Your search found 373 Results
Global Health, Science and Practice. 2018 Jun 27; 6(2):247-248.Add to my documents.
Global Health, Science and Practice. 2018 Jun 27; 6(2):257-259.Add to my documents.
Professional care delivery or traditional birth attendants? The impact of the type of care utilized by mothers on under-five mortality of their children.
Tropical Medicine and Health. 2018; 46(1)Background: Because of the high under-five mortality rate, the government in Zambia has adopted the World Health Organization (WHO) policy on child delivery which insists on professional maternal care. However, there are scholars who criticize this policy by arguing that although built on good intentions, the policy to ban traditional birth attendants (TBAs) is out of touch with local reality in Zambia. There is lack of evidence to legitimize either of the two positions, nor how the outcome differs between women with HIV and those without HIV. Thus, the aim of this paper is to investigate the effect of using professional maternal care or TBA care by mothers (during antenatal, delivery, and postnatal) on under-five mortality of their children. We also compare these outcomes between HIV-positive and HIV-negative women. Methods: By relying on data from the 2013-2014 Zambia Demographic Health Survey (ZDHS), we carried out propensity score matching (PSM) to investigate the effect of utilization of professional care or TBA during antenatal, childbirth, and postnatal on under-five mortality. This method allows us to estimate the average treatment effect on the treated (ATT). Results: Our results show that the use of professional care as opposed to TBAs in all three stages of maternal care increases the probability of children surviving beyond 5 years old. Specifically for women with HIV, professional care usage during antenatal, at birth, and during postnatal periods increases probability of survival by 0.07 percentage points (p.p), 0.71 p.p, and 0.87 p.p respectively. Similarly, for HIV-negative women, professional care usage during antenatal, at birth, and during postnatal periods increases probability of survival by 0.71 p.p, 0.52 p.p, and 0.37 p.p respectively. However, although there is a positive impact when mothers choose professional care over TBAs, the differences at all three points of maternal care are small. Conclusion: Given our findings, showing small differences in under-five child's mortality between utilizers of professional care and utilizers of TBAs, it may be questioned whether the government's intention of completely excluding TBAs (who despite being outlawed are still being used) without replacement by good quality professional care is the right decision. © 2018 The Author(s).
Global guidance on criteria and processes for validation: Elimination of mother-to-child transmission of HIV and syphilis. Second edition.
Geneva, Switzerland,WHO, 2017. 52 p.This second edition of the EMTCT global validation guidance document provides standardized processes and consensus-developed criteria to validate EMTCT of HIV and syphilis, and to recognize high-HIV burden countries that have made significant progress on the path to elimination. The guidance places strong emphasis on country-led accountability, rigorous analysis, intensive programme assessment and multilevel collaboration, including the involvement of communities of women living with HIV. It provides guidance to evaluate the country’s EMTCT programme, the quality and accuracy of its laboratory and data collection mechanisms, as well as its efforts to uphold human rights and equality of women living with HIV, and their involvement in decision-making processes.
Programme reporting standards for sexual, reproductive, maternal, newborn, child and adolescent health.
Geneva, Switzerland, World Health Organization [WHO], 2017. 32 p.Information about design, context, implementation, monitoring and evaluation is central to understanding the processes and impacts of sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) programmes, in support of effective replication and scale-up of these efforts. Existing reporting guidelines do not demand sufficient detail in the reporting of contextual and implementation issues. We have, therefore, developed programme reporting standards (PRS) to provide guidance for complete and accurate reporting on the design, implementation, monitoring and evaluation processes of SRMNCAH programmes. The PRS can be used by SRMNCAH programme implementers and researchers. The PRS can be used prospectively to guide the reporting of a programme throughout its life cycle, or retrospectively to describe what was done, when, where, how and by whom. The PRS is intended as a guide for implementation researchers who need to document important details of implementation and context in addition to the results of their studies. The PRS is intended for programme managers and other staff or practitioners who have designed, implemented and/or evaluated SRMNCAH programmes. It can be used by governmental and nongovernmental organizations, bilateral and multilateral agencies, as well as by the private sector. The PRS is also intended as a guide for implementation researchers who need to document important details of implementation and context in addition to the results of their studies
Managing complications in pregnancy and childbirth (MCPC): A guide for midwives and doctors. Highlights from the World Health Organization’s 2017 Second Edition.
[Geneva, Switzerland], WHO, 2017 May. 8 p. (WHO/MCA/17.02; USAID Cooperative Agreement No. AID-OAA-A-14-00028)Since it was first published in 2000, the World Health Organization’s (WHO’s) Managing Complications in Pregnancy and Childbirth (MCPC) manual has been used widely around the world to guide the care of women and newborns who have complications during pregnancy, childbirth and the immediate postnatal period. The MCPC manual targets midwives and doctors working in district-level hospitals. Selected chapters from the first edition of the MCPC were revised in 2016 based on new WHO recommendations, and the second edition of the MCPC manual is now available. This brief reviews the revision process and summarizes updated clinical guidelines for a subset of revised chapters, including: emotional and psychological support; hypertensive disorders of pregnancy; bleeding in early pregnancy and after childbirth; and prevention and management of infection in pregnancy and childbirth. (Excerpt)
Strengthening the capacity of community health workers to deliver care for sexual, reproductive, maternal, newborn, child and adolescent health.
Geneva, Switzerland, World Health Organization [WHO], 2015. 20 p.Government institutions, United Nations agencies, and global partners have been repositioning the role that community health workers (CHWs) can play in increasing access to essential quality health services in the context of national primary health care and universal health coverage. Given the growing momentum and interest in training CHWs, the United Nations health agencies (H4+) have developed this technical brief to orient country programme managers and global partners as to key elements for strengthening the capacity of CHWs, including health system and programmatic considerations, core competencies, and evidence-informed interventions for CHWs along the SR/MNCAH continuum of care. These key elements need to be adapted and contextualized by countries to reflect the structure, gaps, and opportunities of the national primary health care system, the interaction between the health sector with other sectors, and the specific roles and competencies that CHWs already have within that system. These key elements should also guide H4+ members and partners to take a joint and harmonized approach to supporting countries in their capacity-development efforts. Annex 1 lists SR/MNCAH interventions that CHWs can perform based on the best available evidence and existing WHO guidance.
Geneva, Switzerland, WHO, 2015. 124 p.The report delivers both promising and disappointing messages about the situation in low- and middle-income countries. Within-country inequalities have narrowed, with a tendency for national improvements driven by faster improvements in disadvantaged subgroups. However, inequalities still persist in most reproductive, maternal, newborn and child health indicators. The extent of within-country inequality differed by dimension of inequality and by country, country income group and geographical region. There is still much progress to be made in reducing inequalities in RMNCH.
Bulletin of the World Health Organization. 2017 Jun; 95(6):445-452I.Objective To assess the feasibility of applying the World Health Organization’s proposed 15 indicators of quality of care for maternal and newborn health at health-facility level in low- and middle-income settings. Methods Six of the indicators are about maternal health, five are for newborn health and four are general cross-cutting indicators. We used data collected routinely in facility registers and obtained as part of facility assessments from 963 health-care facilities specializing in maternity services in 10 countries in Africa and Asia. We made a feasibility assessment of the availability of data and the clarity of indicator definitions and identified additional information and data collection processes needed to apply the proposed indicators in real-life settings. Findings Of the indicators evaluated, 10 were clearly defined, of which four could be applied directly in the field and six would require revisions to operationalize them. The other five indicators require further development, with one of them being ready for implementation by using information readily available in registers and four requiring further information before deployment. For indicators that measure coverage of care or availability of services or products, there is a need to further strengthen measurement. Information on emergency obstetric complications was not recorded in a standard manner, thus limiting the reliability of the information. Conclusion While some of the proposed indicators can already be applied, other indicators need to be refined or will need additional sources and methods of data collection to be applied in real-world settings.
Caring for newborns and children in the community. Planning handbook for programme managers and planners.
Geneva, Switzerland, World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health, 2015. 168 p.Prevention and treatment services need to be brought closer to children who are not adequately reached by the health system. To help meet this need, WHO and UNICEF have developed state-of-the-art packages to enable community health workers to care for pregnant women, newborns and children. Caring for Newborns and Children in the Community comprises three packages of materials for training and support of CHWs. Countries will assess their current community-based services and choose to what extent they are able to implement these packages for improving child and maternal health and survival: (1) Caring for the newborn at home, (2) caring for the child's healthy growth and development, (3) caring for the sick child in the community.
Midwifery. 2016 Feb; 33:7.Add to my documents.
Expanding the evidence base for global recommendations on health systems: strengths and challenges of the OptimizeMNH guidance process.
Implementation Science. 2016 Jul 18; 11:98.BACKGROUND: In 2012, the World Health Organization (WHO) published recommendations on the use of optimization or "task-shifting" strategies for key, effective maternal and newborn interventions (the OptimizeMNH guidance). When making recommendations about complex health system interventions such as task-shifting, information about the feasibility and acceptability of interventions can be as important as information about their effectiveness. However, these issues are usually not addressed with the same rigour. This paper describes our use of several innovative strategies to broaden the range of evidence used to develop the OptimizeMNH guidance. In this guidance, we systematically included evidence regarding the acceptability and feasibility of relevant task-shifting interventions, primarily using qualitative evidence syntheses and multi-country case study syntheses; we used an approach to assess confidence in findings from qualitative evidence syntheses (the Grading of Recommendations, Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach); we used a structured evidence-to-decision framework for health systems (the DECIDE framework) to help the guidance panel members move from the different types of evidence to recommendations. RESULTS: The systematic inclusion of a broader range of evidence, and the use of new guideline development tools, had a number of impacts. Firstly, this broader range of evidence provided relevant information about the feasibility and acceptability of interventions considered in the guidance as well as information about key implementation considerations. However, inclusion of this evidence required more time, resources and skills. Secondly, the GRADE-CERQual approach provided a method for indicating to panel members how much confidence they should place in the findings from the qualitative evidence syntheses and so helped panel members to use this qualitative evidence appropriately. Thirdly, the DECIDE framework gave us a structured format in which we could present a large and complex body of evidence to panel members and end users. The framework also prompted the panel to justify their recommendations, giving end users a record of how these decisions were made. CONCLUSIONS: By expanding the range of evidence assessed in a guideline process, we increase the amount of time and resources required. Nevertheless, the WHO has assessed the outputs of this process to be valuable and is currently repeating the approach used in OptimizeMNH in other guidance processes.
Washington, D.C., World Bank, 2015 Feb.  p. (From Evidence to Policy)Poor children face barriers to healthy development even before they are born. Their mothers may not have nutritious food or proper prenatal care, which can harm a baby s brain development when it needs it most. Mothers may not deliver in a health facility nor have a skilled birth attendant present, increasing the risk of complications and ultimately putting their life and that of the baby at risk. In Argentina, the World Bank supported a government program, Plan Nacer, to improve maternal-child health outcomes through increased coverage and quality of health services. The program gives provincial authorities financial incentives for enrolling pregnant women and children in the program and for achieving specific primary health care goals. An impact evaluation found that Plan Nacer improved the birth weight of babies and reduced newborn deaths, while improving access to public health facilities and boosting the quality of care. The evidence from this evaluation will equip policy makers in low and middle income countries with additional information when designing health programs aimed at improving specific outcomes. As governments around the world look for ways to create effective programs to help their poorest citizens, the results from this impact evaluation provide an example of how health sector reforms can give children the right start in life.
[Washington, D.C.], World Bank, 2012 Jun. 4 p. (en breve No. 177)The Latin America and Caribbean (LAC) region fares well on achievement of the MDG targets when compared with other regions, but the region has great disparities between and within countries on these goals. The region is also performing better than the rest of the developing world in relation to child mortality, having achieved more than 70% of the progress needed to reduce under-five mortality by two-thirds. However, LAC still faces serious challenges regarding maternal mortality, achieving good public and individual health and alleviating poverty. For LAC, the MDGs are a historic opportunity to address all forms of inequality and attain the political will needed to achieve these goals. (excerpt)
New York, New York, UNICEF, 2016 Jun.  p.Every child has the right to health, education and protection, and every society has a stake in expanding children’s opportunities in life. Yet, around the world, millions of children are denied a fair chance for no reason other than the country, gender or circumstances into which they are born. The State of the World’s Children 2016 argues that progress for the most disadvantaged children is not only a moral, but also a strategic imperative. Stakeholders have a clear choice to make: invest in accelerated progress for the children being left behind, or face the consequences of a far more divided world by 2030. At the start of a new development agenda, the report concludes with a set of recommendations to help chart the course towards a more equitable world.
British Journal of Nursing. 2016 Mar 24-Apr 13; 25(6):344-5.Add to my documents.
Reproductive, maternal, newborn, and child health. Disease control priorities. Third edition. Volume 2.
Washington, D.C., World Bank Group, 2016.  p.The Russian Federation's population has been declining since 1992, but recently the decline appears to be over. Although fertility has risen since the 2007 introduction of the family policy package, which focused on stimulating second and higher-order births, total fertility rates still remain significantly below replacement rate. Unlike some Western European countries, low overall fertility in Russia can be explained predominantly by a high prevalence of one-child families, despite the two-child ideal family size reported by the majority of Russians. This paper examines the correlates of Russian first-time mothers' desire and decision to have a second child. Using the 2004–12 waves of the Russia Longitudinal Monitoring Survey, the study focuses on the motherhood-career trade-off as a potential obstacle to higher fertility in Russia. The preliminary results indicate that among Russian first-time mothers, being in stable employment is positively associated with the likelihood of having a second child. Moreover, the desire to have a second child is positively associated with the first child attending formal childcare, which suggests that the availability, affordability, and quality of such childcare can be important for promoting fertility. These results are broadly consistent with previous studies in other European countries that indicate that the ability of mothers to combine work and family has important implications for fertility, and that pro-natalist policies focusing on childcare accessibility can offer the greatest payoffs. In addition to these factors, better housing conditions, being married, having an older child, and having a first-born boy are also positively associated with having a second child.
Delivering the Millennium Development Goals to reduce maternal and child mortality: a systematic review of impact evaluation evidence.
[Washington, D.C.], World Bank, Independent Evaluation Group, .  p.Interventions that may improve maternal and child health are numerous and spread across many development sectors. Even when such interventions are known to be effective in controlled conditions, however, questions remain about implementation, delivery, and uptake. This review gathers impact evaluation evidence of fielded interventions that aim to improve skilled birth attendance and reduce maternal and child mortality rates. To aid policy makers, it reviews effectiveness evidence from multiple sectors on the distal causes of maternal and child mortality, complementing the body of effectiveness evidence from reviews specific to the health sector (such as the Lancet series on maternal and child health) that focus on proximate interventions for intermediate outcomes. This systematic review by the Independent Evaluation Group (IEG) is a learning exercise that looks beyond World Bank experience. In doing so, it draws on impact evaluations other than those conducted by the Bank or on Bank projects. It is intended to be used as a reference for practitioners in the Bank and elsewhere with an interest in interventions that have demonstrated attributable improvements in skilled birth attendance and reductions in maternal and child mortality. This review also identifies important gaps in the impact evaluation evidence for interventions that may be effective in reducing maternal and child mortality but whose impacts have not yet been tested using robust impact evaluation methods. (Excerpt)
WHO recommendations for prevention and treatment of maternal peripartum infections: Highlights and key messages from the World Health Organization's 2015 global recommendations.
[Geneva, Switzerland], WHO, 2015 Sep.  p. (WHO/RHR/15.19; WHO/MCA/15.01)Bacterial infections around the time of childbirth account for about one-tenth of maternal deaths and contribute to severe morbidity and long-term disability for many affected women. Standard infection prevention and control measures are a cornerstone of peripartum infection prevention (e.g., hand hygiene and use of clean equipment). WHO recommendations for prevention and treatment of maternal peripartum infections include both recommended and non-recommended interventions during labour, childbirth, and the postpartum period. Clinical monitoring, early detection, and prompt treatment of peripartum infection with an appropriate antibiotic regimen are essential for reducing death and morbidity in affected women. Recommendations for antibiotic prophylaxis / treatment for specific indications balance health benefits for the mother and newborn with safety concerns (e.g., adverse effects) and the public health imperative to control antibiotic resistance.
Geneva, Switzerland, WHO, 2015.  p. (WHO/RHR/15.21)This document consists largely of GRADE: Grading of Recommendations Assessment, Development and Evaluation tables for studies on maternal peripartum infection prevention and treatment practices.
Geneva, Switzerland, WHO, 2015.  p.The goal of the present guideline is to consolidate guidance for effective interventions that are needed to reduce the global burden of maternal infections and their complications around the time of childbirth. This forms part of WHO’s efforts to improve the quality of care for leading causes of maternal death, especially those clustered around the time of childbirth, in the post-MDG era. Specifically, it presents evidence-based recommendations on interventions for preventing and treating genital tract infections during labour, childbirth or the puerperium, with the aim of improving outcomes for both mothers and newborns.The primary audience for this guideline is health professionals who are responsible for developing national and local health protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to those directly providing care to pregnant women, including obstetricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for both pre- and inservice training of health workers to enhance their delivery of care to prevent and treat maternal peripartum infections. (Excerpts)
WHO recommendations on interventions to improve preterm birth outcomes. Highlights and key messages from the World Health Organization's 2015 Global Recommendations.
[Geneva, Switzerland], WHO, 2015 Aug.  p. (WHO/RHR/15.16; WHO/MCA/15.02; USAID Cooperative Agreement No. AID-OAA-A-14-00028)This evidence brief provides highlights and key messages from World Health Organization’s 2015 recommendations on interventions to improve preterm birth outcomes. The brief summarizes the recommended practices to improve the quality of care related to preterm birth and the outcomes for preterm infants. Additionally, justifications and policy implications associated with the recommendations are outlined. This brief is intended for policy-makers, programme managers, educators and health care providers.
Geneva, Switzerland, WHO, 2015.  p. (WHO/RHR/15.17)This document presents the evidence base supporting the WHO recommendations on interventions to improve preterm birth outcomes in tabular form with over 50 tables presenting data on the interventions and their variations.
Geneva, Switzerland, WHO, 2015.  p.The present guideline is focused on interventions that could be provided during pregnancy, labour and during the newborn period with the aim of improving outcomes for preterm infants. Recommendations on interventions to prevent and reduce the risk of preterm birth or modify risk in at-risk pregnant women are outside the scope of this guideline.The primary audience for this guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to those directly providing care to pregnant women and preterm infants, such as obstetricians, paediatricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for pre- and in-service training of health workers to enhance their delivery of maternal and neonatal care relating to preterm birth. (Excerpts)
Geneva, Switzerland, WHO, 2013 Oct.  p.The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time. Yet, this is the most neglected period for the provision of quality care. WHO guidelines on postnatal care have been recently updated based on all available evidence. The guidelines focus on postnatal care of mothers and newborns in resource-limited settings in low- and middle-income countries. The guidelines address timing, number and place of postnatal contacts, and content of postnatal care for all mothers and babies during the six weeks after birth. The primary audience for these guidelines is health professionals who are responsible for providing postnatal care to women and newborns, primarily in areas where resources are limited. The guidelines are also expected to be used by policy-makers and managers of maternal and child health programmes, health facilities, and teaching institutions to set up and maintain maternity and newborn care services. The information in these guidelines is expected to be included in job aids and tools for both pre- and in-service training of health professionals to improve their knowledge, skills and performance in postnatal care. These recommendations will be regularly updated as more evidence is collated and analysed on a continuous basis, with major reviews and updates at least every five years. The next major update will be considered in 2018 under the oversight of the WHO Guidelines Review Committee.