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Posts Tagged ‘HIV’

Tuesday (6/8) marked day two of Women Deliver 2010. Day two was all about innovation and (high and low) technology to improve the health of women and infants worldwide–in fact, the conference organizers marketed Tuesday’s sessions as a stand-alone symposium called Technology as a Catalyst for Social Transformation.

Take a look at two examples of technologies that were discussed at the conference on Tuesday…

Microbicide Vaginal Rings (High Tech)

“The nonprofit International Partnership for Microbicides (IPM) today announced the initiation of the first trial among women in Africa testing a vaginal ring containing an antiretroviral drug (ARV) that could one day be used to prevent HIV transmission during sex. The clinical trial, known as IPM 015, tests the safety and acceptability of an innovative approach that adapts a successful technology from the reproductive health field to give women around the world a tool to protect themselves from HIV infection…”

Read the full press release here.

Clean Delivery Kits (Low Tech)

Clean Birth Kits–Potential to Deliver?, a publication supported by Save the Children/Saving Newborn Lives, Norwegian Ministry of Foreign Affairs, Immpact (University of Aberdeen), and the Maternal Health Task Force at EngenderHealth, was released at a session at Women Deliver yesterday. The session was chaired by Claudia Morrissey of Save the Children; moderated by Richard Horton, Editor of the Lancet; and presenters included Wendy Graham of University of Aberdeen, and Haris Ahmed of PAIMAN. The goal of the session was to summarise the evidence base for clean delivery kits, discuss practical implementation experiences from the field, and to have a lively debate on the “risks” associated with promoting birth kits. The report will be available online soon.

Subscribe to the MHTF Blog for updates on this project/report–as well as updates on other MHTF projects and commentary on a variety of maternal health issues.

Check out a recent blog post, A Good Idea or an Expensive Diversion: Workshop on the Evidence Base for Clean Birth Kits, by Ann Blanc, Director of the Maternal Health Task Force, on a workshop leading up to the new report on delivery kits.

Click here for the webcast of a session at Women Deliver 2010 that explores “What’s on the Horizon” for new technologies in contraception.

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Dr. Fred Sai is co-host of Women Deliver 2010, former reproductive health and HIV/AIDS advisor to the Ghanaian government, and has spent 40 years working to improve the health of women and children in Ghana and throughout Africa.  In his June 2nd blog post, A New Role For Africans in Maternal Health, on the ONE Blog, Dr. Sai comments on the new maternal mortality estimates published in the Lancet that show a dramatic reduction in global maternal deaths–and asks questions about why Africa (as a whole) has not seen these same reductions. He also expresses confidence that a shift in approach (described in his post) will lead to major improvements in the health of women and children throughout Africa.

The ONE Blog

“…It is an unfortunate truth that progress for the world at large does not necessarily mean progress for Africa. In 1980, almost a quarter of maternal deaths occurred in African countries. Today that figure has doubled to more than half. All but one of the 30 countries with the worst maternal mortality statistics are in Africa. And while countries like Ghana and Rwanda have seen a steady decline in maternal deaths over the past 15 years, others such as Malawi, Lesotho, Zimbabwe, Nigeria and Cote d’Ivoire actually have higher maternal mortality rates than they did in 1990.

Addressing maternal mortality in Africa is complex and challenging. Our countries face increasing rates of HIV, entrenched and debilitating poverty, food shortages, weak education and health care systems, problematic governance, corruption, and civil conflict. These are huge issues in their own right, but they also have significant impact on maternal, newborn and child health. The challenges, however, are not the whole story…”

Read the full post, A New Role For Africans in Maternal Health.

For additional reactions to the Lancet publication from other leaders in the maternal health field, click here.

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On April 13th 2010, the New York Times published an article,  Maternal Deaths Decline Sharply Across the Globe, about the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality. Since then, the paper has published a series of Letters to the Editor. These letters come  from leaders of organizations working on reproductive and maternal health and from health professionals working on maternal health on the ground in countries where maternal mortality continues to be a major problem.

The New York Times

A variety of opinions and sentiments are expressed in these letters that certainly add depth to the initial story published in the Times. Two themes pound through the letters: a new sense of hope that improvements in maternal health are possible and a sense of urgency that this battle has not yet been won–that now, more than ever, is the time for the maternal health community to stick together (despite squabbles among advocates over whether or not the Lancet should have published the paper when they did) and engage in concerted efforts (that include emergency obstetric care, HIV services, and expanded access to family planning) to achieve MDG5.

A careful look at these letters will stimulate a much more robust understanding of the myriad of factors contibuting to global maternal mortality—as well as the potential implications of the findings of the Lancet paper and necessary next steps towards achieving MDG5.

Some authors express cautious excitment that investments are (or might be depending on the author) paying off while simultaneously declaring that it is not yet time to celebrate; far too many women are still dying of pregnancy-related causes!  Joanne Jorissen Chiwaula, director of the African Mothers Health Initiative describes her frustration with Chris Murray (one of the authors of the Lancet paper) for downplaying the importance of emergency obstetric care services in favor of playing up the importance of HIV services, when a comprehensive approach is really what is needed. Mary Robinson, president of Realizing Rights: The Ethical Globalization Initiative, calls attention to the relationship between maternal health and discimination against women, lack of reproductive choices for women, child marriage, sexual violence, unsafe abortions and inability to own property. She emphasizes the importance of considering maternal health in the context of human rights—and also points out the need to focus on strengthening entire health systems. 

Take a look at a group of Letters to the Editor published on April 18th, and more on April 19th.

For readers comments on the initial story in the Times, click here.

And for Nicholas Kristof’s take on the new maternal mortality estimates, click here.

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Horton comments on the new study, Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5, published today in the Lancet Online First, that suggests a dramatic reduction in global maternal mortality between 1980 and 2008. Horton describes additional significant findings in the paper–aside from the overall drop in maternal deaths. He also outlines five lessons to be learned from this paper. 

 The Lancet

“…What lessons can be drawn from these new data? First, the latest figures are, globally, good news. The provide robust reason for optimism. More importantly, these numbers should now act as a catalyst, not a brake, for accelerated action on MDG-5, including scaled-up resource commitments. Investment incontrovertibly saves the lives of women during pregnancy. 

       Second, the intimate connection between HIV and maternal health is now explicitly laid bare. Such an association, including tuberculosis, has been gaining important recent ground. This latest evidence therefore supports growing calls to integrate maternal and child survival programmes into vertical funding mechanisms for the MDGs, such as the Global Fund to fight AIDS, Tuberculosis, and Malaria…”

Read the full commentary, Maternal mortality: Surprise, hope and urgent action.

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A new paper, Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5, published today in the Lancet Online First, suggests that global maternal deaths have dropped from 526,300 in 1980 to 342,900 in 2008.

The Lancet

The authors of the paper, estimate that the global MMR decreased from 422 maternal deaths/100,000 live births in 1980 to 251 maternal deaths/100,000 live births in 2008. They also conclude that more than 50%  of all maternal deaths in 2008 occurred in six countries alone: India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of Congo.

“…Our analysis of all available data for maternal mortality from 1980 to 2008 for 181 countries has shown a substantial decline in maternal deaths. Progress overall would have been greater if the HIV epidemic had not contributed to substantial increases in maternal mortality in eastern and southern Africa. Global progress to reduce the MMR has been similar to progress to reduce maternal deaths, since the size of the global birth cohort has changed little during this period. Across countries, average yearly rates of decline from 1980 to 2008 in the MMR differed widely. This new evidence suggests there is a much greater reason for optimism than has been generally perceived, and that substantial decreases in the MMR are possible over a fairly short time…”

Read the full paper here.

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