Tracking the journey to scale for lifesaving maternal, newborn, and child health and nutrition interventions
PATH's Asset Tracker explores the status of scale-up of key evidence-based interventions that improve health for moms and kids.
It is crucial that health system leaders and decision-makers collect and use data to identify and unblock barriers for the delivery of high-quality maternal, newborn, and child health and nutrition (MNCHN) services to improve health and save lives. Despite childhood mortality reaching record lows in 2019, according to the World Health Organization's latest estimates, each year approximately 5 million children die before their fifth birthday, with almost half of those deaths occurring among newborns in the first month of life. Approximately 287,000 women died from pregnancy or childbirth-related complications in 2020. Most maternal, newborn, and child deaths and morbidities are preventable.
High-quality MNCHN health services are not possible without access to essential medicines, devices, and interventions—what we call “assets.” Despite marked improvements in access to these MNCHN assets globally, progress has been slow and uneven, and significant gaps remain in their coverage, particularly in low- and middle-income country settings. In order to address these challenges, decision-makers and advocates need data to better understand what barriers are preventing these assets from scaling up.
PATH undertook a rapid and rigorous analysis of the access, uptake, implementation, and coverage of 14 proven MNCHN interventions across 81 countries. We compiled the resulting set of data online in the interactive Asset Tracker tool to inform global, national, and local strategies for improving MNCHN. This project is ongoing, and we will continue to incorporate additional priority assets into the Asset Tracker.
MNCHN Asset Tracker Dashboard
Explore the dashboard tool
For the 14 key assets, PATH identified 26 milestones along the journey to scale and mapped the progress of where each asset is along this pathway in a subset of focus countries. The tracker also draws on national health information systems, global and country surveys, and other widely accepted data sources to aggregate data for each of the assets on population coverage, availability, and further detail on the extent of implementation of scale-up for the asset. By pulling together publicly available data into one place, the Asset Tracker can be used to quickly and efficiently compare different indicators or countries.
Journey to scale: effective coverage framework
For MNCHN assets to save lives, they must be available to those who need them, when and where they are needed. The pathway to scaling up an asset—in other words, the steps taken to achieve effective coverage in a population—is long and complex. PATH reviewed existing theory and literature to develop a framework of the typical pathway assets take as they move toward scale. The Asset Tracker dashboard is organized around 26 steps (or “milestones") an asset has achieved in its journey to scale.
The steps are broken down into six stages:
- Ensuring the asset is included in global guidelines and is available in the market.
- Including the asset in key national policies such as essential medicines lists and budgets.
- Integrating the asset into the country's data, training, and other health system components.
- Disseminating and rolling out guidelines for use of the asset to supervision and mentorship to ensure high-quality implementation of the asset.
- Ensuring the asset is available in health facilities.
- Achieving equitable coverage in the population.
There are six maternal health assets included in the dashboard:
- Magnesium sulfate (MgSO4) for the prevention of eclampsia in women
- Oxytocin as part of active management for the third stage of labor
- Misoprostol for prevention and management of post-partum haemorrhage
- Iron folic acid (IFA) daily supplementation for pregnant women to reduce the risk of adverse birth outcomes
- Multiple micronutrient supplements (MMS) antenatal supplementation for pregnant women to promote healthy births
- Balanced energy protein supplementation (BEP) antenatal supplementation to ensure pregnant women are getting the nutrients they need
Newborn and child health
There are eight newborn and child health and nutrition assets included in the dashboard:
- 7.1% chlorhexidine (CHX) for umbilical cord care
- Neonatal/newborn resuscitation for improving birth outcomes in emergencies
- Kangaroo mother care (KMC) skin-to-skin contact to improve outcomes for low birth weight or preterm infants
- Community regimen for the treatment of possible severe bacterial infection (PSBI) for early identification and timely treatment of bacterial infection in infants
- Amoxicillin dispersible tablet (Amox DT) for pneumonia among children between the age of 2 months and five years
- Early initiation and exclusive breastfeeding (EIBF/EBF) to protect newborns from infection and reduce newborn mortality
- Feeding of small and sick newborns (FSSN) to ensure the most vulnerable infants are given the high-quality care they need to thrive
- Management of acute malnutrition (MgmtAM) in children less than five years
This tool aids advocates in how to read, package, and present data from the MNCHN Asset Tracker to inform advocacy efforts. This document includes:
> Background information on the Asset Tracker.
> A how-to guide on interacting with the dashboards.
> An example from Nigeria on how to use the Asset Tracker for advocacy.
> Other available data sources to inform MNCHN advocacy efforts.
In addition to the overall Asset Tracker, PATH undertook a subnational assessment in Burkina Faso, Ethiopia, India, Kenya, and Nigeria on barriers and enablers to uptake and implementation of assets. We interviewed healthcare providers and district health management teams on challenges and successes in the journey to scale-up for each of the 14 assets and conducted facility spot-checks. Our subnational data are summarized into two dashboards based on the type of data collected, one highlighting perspectives on the barriers and enablers to scale for each asset (qualitatively assessed from interviews), and the other comparing asset performance in terms of data, availability, policy, training, and status of scale up (quantitatively assessed through structured questions).
Explore the qualitative dashboard.
Explore the quantitative dashboard.
As part of an ongoing series about data resources for advocacy organized in partnership with the Global Financing Facility (GFF) Secretariat, the Global Civil Society Coordinating Group for the GFF, PAI, Countdown 2030, Global Health Visions, the World Health Organization, and the Partnership for MNCH, PATH led a webinar introducing the Asset Tracker to civil society and youth stakeholders from all regions engaging in GFF processes at the global and country level. The discussion also included experiences shared from CSOs already trained on the Asset Tracker and addressed questions from participants.
To ensure the Asset Tracker reached advocates who could benefit from it, PATH partnered with the Medicines Transparency Alliance (MeTA Kenya) to disseminate the Asset Tracker to advocates from CSOs working in Kenya’s Lake Region Economic Bloc and train them in its use. This case study captures their experiences and reflections.
This case study provides an overview of the initial project, during which PATH investigated the coverage and impact of nine key health interventions across 81 countries, including details on the rationale and methodology.