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Posts Tagged ‘pregnancy complications’

On Sunday, the New York Times ran an Op-Ed by Nicholas Kristof about the use of Misoprostol for medical abortion. In his column, Another Pill That Could Cause a Revolution, Nick explains that Misoprostol is a safe and cheap method for ending a pregnancy. It is also difficult to regulate because the drug was originally intended to prevent stomach ulcers–and is also used to treat postpartum hemorrhage.

Excerpt from the column:

“Could the decades-long global impasse over abortion worldwide be overcome — by little white pills costing less than $1 each?

That seems possible, for these pills are beginning to revolutionize abortion around the world, especially in poor countries. One result may be tens of thousands of women’s lives saved each year.

Five-sixths of abortions take place in developing countries, where poor sterilization and training often make the procedure dangerous. Up to 70,000 women die a year from complications of abortions, according to the World Health Organization.

But researchers are finding an alternative that is safe, cheap and very difficult for governments to restrict — misoprostol, a medication originally intended to prevent stomach ulcers…”

Read the full story here.

Click here to learn about a recent initiative organized by Gynuity Health Projects to evaluate the safety, efficacy, and acceptability of sublingual misoprostol to treat postpartum hemorrhage.

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Several U.N. agencies recently collaborated on a text messaging initiative to improve communication between community health workers and pregnant women in a community in Rwanda. Local women, health workers, and hospital directors are raving about the initiative but scaling up the project throughout the country may prove challenging; only 6% of the population in Rwanda has electricity and charging phones often means long walks to charging stations.

Reuters

“…John Kalach, director of the nearest hospital in Ruhengeri, says since Rapid SMS launched in August 2009, his hospital has had no maternal deaths, compared to 10 the previous year.

‘We used to get ladies coming here with serious complications just because they delayed the decision because the journey was very long,’ he says.

Kalach says authorities can use the data to work out which diseases affect women during pregnancy, the causes of death for children below five years, the volume and type of drugs required, and to monitor population growth rates.

Friday Nwaigwe, UNICEF’s country head of child health and nutrition, says the next step is to give mobile phones to 17,500 maternal health workers across the country and eventually to all 50,000 community health workers…”

Read the full story here.

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In honor of World Health Day, I wrote a post for the Global Network for Neglected Tropical Diseases blog, End the Neglect. The post looks at the relationship between these two historically neglected global health issues–and calls for more integration.

End the Neglect

“The theme of this year’s World Health Day is “Urbanization and Health.” Maternal mortality and morbidity, and neglected tropical diseases have a hugely debilitating impact on urban slum populations—who often lack access to health services. I would like to take this day to celebrate the increased attention to the connected issues of neglected tropical diseases and maternal health and to highlight the importance of a comprehensive, integrated approach to maternal health. This sort of approach not only includes universal access to reproductive health services but also addresses neglected tropical diseases—and their impact on maternal morbidity and mortality…”

Read the full post, Women and NTDs: Shared History, Shared Hope.

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Five recent stories published on the site have raised various issues impacting maternal health—including leadership and innovation, maternal death audits, access to primary health care and safe delivery, human rights, and even a proposal for a separate maternal health ministry.

allAfrica.com

Namibia: Leadership Development, Social Innovation and Improved System Performance

The Maternal Health Initiative Team,  an offshoot of the African Public Health Leadership and Systems Innovation Initiative, funded by the Bill and Melinda Gates Foundation, is “developing a model for improving public health leadership and system performance.”

“…The project is underpinned by three principles: local leadership development, social innovation and improved system performance.

The initiative applies a business-consulting approach called the Innovation Lab. Through the Innovation Lab, multi-stakeholder teams are guided through an intensive leadership development and problem-based learning experience. The aim is to tackle a complex social and system problem through a multi-stakeholder and innovation response.

When deciding on a priority health problem to tackle as a pilot, it wasn’t hard for Namibian health leaders to choose maternal health. Between 2000 and 2006, maternal mortality jumped to 449 deaths per 100 000 births, an increase of 178 deaths…”

Read the full article,  Namibia:Health Authorities Tackle Maternal Mortality.

Rwanda: A Call for Maternal Death Audits

“…As a strategic move to curb the maternal death rate further and achieve millennium development goal 5, the government recently extended the fight to the village level.

This was announced recently by the Minister of Health, Dr. Richard Sezibera, during a meeting that was held with a visiting US medical team to discuss Rwanda’s health progress.

During the discussions, Sezibera noted that it was imperative to engage the community in fighting maternal death rates so that leaders at the village level can identify the causes of these deaths in bid to find a lasting solution.

‘This year we started maternal death audits in villages because we believe that social audits on death causes will enable authorities identify answers to this problem,’ the minister said…”

Read the full article, Rwanda: Maternal Mortality Control Extends to Village Level.

Nigeria: Improving Access to Primary Health Care and Safe Delivery

“Health System Development Project II, a World Bank assisted project has commissioned two Comprehensive Primary Health Centres at Dagiri community in Gwagwalada and Dabi village at Kwali.

The Health Centres are to address the high rate of maternal and child mortality cases in the country, said Mrs Anne Okigbo-fisher, World Bank task team leader during the hand over ceremony of the centres. She said Nigeria records 10 percent of the world’s maternal mortality rates out of the 524,000 women that die yearly during child birth, adding that approximately 99 percent of the mortality rate is due to child birth complications in developing countries.

According to her the objective of HSDP II is to reduce such complications and improve safe delivery in the country…”

Read the full article, Nigeria: World Bank Commissions N104 Million Hospitals in Abuja.

Kenya: Human Rights Impacting Maternal Health

Amnesty International calls on Kenya’s Parliament to ensure that the draft Constitution of Kenya upholds respect for, the protection and fulfilment of all human rights. The draft Constitution should retain social and economic rights as enforceable rights. In addition, the organization also calls on Parliament to remove the provision stipulating that the right to life begins at conception and if the article on abortion access is retained, provide for abortion for rape victims…

…If the Constitution explicitly limits women’s access to abortion services, it must, at least ensure women’s access to safe and timely abortion services in cases of risk to the life or health of the woman or pregnancy resulting from rape or incest. Such an exemption is required by international law and is required by the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa, which Kenya signed in 2003. In view of the high number of maternal deaths resulting from abortion complications, the State should protect women’s right to life by ensuring meaningful access to sexual and reproductive health services including information and contraception and commit to address sexual violence and coercion…”

Read the full article, Kenya: New Constitution Must Ensure Rights for All.

Uganda: A Call for an Independent Maternal Health Ministry

“An independent ministry should be set up to handle maternal health, the deputy Speaker of Parliament, Rebecca Kadaga, has said.

‘Who is planning for women’s health in this country? Basic things like antibiotics, oxytocins (drugs that help manage bleeding) which cost sh300 and manual vacuum aspirators to remove retained products from the womb are not there,’ she told journalists at a briefing on the state of maternal health on Friday…”

Read the full story, Uganda: Kadaga Wants Independent Maternal Health Ministry.

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International aid groups and public hospitals are struggling to keep up with births in post-earthquake Haiti. The city still lacks adequate numbers of health workers and supplies–leaving many pregnant women without access to obstetric care services.

Miami Herald

A young Haitian doctor finishes delivering 26-year-old Joanne Desir's first baby as she's being held by her husband, Patrice Zephir, in the back of a pickup truck outside the General Hospital in Port-au-Prince. PATRICK FARRELL / MIAMI HERALD STAFF

“..There are new concerns for the 63,000 pregnant women now living in Port-au-Prince. More than 7,000 are expected to give birth this month.

`People here are giving birth under the absolute worst conditions,’ said Dr. Jonathan Evans, a pediatric gastroenterologist volunteering at the University of Miami field hospital. `They can’t find access to midwives. Little problems become big problems.’

In the sprawling camp at the city center of Champs de Mars, where the fruit flies are unrelenting and the stench of human waste inescapable, Antoine Toussaint worries about the health of her unborn child.

Toussaint, 27, is nine months into her pregnancy. She lost her last baby, a son, in childbirth two years ago. This time, Toussaint will have only the help of her family if complications arise…”

Read the full story here.

For more information on the University of Miami response to the earthquake, click here.

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The mobile cinema, backed by UNICEF, is traveling from village to village in Mali screening films that encourage communities to talk openly about maternal and child health issues. After the screening, project leaders hold open discussions with communities about female genital cutting—and the health implications of the practice.

SOS Children’s Villages

“More than 85 per cent of women aged between 15 and 49 in Mali have been circumcised, a practice that has many harmful physical and psychological effects. Across the world, the figure is up to 140 million women and girls in 28 countries, especially in Africa and the Middle East. ‘The female genital mutilation or cutting poses immediate and long-term consequences for the health of women and girls and violates their human rights’, the United Nations Children Fund (UNICEF) said on Friday, before the International Day against Female Genital Mutilation.
The mobile cinema, backed by UNICEF, turned Djènèba Doumbia’s attitudes on the practice on their head. Since seeing the film, she no longer supports female cutting and now does not want to pass the tradition on to the daughters of the community. ‘I tell all women not to circumcise their daughters, to leave them as they are, because we realize that the disadvantages of this practice are numerous and real,’ said Ms Doumbia. ‘So if they let the girls be, the whole family benefits.’ Women at the aftershow discussion hear how those who have been cut are more likely than uncut women to have complications in and after childbirth…”

Read the full story here.

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According to a report by Observatorio de Salud Sexual y Reproductiva, Argentina has the means to address  maternal mortality, but fails to do so because of a lack of political will.

Inter Press Service News Agency (IPS)

“…Argentina has a maternal mortality rate of 44 for every 100,000 live births – two and a half times higher than the average in neighbouring Chile and Uruguay, and a far cry from the six per 100,000 or seven per 100,000 live births in Spain and Italy, for example. Both national authorities and independent experts working on these issues say that at this pace, Argentina will fail to meet the United Nations Millennium Development Goal (MDG) of significantly reducing the number of maternal deaths by 2015, bringing it down to Chile’s and Uruguay’s current levels…”

Read the full story here.

Visit the Observatorio de Salud Sexual y Reproductiva site here.

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