How Implementation Scientists Can Help Improve Maternal and Neonatal Health

Published: August 27th, 2025

Every day, around 800 women die from preventable pregnancy-related causes, and nearly 7,000 newborns die in their first month of life. The tragic part? We already know how to save most of these lives. Global health authorities widely recommend proven interventions like skilled birth attendance, postpartum monitoring and kangaroo mother care.

The challenge isn’t a lack of solutions; it’s that providers don’t always implement these solutions consistently or fairly. In this article, we explore how implementation science is helping close that gap, turning proven interventions into everyday practice.

Examples of Implementation Science in Maternal and Neonatal Health

Implementation science focuses on how to get evidence-based practices into routine use in real-world healthcare settings, especially in the places and populations that need them most. One of those areas is maternal and neonatal health.

Below are a few real-world examples of how implementation science is helping improve outcomes for mothers and newborns during delivery and beyond.

#1 Kangaroo Mother Care (KMC)

One example of an intervention with strong evidence but uneven implementation is kangaroo mother care. The following breakdown shows what KMC is, why it matters and how implementation strategies have played out around the world.

What It Is

Also known as skin-to-skin contact, kangaroo mother care (KMC) involves placing a newborn — typically a premature or low-birth-weight infant — upright against the bare chest of a caregiver. This simple yet powerful method has been shown to:

Reduce neonatal mortality
Support early and exclusive breastfeeding
Improve weight gain
Lower the risk of hospital readmission

The World Health Organization (WHO) recommends KMC as a cost-effective, high-impact intervention for clinically stable newborns weighing 2,000 grams or less.

The Challenge

Although KMC is increasingly used in well-resourced urban hospitals, it remains underutilized in low-resource settings. Barriers to consistent implementation include:

A lack of caregiver training
Limited hospital space
Insufficient beds or designated KMC areas
Inadequate access to essential supplies like wraps or chairs

Implementation Approach

A team of organizational partners (including WHO, UNICEF and Save the Children) developed a coordinated strategy to scale up KMC globally. This involved:

Policy advocacy
Development of national guidelines
Hands-on training for healthcare workers
Health system strengthening

Their goal? To reach 50% KMC coverage of eligible newborns by 2020 and 75% by 2025 in 25 low- and middle-income countries.

Outcome

By 2018, 32% of the 25 UNICEF-supported countries had integrated KMC into their national health information systems, up from just 8% in 2015. Over 14,000 health workers were trained, and KMC was introduced in many specialized and teaching hospitals.

Still, coverage remained uneven: Only 9% of eligible babies in equipped facilities received KMC, highlighting the continued need for supportive supervision, infrastructure and community engagement to bridge the gap between policy and practice.

WHO Safe Childbirth Checklist (SCC)

Another widely endorsed intervention with inconsistent use is the WHO Safe Childbirth Checklist. Below, we explore what it is, the challenges of putting it into practice and the implementation strategies used in India and Rwanda.

What It Is

The WHO Safe Childbirth Checklist is a 29-item tool consisting of evidence-based practices aimed at improving care during the critical periods of childbirth. It’s used at four key moments: upon admission, before delivery, within one hour after birth and before discharge.

The goal is to reduce maternal and newborn mortality by prompting providers to take life-saving actions such as:

Hand hygiene
Antibiotic use
Oxytocin administration
Newborn warming
Monitoring for complications in the mother or baby

The Challenge

In a case study from Tamil Nadu, India, some staff viewed the checklist as additional paperwork rather than a helpful guide. Implementation was also complicated by high staff turnover, existing workloads and the disruptions caused by COVID-19.

Implementation Approach

At Tamil Nadu’s Sree Renga Hospital, the SCC was integrated into existing quality improvement efforts. A multidisciplinary team launched the program with leadership support, hands-on coaching, live demonstrations and real-time feedback, sometimes even using WhatsApp groups to stay connected.

In another implementation effort in the East African city of Rwanda, all clinical staff received training, and SCC posters were placed throughout the facility as visual cues. A hospital-led quality improvement team helped identify gaps and provided consistent, on-the-ground feedback for three weeks.

Outcome

At Sree Renga Hospital, adherence to the SCC increased from 48% to 77% during the first Plan-Do-Study-Act (PDSA) cycle. During the second cycle, it improved even more, with 94% checklist completion, and 70% of the checklists being completed at the necessary time.

In Rwanda, compliance with essential birth practices improved from 46% to 56%, with the most significant gains observed before discharge.

Why Implementation Science Matters in Maternal and Neonatal Health

Despite decades of research, proven solutions don’t always reach the people who need them most. Implementation science helps health systems bridge the gap between knowing what works and actually delivering it, especially in under-resourced or overburdened settings.

The case studies above show that when implementation strategies are done thoughtfully, with attention to local context and employee support, they can dramatically improve adherence to life-saving practices. This ultimately leads to better outcomes for mothers and newborns.

As global health organizations work toward reducing preventable maternal and neonatal deaths, implementation scientists play a critical role: making sure best practices turn into real bedside care, not just words on a page.

Take the Next Step in Your Health Science Career

Whether your focus is on maternal and neonatal health or another area of health science, you can amplify your impact with UF’s fully online Graduate Certificate in Implementation Science. Designed for working professionals, you can complete the program in as little as one year, on your own schedule.

From clinicians to researchers, you’ll gain practical skills to bridge the gap between evidence-based practices and their real-world implementation. Learn from experts, strengthen your resume and prepare to lead meaningful change in healthcare settings.

Ready to turn proven solutions into life-saving interventions? The first step is only a click away.

Sources:
https://www.unfpa.org/maternal-health
https://pmc.ncbi.nlm.nih.gov/articles/PMC7924893
https://www.joghr.org/article/30751-promising-practices-for-adapting-and-implementing-the-who-safe-childbirth-checklist-case-studies-from-india-and-rwanda

University of Florida

Implementation Science

College of Medicine