Introduction

The Maternal and Child Health Handbook (MCH HB) is an informational resource and home-based health record tool that supports women and their families during pregnancy, childbirth, and infancy. The MCH HB was created in post-WWII Japan in 1948, to tackle the high rates of mother and infant mortality, the handbook has since evolved to include educational informational, psychological support resources, and a home-based record keeping tool.

The 13th International Conference on the MCH HB was held on August 24th-25th, 2022 at the University of Toronto, with over 700 global health leaders, policymakers, medical professionals, academics, and stakeholders, representing 61 countries, united to advocate for maternal and child health. The theme of the conference, “Making Me Visible”, aimed to amplify the silenced voices of mothers and children. The conference featured keynote speakers, such Her Imperial Highness Crown Princess Akishino of Japan, and representatives from world-renowned organizations, such as the World Health Organization, UNICEF, and the Japanese International Cooperation Agency.

The COVID-19 pandemic exacerbated the existing gaps in maternal and child healthcare (MCH), highlighting the urgent need to prioritize accessible and equitable care. The primary objectives of the conference: (i) advocate for equitable MCH globally, (ii) promote the implementation of the MCH HB as a global standard tool, and (iii) support the needs of underprivileged families by integrating equity, diversity, and inclusion principles into healthcare. The conference focused on highlighting the positive impact of the implementation of the MCH HB on empowering women and their families to increase health literacy, strengthen relationships with health professionals, and foster autonomous decision-making. In addition, strategies to overcome inaccessibility in vulnerable communities, specifically remote low-income areas were explored. The international implementation of the MCH HB has the potential to integrate solutions that prioritize innovation, technology, and most importantly, health equity for women and children everywhere.

The MCH HB provides advice on how to combat the social determinants of health that influence MCH outcomes, including nutrition, infectious diseases, and breastfeeding practices. The handbook provides tools to support mothers and families, including immunization records, tracking appointments, and navigating mental health and physical resources. Furthermore, digital handbooks can be more accessible for families in remote locations, by helping to track MCH data, and assist in emergency preparedness.

The MCH HB is a two-way communication tool that ensures continuum of care for mothers and children. Speakers shared their experiences with the global implementation of the MCH HB in both developed and developing countries (i.e., Pakistan, Netherlands, Bangladesh, Ghana, Canada, and Indonesia). In the Netherlands and Bangladesh, the digitization of the MCH HB increased accessibility by keeping track of pregnancy status, and providing SMS and voice call reminders prior to scheduled appointments. Discussions regarding best practices of MCH HB adoption at a global scale contributed to possible future trajectories, scopes, and strategies to promote MCH.

The conference concluded by ‘Toronto Declaration’ urging the following for MCH internationally: (i) Implementation of Equity, Diversity, and Inclusion into primary healthcare, (ii) Prioritization of holistic approaches in healthcare provision, (iii) Digitization of the MCH HB, (iv) Promotion of the sustainability of the MCH HB, and (v) Establishment of the MCH HB as a standard global self-care tool. The Toronto Declaration emphasizes the innovative, equitable, and sustainable development of reproductive, maternal, neonatal, child, and adolescent health (RMNCAH) by integrating the MCH handbook as a standard self-care tool. International committee on MCH HB, stakeholders and participants are committed to the MCH Handbook concept to ensure that in the future, “Every woman and child is visible.”

The MCH-HB Work Report 2022 advocates for the use of the MCH HB in facilitating improved MCH pre- and post-pregnancy, empowering mothers and families to communicate effectively with healthcare professionals. A pre- and post-conference survey indicated that the majority of attendees were highly engaged & supportive to learn of an accessible, home-based tool that may be used by mothers world-wide. In emphasizing equitable access to MCH resources to ensure improved health outcomes, the MCH HB initiative was very well-received. It is evident that if the MCH HB is universally applied, it could save millions of mothers and babies, while also acting as a crucial driver in achieving Sustainable Development Goals by 2030.

Acknowledgment: Authors recognized the contributions of the 13th International conference on MCH Handbook at DLSPH, U of T host committee, invited guest speakers, international participants, proud sponsors [DLSPH, U of T and MOH Japan] and international committee on MCH Handbook.