A Presentation to __________ Healthy Timing and Spacing of Pregnancy (HTSP): For healthy babies, healthy mothers, and healthy communities

Improving Maternal, Newborn, and Child Health Nearly every country supports efforts to improve Maternal, Newborn, and Child Health. “No woman should die bringing life into the world and no child should die when we know how to save them” UN Secretary General Ban- Ki Moon

International Support and Guidance for Improving MNCH 1994 International Conference on Population and Development endorsed by 180 nations United Nations Millennium Development Goals promote significant improvements in MNCH by 2015 The US Global Health Initiative heavily invests in MNCH (add any national or regional declarations that have addressed MNCH)

GHI The Global Health Initiative (GHI) will invest $63 billion to improve the health of women, newborns and children. The GHI aims to: Reduce maternal mortality by 30% in assisted countries thus saving the lives of 360,000 women Improve child health by reducing under 5 mortality by 35% in assisted countries, saving the lives of 3 million children. including 1.5 million newborns, Improve access to family planning and reproductive health by increasing contraceptive prevalence to 35%, preventing 54 million unintended pregnancies. reducing to 20 percent the number of first births by women under 18.

Maternal and Child Health in (Your Country) In this slide provide information on MNCH in your country or community including data on maternal and child illness and death. Also, include information on what is being done through policies, health services and community education by governments and NGOs to improve MNCH.

USAD recommends a simple and cost- effective approach to achieving these goals USAID supported six studies to examine the effect of closely spaced pregnancies on the health of women and children These studies were reviewed by a group of technical experts convened by the World Health Organization.

The technical experts concluded that closely spaced pregnancies can lead to the following: Babies may be: Born too early Of low birth weight Too small More likely to die Mothers may be: More likely to die in childbirth More likely to miscarry a pregnancy More likely to seek an unsafe abortion Source: Report of a Technical Consultation Report on Birth Spacing (WHO)

Birth-to-Pregnancy Intervals and the Risk of Poor Health Outcomes among Mothers and Children Sources: Conde-Agudelo, 2000, 2005; and DaVanzo et al, 2007

Birth-to-Pregnancy Intervals and Relative Risk of Neonatal and Infant Mortality Source: Rutstein, 2008

Pregnancy Timing Women under the age of 18 are twice as likely to die, and women under the age of 15 are five times more likely to die of complications than women over the age of 18. Death and illness is greater among children born to adolescent mothers compared to women over 20:

Healthy Timing and Spacing of Pregnancy (HTSP) USAID recommends that women practice healthy timing and spacing of pregnancy. This means that: 1. After a live birth, women and couples should wait at least 24 months before trying to become pregnant again. 2. After a miscarriage or abortion, women and couples should wait at least six months before trying to become pregnant again. 3. Adolescents should delay pregnancy until at least 18 years of age. 4. Women and men should use a family planning method of their choice to delay and space their pregnancies.

A word about language: pregnancy spacing vs. birth spacing Birth spacing refers specifically to the period of time between when a woman gives birth and when she gives birth again. Pregnancy spacing refers to the period of time between when a woman gives birth and when she gets pregnant again.

The Benefits of HTSP: For Women A reduced risk of pregnancy-related complications high blood pressure Blocked or prolonged labor prolonged labor anemia death Gives mothers two years to fully prepare for her next pregnancy Keeps girls in school and improves their opportunities

The Benefits of HTSP: For Children A reduced risk of: Pre term births Small for gestational age Low birth weight Stunting Death An opportunity to breastfeed for a full two years, as recommended by WHO and UNICEF.

The Benefits of HTSP: For Men Provides an action that men can take to safeguard the health and wellbeing of their partners and children. Involves men in making decisions about family planning, child spacing, and the health of the family. Allows men time to emotionally and financially prepare for the birth of a child.

The Benefits of HTSP: For Communities When more women and couples are able to space their pregnancies, communities will see: Less illness and death to among mothers, babies, and children; reduced poverty; Improvements in the quality of life Women have more educational opportunities Women can contribute to community development Less stress for men and women

Family Planning : Critical for HTSP Access to family planning is essential. FP can reduce the number of high risk pregnancies HTSP help to better link FP and other health information and services, including MNCH, ANC, PPC, PAC and Youth Friendly Services

What can you do to improve knowledge about the benefits of HTSP? Advocate for HTSP information to be included in relevant policies and guidelines Train health workers to educate and counsel on HTSP. Produce education materials that discuss HTSP Gain the support of community leaders and local policymakers for HTSP. Educate communities about HTSP in churches, mosques, schools, workplace, community events. Help the media disseminate information on HTSP

HTSP: A Small Change that Produces Big Results Reducing closely spaced pregnancies. Timing pregnancies at the best age possible. Contributing to the healthiest outcomes for mothers, babies, families and communities.

Implementing HTSP in (Your Community) What opportunities and mechanisms exist for implementing this simple, yet life-saving message?

Final Thoughts We know what works to save women’s and children’s lives. We must muster the will to do it

Acknowledgements