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3.
Title: Impact of new WHO growth standards on the prevalence of acute malnutrition and operations of feeding programs - Darfur, Sudan, 2005-2007.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 5;58(21):591-4.
Abstract: Acute malnutrition among children aged 6-59 months is a key indicator routinely used for describing the presence and magnitude of humanitarian emergencies. In the past, the prevalence of acute malnutrition and admissions to feeding programs has been determined using the growth reference developed by the World Health Organization (WHO), CDC, and the National Center for Health Statistics (NCHS). In 2006, WHO released new international growth standards and recommended their use in all nutrition programs. To evaluate the impact of transitioning to the new standards, CDC analyzed anthropometric data for children aged 6-59 months from Darfur, Sudan, collected during 2005-2007. This report describes the results of that analysis, which indicated that use of the new standards would have increased the prevalence of global acute malnutrition on average by 14% and would have increased the prevalence of severe acute malnutrition on average by 100%. Admissions to feeding programs would have increased by 56% for moderately malnourished children and by 260% for severely malnourished children. For programs in Darfur, this would have resulted in approximately 23,200 more children eligible for therapeutic feeding programs. For the immediate future, the prevalence of acute malnutrition in children should be reported using both the old WHO/CDC/NCHS reference and the new WHO standards. More research is needed to better ascertain the validity of the admission criteria based on the new WHO standards in predicting malnutrition-related morbidity and mortality.
Language: English
Keywords:
SUDAN | SUMMARY REPORT | WHO | STANDARDS | PREVALENCE | CHILD DEVELOPMENT | GROWTH | MALNUTRITION | NUTRITION PROGRAMS | EVALUATION | Developing Countries | Africa, North | Africa | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Measurement | Biology | Nutrition Disorders | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health
Document Number: 341622

4.
Title: Progress toward the 2012 measles elimination goal--Western Pacific Region, 1990-2008.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 26;58(24):669-73.
Abstract: In 2003, the World Health Organization (WHO) Regional Committee of the Western Pacific Region (WPR) formally declared a measles elimination goal, and in 2005, the committee established a target date of 2012 for regional measles elimination. Key strategies recommended by WHO for achievement of measles elimination include 1) very high (>or=95%) vaccination coverage with 2 doses of measles-containing vaccine (MCV1 and MCV2) through routine vaccination and/or supplemental immunization activities (SIAs); 2) high-quality case-based measles surveillance; and 3) access to an accredited measles laboratory network for testing of suspected measles cases and identification of measles virus genotypes. This report describes progress toward measles elimination in the WPR through 2008. Measles likely has been eliminated or nearly eliminated in 24 of the 37 countries and areas in the WPR (referred to in this report as countries). However, large numbers of measles cases continue to be reported from several countries. During 2008, a total of 131,441 confirmed measles cases (98.4 per million population) were reported from China and 11,015 cases (86.1 per million population) from Japan, two countries that account for 82% of the region's population and >97% of its confirmed measles cases. Intensified efforts by WPR countries, particularly China and Japan, will be required to achieve the 2012 goal.
Language: English
Keywords:
OCEANIA | SUMMARY REPORT | INCIDENCE | MEASLES | VACCINES | IMMUNIZATION | PREVENTION AND CONTROL | MONITORING | SCREENING | Developing Countries | Measurement | Research Methodology | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Primary Health Care | Evaluation | Examinations and Diagnoses
Document Number: 341752

Title: Human resources for health in the low-resource world: collaborative practice and task shifting in maternal and neonatal care.
Author: FIGO Safe Motherhood and Newborn Health Committee
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):74-6.
Abstract: An important barrier to the attainment of Millennium Development Goals (MDGs) 4 and 5 in many countries is the lack of trained and skilled clinical staff who can provide timely and high-quality care to mothers with pregnancy complications. This article presents guidelines and recommendations on how to better make use of existing health human resources in order to improve maternal and neonatal care.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | HEALTH PERSONNEL | MATERNAL-CHILD HEALTH SERVICES | HUMAN RESOURCES | GYNECOLOGY | OBSTETRICS | OBSTETRICAL SURGERY | TRAINING PROGRAMS | Delivery of Health Care | Health | Primary Health Care | Health Services | Economic Factors | Medicine | Surgery | Treatment | Medical Procedures | Education
Document Number: 341381

Title: Delivering services and influencing policy: health care professionals join forces to improve maternal, newborn, and child health.
Author: Health Care Professional Association Writing Group
Source: International Journal of Gynaecology and Obstetrics. 2009 Jun;105(3):271-4.
Abstract: This article reviews the major activities of health care professional organizations (HCPAs), and emphasizes the role they can play in advocating for women and children and influencing maternal, newborn, and child health (MNCH) programs and policies. The ICM/FIGO joint effort to prevent postpartum hemorrhage and the 40-year partnership between the American Academy of Pediatrics (AAP) and the Indian Health Service (IHS) are highlighted as examples of how and why HCPAs should assume a leadership role in advocacy work. The action-oriented multicountry HCPA workshops organized by the Partnership for Maternal, Newborn, and Child Health (PMNCH) and the international HCPAs are also described. These capacity building workshops are aimed at strengthening the ability of HCPAs to organize, coordinate activities, and become more involved in program and policy development.
Language: English
Keywords:
INDIA | RESEARCH REPORT | HEALTH PERSONNEL | CAPACITY BUILDING | MATERNAL HEALTH | CHILD HEALTH | ANTENATAL CARE | HEALTH POLICY | Asia, Southern | Asia | Developing Countries | Delivery of Health Care | Health | Program Sustainability | Programs | Organization and Administration | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Policy | Political Factors | Sociocultural Factors
Document Number: 341372

Title: Starting with the classroom: updating family planning knowledge in East Africa.
Author: IntraHealth International. Capacity Project
Source: Chapel Hill, North Carolina, IntraHealth International, Capacity Project, 2009 Feb. [2] p. (Voices No. 28)
Abstract: In Kenya, a dedicated midwifery tutor is working hard to train students at Aga Khan University but worries that he isn't teaching them the latest information and techniques. Many of his fellow instructors are in the same situation. "We had our last refresher training ten years ago," he laments. In Tanzania, a midwifery tutor from Tumaini University Faculty of Nursing observes, "Many nurses who are providing service have never been updated on new issues [in family planning]. It will be our responsibility to see how we can help as a training institution because we will send our students to some of these clinics." To build instructors' capacity and address the knowledge gaps, the Capacity Project partnered with East, Central and Southern Africa (ECSA) Health Community and Africa's Health in 2010 to deliver a week-long workshop on Contemporary Issues in Family Planning for midwifery tutors in Kenya, Tanzania and Uganda. Held in Dar es Salaam in April 2008, the workshop updated the knowledge of 22 tutors and enabled them to teach their students more effectively. A quantitative and qualitative evaluation showed the workshop to be highly successful. Average scores climbed from 58% on the pre-test to 81% on the post-test. Additionally, 94% reported that they have used the workshop information and resources to update their colleagues. (excerpt)
Language: English
Keywords:
AFRICA, SUB SAHARAN | PROGRESS REPORT | EVALUATION | MIDWIVES AND MIDWIFERY | NURSE-MIDWIVES | FAMILY PLANNING EDUCATION | SEX EDUCATION | USAID | CAPACITY BUILDING | WORKSHOPS | CONTRACEPTION | MATERNAL-CHILD HEALTH SERVICES | PERFORMANCE IMPROVEMENT | AUDIOVISUAL AIDS | Africa | Developing Countries | Health Personnel | Delivery of Health Care | Health | Education | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Program Sustainability | Programs | Organization and Administration | Family Planning | Primary Health Care | Health Services | Management | Educational Methods | Educational Activities
Document Number: 325236

Title: Expert Group Meeting to Assess the Progress in the Implementation of the Plan of Action on Population and Poverty Adopted at the Fifth Asian and Pacific Population Conference, 3-5 February 2009, Bangkok. Report.
Author: United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]; United Nations Population Fund [UNFPA]
Source: Bangkok, Thailand, ESCAP, 2009. 38 p.
Abstract: The Expert Group Meeting to Assess the Progress in the implementation of the Plan of Action on Population and Poverty adopted at the Fifth Asian and Pacific Population Conference was held at the United Nations Conference Centre, Bangkok from 3 to 5 February 2009. The Expert Group Meeting was organized by the Social Policy and Population Section, Social Development Division, ESCAP in collaboration with the UNFPA Asia and the Pacific Regional Office. The meeting benefited from background papers and country reports prepared by resource persons and representatives of governments.
Language: English
Keywords:
ASIA | OCEANIA | CONFERENCES AND CONGRESSES | ESCAP | POPULATION | SUSTAINABLE DEVELOPMENT | POVERTY | REPRODUCTIVE HEALTH | MATERNAL-CHILD HEALTH SERVICES | GENDER ISSUES | MIGRATION | HIV INFECTIONS | AIDS | IMPLEMENTATION | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Economic Development | Economic Factors | Socioeconomic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Population Dynamics | Demographic Factors | Viral Diseases | Diseases | Programs | Organization and Administration
Document Number: 331854

10.

11.

Peer Reviewed

Title: Assessment of childhood immunisation coverage [letter]
Author: Aaby P; Benn CS
Source: Lancet. 2009 Apr 25;373(9673):1428.
Abstract: Stephen Lim and colleagues scrutinise coverage with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) in 193 countries. With donor emphasis on DTP3 coverage, it is not surprising that the national estimates might be inflated. Still, there is little doubt that DTP3 coverage has increased in recent decades. But maybe we should be more concerned about the health implications of this trend than about the accuracy of the estimate. From a public health perspective, the fact that DTP3 coverage is now higher than measles vaccine coverage in most African countries is of questionable value. Numerous studies have shown that measles vaccine is beneficial for child survival, but there are conflicting data about the effect of DTP. DTP has frequently been associated with increased mortality in situations with herd immunity. Furthermore, as a result of the drive to increase the DTP3 coverage, more children receive DTP simultaneously with or after measles vaccine. We have found consistently that DTP given simultaneously with measles vaccine (table) or after it is associated with increased mortality compared with having measles vaccine alone as the most recent vaccine. In a study from Bangladesh, children who received DTP/BCG after the age of measles vaccine administration had around threefold higher mortality than unvaccinated children. These observations have not been contradicted. If they are true, the drive to boost the DTP3 coverage could lead to increased child mortality. Current policy is based on the assumption that receiving three DTP vaccines is associated with decreased child mortality. It should be a major priority to determine whether this assumption is correct. (full-text)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | CROSS-CULTURAL COMPARISONS | EPIDEMIOLOGIC METHODS | CHILDREN | IMMUNIZATION | PERTUSSIS | TETANUS | DIPHTHERIA | Comparative Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Bacterial and Fungal Diseases | Infections | Diseases
Document Number: 341150

12.

Title: Wealth Index association with gender issues and the reproductive health of Egyptian women.
Author: Afifi M
Source: Nursing and Health Sciences. 2009 Mar;11(1):29-36.
Abstract: This study investigated the association of the Wealth Index of married women in Egypt with a number of gender and reproductive health issues found in the 2005 Egypt Demographic Health Survey. The data from a subsample of 5249 currently married women from a total of 19,474 was examined using logistic regression analysis. The women's lowest wealth quintile predicted the intention to continue female genital cutting for their daughters, exposure to physical and sexual marital violence, not being empowered in household decisions, having a higher number of children, having an unintended last child, mothers' maltreatment of their children, the perception of a lack of health-care providers or drugs as an obstacle to receiving care, and not being covered by health insurance. The association of poverty with the aforementioned adverse health outcomes are discussed. Physicians should understand the effect of poverty on health and endeavour to influence policy-makers to reduce the poverty burden on health.
Language: English
Keywords:
EGYPT | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN | GENDER ISSUES | REPRODUCTIVE HEALTH | POVERTY | ANTENATAL CARE | SOCIOECONOMIC FACTORS | WOMEN'S HEALTH | HEALTH POLICY | Developing Countries | Africa, North | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Sociocultural Factors | Health | Economic Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Policy | Political Factors
Document Number: 342089

13.

Peer Reviewed

Title: PMTCT, HAART, and childbearing in Mozambique: an institutional perspective.
Author: Agadjanian V; Hayford SR
Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S103-S112.
Abstract: Maternal and Child Health (MCH) units, where VCT/PMTCT/HAART have been integrated with traditional services, play a critical role in the connection between the massive HAART rollout and reproductive behavior. In this article, we use data from semi-structured interviews with MCH workers and ethnographic observations carried out in southern Mozambique to explore this role from the institutional perspective. We find that, along with logistical and workload problems, the de facto segregation of PMTCT/HAART clients within the �integrated� MCH system and the simplistic and uncompromising message discouraging further fertility and stressing condom-based contraception may pose serious challenges to a successful formulation and implementation of reproductive goals among seropositive clients. Although the recency of PMTCT/HAART services may partly explain these challenges, we argue that they are due largely to cultural miscommunication between providers and clients. We show how the cultural gap between the two is bridged by community activists and peer interactions among clients.
Language: English
Keywords:
MOZAMBIQUE | RESEARCH REPORT | HEALTH PERSONNEL | SUPPORT GROUPS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | VOLUNTARY COUNSELING AND TESTING | MATERNAL-CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | HEALTH SERVICES ADMINISTRATION | INTERVIEWS | FERTILITY PREFERENCES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Delivery of Health Care | Health | Social Networks | Friends and Relatives | Family and Household | Sociocultural Factors | Disease Transmission Control | Prevention and Control | Diseases | HIV | HIV Infections | Viral Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Primary Health Care | Programs | Organization and Administration | Management | Data Collection | Research Methodology | Fertility | Population Dynamics | Demographic Factors | Population
Document Number: 341906

14.
Title: Evaluation of transmitted HIV drug resistance among recently-infected antenatal clinic attendees in four Central African countries.
Author: Aghokeng AF; Vergne L; Mpoudi-Ngole E; Mbangue M; Deoudje N; Mokondji E; Nambei WS; Peyou-Ndi MM; Moka JJ; Delaporte E; Peeters M
Source: Antiviral therapy. 2009;14(3):401-11.
Abstract: BACKGROUND: The rapid expansion of antiretroviral treatment in resource-limited settings is raising concerns regarding the emergence and transmission of HIV drug resistance (HIVDR). We evaluated the extent of transmission of drug-resistant HIV strains in four Central African countries: the Republic of Congo, Central African Republic, Chad and Cameroon. METHODS: The World Health Organization (WHO) HIVDR threshold survey was implemented in major treatment areas in each country. Pregnant women who were aged <25 years, who were at first pregnancy and who were HIV type-1-positive were enrolled at each site in 2006-2007 for genotyping. HIVDR prevalence was categorized using the WHO threshold survey binomial sequential sampling method. RESULTS: The prevalence of HIVDR in Brazzaville and Bangui sites could not be classified because the eligible sample number was not reached. HIVDR prevalence was low (<5%) in N'Djamena for all drug classes. In Yaounde, we found one individual with the D67D/N mutation and two with K103N. HIVDR prevalence was categorized as low (<5%) for protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs), and moderate (> or =5-< or =15%) for non-NRTIs (NNRTIs). HIVDR prevalence in Douala was low for PIs and NNRTIs, and moderate for NRTIs as we identified one individual with M184V plus K101E plus G190A mutations and a second with D67D/N. CONCLUSIONS: The moderate HIVDR prevalence found in Yaounde and Douala indicate that efforts should be made in Cameroon to prevent HIVDR; however, additional surveys are needed to confirm this trend. This study highlighted challenges presented by the WHO methodology, such as additional costs, workload, difficulties in acquiring even small sample numbers and the necessity for better quality assurance of HIV testing and record keeping at antenatal clinics.
Language: English
Keywords:
CAMEROON | CENTRAL AFRICAN REPUBLIC | CHAD | REPUBLIC OF THE CONGO | RESEARCH REPORT | SAMPLING STUDIES | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | PREVALENCE | ANTENATAL CARE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Africa, Central | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care
Document Number: 342346

15.

Title: Prevention of low birthweight.
Author: Alam DS
Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:209-21; discussion 221-5, 259-68.
Abstract: Globally an estimated 20 million infants are born with low birthweight (LBW), of those over 18 million are born in developing countries. These LBW infants are at a disproportionately higher risk of mortality, morbidity, poor growth, impaired psychomotor and cognitive development as immediate outcomes, and are also disadvantaged as adults due to their greater susceptibility to type 2 diabetes, hypertension and coronary heart disease. Maternal malnutrition prior to and during pregnancy manifested by low bodyweight, short stature, inadequate energy intake during pregnancy and coexisting micronutrient deficiency are considered major determinants in developing countries where the burden is too high. LBW is a multifactorial outcome and its prevention requires a lifecycle approach and interventions must be continued for several generations. So far, most interventions are targeted during pregnancy primarily due to the increased nutritional demand and aggravations of already existing inadequacy in most women. Several individually successful interventions during pregnancy include balanced protein energy supplementation, several single micro-nutrients or more recently a mix of multiple micronutrients. Nutrition education has been successful in increasing the dietary intake of pregnant women but has had no effect on LBW. The challenge is to identify a community-specific intervention package. Current evidence supports intervention during pregnancy with increased dietary intakes including promotions of foods rich in micronutrients and micronutrient supplementation, preferably with a multiple micronutrient mix. Simultaneously a culturally appropriate educational component is required to address misconceptions about diet during pregnancy and childbirth including support for healthy pregnancy with promotion of antenatal and perinatal care services. While further research is needed to identify more efficacious interventions, an urgent public health priority would be to select and implement an optimal mix of interventions to avert the immediate adverse consequences of LBW and to prevent the impending epidemic of type 2 diabetes, hypertension and coronary heart disease which are negatively associated with LBW.
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | LOW BIRTH WEIGHT | PREVALENCE | INTERVENTIONS | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | FOOD SUPPLEMENTATION | VITAMINS AND MINERALS | DIET | Birth Weight | Body Weight | Physiology | Biology | Measurement | Research Methodology | Programs | Organization and Administration | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341347

16.

Title: Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis.
Author: Alderman H; Ndiaye B; Linnemayr S; Ka A; Rokx C; Dieng K; Mulder-Sibanda M
Source: Public Health Nutrition. 2009 May;12(5):667-73.
Abstract: There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0.83 (95% CI 0.686, 1.000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control.
Language: English
Keywords:
SENEGAL | RESEARCH REPORT | COHORT ANALYSIS | RURAL POPULATION | CHILD NUTRITION | INTERVENTIONS | NUTRITION PROGRAMS | PROGRAM EFFECTIVENESS | BODY WEIGHT | COMMUNITY HEALTH SERVICES | PROMOTION | BEHAVIOR CHANGE | GROWTH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Program Evaluation | Physiology | Biology | Marketing | Economic Factors | Behavior | Child Development
Document Number: 342116

17.
Title: Women's perspective in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth.
Author: Almeida CA; Tanaka OY
Source: Revista De Saude Publica. 2009 Feb;43(1):98-104.
Abstract: OBJECTIVE: To analyze the importance of inclusion, from women's perspective, in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth, carried out by the Brazilian Ministry of Health. METHODOLOGICAL PROCEDURES: This qualitative study was based on primary data collected in 2003 in an evaluation of the Program conducted in seven towns spread out among Brazil's five geographic regions. These sites were selected from a Federal Government data base utilized for quantitative analysis. Women attended by the Program were considered key informants when primary data was collected. Sixteen focal groups were performed in the primary care units. The Collective Subject Speech (CSS) method was used for qualitative analysis. The theoretical concepts of accessibility and Paideia Health within the framework of public health were used to interpret the findings. ANALYSIS OF RESULTS: The Program standardizes procedures to be taken in antenatal care and childbirth for all health services in the country, including the flow among these services. However, analysis of women's discourse in the focal groups elucidated the existence of dissonances between their needs and desires and many of the program's recommendations. Pregnant women thus choose among available services and professionals and try to set up their own schedules which, in turn, do not correspond to those set up by the program. This discrepancy damages the bond women establish with the health services and creates obstacles for the control of the activities actually provided by the health services to the women. CONCLUSIONS: Analysis of the Program based on women's perspective identified aspects that might result in more humanized and effective antenatal care, if they are taken into account in the redefinition or correction of the Program schedule Miolo abstract Miolo abstract Miolo abstract.
Language: EnglishPortuguese
Keywords:
BRAZIL | RESEARCH REPORT | FOCUS GROUPS | PREGNANT WOMEN | ANTENATAL CARE | MATERNAL-CHILD HEALTH SERVICES | DELIVERY OF HEALTH CARE | NEEDS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Maternal Health Services | Primary Health Care | Health Services | Health | Economic Factors | Programs | Organization and Administration
Document Number: 341988

19.

Peer Reviewed

Title: Faith and child survival: the role of religion in childhood immunization in Nigeria.
Author: Antai D
Source: Journal of Biosocial Science. 2009 Jan;41(1):57-76.
Abstract: This study assessed the role of mother's religious affiliation in child immunization status of surviving children 12 months of age and older in Nigeria, using data from the 2003 Nigeria Demographic and Health Survey (NDHS). Guided by two competing hypotheses--the 'characteristics hypothesis' and the 'particularized theology hypothesis'--variations in the risks of child immunization in Nigeria were examined using logistic regression analysis. The results indicate that religion plays a role in the risk of non-immunization; religion was not associated with the risk of partial immunization; however, religion was significantly associated with the reduced risk of full immunization.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | MOTHERS | CHILDREN | IMMUNIZATION | RELIGION | UTILIZATION OF HEALTH CARE | BELIEFS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Primary Health Care | Health Services | Delivery of Health Care | Health | Culture
Document Number: 330568

20.
Peer Reviewed

Title: Quality of obstetric care in public-sector facilities and constraints to implementing emergency obstetric care services: evidence from high- and low-performing districts of Bangladesh.
Author: Anwar I; Kalim N; Koblinsky M
Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):139-55.
Abstract: This study explored the quality of obstetric care in public-sector facilities and the constraints to programming comprehensive essential obstetric care (EOC) services in rural areas of Khulna and Sylhet divisions, relatively high- and low-performing areas of Bangladesh respectively. Quality was explored by physically inspecting all public-sector EOC facilities and the constraints through in-depth interviews with public-sector programme managers and service providers. Distribution of the functional EOC facilities satisfied the United Nation's minimum criteria of at least one comprehensive EOC and four basic EOC facilities for every 500,000 people in Khulna but not in Sylhet region. Human-resource constraints were the major barrier for maternal health. Sanctioned posts for nurses were inadequate in rural areas of both the divisions; however, deployment and retention of trained human resources were more problematic in rural areas of Sylhet. Other problems also plagued care, including unavailability of blood in rural settings and lack of use of evidence-based techniques. The overall quality of care was better in the EOC facilities of Khulna division than in Sylhet. 'Context' of care was also different in these two areas: the population in Sylhet is less literate, more conservative, and faces more geographical and sociocultural barriers in accessing services. As a consequence of both care delivered and the context, more normal vaginal and caesarian-section deliveries were carried out in the public-sector EOC facilities in the Khulna region, with the exception of the medical college hospitals. To improve maternal healthcare, there is a need for a human-resource plan that increases the number of posts in rural areas and ensures availability. All categories of maternal healthcare providers also need training on evidence-based techniques. While the centralized push system of management has its strengths, special strategies for improving the response in the low-performing areas is urgently warranted.
Language: English
Keywords:
BANGLADESH | RURAL AREAS | RESEARCH REPORT | OBSTETRICS | EMERGENCY SERVICES | IMPLEMENTATION | MATERNAL HEALTH SERVICES | QUALITY OF HEALTH CARE | OBSTACLES | HEALTH FACILITIES | PUBLIC SECTOR | HUMAN RESOURCES | BLOOD SUPPLY | SAFE MOTHERHOOD | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Maternal-Child Health Services | Primary Health Care | Health Services Evaluation | Program Evaluation | Macroeconomic Factors | Economic Factors | Equipment and Supplies | Medical Procedures | Maternal Health
Document Number: 341937

21.

Peer Reviewed

Title: Growth faltering due to breastfeeding cessation in uninfected children born to HIV-infected mothers in Zambia.
Author: Arpadi S; Fawzy A; Aldrovandi GM; Kankasa C; Sinkala M; Mwiya M; Thea DM; Kuhn L
Source: American Journal of Clinical Nutrition. 2009 Aug;90(2):344-53.
Abstract: BACKGROUND: The effect of breastfeeding on growth in HIV-exposed infants is not well described. OBJECTIVE: The objective was to evaluate the effect of early breastfeeding cessation on growth. DESIGN: In a trial conducted in Lusaka, Zambia, HIV-infected mothers were randomly assigned to exclusive breastfeeding for 4 mo followed by rapid weaning to replacement foods or exclusive breastfeeding for 6 mo followed by introduction of complementary foods and continued breastfeeding for a duration of the mother's choice. Weight-for-age z score (WAZ), length-for-age z score (LAZ), and weight-for-length z score (WLZ) and the self-reported breastfeeding practices of 593 HIV-uninfected singletons were analyzed. Generalized estimating equations were used to adjust for confounders. RESULTS: WAZ scores declined precipitously between 4.5 and 15 mo. The decline was slower in the breastfed infants. At 9, 12, and 15 mo, mean WAZs were, respectively, -0.74, -0.92, and -1.06 in infants who were reportedly breastfed and were -1.07, -1.20, and -1.31 in the weaned infants (P = 0.003, 0.007, and 0.02, respectively). No differences were observed past 15 mo. Breastfeeding practice was not associated with LAZ, which declined from -0.98 to -2.24 from 1 to 24 mo. After adjustment for birth weight, maternal viral load, body mass index, education, season, and marital and socioeconomic status, not breastfeeding was associated with a 0.28 decline in WAZ between 4.5 and 15 mo (P < 0.0001). During the rainy season, not breastfeeding was associated with a larger WAZ decline (0.33) than during the dry season (0.22; P for interaction = 0.02). CONCLUSIONS: Early growth is compromised in uninfected children born to HIV-infected Zambian mothers. Continued breastfeeding partially mitigates this effect through 15 mo. Nutritional interventions to complement breastfeeding after 6 mo are urgently needed. This trial was registered at clinicaltrials.gov as NCT00310726.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | EVALUATION | INFANT | MOTHERS | PERSONS LIVING WITH HIV/AIDS | BREASTFEEDING | CHILD DEVELOPMENT | IMPACT | NEEDS | MATERNAL NUTRITION | NUTRITION PROGRAMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Infant Nutrition | Nutrition | Health | Biology | Communication | Economic Factors | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 342426

22.

Title: Philani program: a case study of an integrative approach of empowerment and social and economic development.
Author: Austin SA; Mbewu N
Source: Social Work In Public Health. 2009 Jan-Apr;24(1-2):148-60.
Abstract: This article reports a case study of a South African nongovernmental organization's role in implementing maternal and child health care services for families in Khayelitsha, an informal township in the Western Cape. The township is an extremely poor community with high unemployment and many other social indicators of high need. The case study explores how services were enhanced to respond to the service needs of children and families. The role of economic development as a means of empowering the mothers is examined within the context of nongovernmental organization services. The implications of developing services that integrate social and economic development are discussed as a model for social work practice in the United States.
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | CASE STUDIES | NONGOVERNMENTAL ORGANIZATIONS | MATERNAL-CHILD HEALTH SERVICES | NEEDS | POVERTY | ECONOMIC DEVELOPMENT | SOCIAL DEVELOPMENT | WOMEN'S EMPOWERMENT | INTEGRATED PROGRAMS | SOCIAL POLICY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Organizations | Political Factors | Sociocultural Factors | Primary Health Care | Health Services | Delivery of Health Care | Health | Economic Factors | Socioeconomic Factors | Women's Status | Programs | Organization and Administration | Policy
Document Number: 341952

23.

Peer Reviewed

Title: Neonatal near miss: a measure of the quality of obstetric care.
Author: Avenant T
Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Jun;23(3):369-374.
Abstract: Thirty-seven percent of under-five deaths occur in the neonatal period. Identifying and correcting factors that contribute to neonatal and maternal care are of the utmost importance. Evaluation of severe acute maternal morbidity, also known as �near miss�, is used to improve obstetric practice. Neonatal near miss in conjunction with neonatal mortality can be used in a similar fashion to identify deficiencies in care. No accepted definition of neonatal near miss currently exists. None of the neonatal morbidity scoring systems is applicable or appropriate for this purpose. Organ system based criteria are objective and allow for identifying severe morbidities and identifying primary causes. This system can be of use in a variety of settings to identify health system problems and to institute remedial action where necessary.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | PREGNANCY | MATERNAL MORTALITY | PERINATAL MORTALITY | MORBIDITY | QUALITY OF HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | MEASUREMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Reproduction | Mortality | Population Dynamics | Demographic Factors | Population | Diseases | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | Research Methodology
Document Number: 341303

24.

Title: Factors predicting BCG immunization status in northern Nigeria: a behavioral-ecological perspective.
Author: Babalola S; Lawan U
Source: Journal of Child Health Care. 2009 Mar;13(1):46-62.
Abstract: This study examines the predictors of Bacille Calmette-Guerin (BCG) immunization status among infants in northern Nigeria using a behavioral-ecological model. The findings show only 37.3 percent of the children had received BCG vaccine, and reveal that BCG immunization status in northern Nigeria is influenced by multiple layers of factors, including child's characteristics, parental or household factors, community characteristics, vaccine supply and the policy environment. At the child's level, place of birth and ownership of an immunization card are the two most significant predictors. The parental and household predictors of BCG immunization status include maternal use of antenatal care, maternal knowledge about immunization, maternal exposure to child health information, social influence and paternal approval of immunization. Both the regularity of vaccine supply to the health facility and the state of residence are associated independently with BCG immunization status. These findings stress the need for interventions at multiple levels in order to increase BCG immunization status.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | ACTION RESEARCH | INFANT | INFANT HEALTH | IMMUNIZATION | SOCIOECONOMIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Health | Health | Primary Health Care | Health Services | Delivery of Health Care | Economic Factors
Document Number: 341722

25.

Peer Reviewed

Title: Maternal mortality in Syria: causes, contributing factors and preventability.
Author: Bashour H; Abdulsalam A; Jabr A; Cheikha S; Tabbaa M; Lahham M; Dihman R; Khadra M; Campbell OM
Source: Tropical Medicine and International Health. 2009 Sep;14(9):1122-7.
Abstract: OBJECTIVES: To describe the biomedical and other causes of maternal death in Syria and to assess their preventability. METHODS: A reproductive age mortality study (RAMOS) design was used to identify pregnancy related deaths. All deaths among women aged 15-49 reported to the national civil register for 2003 were investigated through home interviews. Verbal autopsies were used to ascertain the cause of death among pregnancy related maternal deaths, and causes and preventability of deaths were assessed by a panel of doctors. RESULTS: A total of 129 maternal deaths were identified and reviewed. Direct medical causes accounted for 88%, and haemorrhage was the main cause of death (65%). Sixty nine deaths (54%) occurred during labour or delivery. Poor clinical skills and lack of clinical competency were behind 54% of maternal deaths. Ninety one percent of maternal deaths were preventable. CONCLUSIONS: The causes of maternal death in Syria and their contributing factors reflect serious defects in the quality of maternal care that need to be urgently rectified.
Language: English
Keywords:
SYRIA | RESEARCH REPORT | RECORDS | MATERNAL MORTALITY | CAUSES OF DEATH | PREGNANCY OUTCOMES | MATERNAL HEALTH SERVICES | QUALITY OF HEALTH CARE | Developing Countries | Middle East | Information Processing | Information | Mortality | Population Dynamics | Demographic Factors | Population | Pregnancy | Reproduction | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration
Document Number: 342964

26.

Title: Inadequate use of prenatal services among brazilian women: the role of maternal characteristics.
Author: Bassani DG; Surkan PJ; Olinto MT
Source: International Perspectives On Sexual and Reproductive Health. 2009 Mar;35(1):15-20.
Abstract: CONTEXT: To improve the uptake of prenatal care, it is important to know how the use of prenatal care varies by maternal attitudes and social and demographic factors. METHODS: Information about social and demographic variables, prenatal care, parity, pregnancy planning, abortion attempts, satisfaction with pregnancy and satisfaction with the relationship with the child's father was collected from 611 postpartum women in Porto Alegre in southern Brazil. Multinomial logistic regression was used to evaluate associations between these variables and whether the women's use of prenatal care was adequate, partially inadequate or inadequate. RESULTS: About 40% of women had inadequate or partially inadequate prenatal care. After adjustment for other covariates, including satisfaction with the pregnancy, women having an unplanned pregnancy were significantly more likely to have had inadequate care than women who had planned their pregnancy (odds ratio, 2.0). Not living with the child's father (2.8) and dissatisfaction with pregnancy (2.1) were also associated with inadequate use of prenatal care. Women having their second or higher order birth were significantly more likely to report inadequate use of prenatal care than women having their first birth (3.9-9.0). Household income was inversely associated with inadequate use of care. CONCLUSIONS: The study suggests that maternal attitudes may be important for adequate prenatal care. Interventions should be created to encourage women with negative maternal attitudes to use prenatal care and to ensure that they have access to the care they need.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | STATISTICAL REGRESSION | POSTPARTUM WOMEN | ANTENATAL CARE | UTILIZATION OF HEALTH CARE | ATTITUDES | SOCIOECONOMIC STATUS | PARITY | LIVING ARRANGEMENTS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Analysis | Research Methodology | Puerperium | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Psychological Factors | Behavior | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors
Document Number: 341412

27.

Title: [Newborn babies' health in Rwanda: evolution of factors associated with neonatal mortality trends] La sante des nouveau-nes au Rwanda. Evolution des facteurs associes aux tendances
Author: Beck L
Source: Sante Publique. 2009 Mar-Apr;21(2):159-72.
Abstract: In spite of increasing attention for maternal and child health, neonatal mortality (before the age of one month) represents a significant part of infant mortality in sub-Saharan Africa. Several demographic and health surveys show the lack of any major improvement since the 1980s in Rwanda, and despite some indication of minor improvement, any real progress has been countered by periods of aggravation of the situation. However, a noticeable decrease in neonatal mortality seems to have begun since the year 2000. This study describes the evolution of the determinants of neonatal mortality between 1980 and 2000 and the obstacles that hinder its sustainable decline. Regressive logistical analyses conducted with data on several different generations of newborns showed the persistence of some unfavourable factors and conditions, such as the short period of time between births of babies carried to term and premature births. Nevertheless, although the conditions for pregnancy and delivery are still insufficient, the quality of pre-natal and newborn care seems to be improving.
Language: French
Keywords:
RWANDA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | NEONATAL MORTALITY | DEATH RATE | MORTALITY DETERMINANTS | MATERNAL-CHILD HEALTH SERVICES | NEEDS | QUALITY OF HEALTH CARE | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Infant Mortality | Mortality | Primary Health Care | Health Services | Delivery of Health Care | Health | Economic Factors | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration
Document Number: 342436

28.
Peer Reviewed

Title: Maternal healthcare financing: Gujarat's Chiranjeevi Scheme and its beneficiaries.
Author: Bhat R; Mavalankar DV; Singh PV; Singh N
Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):249-58.
Abstract: Maternal mortality is an important public-health issue in India, specifically in Gujarat. Contributing factors are the Government's inability to operationalize the First Referral Units and to provide an adequate level of skilled birth attendants, especially to the poor. In response, the Gujarat state has developed a unique public-private partnership called the Chiranjeevi Scheme. This scheme focuses on institutional delivery, specifically emergency obstetric care for the poor. The objective of the study was to explore the targeting of the scheme, its coverage, and socioeconomic profile of the beneficiaries and to assess financial protection offered by the scheme, if any, in Dahod, one of the initial pilot districts of Gujarat. A household-level survey of beneficiaries (n=262) and non-users (n=394) indicated that the scheme is well-targeted to the poor but many poor people do not use the services. The beneficiaries saved more than Rs 3000 (US$ 75) in delivery-related expenses and were generally satisfied with the scheme. The study provided insights on how to improve the scheme further. Such a financing scheme could be replicated in other states and countries to address the cost barrier, especially in areas where high numbers of private specialists are available.
Language: English
Keywords:
INDIA | RESEARCH REPORT | PILOT PROJECTS | LOW INCOME POPULATION | MATERNAL HEALTH SERVICES | FINANCIAL ACTIVITIES | OBSTETRICS | EMERGENCY SERVICES | PROGRAM EVALUATION | MATERNAL MORTALITY | QUALITY OF HEALTH CARE | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Medicine | Programs | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Health Services Evaluation
Document Number: 341931

29.

Peer Reviewed

Title: Effect of human immunodeficiency virus treatment on maternal mortality at a tertiary center in South Africa: a 5-year audit.
Author: Black V; Brooke S; Chersich MF
Source: Obstetrics and Gynecology. 2009 Aug;114(2 Pt 1):292-9.
Abstract: OBJECTIVE:: To review facility-based maternal deaths at a tertiary-level center in Johannesburg, South Africa, during a 5-year period (2003 to 2007) and to investigate the proportion of deaths attributable to human immunodeficiency virus (HIV), the etiology of deaths, and the effects of antiretroviral treatment introduced in late 2004. METHODS:: Patient case files, birth registers, death certificates, and mortality summaries were reviewed. Cause of death was assigned through clinical case discussion. Annual maternal mortality ratios were calculated and disaggregated by HIV status. RESULTS:: During the 5-year period, 106 maternal deaths occurred out of 36,708 births (facility-based maternal mortality ratios 289/100,000 live births, 95% confidence interval [CI] 237-349/100,000). In 72% of cases, HIV status was known (76/106), with the majority being HIV-infected (78%, 59/76). Among HIV-infected women, only two had initiated antiretroviral treatment, and 70% of deaths were HIV-related (41/59), mainly from tuberculosis (21) and pneumonia (12). Direct obstetric causes of death such as hypertension and pregnancy-related sepsis predominated in women who were HIV-negative or of unknown status (48.9%, 23/47). Maternal mortality ratios in HIV-infected women were 776/100,000 (95% CI 591-1,000/100,000), 6.2-fold higher (95% CI 3.6-11.4) than in HIV-negative women (124/100,000, 95% CI 72-199/100,000). Changes in mortality over time were not detected. Although HIV testing increased 1.4-fold each year (95% CI 1.3-1.4) and estimated coverage of antiretroviral treatment for pregnant women reached 59.2% in 2007, levels remain suboptimal. CONCLUSION:: In Johannesburg, HIV remains the major cause of maternal mortality despite integration of antiretroviral treatment into prenatal services. Maternal health services should target barriers to uptake of HIV treatment and care. LEVEL OF EVIDENCE:: III.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | PREGNANT WOMEN | HYPERTENSION | MATERNAL-CHILD HEALTH SERVICES | HIV INFECTIONS | AIDS | MATERNAL MORTALITY | CAUSES OF DEATH | HIV/FP INTEGRATION | TREATMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Vascular Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Viral Diseases | Mortality | Population Dynamics | Medical Procedures | Medicine
Document Number: 342270

30.

Peer Reviewed

Title: Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature.
Author: Bollini P; Pampallona S; Wanner P; Kupelnick B
Source: Social Science and Medicine. 2009 Feb;68(3):452-61.
Abstract: Immigrant mothers in developed countries often experience worse pregnancy outcomes than native women. Several epidemiological studies have described the pregnancy outcome of immigrant women in European receiving countries, with conflicting results. The present systematic review makes a quantitative synthesis of available evidence on the association between pregnancy outcomes and integration policies. We reviewed all epidemiological studies comparing the pregnancy outcome of native versus immigrant women in European countries from 1966 to 2004 and retained 65 for analysis, from 12 host countries. Overall, as compared to native women, immigrant women showed a clear disadvantage for all the outcomes considered: 43% higher risk of low birth weight, 24% of pre-term delivery, 50% of perinatal mortality, and 61% of congenital malformations. The risks were clearly and significantly reduced in countries with a strong integration policy. This trend was maintained even after adjustment for age at delivery and parity. On the basis of an analysis of naturalisation rates, five countries in our sample could be categorised as having a strong policies promoting the integration of immigrant communities. The mechanisms through which integration policies may be protective include the increased participation of immigrant communities in the life of the receiving society, and the decreased stress and discrimination they may face. The results of this study highlight a serious problem of equity in perinatal health across European countries. Immigrant women clearly need targeted attention to improve the health of their newborn, but a deep societal change is also necessary to integrate and respect immigrant communities in receiving societies.
Language: English
Keywords:
EUROPE | RESEARCH REPORT | LITERATURE REVIEW | PREGNANT WOMEN | FETUS | PREGNANCY | MIGRATION | ANTENATAL CARE | HEALTH POLICY | PREGNANCY OUTCOMES | Developed Countries | Population Characteristics | Demographic Factors | Population | Reproduction | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors
Document Number: 331051


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