• C Akukwe and A H Nowell.
• George Washington University School of Public Health and Health Care Sciences, Washington, DC, USA.
• J R Soc Promot Health. 1999 Mar 1;119(1):42-9.

AbstractIncreased competition for dwindling financial resources places funding and provision of public health services at risk in all countries of the world. Maternal and Child Health (MCH) clients--often poor, mostly women, their children, and families--are at extraordinary risk of receiving poor or no health care. Not considered a voting constituency, and therefore exercising little leverage over elected officials, specific assurances are necessary to ensure that essential health services are available to MCH target population. Therefore, it is critical that all MCH stakeholders leverage their capacity by networking and by developing common strategies for survival and relevance within the health care system in their jurisdiction. Identifying and working with every segment of the population at risk is a crucial first step. Becoming familiar with the history of the population at risk, and defining their geographic boundaries are essential secondary steps. Developing baseline information on their general health and MCH risk status according to available demographic, socioeconomic and environmental data are important next steps. Then, working with the target population, we propose that MCH advocates adopt the 18 MCH strategies discussed in this article. These strategies will strengthen the ability of programs and initiatives that deal with women, their children and families, to survive the current financial and management struggles of the public health services in developed and developing countries.

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