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Workshop on Gender and Rights in Reproductive and Maternal Health, convened by World Health Organization, Regional Office for the Western Pacific, Kuala Lumpur, Malaysia, 28 November - 2 December 2005. Report.
Manila, Philippines. WHO, Regional Office for the Western Pacific, 2006 Mar. 40 p. ((WP)RPH/ICP/RPH/3.4/001/RPH(3)/2005-E; Report Series No. RS/2005/GE/43(MAA))More than a decade after the International Conference on Population and Development (ICPD) in 1994 and the Fourth World Conference on Women in 1995, governments are expressing their commitment to women's health, in particular to sexual and reproductive health. Unfortunately, high maternal and neonatal mortality remains a feature in many countries in the Western Pacific Region. The complex issues of reproductive and maternal health extend beyond technical and medical factors. Social determinants, such as gender and rights, though recognized as important factors in maternal mortality and morbidity, have not been considered in health services planning, perhaps because of a lack of understanding and inadequate capacity to operationalize the concepts. To achieve the Millennium Development Goals (MDG), it is essential that the gender and rights dimensions are fully understood and mainstreamed in policy, programmes and services. Recognizing the urgency of the situation, the WHO Western Pacific Regional Office decided to organize a workshop in collaboration with the Ministry of Health Malaysia as the host in Kuala Lumpur from 28 November to 2 December 2005. The Workshop on Gender and Rights in Reproductive and Maternal Health was the first ever organized by the Regional Office. Unlike other workshops, this was a training workshop aimed at introducing Concepts as well as some basics kills and tools to enable participants to bring a gender and rights perspective in to their programme services. (excerpt)
Strengthening midwifery within safe motherhood. Report of a collaborative ICM / WHO / UNICEF pre-Congress workshop, Oslo, Norway, 23-26 May 1996.
Geneva, Switzerland, WHO, 1997. , 29, xxix p. (WHO/RHT/MSM/97.3)This report presents an overview of the World Health Organization workshop held during May 23-26, 1996, which included country reports, program activities for strengthening action for safe motherhood, and country action plans for strengthening midwifery for safe motherhood. The nine appendices include a participant list, presenters list, workshop timetable, group work tasks, background paper on maternal mortality and the role of midwives, sponsors, references, data sheets, and model action plan format. The aim of the workshop was to strengthen midwives' capacity to take leadership roles in the development and implementation of their countries' National Safe Motherhood Action Plans. Other objectives included the exploration of global issues related to maternal mortality and midwifery, identification of strategies for active midwife participation in political processes that involve action plans, understanding of the need for life-saving and risk reduction skills for managing obstetric complications, and definitions of concepts of critical thinking skills among midwives and health workers. Further aims were to create an awareness of the need for appropriate regulation of midwife practice that would allow for autonomy and a full range of functions and to develop action plans to strengthen midwifery within national strategies. The first conference on Safe Motherhood was held in the Hague in 1987 following the Nairobi Conference on Safe Motherhood. It was recognized that midwives, as front-line caregivers, were in a key position to develop the competency to handle eclampsia, obstructed labor, hemorrhage, and sepsis. The following workshop in Kobe, Japan, focused on developing community-based education that would strengthen maternity services within existing primary health centers. The third workshop in Vancouver in 1993 addressed how midwives could contribute to improved safe motherhood.
SAFE MOTHERHOOD. 1997; (24):3.This article identifies key features of a June 1997 seminar held among delegates from French-speaking African countries on the World Health Organization's Mother-Baby Package. This package aims to strengthen, integrate, and speed up national efforts to reduce maternal and neonatal mortality in developing countries. Multidisciplinary teams met in subregions. The first group met in Ouagadougou, Burkina Faso; another group met a week later in Libreville, Gabon. WHO's Regional Office for Africa organized the meetings. Participants included representatives from UNDP, UNICEF, and UNFPA and representatives from Algeria, Angola, Benin, Burkina Faso, Burundi, Cameroon, Chad, Comoros, Equatorial Guinea, Gabon, Guinea Bissau, Madagascar, Mali, Mauritania, Niger, Senegal, and Togo. The meetings were conducted in French. Some participants pointed out the needs of countries that recently emerged from periods of armed conflict. It was understood that a minimum level of political stability was required in order for health systems to function effectively and to reduce maternal deaths. Countries are trying to restore health services to be able to respond to obstetric emergencies at any time or place. Information was provided on country-specific experiences with initiatives and problems, such as lack of funding and human resources. Midwife skills are particularly deficient at the local level. Some participants viewed a reproductive health emphasis as slowing safe motherhood efforts, while some viewed reproductive health as the foundation for safe motherhood and a way to strengthen support. Participants agreed on methods of mobilizing resources, identifying appropriate indicators, and collaborating intersectorally. They were committed to using World Health Day 1998 as a way to focus national celebrations on safe motherhood.
Expert Committee on Maternal and Child Health and Family Planning in the 1990s and Beyond: recent trends and advances, World Health Organization, Geneva 7-13, December 1993.
MIDWIFERY. 1994 Mar; 10(1):49-50.This article provides a description of the World Health Organizations Expert Committee on Maternal and Child Health meeting held in 1993. The last meeting was held before the Alma Ata Declaration on Health For All 18 years ago. The recent meeting aimed to clarify the health and development conditions of women and children worldwide, policies impacting on maternal and child health and family planning (MCH/FP), trends and future program directions, shortcomings in MCH/FP, and strategies for improving MCH/FP through monitoring and evaluation. The committee participants included 10 persons who represented fields in pediatrics, public health, and obstetrics and other representatives of UN agencies. The International Confederation of Midwives and International Council of Nurses was represented. The objective of the eight-day meeting was to produce a report and recommendations. Recommendations were made to broaden the classic MCH/FP model in order to provide more comprehensive services, which are client-determined rather than provider-assigned, and to give a variety of services at health care centers. The "one stop, supermarket" approach is desired. This approach requires an appropriate design, equipment, and staffing of health care centers and a multidisciplinary and multisectoral direction. Attention must be given to adolescent needs, to health promotion and protection of the girl child, and to policy development that includes an integrated approach. The Expert Committee recommended that women's health issues be combined with family planning, HIV/AIDS prevention, pregnancy, childbirth, and perinatal health. The role of the midwife was identified as instrumental in first referral services and as an effective link to the community. The midwife is viewed as providing the role of educator and supervisor of traditional birth attendants and other primary health care workers and volunteers associated with MCH/FP services. Legislation may need to be changed to allow better use of a midwife's skills in reducing maternal mortality and to develop a flexible, appropriate, community-based approach for continuing and first-level education. The final document includes a listing of available instruments and conventions on the rights of the child and the elimination of discrimination against women.
Incorporating cost and cost-effectiveness analysis into the development of safe motherhood programs.
Washington, D.C., World Bank, Population and Human Resources Department, 1992 Jan. 37 p. (Policy Research Working Papers, WPS 846)500,000 women die annually from complications related to pregnancy or childbirth; 99% of whom live in developing countries. The Safe Motherhood Initiative was launched at an international conference in 1987 with the goal of reducing maternal mortality by 50% by 2000. This report synthesizes the results of a workshop at the World Bank April 8-9, 1991, comprised of economists, maternal health and family planning professionals, and staff from several multilateral agencies to discern what is known about the components and costs of Safe Motherhood programs, and to establish an agenda for future work on the issue. The goal of the workshop was to begin identifying the conceptual basis of a cost-effectiveness methodology for Safe Motherhood, for use by health planners working to develop and implement programs in developing countries. The workshop also aimed to identify gaps in current knowledge on the efficacy of program options, which will need to be addressed before a general model of cost-effectiveness can be developed and applied in practice. The history and activities of the Safe Motherhood Initiative are summarized, and workshop participants' perceptions of the components of Safe Motherhood programs and possible measures of effectiveness discussed. Costing information and possible data sources are discussed, a specific economic modeling activity is outlined, and additional detail is presented in the report appendix.
Estimating the rate of mother-to-child transmission of HIV. Report of a workshop on methodological issues, Ghent (Belgium), 17-20 February 1992.
AIDS. 1993 Aug; 7(8):1139-48.A meeting was held in 1992 in Ghent, Belgium, under the auspices of the European Economic Community AIDS Task Force in collaboration with the WHO Global program on AIDS and UNICEF. THe objective were: 1) to address methodological issues in the estimation of the rate of mother-to-child (MTCT) transmission of HIV-1, with special reference to developing countries, and 2) to present a critical evaluation of selected perinatal studies using a standardized methodological approach. The discussions and recommendations made during the workshop are summarized. In the previous 8 years, numerous studies had been conducted to estimate the rate of MTCT of HIV. Many of these had encountered problems in data collection and analysis, making it difficult to compare transmission rates between studies. 14 teams of investigators participated, representing studies from central (5) and eastern Africa (3), Europe (2), Haiti (1), and the US (3). A critical evaluation of the projects was carried out under 4 headings: 1) enrollment and follow-up procedures, 2) diagnostic criteria and case definitions, 3) measurement and comparison of MTCT rats, and 4) determinants of transmission. The different estimations of the rate of HIV MTCT reported ranged from 13-32% in industrialized countries and from 26-48% in developing countries. For the purpose of calculating the rate of HIV MTCT, it is important to establish whether a child who dies before 15 months is HIV-infected. 3 definitions were proposed for children who died before their infection status could be determined by serology. Factors identified as possible risk factors for HIV MTCT included impaired maternal clinical and immunological status, HIV-seroconversion during pregnancy, shortened duration of pregnancy, choriamnionitis, vaginal delivery, prolonged and/or complicated labor, and breast-feeding. Maternal age and parity did not appear to be associated with MTCT in most studies.
IAP-IPA-WHO-UNICEF Workshop on Strategies and Approaches for Women's Health, Child Health and Family Planning for the Decade of Nineties, 22nd-23rd January 1991, Hyderabad.
INDIAN PEDIATRICS. 1991 Dec; 28(12):1481-2.In 1991, health professionals attended a workshop to develop strategies and approaches for women's health, child health, and family planning for the 1990s in Hyderabad, India. The Ministry of Health (MOH) of India should improve and strengthen existing health facilities, manpower, materials, and supplies. It should not continue vertical programs dedicated to 1 disease or a few problems. Instead it should integrate programs. The government must stop allocating more funds to family planning services than to MCH services. It should equally appropriate funds to family planning, family welfare, and MCH. The MOH should implement task force recommendations on minimum prenatal care (1982) and maternal mortality (1987) to strengthen prenatal care, delivery services, and newborn care. Health workers must consider newborns as individuals and allot them their own bed in the hospital. All district and city hospitals should have an intermediate or Level II care nursery to improve neonatal survival. In addition, the country has the means to improve child health services. The most effective means to improve health services and community utilization is training all health workers, revision of basic curricula, and strengthen existing facilities. Family planning professionals should use couple protection time rather than couple protection rate. The should also target certain contraceptives to specific age groups. Mass media can disseminate information to bring about behavioral and social change such as increasing marriage age. Secondary school teachers should teach sex education. Health professionals must look at the total female instead of child, adolescent, pregnant woman, and reproductive health. Integrated Child Development Services should support MCH programs. Operations research should be used to evaluate the many parts of MCH programs. The government needs to promote community participation in MCH services.