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Lancet Glob Health 2020; 8: e341–51
Francophone Africa still carries a high burden of communicable and neonatal diseases, probably due to the weakness of health-care systems and services, as evidenced by the almost complete attribution of DALYs t
...
o YLLs. To cope with this burden of disease, francophone Africa should define its priorities and invest more resources in health-system strengthening and in the quality and quantity of health-care services, especially in rural and remote areas. The region could also be prioritised in terms of technical and financial assistance focused on achieving these goals, as much as on demographic investments including education and family planning
more
Breastfeeding is the cornerstone of infant and young child survival, nutrition and development and maternal health. The World Health Organization recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 ye
...
ars and beyond.1 Early and uninterrupted skin-toskin contact, rooming-in2 and kangaroo mother care3 also significantly improve neonatal survival and reduce morbidity and are recommended by WHO.
Corrigendum 23 June 2020
more
Forcibly Displaced Myanmar National / Rohingya Refugee Response.
This document gives guidance for medical providers to understand the care of both healthy and COVID suspect or confirmed patients who present for antenatal (ANC), intrapartum (IP), postnatal (PNC), or emergency obstetric and
...
neonatal care (EmONC) in the context of caring for the forcibly displaced Myanmar national (FDMN) / Rohingya refugee population.
more
This infographic looks at how climate change directly and indirectly impacts maternal health, making pregnancy less safe and worsening neonatal health outcomes.
Climate hazards, including extreme heat, are associated with increased risks of developing complications that lead to adverse maternal and perinatal outcomes. These may include multiple causes of maternal and neonatal morbidity and mortality such as
...
gestational diabetes, hyper tensive disorders of pregnancy, preterm birth, low birth weight and stillbirth. In addition to the health risks related to poor nutrition, water, hygiene and sanitation, the effects of exposure to climate hazards and their aftermath during and after pregnancy can affect mental health and contribute to intergenerational trauma. They may increase stress, anxiety and depression – known risk factors for adverse perinatal outcomes.
more
Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of lo
...
w NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
more
BMJ Open Quality 2017;6:e000145. doi:10.1136/
bmjoq-2017-000145Although there are many evidence-based practices that reduce the risk of maternal and neonatal mortality around the time of birth, there remains a gap between what is known and the care
...
received. This knowdo gap is a source of preventable maternal and perinatal deaths and is the focus of improvement efforts in many countries. Following an increase in perinatal and maternal deaths, Gobabis District Hospital initiated a quality improvement (QI) initiative to increase adherence to these WHO Safe Childbirth Checklist (SCC)-targeted essential birth practices.
more
PLoS ONE 17(9): e0272444. https://doi.org/ 10.1371/journal.pone.0272444.
Based on the RE-AIM metrics, our results show that KMC is a feasible intervention that can improve neonatal outcomes among preterm infants in Zambia. The study findings show a
...
promising, practical approach to scaling up KMC in Zambia.
more
This is a pocket-sized manual for use by doctors, senior nurses and other senior health workers who are responsible for the care of young children at the first referral level in developing countries. It presents up-to-date clinical guidelines which are based on a review of the available published ev
...
idence by subject experts, for both inpatient and outpatient care in small hospitals where basic laboratory facilities and essential drugs and inexpensive medicines are available. It focuses on the inpatient management of the major causes of childhood mortality, such as pneumonia, diarrhoea, severe malnutrition, malaria, meningitis, measles, HIV infection and related conditions. It covers neonatal problems and surgical conditions of children which can be managed in small hospitals. This pocket book is part of a series of documents and tools that support the Integrated Management of Childhood Illness (IMCI).
more
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 tho
...
se 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.
more
DHS Working Papers No. 69
This paper uses data from the three Indian National Family Health Surveys (1992-93, 1998-99, 2005-06) to examine how the relationship between household wealth and child mortality evolved during a time of significant economic change in India. The main predictor is a new ... measure of household wealth that captures changes in wealth over time. Outcomes include neonatal mortality, postneonatal mortality, child mortality, and under-five mortality. Multivariate analysis is conducted at the national, urban, rural, and regional levels.
Results indicate that the overall relationship between household wealth and mortality weakened over time, as evidenced by the coefficients for under-five mortality at the national level. more
This paper uses data from the three Indian National Family Health Surveys (1992-93, 1998-99, 2005-06) to examine how the relationship between household wealth and child mortality evolved during a time of significant economic change in India. The main predictor is a new ... measure of household wealth that captures changes in wealth over time. Outcomes include neonatal mortality, postneonatal mortality, child mortality, and under-five mortality. Multivariate analysis is conducted at the national, urban, rural, and regional levels.
Results indicate that the overall relationship between household wealth and mortality weakened over time, as evidenced by the coefficients for under-five mortality at the national level. more
This updated implementation guidance is intended for all those who set policy for, or offer care to, pregnant women, families and infants: governments; national managers of maternal and child health programmes in general, and of breastfeeding- and BFHI-related programmes in particular; and health-f
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acility managers at different levels (facility directors, medical directors, chiefs of maternity and neonatal wards). The document presents the first revision of the Ten Steps since 1989. The topic of each step is unchanged, but the wording of each one has been updated in line with the evidence-based guidelines and global public health policy.
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2018 monitoring report: current status and strategic priorities
The report sets out the status of women’s, children’s and adolescents’ health, and on health systems and social and environmental determinants. Regional dashboards on 16 key indicators highlight where progress is being made o ... r lagging. There is progress overall, but not at the level required to achieve the 2030 goals. There are some areas where progress has stalled or is reversing, namely neonatal mortality, gender inequalities and health in humanitarian settings. more
The report sets out the status of women’s, children’s and adolescents’ health, and on health systems and social and environmental determinants. Regional dashboards on 16 key indicators highlight where progress is being made o ... r lagging. There is progress overall, but not at the level required to achieve the 2030 goals. There are some areas where progress has stalled or is reversing, namely neonatal mortality, gender inequalities and health in humanitarian settings. more
Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approximately twice as high as high-resource settings (15 o
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ut of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
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The Ethiopian Hospital Services Transformation Guidelines (EHSTG) build on and expand the Ethiopian Hospital Reform Implementation Guidelines (EHRIG) and are consistent with the Health Sector Transformation Plan (HSTP). The EHSTG, which is consistent with the national focu
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s on quality improvement in health care, contains a common set of guidelines to help hospital Chief Executive Officers(CEOs), managers, and clinicians (care providers) in steering the consistent implementation of these transformational systems and processes in hospitals throughout the country. The EHSTG focused on selected management and clinical functions, including new individual service specific chapters for Emergency Medical, Outpatient and Inpatient Services, Nursing and Midwifery, Maternal, Neonatal and Child Health and Teaching Hospitals’ Management. These guidelines also incorporate recent lessons from the operationalization of the EHRIG, as well as, new national initiatives such as the Guidelines for the Management of Federal Hospitals in Ethiopia, Hospital Development Army (HDA), Clean and Safe Hospital (CASH), and Auditable Pharmaceutical Transaction and Service (APTS).
II10 Pharmacy ChapterIt is expected that the guidelines will continuously evolve as new evidence emerges regarding improved hospital care and practices that are better tailored to needs and circumstances of different tiers of public hospitals. We are grateful to all partners that have participated in the production of these guidelines. Special thanks go to our colleagues at the Clinton Health Access Initiative for their substantial contributions and support throughout the development of these guidelines as well as their dedicated efforts in support of our health reform efforts in so many other capacities
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Over a period of two decades, under-5 mortality rate in Bangladesh has declined by 66% from 133 per 1000 live births in 1993-94 to 45 per 1000 live births in 2017-18. The country reached the MDG-4 goal in the reduction of child mortality on time. However, the comparison of
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neonatal and under-5 mortality rates in Bangladesh over the same years reveals that the reduction in the neonatal mortality rate was much slower than the child mortality rate. This led to a rise in the proportion of neonatal deaths in overall under-five deaths from 40% in 1993-1994 to 67% percent in 2017-2018. More than 75% of neonatal deaths occur within the first 7 days. To achieve SDG target 3.2, Bangladesh has to further reduce under-5 mortality rate by 44% and newborn deaths by 60%. Infection is the leading cause of preventable deaths among the neonates and the young infants and the standard recommendations for treating severe bacterial infections in infants under 2 months of age include hospitalization and 7-10 days of parenteral therapy.
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En 2015, murieron 5,9 millones de niños menores de cinco años (1). Las principales causas de muerte en los niños a nivel mundial son la neumonía, la prematuridad, las complicaciones durante el parto, la sepsis neonatal, las anomalías conge
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́nitas, las enfermedades diarreicas, las lesiones y la malaria (2). La mayoría de estas enfermedades y condiciones son provocadas al menos en parte por el medio ambiente.
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In the last decade, Timor-Leste has made remarkable progress in strengthening its health system and improving the health status of its population. This has resulted in an increased life expectancy, and the achievement of Millennium Development Goals such as a reduction in infant and under-five morta
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lity, an improvement in maternal and child health outcomes, and an increase in immunization coverage. Further, the country has successfully eliminated infectious diseases such as polio, measles, and maternal and neonatal tetanus. There is full political commitment to reducing the incidence of tuberculosis (TB) by 80% and the number of deaths due to TB by 90% by 2030. The country has made great progress in the context of the pandemic, having established numerous quarantine facilities/isolation centres; trained health-care workers; streamlined the procurement and supply of medicines, consumables, personal protective equipment and other equipment; and strengthened the capacity in critical care across secondary and tertiary health care, to better respond to future pandemics and other disaster situations.
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Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health care resulting in failure to provide adequate, accessible and quality m
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aternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
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Background: To track donor assistance to maternal, newborn, and child health-related activities is necessary to assess progress towards Millennium Development Goals 4 and 5 and to foster donor accountability. Our aim was to analyse aid flows to maternal, newborn, and child health for 2005 and 2006 a
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nd trends between 2003 and 2006.
Methods: We analysed and coded the complete aid activities database for 2005 and 2006 with methods that we developed previously to track official development assistance. For the 68 Countdown priority countries, we report two indicators for use in monitoring donor disbursements: official development assistance to child health per child and official development assistance to maternal and neonatal health per livebirth.
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