COVID-19 is a pandemic that is currently ravaging the world. Infection rate is steadily increasingin Sub-Saharan Africa. Pregnant women and their infants may suffer severe illnesses due to theirlower immunity. This guideline prepares and equips clinicians working in the maternal and new-born section...s in the sub-region to manage COVID-19 during pregnancy and childbir
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Needs assessment and analysis
Collect and analyze sex, age and disability disaggregated data (SADDD) and conduct a participatory gender analysis to understand different health needs, capacities, barriers and aspirations and identify populations with special health requirements
Population demogra...phics. E.g. pregnant and lactating women, infants, elderly, unaccompanied children, persons with disabilities, chronically ill persons 9 Gender roles and power dynamics. E.g. ability of women, girls, men and boys to make health decisions and access services; roles and responsibility of household members in health.
Gender and cultural norms and practices. E.g. preference for mixed/segregated facilities and staff; socio-cultural and religious taboos and beliefs around health, practices and beliefs on menstruation, practices and expectations on pregnancy, childbirth and breastfeeding; traditional health care providers
Intersectional issues. E.g. access to health care for LGBTIQ persons, for GBV survivors, for adolescent girls and boys
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Lack of trained providers capable of identifying which labouring women could benefit from assisted vaginal birth (AVB), and of safely performing the procedure is a major barrier for its use. Education and training are, therefore, considered crucial for building skills and confidence in conducting AV...B and there is evidence that it would be welcomed by healthcare providers. However, acquiring and maintaining AVB skills is a complex task that requires a supportive environment, mentorship, supervision and accountability. As with other practices to manage infrequent procedures and complications, continuous education and on-site supervision are essential to ensure the safe and sustainable use of AVB.
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Every Newborn: an action plan to end preventable deaths is a roadmap for change. It takes forward the Global Strategy for Women’s and Children’s Health by focusing specific attention on newborn health and identifying actions for improving their survival, health and development.
La Lista OMS de verificación de la seguridad del parto es un instrumento destinada a mejorar la calidad de la atención provista a las mujeres y bebés durante el parto. Es una lista estructurada de prácticas esenciales de atención del parto con fundamento científico que se centra en las princip...ales causas de muerte materna, mortinatalidad y muerte neonatal que ocurren en instituciones de salud de todo el mundo. También se ha elaborado una guía de aplicación de la Lista OMS de verificación para ayudar a las instituciones a aplicarla con éxito
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The information provided here can be used to understand the current situation, increase attention to preterm births in Rwanda and to inform dialogue and action among stakeholders. Data can be used to identify the most important risk factors to target and gaps in care in order to identify and impleme...nt solutions for improved outcomes.
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Este manual y la herramienta de Excel que lo acompaña se encuentran en proceso de revisión. La edición revisada se publicará próximamente.
In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data collection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in ...all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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The Early Childhood Development Policy and its Strategic Plan seek to provide a framework to ensure such a holistic and integrated approach to the development of young children. International research has demonstrated the high economic returns on ECD investment and its positive impact on health and ...education outcomes as well as the overall economic development of a nation. The implementation of the ECD Policy will thus provide Rwanda with the basis for achieving the objectives and goals of the EDPRS and Vision 2020.
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The goal of this course is to provide participants with the foundational skills needed to begin the development, implementation and ongoing improvement of a congenital anomalies surveillance programme, in particular for countries with limited resources. It focuses on the methodology needed to devel...op either population-based or hospital based surveillance programmes.
A set of congenital anomalies will be used as examples throughout this course. The specific examples used are typically severe enough that they would probably be captured within the first few days after birth, have a significant public health impact and, for some of them, have the potential for primary prevention.
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