title: Innovative approaches for improving maternal and newborn health--A landscape analysis.
abstract: BACKGROUND
  Essential interventions can improve maternal and newborn health (MNH) outcomes in low- and middle-income countries, but their implementation has been challenging. Innovative MNH approaches have the potential to accelerate progress and to lead to better health outcomes for women and newborns, but their added value to health systems remains incompletely understood. This study's aim was to analyze the landscape of innovative MNH approaches and related published evidence.
  
  
  METHODS
  Systematic literature review and descriptive analysis based on the MNH continuum of care framework and the World Health Organization health system building blocks, analyzing the range and nature of currently published MNH approaches that are considered innovative. We used 11 databases (MedLine, Web of Science, CINAHL, Cochrane, Popline, BLDS, ELDIS, 3ie, CAB direct, WHO Global Health Library and WHOLIS) as data source and extracted data according to our study protocol.
  
  
  RESULTS
  Most innovative approaches in MNH are iterations of existing interventions, modified for contexts in which they had not been applied previously. Many aim at the direct organization and delivery of maternal and newborn health services or are primarily health workforce interventions. Innovative approaches also include health technologies, interventions based on community ownership and participation, and novel models of financing and policy making. Rigorous randomized trials to assess innovative MNH approaches are rare; most evaluations are smaller pilot studies. Few studies assessed intervention effects on health outcomes or focused on equity in health care delivery.
  
  
  CONCLUSIONS
  Future implementation and evaluation efforts need to assess innovations' effects on health outcomes and provide evidence on potential for scale-up, considering cost, feasibility, appropriateness, and acceptability. Measuring equity is an important aspect to identify and target population groups at risk of service inequity. Innovative MNH interventions will need innovative implementation, evaluation and scale-up strategies for their sustainable integration into health systems.
authors.affiliation: Department of Medicine Boston, Boston University, Boston, MA, USA. karsten.lunze@post.harvard.edu.|Health Section, UNICEF, 3 United Nations Plaza, New York, NY, 10017, USA. karsten.lunze@post.harvard.edu.
authors.forename: Karsten
authors.initials: K
authors.lastname: Lunze
authors.affiliation: Health Section, UNICEF, 3 United Nations Plaza, New York, NY, 10017, USA. ahiggins@unicef.org.|Concern Worldwide, 355 Lexington Avenue, New York, NY, 10017, USA. ahiggins@unicef.org.
authors.forename: Ariel
authors.initials: A
authors.lastname: Higgins-Steele
authors.affiliation: Health Section, UNICEF, 3 United Nations Plaza, New York, NY, 10017, USA. askapeu@unicef.org.
authors.forename: Aline
authors.initials: A
authors.lastname: Simen-Kapeu
authors.affiliation: Health Section, UNICEF, 3 United Nations Plaza, New York, NY, 10017, USA. linda.vesel@gmail.com.|Concern Worldwide, 355 Lexington Avenue, New York, NY, 10017, USA. linda.vesel@gmail.com.
authors.forename: Linda
authors.initials: L
authors.lastname: Vesel
authors.affiliation: Health Section, UNICEF, 3 United Nations Plaza, New York, NY, 10017, USA. juliackim99@gmail.com.|GNH Centre Bhutan, Jaffa's Commercial Building, Room 302, Thimphu, Bhutan. juliackim99@gmail.com.
authors.forename: Julia
authors.initials: J
authors.lastname: Kim
authors.affiliation: Health Section, UNICEF, 3 United Nations Plaza, New York, NY, 10017, USA. kdickson@unicef.org.
authors.forename: Kim
authors.initials: K
authors.lastname: Dickson
mesh_terms: D003906:Developing Countries; D005260:Female; D005378:Financial Support; D006301:Health Services Needs and Demand; D006280:Health Workforce; D006801:Humans; D000068104:Infant Health / Q000191:economics / Q000592:standards*; D007231:Infant, Newborn; D007857:Leadership; D008427:Maternal Health Services / Q000191:economics / Q000592:standards*; D011247:Pregnancy; D012111:Residence Characteristics