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Program Science—A Framework for Improving Global Maternal, Newborn, and Child Health

Maryanne Crockett, MD, MPH, FRCPC, DTM&H1; Lisa Avery, MD, MIH, FRCPC2; James Blanchard, MD, MPH, PhD3
[+] Author Affiliations
1Departments of Pediatrics and Child Health, Medical Microbiology, Community Health Sciences, and Centre for Global Public Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
2Departments of Medical Microbiology, Community Health Sciences, Obstetrics, Gynecology and Reproductive Sciences, and Centre for Global Public Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
3Departments of Community Health Sciences and Centre for Global Public Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
JAMA Pediatr. 2015;169(4):305-306. doi:10.1001/jamapediatrics.2015.9.
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In 2000, leaders from 189 countries set forth Millennium Development Goals, 2 of which focused on significant reductions in child mortality and maternal mortality by 2015. Despite substantial progress toward these goals, many countries are lagging, with increasing disparity among countries with differing resources. There is a strong consensus that much of this mortality could be prevented through the effective implementation of known evidence-based interventions.13 In particular, there is evidence that the greatest effect on mortality occurs when efforts are initially focused on the most vulnerable individuals.4 Therefore, the main challenges in reducing mortality relate to how best to improve the availability, quality, and use of these critical interventions, especially for those who most need them. Meeting this challenge will require a better understanding of the distribution and configuration of health services, factors that are associated with enhancing and maintaining the quality of services, and the factors that promote and prevent use of these services along the continuum of care.5 In this regard, academic institutions can and should contribute much more effectively to generate and translate scientific knowledge that will result in better programs to improve maternal, newborn, and child health (MNCH). To fulfill this important academic mission, “science must leave the ivory tower and enter the agora,” as Gibbons urged 17 years ago.6

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Conceptual Framework for Improving Maternal, Newborn, and Child Health (MNCH) Across the Continuum of Care

Program science aims to ensure that a critical package of high-quality MNCH interventions is available, accessible, and used throughout the continuum of care.

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