Table 3.

Expert Panel recommendations for strengthening the delivery system for improved maternal, neonatal and child health

Main recommendations	Details
Extend the delivery system to every community and household	Involve community members in the delivery of services.
	Train and support community–level workers who (1) receive sufficient incentives or salary to support their long–term involvement, (2) receive appropriate supportive and technical supervision from staff based at the nearest health facility, and (3) are accountable to their local community.
	Provide appropriate training and supervision of community–level workers (who preferably are selected from and by the communities where they will work) to perform health tasks that respond to local health needs and that address the epidemiological priorities of mothers and their children.
	Train and support neighborhood volunteers for peer–to–peer health promotion.
	Develop an appropriate balance of community–level workers for the required service intensity (while at the same time ensuring a suitable workload for an appropriate number of tasks and ensuring enough time required for each task, given the distance to homes and the level of remuneration/ incentives).
	Coordinate the activities of the formal health sector with the informal health sector (drug sellers and individual practitioners, including traditional healers).
Promote delivery of interventions to those at greatest risk	Provide “safety nets” that reduce barriers to accessing and providing services (eg, “CBPHC–friendly” insurance systems to remunerate providers and incentive schemes to promote utilization of health services).
	Create equitable service delivery strategies that identify and reach those in greatest need
Build a stronger, more efficient, and more effective health delivery system	Provide adequate, sustainable and flexible global, national and local financing that responds to the needs of community–based programs in relation to the amount being spent for facility–based care.
	Foster investments at the community and local level for support of community–based programs and for strengthening primary health care at peripheral health facilities.
	Provide adequate supplies for service delivery.
	Integrate services at the community level (based on delivery system capacity and local need).
	Monitor expenditures for CBPHC against those for primary health centers and hospitals and ensure that these levels are appropriate given the importance of CBPHC for averting deaths.