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Thousands of HIV-positive women give birth every year. Further, because many pregnant women are not tested for HIV and therefore do not receive treatment, the number of children born with HIV is still unacceptably high. What can we do to eliminate this tragic and costly inheritance? In response to a congressional request, this book evaluates the extent to which state efforts have been effective in reducing the perinatal transmission of HIV. The committee recommends that testing HIV be a routine part of prenatal care, and that health care providers notify women that HIV testing is part of the usual array of prenatal tests and that they have an opportunity to refuse the HIV test. This approach could help both reduce the number of pediatric AIDS cases and improve treatment for mothers with AIDS. Reducing the Odds will be of special interest to federal, state, and local health policymakers, prenatal care providers, maternal and child health specialists, public health practitioners, and advocates for HIV/AIDS patients. January
The proliferation of Acquired Immune Deficiency Syndrome (AIDS) among women and children represents one of the gravest health issues confronting contemporary society. Women, most of childbearing age, now constitute 11 percent of all cases, and the U.S. Public Health Service has projected over 3,000 cases of pediatric AIDS by the end of 1991. In the face of these sobering statistics, experts have been called upon to grapple with a difficult, compelling question: under what conditions, if any, should HIV testing of women and children be required? Also at issue are the surreptitious testing for HIV antibodies as part of routine prenatal and neonatal examinations, and whether such testing should be performed on all women and infants, or only those who belong to groups judged at "high risk". In this unique contribution to the debate about HIV screening and testing, Ruth Faden, Madison Powers, and Gail Geller have assembled perspectives from experts in public health, medicine, law, and ethics. Their wide-ranging treatment examines the history of prenatal and neonatal screening programs; informed consent; legal issues and confidentiality; reproductive decision-making; and numerous other aspects of HIV testing. Alternative policy options for both now and the future are discussed in detail. This volume provides a comprehensive analysis of these pressing medical, public health, legal, ethical, and social issues, and is essential reading for AIDS researchers and clinicians, public health specialists, ethicists, health policymakers and analysts, obstetricians, and pediatricians.
The main aim of this practical Handbookis to strengthen counselling and communication skills of skilled attendants (SAs) and other health providers, helping them to effectively discuss with women, families and communities the key issues surrounding pregnancy, childbirth, postpartum, postnatal and post-abortion care. Counselling for Maternal and Newborn Health Careis divided into three main sections. Part 1 is an introduction which describes the aims and objectives and the general layout of the Handbook. Part 2 describes the counselling process and outlines the six key steps to effective counselling. It explores the counselling context and factors that influence this context including the socio-economic, gender, and cultural environment. A series of guiding principles is introduced and specific counselling skills are outlined. Part 3 focuses on different maternal and newborn health topics, including general care in the home during pregnancy; birth and emergency planning; danger signs in pregnancy; post-abortion care; support during labor; postnatal care of the mother and newborn; family planning counselling; breastfeeding; women with HIV/AIDS; death and bereavement; women and violence; linking with the community. Each Session contains specific aims and objectives, clearly outlining the skills that will be developed and corresponding learning outcomes. Practical activities have been designed to encourage reflection, provoke discussions, build skills and ensure the local relevance of information. There is a review at the end of each session to ensure the SAs have understood the key points before they progress to subsequent sessions.
Proposals for screening pregnant women and newborns for HIV infection have provoked much controversy. This volume analyzes the possible goals of such screening programs and assesses whether these goals can currently be achieved. It also provides guidance to policymakers in developing and implementing sound screening policy.
The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.