These WHO guidelines which were updated in 2018, are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
The 2018 edition of the guidelines includes the re...vision of the recommendation regarding the use of 80% fraction of inspired oxygen (high FiO2) in surgical patients under general anaesthesia with tracheal intubation and the update of the section on implementation. Between 2017 and 2018, WHO re-assessed the evidence on the use of high FiO2 by updating the systematic review related to the effectiveness of this intervention to reduce SSI and commissioning an independent systematic review on adverse events potentially associated with it. Based on the updated evidence, the GDG decided to revise the strength of the recommendation from strong to conditional.
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Lancet Glob Health 2015; 385: e387–95. Open Access
The Baby-friendly Hospital Initiative (BFHI) is a global effort launched by WHO and UNICEF to implement practices that protect, promote and support breastfeeding. It was launched in 1991 in response to the Innocenti Declaration. The global BFHI materials have been revised, updated and expanded for i...ntegrated care. The materials reflect new research and experience, reinforce the International Code of Marketing of Breast-milk Substitutes, support mothers who are not breastfeeding, provide modules on HIV and infant feeding and mother-friendly care, and give more guidance for monitoring and reassessment.
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In 2015, WHO proposed the use of the Robson classification (also known as the 10-group classification) as a global standard for assessing, monitoring and comparing caesarean section rates both within healthcare facilities and between them. The system classifies all women into one of 10 categories t...hat are mutually exclusive and, as a set, totally comprehensive. The categories are based on 5 basic obstetric characteristics that are routinely collected in all maternities (parity, number of foetuses, previous caesarean section, onset of labour, gestational age, and fetal presentation).
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This brochure informes HIV postivie pregnant women what they can do for their and their babies health and stresses the importance of a good medical adivce in the beginning of the pregnancy.
It is also available in several other languages: http://aidshilfe.de/de/shop/positiv-schwanger-deutsch-eng...lisch-franzoesisch-spanisch
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DHS Further Analysis Reports No. 97
This summary brief highlights key messages from the updated World Health Organization’s recommendation on tranexamic acid (TXA) for the treatment of postpartum haemorrhage (PPH), including policy and program implications for translating the TXA recommendation into action at the country level. In 2...012, WHO published recommendations for the prevention and treatment of postpartum haemorrhage, including a recommendation on the use of TXA for treatment of PPH. The 2017 updated WHO Recommendation on TXA is based on new evidence on use of TXA for treatment of PPH. This summary brief is intended for policy-makers, programme managers, educators and providers.
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This new guideline on non-clinical interventions to reduce unnecessary caesarean sections incorporates the views, fears and beliefs of both women and health professionals about caesarean sections. It also considers the complex dynamics and limitations of health systems and organizations and relation...ships between women, health professionals and organization of health care services.
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A cross-sectional descriptive study design covering all states and regions was undertaken to:
1) To assess availability, utilization and supply chain management system for RH commodities at different levels of health facilities,
2) To assess quality of RH services with emphasis on family ...planning in terms of training, supervision, use of guidelines and ICT, and
3) To determine clients’ accessibility to RH services provided at different level of facilities.
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This booklet provides policymakers, planners, and other interested parties with insight into the current state of the Rwandan health sector. These statistics provide a basis for policies, strategies, and planned interventions to ensure they are responsive to the needs of the health sector and, cruci...ally, are focused on addressing current priorities that aim to improve the health of the Rwandan population.
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The guidelines presented in this document are designed to provide a useful resource for healthcare professionals involved in clinical case management. They were developed taking into consideration services provided at different levels within the health system and resources available. These guideline...s are intended to standardize care at both tertiary and secondary levels of service delivery across different socio economic stratifications of our society.
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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 advice is presented in a Q&A format, addressing the following questions:
Are pregnant women at higher risk from COVID-19?
I’m pregnant. How can I protect myself against COVID-19?
Should pregnant women be tested for COVID-19?
Can COVID-19 be passed from a woman to her unborn or newborn ba...by?
What care should be available during pregnancy and childbirth?
Do pregnant women with suspected or confirmed COVID-19 need to give birth by caesarean section?
Can women with COVID-19 breastfeed?
Can I touch and hold my newborn baby if I have COVID-19?
I have COVID-19 and am too unwell to breastfeed my baby directly. What can I do?
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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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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