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Integrating Health Interventions for Women, Newborn Babies, and Children: a Framework for Action

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Alma-Ata: Rebirth and Revision 7 Integrating health interventions for women, newborn babies, and children: a framework for action
Björn Ekman, Indra Pathmanathan, Jerker Liljestrand
Lancet 2008; 372: 990–1000

See Editorial page 863
This is the seventh in a Series of eight papers about Alma-Ata: rebirth and revision Lund University, Lund Sweden (B Ekman PhD); Kuala Lumpur, Malaysia (I Pathmanathan PhD); Ystad, Sweden (J Liljestrand PhD) Correspondence to: Dr Jerker Liljestrand, Götgången 12 27144 YSTAD, Sweden jerker@ystad.nu

For women and children, especially those who are poor and disadvantaged, to benefit from primary health care, they need to access and use cost-effective interventions for maternal, newborn, and child health. The challenge facing weak health systems is how to deliver such packages. Experiences from countries such as Iran, Malaysia, Sri Lanka, and China, and from projects in countries like Tanzania and India, show that outcomes in maternal, newborn, and child health can be improved through integrated packages of cost-effective health-care interventions that are implemented incrementally in accordance with the capacity of health systems. Such packages should include community-based interventions that act in combination with social protection and intersectoral action in education, infrastructure, and poverty reduction. Interventions need to be planned and implemented at the district level, which requires strengthening of district planning and management skills. Furthermore, districts need to be supported by national strategies and policies, and, in the case of the least developed countries, also by international donors and other partners. If packages for maternal, newborn and child health care can be integrated within a gradually strengthened primary health-care system, continuity of care will be improved, including access to basic

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