The primary audience for this guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to tho...se directly providing care to pregnant women and preterm infants, such as obstetricians, paediatricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for pre- and in-service training of health workers to enhance their delivery of maternal and neonatal care relating to preterm birth.
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The Thinking Health manual outlines an evidence-based approach describing how community health workers can reduce prenatal depression through evidence-based cognitive-behavioural techniques recommended by the mhGAP programme.
This manual is the first volume of WHO’s new series on low-intensity p...sychological interventions.
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En el presente documento se comunica el progreso logrado en la Región hacia la eliminación de la transmisión maternoinfantil del VIH y la sífilis entre los años 2010 y 2017. Se trata también del primer informe regional sobre la eliminación de la transmisión maternoinfantil y durante la prime...ra infancia de la hepatitis B y la enfermedad de Chagas congénita. Los resultados principales son los siguientes: El acceso de las embarazadas a la atención prenatal y del parto es alto en la Región de las Américas.
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Este documento ha sido concebido para proporcionar un marco que respalde los estudios de prevalencia de las ITS en los niveles local y nacional. El propósito de estos estudios es conocer la carga de las infecciones por NG y CT, dos ITS prioritarias que dan lugar a resultados obstétricos y perinata...les adversos.
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Santé de la mère au Sénégal selon l’Enquête Continue 2014
Le présent document expose des recommandations exhaustives de l’OMS sur les soins prénatals systématiques à l’intention des femmes enceintes et des adolescentes. Le but de ces recommandations est de compléter les directives de l’OMS existantes sur la prise en charge des complications spé...cifiques associées à la grossesse. Elles sont destinées à refléter et à répondre à la nature complexe des problèmes entourant la pratique et la délivrance des soins prénatals et à donner la priorité à la santé et au bien-être de la personne – et pas seulement à la prévention de la mortalité et de la morbidité – selon une démarche visant le respect des droits de l’homme.
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Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effec...t on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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The main objective of the 2014-15 RDHS was to obtain current information on demographic and health indicators, including family planning; maternal mortality; infant and child mortality; nutrition status of mothers and children; prenatal care, delivery, and postnatal care; childhood diseases; and ped...iatric immunization. In addition, the survey was designed to measure indicators such as domestic violence, the prevalence of anemia and malaria among women and children, and the prevalence of HIV infection in Rwanda. For the first time, this 2014-15 RDHS also includes indicators to monitor HIV testing among children age 0-14 as well as domestic violence for males age 15-59.
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En 2016, en ce début de l’ère des objectifs de développement durable (ODD), la morbidité et la mortalité évitables liées à la grossesse restent inacceptablement élevées. Bien que des progrès substantiels aient été enregistrés, les pays doivent consolider et faire progresser ces acqui...s et élargir leurs objectifs pour aller au-delà de la survie, en visant, pour leurs populations, un niveau de santé et de potentiel optimal.
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L’OMS recommande aux femmes enceintes de faire un test de dépistage du VIH, de la syphilis et de l’hépatite B (HBsAg) au moins une fois pendant la grossesse, de préférence au cours du premier trimestre. Le double test de diagnostic rapide (TDR) VIH/syphilis peut être utilisé comme premier ...test pour les femmes enceintes dans le cadre des soins prénataux. Ces tests simples peuvent être utilisés sur le lieu de soins et sont économiques par rapport aux tests standards de soins prénataux.
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Fetal alcohol spectrum disorders (FASD) represent a range of physical, mental, and behavioral disabilities caused by alcohol use during pregnancy, or prenatal alcohol exposure (PAE). FASDs are considered to be one of the leading preventable causes of developmental disability. Despite its high preval...ence, FASD is often misdiagnosed or underdiagnosed, making interventions more challenging or delayed.
his publication was initially developed for use in Spanish-speaking countries of the Americas and is intended to serve as a training workbook for providers of various disciplines to learn about the fundamentals of diagnosing FASD and to apply them to several case scenarios. It also discusses ethical implications of diagnosing FASD to the mother and child. Target audiences include physicians, psychologists, allied health professionals, social workers, and other providers that may encounter individuals affected by FASD. It is ideally used as a supplement for in-person training by experts in the fields of dysmorphology, epidemiology, and neuropsychology.
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En 2015, el 26% de los decesos de 5,9 millones de niños que murieron antes de cumplir los cinco años podría haberse prevenido
abordando los riesgos medioambientales; una impactante oportunidad perdida. El período prenatal y de la primera infancia
representa un escenario de particular vulnerabi...lidad, donde los peligros medioambientales pueden conducir al parto prematuro y otras complicaciones, y aumentar el riesgo de desarrollar una enfermedad de por vida, como enfermedades respiratorias, enfermedades cardiovasculares y cáncer. De este modo, el medio ambiente representa un factor importante en la salud infantil, así como una gran oportunidad de implementar mejoras, con efectos observados en cada región del mundo
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En 2015, 26 % des décès de 5,9 millions d'enfants de moins de cinq ans auraient pu être évités si les facteurs de risque
environnementaux avaient été pris en compte – cette possibilité manquée de sauver des vies est révoltante. La période prénatale
et de la petite enfance constitue u...ne source de vulnérabilité particulière, les menaces environnementales pouvant provoquer une
naissance prématurée et d'autres complications, et accroître le risque de maladies chroniques, et notamment de troubles respiratoires, de maladie cardiovasculaire et de cancer. L'environnement est donc un facteur majeur de la santé des enfants et offre d'importantes possibilités d'amélioration dont les effets se manifestent dans toutes les régions du monde.
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In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents
a window of particular vulnerability, where enviro...nmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
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En 2014, le taux de mortalité maternelle au Cambodge était estimé à 170 décès pour 100 000 naissances vivantes, et le taux de mortalité néonatale à 18 décès pour 1000 naissances vivantes, selon l’enquête démographique et de santé menée au Cambodge en 2014 . Ces chiffres signifient q...ue le Cambodge a atteint les cibles des Objectifs du Millénaire pour le Développement (OMD) en 2015 pour la mortalité maternelle, la mortalité néonatale et d’autres indicateurs majeurs de la santé de la
mère, du nouveau-né et de l’enfant tels que les accouchements avec l’assistance de personnel qualifié, les accouchements dans des établissements de santé, les deuxièmes consultations de soins prénatals (ANC2+), les accouchements par césarienne et le ratio d’établissements d’orient
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Background: In 2015, 5.3 million babies died in the third trimester of pregnancy and first month following birth. Progress in reducing neonatal mortality and stillbirth rates has lagged behind the substantial progress in reducing postneonatal and maternal mortality rates. The benefits to prenatal an...d neonatal health (PNH) from maternal and child health investments cannot be assumed. Methods: We analysed donor funding for PNH over the period 2003–2013. We used an exhaustive key term search followed by manual review and classification to identify official development assistance and private grant (ODA+) disbursement records in the Countdown to 2015 ODA+ Database.
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We created a dataset to generate estimates of donor-reported ‘official development assistance’ and private grants (ODA+) to reproductive, maternal, newborn and child health (RMNCH) by donor, recipient country and activity type over the period 2003–2013. We collected disbursement information fr...om the Organisation for Economic Co-operation and Development Creditor Reporting System (CRS) in January 2015. All 2.1 million records across all sectors were coded based on donor name, project title, short and long descriptions, and CRS code describing the purpose of the disbursement. We classified records according to the degree to which they would promote attainment of Millennium Development Goals 4 and 5 (reproductive and sexual health, maternal and newborn health, and child health). We also classified records according to whether they supported prenatal and neonatal health (PNH). The dataset includes project funding as well as allocating shares of general budget support, health sector support and basket funding. The data can be used to analyse resource flows to RMNCH or to other purposes or beneficiaries of ODA+.
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Just under 2.5 million people die annually due to alcohol use. This global estimate, however, excludes most of the health burden
borne by others than the alcohol user. Alcohol’s harm to others includes a multitude of conditions, such as trauma from traffic crashes, fetal disorders due to prenatal... exposure to alcohol, as well as interpersonal and intimate partner violence. While alcohol’s causal role in these conditions is well-established, alcohol’s harm to others’ contribution to the overall health burden of alcohol remains unknown. This knowledge gap leads to a situation in which alcohol policy and prevention strategies largely focus on the reduction of alcohol’s detrimental health harms on the alcohol users, neglecting affected others and population groups most vulnerable to these harms, including women and children. In this article, we seek to elucidate why estimates for alcohol’s harm to others are lacking and offer guidance for future research. We also argue that a full assessment of the alcohol health burden that includes the harm caused by others’ alcohol use would enhance the visibility and public awareness of such harms, and advancing the evaluation of policy interventions to mitigate them.
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