Remarks

• In making this recommendation, the Guideline Development Group (GDG) considered evidence from trials where home visits for the provision of postnatal care were conducted mainly during the first week after birth.
• The content of postnatal care during home visits in the trials included assessments of the woman and newborn’s physical well-being and the woman’s emotional well-being with referral for further care where necessary, health education, counselling and breastfeeding promotion and support.
• The GDG noted that most trials showing a reduction in neonatal mortality were conducted in rural, low-resource settings with low access to health services and included community packages with home visits by trained community health workers, accompanied by antenatal home visits and community mobilization.
• The capacity of the health system to provide postnatal care home visits should be assessed based on local availability of skilled and trained health work force, distribution of tasks among the health workforce and the competing responsibilities with other health programmes, capacity to provide initial and continuous training and supervision, content of the postnatal care home visits, accessibility for hard to reach populations, coordination between facility- and community-based services, and sustainability of the home visits programme and of the supply systems.