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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 preventable and treatable, PPH results in around 70 000 de
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aths 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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Information note.
This information note provides a strategic overview of key implementation considerations for diagnostic integration using these devices, and is primarily intended for use by national laboratory services and TB, HIV, and hepati ... tis programme managers.
It may also be of interest to managers of maternal, newborn and child health programmes and sexual and reproductive health programmes, international and bilateral agencies, and organizations that provide financial and technical support to the relevant national health programmes. more
This information note provides a strategic overview of key implementation considerations for diagnostic integration using these devices, and is primarily intended for use by national laboratory services and TB, HIV, and hepati ... tis programme managers.
It may also be of interest to managers of maternal, newborn and child health programmes and sexual and reproductive health programmes, international and bilateral agencies, and organizations that provide financial and technical support to the relevant national health programmes. more
The 2007 Rwanda Service Provision Assessment (RSPA) was a national representative survey conducted in 538 health facilities throughout Rwanda. The survey covered hospitals, health centers, dispensar
...
ies and
health posts, including all public facilities such as government and government-assisted health facilities. The 2007 RSPA used interviews with health service providers and clients and observations of provider client consultations to obtain information on the capacity of facilities to provide quality services and the existence of functioning systems to support quality services. The areas addressed were the overall facility
infrastructure, maternal and child health, reproductive health, tuberculosis, malaria services; and services for sexually transmitted infections and HIV/AIDS. The objective was to assess the strengths and
weaknesses of the infrastructure and systems supporting these services, and to assess the adherence to standards in the delivery of services.
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This policy will serve as a cornerstone from which to address the accessibility of Family Planning services and to encourage its integration with services for HIV/AIDS, maternal
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health, child health, and other development initiatives. This policy is timely, as Rwanda is embarking on the introduction of community-based provision of Family Planning through community health workers. In addition, the expansion of adolescent sexual and reproductive health programs is a pillar of this policy that will help attract and retain the next generation of Family Planning users. These efforts are anticipated to trigger a paradigm change in the way Family Planning services are provided and accessed in order to contribute towards a healthy and productive Rwanda for all.
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The document outlines essential steps and provides guidance to countries on the adoption and deployment of c-IPTp so that it is integrated into the existing health system. It draws upon best practices and lessons learned from pilot implementation ex
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periences in eight African countries and targets stakeholders at the national level that are involved in the provision of maternal and child services, including national and local policymakers and implementers of malaria, maternal health, child health, reproductive health and community health programmes, and nongovernmental and other organizations.
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Outstanding child and adolescent TB priorities include the need to: find the missing children with active TB and link them to TB care; prevent TB in children who are in contact with infectious TB cases (through implementation of active contact investigation and provision of preventive treatment); an
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d advance integration within general child health services, including maternal and child health/ reproductive, maternal, newborn, child and adolescent health, HIV, nutrition and other programmes.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community
...
health worker has been used to refer to volunteers and salaried, professional or lay health workers with a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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This checklist covers five areas of competence needed by health care providers to provide quality of care in contraceptive information and services including: respecting users’ privacy and guarant
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eeing contfidentiality, choice, accessible and acceptable services, involvement of users in improving services and fostering continuity of care and follow-up.
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Not all that bleeds is Ebola
recommended
How has the DRC Ebola outbreak impacted Sexual and Reproductive Health in North-Kivu?
Recommendations (more specifics found in the assessment):
1. Sexual and
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reproductive health needs and services are to be embedded in the EVD response from the outset.
2. Reduce delays at every stage of the patient journey, particularly for women experiencing obstetric complications, including complications from abortion.
3. Support individuals and communities to mitigate SRH risks posed during and after EVD epidemic:
4. Formulate SRH guidelines for the EVD context involving experts in all relevant fields.
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Training Manual
Building on earlier EngenderHealth work in counseling, Counseling for Effective Use of Family Planning responds to an identified gap in existing materials and fills the needs expressed by those in the field. The intended audiences for this curriculum are
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health care providers, their supervisors, and the managers of the programs in which they work. The counseling skills addressed here are expected to be relevant to the provision of both preventive and curative health services through the workshop participants’ national health systems. Finally, the curriculum’s participatory approach to defining terms and to generating profiles of potential clients is designed to assist trainees in addressing the realities and exploring the reproductive health priorities of their communities in a culturally appropriate manner.
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This implementation brief addresses integration of HIV testing services into family planning (FP) services. It is intended as a practical resource for national
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health programmes seeking to introduce or scale up HIV testing and linkage to HIV prevention, sexually transmitted infection, and antiretroviral therapy services in FP.
This document highlights emerging good practices and country experiences of integrated HIV prevention and testing services within FP and advocates for increased linkage for FP clients to HIV services according to their needs. It also brings together information on models of integration of HIV testing into FP services, programme examples from east and southern Africa and guidance on the implementation monitoring process.
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Health systems strengthening, including for sexual and reproductive health and rights services
Provision of integrated RH/FP/STI/HIV services
In Togo, the limited access of populations, especially women, young girls and children to Reproductive Health (RH), Family Planning, treatment of ... sexually transmissible infections (STI) and struggle against HIV quality services is responsible for the continuously low indicators in these areas. To remedy the problem, UNFPA Togo, in partnership with the Department of Family Health, the Health districts and the NGOs 3ASC and ATBEF, support the initiative of the Mobile Clinic to bring RH/FP/STI/HIV quality services closer to the women, the young girls and children living in rural areas in its intervention areas, with the aim of reaching MDG 4 and 5. more
In Togo, the limited access of populations, especially women, young girls and children to Reproductive Health (RH), Family Planning, treatment of ... sexually transmissible infections (STI) and struggle against HIV quality services is responsible for the continuously low indicators in these areas. To remedy the problem, UNFPA Togo, in partnership with the Department of Family Health, the Health districts and the NGOs 3ASC and ATBEF, support the initiative of the Mobile Clinic to bring RH/FP/STI/HIV quality services closer to the women, the young girls and children living in rural areas in its intervention areas, with the aim of reaching MDG 4 and 5. more
Nepal has performed exceptionally in improving reproductive, maternal and child health outcomes over the past two decades. In this article, we discuss these achievements and outline a vision for the
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future of maternal, newborn and child survival in Nepal after the era of the Millennium Development Goals. On the pathway towards quality universal health care services for all, we propose strengthening of health information systems, gradual health system reforms, improvement of existing facility based services, development of integrated service delivery models, improved technical and managerial capacity at district and facility levels. Elimination of all preventable causes of maternal, newborn and child deaths in Nepal should be our collective aspirational goal.
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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 15–19 years old in low- and middle-income countries be
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come 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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EngenderHealth's tool kit of related job aids is designed to help users support individuals in making informed and voluntary family planning decisions. The first volume in the series "Realizing Rights in Sexual and Reproductive
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Health Services," Choices in Family Planning: Informed and Voluntary Decision Making is intended for use by a wide range of audiences in different family planning settings, including service providers, trainers, managers of service programs, managers and members of community-based organizations, policymakers, and donors.
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Women and girls are paying the price of the war in Yemen – Humanitarian actors must increase the priority given to women and girls’ needs, with specific attention to GBV prevention and response, and reproductive
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health services
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This report is from the National study on living conditions among people
with disabilities carried out in Nepal in 2014-2015. The study was carried
out as a household survey with two-stage stratified sampling, including a screening/listing procedure using the Washington Group on Disability
Statis
...
tics 6 questions, one Household questionnaire administered to
households with (Case HHs) and without disabled members (Control
HHs), one Individual Case questionnaire administered to individuals who were found to qualify as being disabled in the screening (Case
individuals), and an Individual Control questionnaire administered to
matched non-disabled individuals in the Control HHs (Control individuals). The study covers a range of indicators on level of living, such as socioeconomic indicators, economic activity, income, ownership and infrastructure, health (including reproductive health), access to health information, access to services, education, access to information, social participation, and exposure to discrimination and abuse (see all
questionnaires in Appendix).
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Levels of humanitarian need continue to stagger in Yemen. Fighting sporadically escalated in different parts of the country leading to spikes in displacement and civilian casualties. As of May some 36,506 families have been displaced across Yemen since the beginning of the year. Hajjah is one of the
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most conflict-affected govern orates in Yemen.Between February and May, fighting displaced 33,949 families (about203,694 people). Displaced families are scattered across more than 300sites. In the face of such displacement, UNFPA has scaled up its response and developed preparedness plans to respond to any future large-scale displacement. Through the Rapid Response Mechanism (RRM), led byUNFPA, 30,504 families were provided wither kits. UNFPA is also supporting 12 health facilities in Hajjah to provide lifesaving reproductive health services.
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the Pocket Guide includes
information on HIV clinical care; growth and development; mental health; child protection;
counselling and communication; disclosure; loss, grief, and bereavement; adherence; sexual
and
...
reproductive health; transition of care; support systems; and monitoring and evaluation
of psychosocial services. The information provided in this Pocket Guide aims to serve as a
convenient clinical resource to equip health care providers (HCPs) with knowledge and skills
that will help them to maximise resiliency, minimise risk factors, and promote positive personal
growth among the children and adolescents they care for who are living with and affected
by HIV.
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