Access to Clinical and Community Maternal, Neonatal and Women's Health Services (ACCESS) Program

ACCESS is a follow-up programme to JHPIEGO's Maternal and Neonatal Health Program (MNH), which was launched in 1998 in 18 countries. Through the MNH Program, JHPIEGO and its partners have developed global guidelines, best practices, and evidence-based treatments. They have worked to educate in-country experts who can practice, teach, and advocate for communities, patients, and families. They have sought to mobilise communities to demand more and higher-quality health care, seeking to raise awareness of the importance of integrating care for mothers and newborns. They have introduced infection prevention techniques and a quality improvement process at local hospitals and clinics. ACCESS represents wider implementation of the programmes piloted through MNH, with an increased emphasis both on improving care seeking and healthy behaviours in the home, and promoting proven, cost-effective clinical interventions within existing health systems.

ACCESS actively collaborates with USAID missions, governments, local communities, faith-based organisations (FBOs), and partner agencies in developing countries to engage policymakers, providers, and other key stakeholders in an effort to ensure that integrated, high-quality services reach women, families, and communities (particularly marginalised and vulnerable populations). Partnership and participation are themes characterising ACCESS approaches and activities:

• Community-based interventions - social mobilisation to involve communities in planning and implementing services and in improving birth preparation (self-care, identification of a skilled attendant, planning for emergency transport and care); behaviour change strategies to improve home preventive practices; and approaches for community-based delivery of key interventions at the household level, where appropriate. Evidence-based interventions are a key focus.
• Clinical interventions - strategies to support the provision of key interventions at each point across the household-to-hospital continuum, encompassing:
  
  
  • focused antenatal care - prevention and control of malaria, prevention of mother-to-child-transmission (MTCT) of HIV/AIDS, tetanus toxoid immunisation, adequate nutrition (including micronutrient supplementation), and identification and treatment of complications and infections, especially sexually transmitted infections (STIs)
  • safe delivery - services to prevent postpartum hemhorrhage, infection, prolonged and obstructed labour, and MTCT of HIV/AIDS
  • postpartum care - maternal nutrition, hygiene, and family planning
  • treatment of obstetric complications - postabortion care and obstetric fistula
  • normal newborn care - drying and warming, eye and cord care, early breastfeeding, vitamin A, and immunisations
  • basic care for sick newborns - neonatal resuscitation, kangaroo mother care for low birth weight infants, and treatment of infections.
• Health systems strengthening - quality improvement processes to strengthen facilities and improve provider performance; development of training and education systems for health providers; and support for district-level health planning and improved information systems.
• Policy and advocacy:
  
  
  • international and national partnerships and alliance building; for example, ACCESS is a key partner in USAID's Malaria Action Coalition, offering technical assistance to countries to strengthen the link between prevention and treatment of malaria and antenatal care services
  • national-level dialogue and promotion of supportive policies and systems, such as internationally accepted standards of practice, evidence-based norms and guidelines, adequate financing and fee policies, and functional referral systems.

Children, Women, Health.

According to JHPIEGO, every year more than 529,000 women die as a result of pregnancy and childbirth, and 4 million newborns die within the first 28 days of life.

Founded in 1973, JHPIEGO builds global and local partnerships to enhance the quality of healthcare services for women and families through training and support for healthcare providers including doctors, nurses, midwives, and health educators working in limited resource settings throughout Africa, Asia, the Middle East, Latin America, and Europe.