Introduction – Why Quality Matters

This short introductory section provides an overview of the burden of maternal and newborn mortality, of global commitments and of the opportunities and challenges of providing maternal and neonatal services. It also provides an overview of the context of providing quality Maternal and Newborn Health (MNH) services and of the transition from coverage towards acceptable quality services. It also summarises what you can expect to learn from this resource.


To introduce the topic of quality and MNH services in low and middle income countries.

Learning Objectives
When you have completed this section, you should be able to:
  • Highlight the importance of quality considerations in MNH services.
  • Understand what you will gain from this resource and plan how you will use it to improve your knowledge and practice.
The question should not be why do women not accept the service that we offer, but why do we not offer the service that women will acceptFathalla M F, 1998

Professor Mahmoud Fathalla wrote those now famous, and often quoted, words in his preface to a journal supplement dedicated to reporting the World Health Organization’s antenatal care trial.

In his paper, Professor Fathalla reminds us that the theme for the World Health Day that year was `Pregnancy is special; let’s make it safe’. He also comments on issues of the day, including the problems of replicating health service models out of context, affordability and scientific evaluations.

The concerns of providing a quality MNH service were as evident then as they are today, although perhaps articulated in a different way. Safety (doing no harm) was a concern then, and it has again regained prominence in current discourse. Methodological rigour in producing evidence was fast improving at the time, and today we have learnt much more about how to produce high quality evidence for action in improving our approaches to providing a high quality MNH service. The extent of the problem of acceptable MNH services is beginning to be more clearly documented, and the capture of that information has led to powerful action using a range of approaches and tools.

This section will provide a flavour of the areas to be covered in the learning resource and will touch on topics which will be explored in greater depth across the various learning units.

Introduction – Why Quality Matters was last modified: February 23rd, 2016 by Adrian Bannister