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Effect of mHealth in improving antenatal care utilization and skilled birth attendance in low- and middle-income countries: a systematic review protocol.
JBI Database of Systematic Reviews and Implementation Reports. 2017 Jul; 15(7):1778-1782.REVIEW QUESTION/OBJECTIVE: The objective of this review is to identify and synthesize the best available evidence on the effect of mobile health (mHealth) interventions in antenatal care utilization and skilled birth attendance in low- and middle-income countries.More specifically, the review questions are as follows.
Validation of maternal and neonatal tetanus elimination in Equatorial Guinea, 2016. alidation de l'elimination du tetanos maternel et neonatal en Guinee equatoriale, 2016.
Releve Epidemiologique Hebdomadaire. 2017 Jun 16; 92(24):333-44.Add to my documents.
Assessing the availability of LLINs for continuous distribution through routine antenatal care and the Expanded Programme on Immunizations in sub-Saharan Africa.
Malaria Journal. 2016 May 04; 15(1):255.BACKGROUND: In addition to mass distribution campaigns, the World Health Organization (WHO) recommends the continuous distribution of long-lasting insecticidal nets (LLINs) to all pregnant women attending antenatal care (ANC) and all infants attending the Expanded Programme on Immunization (EPI) services in countries implementing mosquito nets for malaria control. Countries report LLIN distribution data to the WHO annually. For this analysis, these data were used to assess policy and practice in implementing these recommendations and to compare the numbers of LLINs available through ANC and EPI services with the numbers of women and children attending these services. METHODS: For each reporting country in sub-Saharan Africa, the presence of a reported policy for LLIN distribution through ANC and EPI was reviewed. Prior to inclusion in the analysis the completeness of data was assessed in terms of the numbers of LLINs distributed through all channels (campaigns, EPI, ANC, other). For each country with adequate data, the numbers of LLINs reportedly distributed by national programmes to ANC was compared to the number of women reportedly attending ANC at least once; the ratio between these two numbers was used as an indicator of LLIN availability at ANC services. The same calculations were repeated for LLINs distributed through EPI to produce the corresponding LLIN availability through this distribution channel. RESULTS: Among 48 malaria-endemic countries in Africa, 33 malaria programmes reported adopting policies of ANC-based continuous distribution of LLINs, and 25 reported adopting policies of EPI-based distribution. Over a 3-year period through 2012, distribution through ANC accounted for 9 % of LLINs distributed, and LLINs distributed through EPI accounted for 4 %. The LLIN availability ratios achieved were 55 % through ANC and 34 % through EPI. For 38 country programmes reporting on LLIN distribution, data to calculate LLIN availability through ANC and EPI was available for 17 and 16, respectively. CONCLUSIONS: These continuous LLIN distribution channels appear to be under-utilized, especially EPI-based distribution. However, quality data from more countries are needed for consistent and reliable programme performance monitoring. A greater focus on routine data collection, monitoring and reporting on LLINs distributed through both ANC and EPI can provide insight into both strengths and weaknesses of continuous distribution, and improve the effectiveness of these delivery channels.
Seminars In Perinatology. 2015 Oct; 39(6):430-6.Induction of labor in resource-limited settings has the potential to significantly improve health outcomes for both mothers and infants. However, there are relatively little context-specific data to guide practice, and few specific guidelines. Also, there may be considerable issues regarding the facilities and organizational capacities necessary to support safe practices in many aspects of obstetrical practice, and for induction of labor in particular. Herein we describe the various opportunities as well as challenges presented by induction of labor in these settings. Copyright (c) 2015 Elsevier Inc. All rights reserved.
Severe maternal morbidity and near misses in tertiary hospitals, Kelantan, Malaysia: a cross-sectional study.
BMC Public Health. 2016 Mar 5; 16(229):1-13.Background Severe maternal conditions have increasingly been used as alternative measurements of the quality of maternal care and as alternative strategies to reduce maternal mortality. We aimed to study severe maternal morbidity and maternal near miss among women in two tertiary hospitals in Kota Bharu, Kelantan, Malaysia. Methods A cross-sectional study with record review was conducted in 2014. Severe maternal morbidity and maternal near miss were classified using the new World Health Organization criteria. Health indicators for obstetric care were calculated and descriptive analyses were performed using SPSS version 22.0. Results In total, 21,579 live births, 395 women with severe maternal morbidity, 47 women with maternal near miss and two maternal deaths were analyzed. The severe maternal morbidity incidence ratio was 18.3 per 1000 live births and the maternal near miss incidence ratio was 2.2 per 1000 live births. The maternal near miss mortality ratio was 23.5 and the mortality index was 4.1%. The process indicators for essential interventions were almost 100.0%. Haemorrhagic disorders were the most common event for severe maternal morbidity (68.6%) and maternal near miss (80.9%) and management-based criteria accounted for 85.1%. Conclusions Comprehensive emergency care and intensive care as well as overall improvements in the quality of maternal health care need to be achieved to substantial reduce maternal death.
Recommendations for augmentation of labour. Highlights and key messages from World Health Organization's 2014 global recommendations.
[Geneva, Switzerland], WHO, 2015 Apr.  p. (WHO/RHR/15.05; USAID Cooperative Agreement No. AID-OAA-A-14-00028.)This evidence brief provides highlights and key messages from the World Health Organization’s 2014 Global Recommendations on the Augmentation of Labor. The goal of the brief is to summarize guidelines for effective interventions for safe augmentation to accelerate their dissemination and use. Additionally, policy and programme actions to incorporate the new guidelines are outlined alongside the recommendations. This brief is intended for policy-makers, programme managers, educators and providers who care for pregnant woman.
Geneva, Switzerland, WHO, 2014.  p.Optimizing outcomes for women in labour at the global level requires evidence-based guidance of health workers to improve care through appropriate patient selection and use of effective interventions. In this regard, WHO published recommendations for induction of labour in 2011. The goal of the present guideline is to consolidate the guidance for effective interventions that are needed to reduce the global burden of prolonged labour and its consequences. The primary target audience includes health professionals responsible for developing national and local health protocols and policies, as well as obstetricians, midwives, nurses, general medical practitioners, managers of maternal and child health programmes, and public health policy-makers in all settings. Augmentation of labour is the process of stimulating the uterus to increase the frequency, duration and intensity of contractions after the onset of spontaneous labour. It has commonly been used to treat delayed labour when poor uterine contractions are assessed to be the underlying cause. The WHO technical consultation adopted 20 recommendations covering practices relating to the diagnosis, prevention and treatment of delayed progress in the first stage of labour, and supportive care for women undergoing labour augmentation. For each recommendation, the quality of the supporting evidence was graded as very low, low, moderate or high. The contributing experts qualified the strength of these recommendations (as strong or weak) by considering the quality of the evidence and other factors, including values and preferences of stakeholders, the magnitude of effect, the balance of benefits versus harms, resource use and the feasibility of each recommendation. To ensure that each recommendation is correctly understood and used in practice, additional remarks and an evidence summary have also been prepared, and these are provided in the full document, below each recommendation. Guideline users should refer to this information in the full version of the guideline if they are in any doubt as to the basis for any of the recommendations. (Excerpts)
South African Family Practice. 2014 Jul-Aug; 56(4):250-251.Globally, breastfeeding has been acknowledged as one of the most effective ways of ensuring the adequate health, development and survival of a child. In 1991, in order to ensure the right start for every infant and to extend the desired support to the postnatal mothers to execute successful breastfeeding, the World Health Organization and the United Nations Children’s Fund (UNICEF) implemented the Baby-Friendly Hospital Initiative (BFHI). Irrespective of the multiple advantages of baby-friendly hospitals, none of the evaluation studies have identified completely adherent facilities to the 10 steps. To ensure successful implementation and long-term sustainability of the BFHI in different healthcare facilities, different measures have been proposed. To conclude, despite the availability of a definitive evidence of BFHI having a successful impact on different breastfeeding outcomes, only a comprehensive and multisectoral approach can enable every mother and family to give every child the best start in life.
The prevention and elimination of disrespect and abuse during facility-based childbirth. WHO statement.
Geneva, Switzerland, WHO, 2014.  p. (WHO/RHR/14.23)Many women experience disrespectful and abusive treatment during childbirth in facilities worldwide. Such treatment not only violates the rights of women to respectful care, but can also threaten their rights to life, health, bodily integrity, and freedom from discrimination. This statement calls for greater action, dialogue, research and advocacy on this important public health and human rights issue.
International Perspectives On Sexual and Reproductive Health. 2013 Mar; 39(1):32-41.CONTEXT: Despite the fact that most maternal deaths are preventable, maternal mortality remains high in many developing countries. Target A of Millennium Development Goal (MDG) 5 calls for a three-quarters reduction in the maternal mortality ratio (MMR) between 1990 and 2015. METHODS: We derived estimates of maternal mortality for 172 countries over the period 1990-2008. Trends in maternal mortality were estimated either directly from vital registration data or from a hierarchical or multilevel model, depending on the data available for a particular country. RESULTS: The annual number of maternal deaths worldwide declined by 34% between 1990 and 2008, from approximately 546,000 to 358,000 deaths. The estimated MMR for the world as a whole also declined by 34% over this period, falling from 400 to 260 maternal deaths per 100,000 live births. Between 1990 and 2008, the majority of the global burden of maternal deaths shifted from Asia to Sub-Saharan Africa. Differential trends in fertility, the HIV/AIDS epidemic and access to reproductive health are associated with the shift in the burden of maternal deaths from Asia to Sub-Saharan Africa. CONCLUSIONS: Although the estimated annual rate of decline in the global MMR in 1990-2008 (2.3%) fell short of the level needed to meet the MDG 5 target, it was much faster than had been thought previously. Targeted efforts to improve access to quality maternal health care, as well as efforts to decrease unintended pregnancies through family planning, are necessary to further reduce the global burden of maternal mortality.
Hu Li Za Zhi the Journal of Nursing. 2013 Feb; 60(1):23-8.The Baby-Friendly Hospital Initiative (BFHI), developed by the World Health Organization and the United Nations Children's Fund to promote breastfeeding in maternity facilities worldwide, has had a global impact on breastfeeding outcomes. However, further interventions are necessary before and after hospital discharge to meet the initiative's recommended 6-month targets. The Baby-Friendly Community Initiative (BFCI), a multifaceted program for community based breastfeeding promotion designed to complement BFHI, addresses this challenge. The purpose of this paper is to introduce the origin of BFCI and its current implementation status in several countries as a reference for effective BFCI promotion in Taiwan.
WHO Guidelines on preventing early pregancy and poor reproductive outcomes among adolescents in developing countries.
Journal of Adolescent Health. 2013 May; 52(5):517-522.Adolescent pregnancy and its consequences represent a major public health concern in many low- to middle-income countries of the world. The World Health Organization has recently developed evidence-based guidelines addressing six areas: preventing early marriage; preventing early pregnancy through sexuality education; increasing education opportunities and economic and social support programs; increasing the use of contraception; reducing coerced sex; preventing unsafe abortion; and increasing the use of prenatal care childbirth and postpartum care. In each of these areas, the World Health Organization recommends directions for future research. The summary concludes with a brief look at global and regional initiatives that provide a window of opportunity for stepping up action in this important area.
London, United Kingdom, IPPF, 2012 May.  p.There are approximately 3 billion people under 25 and a large percentage of those young people lack the access to sexual and reproductive health services or information that they need to translate their decisions into realities for their lives now and in the future. The Keys to youth-friendly services series explores what IPPF considers to be the key elements for ‘unlocking’ access to sexual and reproductive health services for young people. We believe that if every health professional and health-providing institution adopted these keys in the day-to-day implementation of their work, that it would go a long way in eradicating the stigma and other barriers that prevent young people from accessing the services, information and support that they are entitled to receive. (Excerpt)
Bulletin of the World Health Organization. 2012 Feb 1; 90(2):79A.Despite global commitment and prevention through well-known interventions, progress has been slow towards Millennium Development Goal 5 of reducing global maternal mortality. The United Nations (UN) Human Rights Council has highlighted maternal mortality as an issue bearing not just on development, but also on human rights. In August 2011, the Committee on the Elimination of Discrimination against Women became the first UN human rights body to issue a decision on maternal mortality. The case Alyne da Silva Pimentel v. Brazil established that States have a human rights obligation to guarantee women of all racial and economic backgrounds timely and non-discriminatory access to appropriate maternal health services. After the death of this Brazilian woman who died from pregnancy-related causes after a misdiagnosis and delay in provision of emergency obstetric care, the Convention of All Forms of Discrimination against Women (CEDAW) argued that there was no effort to establish professional responsibility and that she was unable to obtain justice in Brazil. The Committee found violations of the right to access health care and effective judicial protection in the context of non-discrimination; cases like this furnish opportunities for international and domestic accountability. The Committee made several general recommendations intended to reduce preventable maternal deaths, which include ensuring women’s rights to safe motherhood and emergency obstetric care, providing professional training for health workers, and implementing Brazil’s national Pact for the Reduction of Maternal and Neonatal Mortality.
[Hove, United Kingdom], International HIV / AIDS Alliance, 2012 Jun.  p.Our vision is a world in which people do not die of aids. For us, this means a world in which communities: have brought HIV under control by preventing its transmission; enjoy better health; and can fully exercise their human rights. Our mission is to support community action to prevent HIV infection, meet the challenges of AIDS, and build healthier communities.We take great pride investing in a community-based response that understands what works in a local context, and that is strengthened by learning from a global partnership of national organisations. In 2011 this approach enabled us to reach 2.8 million people.
Geneva, Switzerland, WHO, .  p.The Preventing early pregnancy: What the evidence says? in Developing Countries presents the evidence to design national policies and strategies. It contains recommendations on action and research for preventing: (1) early pregnancy: by preventing marriage before 18 years of age; by increasing knowledge and understanding of the importance of pregnancy prevention; by increasing the use of contraception; and by preventing coerced sex; (2) poor reproductive outcomes: by reducing unsafe abortions; and by increasing the use of skilled antenatal, childbirth and postnatal care. These guidelines are primarily intended for policy-makers, planners and programme managers from governments, nongovernmental organizations and development agencies. They are also likely to be of interest to public health researchers and practitioners, professional associations and civil society groups. They have been developed through a systematic review of existing research and input from experts from countries around the world, in partnership with many key international organizations working to improve adolescents’ health. Similar partnerships have been forged to distribute them widely and to support their use. (Excerpt)
European Journal of Contraception and Reproductive Health Care. 2010 Oct; 15(5):301-4.Add to my documents.
Guidelines for integrating sexual and reproductive health into the HIV / AIDS component of country coordinated proposals to be submitted to the Global Fund to Fight AIDS, Tuberculosis and Malaria: Round 8 and beyond. Updated 18 February 2008.
[London, England], Interact Worldwide, 2008 Feb 18. 36 p.The Global Fund to Fight AIDS, Tuberculosis and Malaria, a unique multilateral partnership that has proven itself to be a successful mechanism for fighting these diseases, is an important funding vehicle for innovative responses to the three diseases, including SRH-HIV / AIDS integration. In preparation for upcoming and future Global Fund funding rounds, Guidelines for Integrating Sexual and Reproductive Health into the HIV / AIDS Component of Country Coordinated Proposals to be submitted to the Global Fund to Fight AIDS, Tuberculosis and Malaria is designed to support Country Coordinated Mechanisms (CCMs) to develop Country Coordinated Proposals for the Global Fund that integrate sexual and reproductive health into the HIV / AIDS component. (Excerpt)
[Crisis in human resources for health: millennium development goals for maternal and child health threatened] Tekort aan gezondheidswerkers in Afrika: millenniumdoelstellingen voor moeder- en kindzorg in gevaar.
Nederlands Tijdschrift Voor Geneeskunde. 2010; 154(5):A1159.International migration of health care workers from low-income countries to the West has increased considerably in recent years, thereby jeopardizing the achievements of The Millennium Development Goals, especially number 4 (reduction of child mortality) and 5 (improvement of maternal health).This migration, as well as the HIV/AIDS epidemic, lack of training of health care personnel and poverty, are mainly responsible for this health care personnel deficit. It is essential that awareness be raised amongst donors and local governments so that staffing increases, and that infection prevention measures be in place for their health care personnel. Western countries should conduct a more ethical recruitment of health care workers, otherwise a new millennium development goal will have to be created: to reduce the human resources for health crisis.
Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2008.  p.The Medical eligibility criteria for contraceptive use -one of the four cornerstones of the World Health Organization's (WHO) evidence-based family planning guidance -provides evidence-based recommendations on whether an individual can safely use a contraceptive method. This guideline is intended for use by policy-makers, programme managers, and the scientific community in the preparation of national family planning/sexual and reproductive health programmes for delivery of contraceptives. The first edition of the Medical eligibility criteria for contraceptive use was published in 1996; subsequent editions were published in 2000 and 2004.
International Journal of Gynaecology and Obstetrics. 2008 Aug; 102(2):189-90.Recent articles in these pages have referred to the Millennium Development Goals (MDGs). These goals were set in 2000 by the General Assembly of the United Nations to be achieved by 2015. While aimed primarily at development and poverty reduction, 3 goals refer to measures of health. Of the 8 goals, the one of interest to this section of IJGO is MDG5, which refers to maternal health: Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio; Achieve, by 2015, universal access to reproductive health care; A related goal is MDG4, which is to: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate. (excerpt)
New York, New York, Family Care International, 2007.  p.This publication explores knowledge, attitudes, and perspectives on pregnancy, delivery, and fistula from 31 country-level needs assessments conducted in 29 countries in the Campaign to End Fistula (see inside back cover for the complete list). Experiences of women living with obstetric fistula, their families, community members, and health care providers are brought to light. This information represents important research on the social, cultural, political, and economic dimensions of obstetric fistula, drawing attention to the factors underlying maternal death and disability. We hope this publication will serve as an advocacy tool to strengthen existing programmes and encourage further research on how to increase access to vital maternal health services, including fistula prevention and treatment. We implore policy makers, programmers, and researchers to listen to these women's voices and consider the promising practices and strategic recommendations described herein. What we have learned so far can help point the way, but much more still needs to be done. We cannot afford to wait-the costs to women, communities, and health systems are simply too great to delay action. Too many of the world's most disadvantaged and vulnerable women have suffered this preventable and treatable condition in silence. Too many women are dying unnecessarily in childbirth. It is time to put an end to the injustice of fistula and maternal death. (author's)
A thematic fund for maternal health. Accelerating progress towards Millennium Development Goal 5: No woman should die giving life.
[New York, New York], UNFPA, . 15 p.The thematic fund (2008-2015) will focus ultimately on supporting 75 countries with the greatest need. In addition to its focus on meeting countries' needs, it will demonstrate good practices for scaling up efforts. It will be launched in a phased manner. This paper provides an overview of the Thematic Fund for Maternal Health and indicative budget for the first period (2008-2011) of US$ 465 million, exclusive of indirect costs. It will be followed by a comprehensive proposal for the first period with an operational plan, which will include a brief preparatory stage followed by phased implementation at scale in at least 25 of the 75 priority countries. Introduction in the remaining countries will continue over the second period (2012-2015), as resources permit and based on a proposal and budget reflecting the experiences of the first period. (excerpt)
Africa Renewal. 2008 Jan; 21(4):8-11.Pumwani Maternity Hospital, in Nairobi, Kenya, is the largest maternal health centre in East and Central Africa. Located close to Mathare and Korogocho, two of Nairobi's biggest slums, the hospital helps some 27,000 women give birth each year. Most are poor and young, between the ages of 14 and 18. The government-run hospital struggles to provide even the most basic services, since it lacks sufficient resources, equipment and staff. "We told patients to buy their own things because of the shortage of supplies," explains Evelyn Mutio, the former head of the hospital's nursing staff. "We told patients to come with gloves, to buy their own syringes, needles, cotton wool and maternity pads." The Pumwani Maternity Hospital exemplifies the state of the health infrastructure in Africa. According to the World Health Organization (WHO), high service costs, lack of trained staff and supplies, poor transport and patients' insufficient knowledge mean that 60 per cent of mothers in sub-Saharan Africa do not have a health worker present during childbirth. That heightens the risks of complications, contributing to greater maternal and child death and disability. (excerpt)
Lancet. 2007 Oct 13; 370(9595):1287-1288.Of all health indicators, maternal mortality reveals the greatest gap between rich and poor women, both between and within countries. Each year, 536 000 women die from complications of pregnancy and childbirth-99% in the developing world-and another 10-20 million women have severe health problems, including obstetric fistula. In 2005, women in developed countries had a one in 7300 lifetime risk of dying from pregnancy-related causes, compared with a one in 75 risk in developing countries. In Africa, the lifetime risk is one in 26. Little change has been seen in the hardest hit areas and the gap is widening. At the midpoint in the timeline to achieve the Millennium Development Goals (MDG), the absence of progress in reduction of maternal mortality and morbidity is unacceptable. The urgent and life-threatening circumstances of millions of women call for quick, concerted, and decisive actions to be taken now and sustained through 2015 and beyond. The new MDG 5 target to achieve universal access to reproductive health, in line with the International Conference on Population and Development, paves the way for faster progress. (excerpt)