence-based models across five areas:

  1. Antenatal care: Improved clinical care, counseling skills and respectful care led to a 42% increase in the number of women giving birth give birth in a health care facility with a skilled birth attendant between 2011 and 2023.
  2. Maternal care during childbirth (delivery): Strengthened routine care and monitoring has improved early detection and management to reduce the number of women who need referral to higher care.
  3. Early Essential Newborn Care (EENC) and Kangaroo Mother Care (KMC): At all provincial and most district hospitals, improved basic, inexpensive care such as skin-to-skin contact and breastfeeding have significantly reduced neonatal mortality. EENC and KMC are now included in an examination that is a prerequisite for graduation from medical school.
  4. Routine quality assessment and improvement, developed and deployed with WHO support in provincial and district hospitals, will be rolled out to all provincial hospitals and selected district hospitals by 2024.
  5. CONNECT initiative strengthens primary health care by engaging communities and strengthening local governance to improve equity and trust in the health system among diverse communities. Additional results include supporting women to vaccinate their infants, and increased rates of facility deliveries and birth registration (enabling better access to services).

After proving effective, antenatal and maternal care, and EENC, models have been rolled out nationwide, and will be sustained through routine quality improvement processes. 

   

A health worker holds a pamphlet to explain nutrition to a young female.
WHO / Enric Catala
Dr Songmanolath educates a mother who recently gave birth regarding nutrition facts and newborn care in Bor Village, Lao People's Democratic Republic.
© Credits

Results

The five areas have saved lives and safeguarded the health of women, newborns and children. They have also brought benefits the overall health system beyond RMNCAH, such as in human resource development, health information systems, development of an essential health service package and the introduction of quality standards and monitoring.

In 2020, the loss of life for mothers during childbirth reached its lowest point in Lao PDR’s history. From 2000 to 2020, the number of women in Lao PDR who died while giving birth fell 80% – one of the ten fastest falling rates in the world. An estimated 207 women died in childbirth in 2020, compared with 1042 in 2000.

This progress reflects years of commitment and investment by the Government and partners. It is the result of increased coverage of essential services, improved quality of health care, more highly skilled health care staff, and improved hygiene and health promotion.

 

 

The work ahead

While effectiveness and quality have been the focus for the past five years, the work ahead must improve efficiency and equity. Until now, many health programmes, like immunization and nutrition, have operated somewhat independently.

  • By better integrating and coordinating these services, under national leadership, policies and strategies, we can ensure that every child who visits a health centre receives immunizations, growth monitoring, nutrition counselling and other basic interventions simultaneously – saving the family and health care providers time and money.
  • Addressing equity requires strengthened primary health care. This involves not only supporting remote health centre staff, but also strengthening the capacity of local government to improve a whole-of-society approach to the health and well-being of women and children. We can leverage the multi-sector collaboration strengthened during the COVID-19 pandemic.
  • WHO will continue to support the Government’s National Strategy and Action Plan on RMNCAH in line with the National Health Development Plan and the ongoing health sector reforms.

 

Our partners

Korea Foundation for International Healthcare (KOFIH)

Luxembourg Aid & Development

The Government of the United States of America through the Centers for Disease Control and Prevention (CDC) and USAID

UNFPA

UNICEF