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NCDs
10
Natural Hazards
9
Zika
8
Pharmacy
8
TB
6
Rapid Response
5
Malaria
5
Social Ethics
4
NTDs
4
2.0 Rapid Response
3
South Sudan
1
Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–
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19 years old in low- and middle-income countries become pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
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BMC Pregnancy Childbirth 2022 Apr 5;22(1):284. doi: 10.1186/s12884-022-04619-w. Adolescent reproductive health is still a challenge in Low and Middle Income Come Countries (LMICs). However, the reasons for the inability of most pregnant adolescent
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girls to access and utilize maternal and child health information (MCHI) are not well-documented. This is despite the policy guidelines promoting the provision of this necessary information to pregnant adolescents in order to prepare them for delivery. This provision is one of the strategies envisaged to improve their attendance of ANC visits and their maternal and child health.
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BMC Pregnancy Childbirth 20, 379 (2020). https://doi.org/10.1186/s12884-020-03064-x
Integrated Management of pregnancy and childbirth
A new formulation of a drug to prevent excessive bleeding following childbirth could save thousands of women’s lives in low- and lower-middle-income countries, according to a study led by the World Health Organization (WHO) in collaboration with M
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SD for Mothers and Ferring Pharmaceuticals.
Currently WHO recommends oxytocin as the first-choice drug for preventing excessive bleeding after childbirth. Oxytocin, however, must be stored and transported at 2–8 degrees Celsius, which is hard to do, in many countries, depriving many women of access to this lifesaving drug. When they can obtain it, the drug may be less effective because of heat exposure.
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The link between cholera in pregnancy and negative childbirth outcomes has been observed since the
19th century, but there is currently no clear understanding of the extent nor the mechanisms to inform
treatment guidelines. The recommendations in
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this Interim Technical Note are based on current
knowledge, including documented experiences of treating pregnant women with cholera during
epidemics.
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Facts For Life
recommended
Handbook on pregnancy, childbirth, childhood illnesses, child development and the care of children. The handbook, Facts for Life, provides vital messages and information for mothers, fathers, other family members and caregivers and communities to us
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e in changing behaviours and practices that can save and protect the lives of children and help them grow and develop to their full potential.
This version of Facts for Life builds on the three previous editions, which have been helping families and communities around the world since 1989. Newborn Health has been added to the Safe Motherhood chapter, giving attention to child survival from the first stage of life. A new chapter, Child Protection, has been included, focusing attention on the actions needed to ensure children grow up in protective environments.
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Standards for improving quality of maternal and newborn care in health facilities
recommended
Bernadette Daelmans, Olufemi Oladapo, Özge Tuncalp et al
World Health Organization (WHO)
(2016)
C_WHO
The standards of care cover the routine care and management of complications occurring for women and their babies during labour, childbirth and the early postnatal period, including those of small babies during the first week of life. They define pr
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iorities for improving the quality of maternal and newborn care for use by planners, managers and health care providers
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Key points for considering adoption of the WHO Labour Care Guide: Policy Brief
World Health Organization WHO
United States Agency for International Development (USAID)
(2022)
C_WHO
To improve the quality of care during labour and childbirth, facilitate effective implementation of the World Health Organization (WHO) recommendations: Intrapartum care for a positive childbirth ex
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perience, published in 2018, and promote a shift towards improving the experience of childbirth, WHO developed the WHO Labour Care Guide (LCG) and an accompanying WHO labour care guide: user's manual. The WHO LCG is a tool to facilitate implementation of quality, evidence-based, woman-centred care for a positive childbirth experience within the context of a broader, rights-based approach.
The goal of this policy brief is to provide maternal and newborn health stakeholders and decision-makers with an overview of the WHO LCG and its guiding principles, key advantages of making the shift from the WHO partograph to the WHO LCG, and what is required to ensure an enabling environment that will facilitate a sustainable introduction of the WHO LCG.
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A health professional's guide to pregnancy and childbirth. Online learning programme
Updated 17 April 2020
Improving care for women during pregnancy and around the time of childbirth to prevent and treat pre-eclampsia and eclampsia is a necessary step towards the achievement of the health targets of the Sustainable Development Goal
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s (SDGs). Efforts to prevent and reduce morbidity and mortality due to these conditions can help address the profound inequities in maternal and perinatal health globally. To achieve this, healthcare providers, health managers, policy makers and other stakeholders need up-to-date and evidence-informed recommendations to guide clinical policies and practices.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being prevent
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able and treatable, PPH results in around 70 000 deaths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review
Maurice Bucagu, Jean M. Kagubare, Paulin Basinga, Fidèle Ngabo, Barbara K Timmons & Angela C Lee
Reproductive Health Matters
(2012)
CC
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit
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erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth - meaning that a woman dies around every two minutes.
Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less
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than 70 maternal deaths per 100 000 live births by 2030.
The United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG) – comprising WHO, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank Group and the United Nations Department of Economic and Social Affairs, Population Division (UNDESA/Population Division) has collaborated with external technical experts on a new round of estimates covering 2000 to 2020. The estimates represent the most up to date, internationally-comparable MMEIG estimates of maternal mortality, using refined input data and methods from previous rounds.
The report presents internationally comparable global, regional and country-level estimates and trends for maternal mortality between 2000 and 2020.
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Accessed June 2014
dapted by PATH from: World Health Organization (WHO)/Department of Reproductive Health and Research.
Managing Complications in Pregnancy and Childbirth: a Guide for Midwives and Doctors.
Geneva: WHO; 2007. Available at: http:
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//whqlibdoc.who.int/publications/2007/9241545879_eng.pdf.
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nformation is scarce about the extent to which official development assistance (ODA) is spent on reproductive health to provide childbirth care; support family planning; address sexual health; and prevent, treat, and care for sexually transmitted in
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fections, including HIV. We analysed flows of ODA to reproductive health for 2009 and 2010, assessed their distribution by donor type and purpose, and investigated the extent to which disbursements respond to need. We aimed to provide global estimates of aid to reproductive health, to assess the allocation of resources across reproductive health activities, and to encourage donor accountability in targeting aid flows to those most in need.
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Bull World Health Organ 2018;96:450–461 | doi: http://dx.doi.org/10.2471/BLT.17.206466
The aim of our study was to determine whether an intervention designed
to involve the male partners of pregnant women in Burkina Faso in facility-based maternity care influences care-seeking and healthy practi
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ces after childbirth.
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Updated May 2017
This document is meant to respond to the questions:
■ What health interventions should be delivered during pregnancy, childbirth and the postnatal period?
■ What health behaviours should the women practise ... (or not practise) during these periods to care for herself and her baby? more
This document is meant to respond to the questions:
■ What health interventions should be delivered during pregnancy, childbirth and the postnatal period?
■ What health behaviours should the women practise ... (or not practise) during these periods to care for herself and her baby? more
The primary audience for these recommendations includes health professionals who are responsible for developing national and local health-care guidelines and protocols and health workers involved in the provision of care to women and their newborns during pregnancy, labour and
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childbirth; this includes midwives, nurses, general medical practitioners and obstetricians. The primary audience also includes managers of maternal and child health programmes, and relevant staff in ministries of health and educational and training institutions, in all settings.
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Antimicrobial resistance (AMR) is impacting our health, economies and development. Up to 5.2 million people may die because of resistant bacterial infections across the Western Pacific Region from 2020-2030. Childbirth, surgery, cancer treatme
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nt and other interventions will become impossibly dangerous if bacterial infections no longer respond to available antibiotics.
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