One of the key recommendations of the Lancet Commission on High-Quality Health Systems in the Sustainable Development Goal Era published in September 2018 is the redesign of childbirth services. In this commentary the authors call for research to develop and test context-specific strategies.

The plea for the childbirth service redesign is underpinned by the assumption that the centralisation of childbirth services to hospitals will result in (1) more efficient delivery care, (2) more skillful maternity providers and (3) more timely emergency care interventions including blood transfusion and caesarean section.

In this commentary published in BMJ Global Health, Claudia Hanson and Joanna Schellenberg call for research to develop and test context-specific redesign strategies for improved childbirth care based on the two continuums of care: from pregnancy, through to childbirth and postnatal care, and from community to specialised referral care.

Strategies need to take into account specific aspects of access, safety and quality of care in the respective setting in order for safe and respectful childbirth care to reach all women.

Author

Professor Joanna Schellenberg

IDEAS Co-Principal Investigator and Professor