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BMJ Open Quality 2017;6:e000145. doi:10.1136/
bmjoq-2017-000145Although there are many evidence-based practices that reduce the risk of maternal and neonatal mortality around the time
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of birth, there remains a gap between what is known and the care received. This knowdo gap is a source of preventable maternal and perinatal deaths and is the focus of improvement efforts in many countries. Following an increase in perinatal and maternal deaths, Gobabis District Hospital initiated a quality improvement (QI) initiative to increase adherence to these WHO Safe Childbirth Checklist (SCC)-targeted essential birth practices.
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In 2008 the Ministry of Health and Social Services (MOHSS) commissioned a national health and social service system review which found that although some progress has been made in primary health care, provision
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of health services did not go beyond the health facilities, irrespective of the fast distances between the Health facilities and community. The review then recommended that health services should be extended in a structured manner to communities through the establishment of paid health workers.
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Challenges in achieving the MDG for maternal mortality. In-depth analysis of the EDHS 2000-2011
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are mor
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e than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso were limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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India contributes to 16% of the global maternal deaths and around 27% of global newborn deaths. Reducing the burden of maternal and newborn
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mortality and morbidity in urban poor settings today requires an expansion of effective Maternal and Newborn Health (MNH) care services and lowering the barriers to the use of such services, especially availability and accessibility.
For designing sensitive, responsive and relevant urban health policy and action, it is important for planners and programme managers to understand the context with regard to current systems and mechanisms, potential organisations and best practices.
In order to adres this need, Save the Children’s Saving Newborn Lives programme commissioned a study that reviewed the literature and looked at available secondary data on MNH in urban poor settings.
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A manual for physicians and other senior health workers. This fourth revision of the manual reflects recent clinical experience and research findings in diarrhoea case management. Compared to earlie
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r versions, it includes revised guidelines on the management of children with acute diarrhoea using the new reduced (low) osmolarity ORS formulation and using zinc supplements, which have been shown to reduce duration and severity of diarrhoeal episodes, and revised guidelines for the management of bloody diarrhoea. Guidelines in the manual are based on the revised WHO chart that are included at the end of this document.
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In where under-five mortality is high and vitamin A deficiency is a public health problem, two high-dose supplements of vitamin A per year, spaced four to six months apart, can strengthen children
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s immune systems and improve their chances of survival.
During much of early childhood – from 6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive. more
During much of early childhood – from 6 months to 5years of age – two high doses of vitamin A every year can prevent blindness and hearing loss, boost children’s immunity against diseases like measles and diarrhoea and provide critical protection against death. Like all forms of malnutrition, vitamin A deficiency is a marker of inequality. In countries where diets are lacking in vitamin A and infections and deaths are prevalent, supplementation programmes give vulnerable children a better chance to survive, develop and thrive. more
Pocket book of hospital care for children
recommended
Guidelines for the Management of common childhood Illness. 2nd edition
These guidelines focus on the management of the major causes of childhood
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mortality in most developing countries, such as newborn problems, pneumonia, diarrhoea, malaria, meningitis, septicaemia, measles and related conditions, severe acute malnutrition and paediatric HIV/AIDS. It also covers common procedures, patient monitoring and supportive care on the wards and some common surgical conditions that can be managed in small hospitals.
A smart phone and tablet application is available from the Apple or Google Play Store.
Special attention is drawn to the following sections, which are particulary relevant within the COVID-19 context:
Chapter 4: information on cough and difficulty in breathing, pneumonia and bronchiolitis;
Chapter 10: information on essential supportive care including feeding, fluid and oxygen provision;
Annex 1: information on related practical procedures.
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Zimbabwe Cholera Control Guidelines
recommended
3rd edition
Maternal and child malnutrition is a significant public health problem in South Sudan. Among children aged 6-59 months, 31% are stunted, 28% are underweight, and nearly 23% are acutely malnourished of
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which 13% are estimated to suffer from moderate acute malnutrition and 10% from severe acute malnutrition.
Overall, South Sudan’s nutrition situation is worrisome, with GAM persistently above the emergency threshold in the Greater Upper Nile, Northern Bahr el Ghazal and Warrap states. Though data on micronutrient deficiencies is scanty, Vitamin A Supplementation (VAS) among children 6-59 months stood at only 2.6% in 2010, showing low uptake (SHHS, 2010). This is against a backdrop of high morbidity levels and a negligible proportion of children 6 to 23 months receiving at least the recommended minimum acceptable diet. In order to ensure optimal child growth, it is essential to ensure good nutrition and basic health care from pregnancy through two years of age (the first 1000 days). more
Overall, South Sudan’s nutrition situation is worrisome, with GAM persistently above the emergency threshold in the Greater Upper Nile, Northern Bahr el Ghazal and Warrap states. Though data on micronutrient deficiencies is scanty, Vitamin A Supplementation (VAS) among children 6-59 months stood at only 2.6% in 2010, showing low uptake (SHHS, 2010). This is against a backdrop of high morbidity levels and a negligible proportion of children 6 to 23 months receiving at least the recommended minimum acceptable diet. In order to ensure optimal child growth, it is essential to ensure good nutrition and basic health care from pregnancy through two years of age (the first 1000 days). more
Since December 2010, Malaria Consortium has been implementing an innovative approach to community management of severe acute malnutrition, together with an existing integrated community case management (ICCM) programme in South Sudan. This learning
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paper considers Malaria Consortiums experience of this combined approach in a highly complex context and shows whether the management of severe acute malnutrition is an effective, acceptable and feasible component of ICCM programming
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This is one of seven Medical Peace Work courses.
These standards for the quality of paediatric care in health facilities form part of normative
guidance for improving the quality of maternal, new
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born, child and adolescent health care.
In view of the importance of the continuum of both the life-course and service delivery (1),
these standards build on the Standards for improving the quality of maternal and newborn
care in health facilities (2), during labour, childbirth and the early postnatal period.
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The purpose of adding the books to the website of MCAI for download, is to make this life-saving, up-to-date information available to all who need it. Fill in a short registration field and you can
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download the pdf-files.
If you work in a hospital in a low income country - providing free care - you are probably intitled to FREE copies of these books. MCAI will send them to you, all you have to do is to read our Flyer and fill in the request form.
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Action on behalf of unaccompanied and separated children should be guided by principles enshrined in international standards. The validity of these principles has been confirmed by
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experience and lessons learnt from conflicts and natural disasters in recent years. The objective of the present publication is to outline the guiding principles which form the basis for action in this regard.
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Strengthening the capacities of SUN Countries by sharing and disseminating good practices in the fight against malnutrition.
This report is a summary of the results
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of the preparation and implementation of the Learning Route (LR) organized jointly by the SUN (Scaling Up Nutrition) Movement’s Secretariat, the Fight Against Malnutrition Unit (CLM, Cellule de Lutte contre la Malnutrition) and PROCASUR Corporation; this Learning Route was held in Senegal from the 26th of May to the 1st of June, 2014. The aim of this publication is to illustrate the experience, its main outcomes, and the lessons learned.
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The IMCI model handbook provides a detailed explanation of the IMCI case management guidelines. It is organized into seven main parts: overview of the IMCI process; assess and classify the sick
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child age 2 months up to 5 years; assess and classify the sick young infant age 1 week up to 2 months; identify treatment; treat the sick child or the sick young infant; communicate and counsel; and give follow-up care.
Teaching institutions are advised to adapt the handbook in two ways:
to ensure that all text, charts and illustrations are consistent with nationally-adapted IMCI clinical guidelines, and
to ensure that its content and format corresponds to the teaching approach used by the institution.
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