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The promotion of maternal health and mortality reduction is of worldwide importance, and constitutes a vital part of the UN Millennium Development Goals. The highest maternal mortality rates are in developing countries, where global and regional initiatives are needed to improve the systems and practices involved in maternal care and medical access. Taking a practical policy approach, this book covers the background and concepts underlying efforts to improve maternal and perinatal mortality, the current global situation and problems that prevent progress.
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
Each year more than 4 million children are born with birth defects. This book highlights the unprecedented opportunity to improve the lives of children and families in developing countries by preventing some birth defects and reducing the consequences of others. A number of developing countries with more comprehensive health care systems are making significant progress in the prevention and care of birth defects. In many other developing countries, however, policymakers have limited knowledge of the negative impact of birth defects and are largely unaware of the affordable and effective interventions available to reduce the impact of certain conditions. Reducing Birth Defects: Meeting the Challenge in the Developing World includes descriptions of successful programs and presents a plan of action to address critical gaps in the understanding, prevention, and treatment of birth defects in developing countries. This study also recommends capacity building, priority research, and institutional and global efforts to reduce the incidence and impact of birth defects in developing countries.
Implementation of guidelines in the health system is a major undertaking, especially in developing countries. An important constraint in guideline development in developing countries is that the guideline recommendations must suit local conditions and must make use of available resources. This is a challenge because the health systems of developing countries have a high burden of disease and little resources; therefore, guidelines must rely on cost-effective healthcare interventions. The BACIS program study was initiated to address some of these challenges in the dissemination and utilization of maternal health guidelines. The BACIS program was piloted, and the results showed that the BACIS program could assist in improving compliance of nurses with the national maternity care guidelines. This is an impressive finding and step forward for maternal healthcare in developing countries. Developing Maternal Health Decision Support Systems in Developing Countries discusses public health aspects of the design and implementation of clinical decision support systems in developing country contexts. Specifically, it focuses largely on the design and evaluation of the BACIS program in South Africa. This is supplemented with a conversation on the possible future research directions in the BACIS program study along with the outlook for clinical decision support systems in developing country contexts in general. This book is ideal for e-health system designers and implementers, managers and policymakers in the area of e-health in developing countries, personnel from NPOs and donor agencies, government officials, IT consultants, medical professionals, practitioners, stakeholders, researchers, academicians, and students who are interested in how decision support systems such as BACIS are being used to improve maternal health in developing countries.
The First International Congress on Maternal and Neonatal Health (IAMANEH) chose as its theme Primary Maternal and Neonatal Health Care: A Global Concern. If the primary goal of all World Health Organization member states of "Health For All By The Year 2000" is to be met, the most difficult challenge lies in the area of maternal and neonatal health care. Indeed, the preventable mortal ity of mothers and their newborns related to the quality of maternity care extracts a greater toll in life expect ancy than any specific disease category. Such mortality is but the tip of an iceberg of morbidity that saps the quality of life of a majority of this world's citizens. They are the less privileged by accident of birth only. An intolerable situation exists. These Proceedings reflect a world concern by m~n~s ters of health, academicians, scientists and providers of maternal and neonatal care. No blueprint is offered for solution of this world's greatest health problem. But the Proceedings do contain an accurate description of the problem and revealing epidemiological diagnoses that both lay bare deficiencies in care and suggest the way to im prove "health for all". The implications of these papers will not bring comfort to those responsible for the allocation of scarce resources for health. They rather suggest radical changes are needed and that failure to make these changes could mean a catastrophic and meaning less loss of life during the balance of this century.
After an overview of women's health, including issues such as poverty, family planning programmes, and urbanization, this comprehensive volume features over 70 essays by doctors, health-care practitioners and policy-makers writing on sexual and reproductive health; maternal and child health and adolescent health. Bibliography; tables; graphs.
The need to improve maternal and child health care may be the most important global health need of the remaining years of the twentieth century. It is central to the World Health Organization's (WHO) goal of Health for All by the Year 2000. The vast majority of births occur in developing countries, where maternity care is often rudimentary. The rates of maternal and infant morbidity and death for these countries are extremely high but much of the morbidity and death is preventable, even with the limited resources available for health care in many parts of the world. The resources devoted to maternal and child care should be greatly expanded, but even the most hopeful projections will leave a wide gap between human needs and available services. WHO estimates that two billion deliveries in the remaining two decades of this century will not be attended by a trained person. At a minimum, it is probable that two million of these women will die in childbirth. There were approximately 130 million births in the world in 1980.
This study provides the most comprehensive and detailed analysis available on factors behind the decline in maternal mortality in Malaysia and Sri Lanka in the past 50 to 60 years and the magnitude of health system expenditures on maternal health. The main findings are that a modest investment in maternal health services, combined with other poverty reduction measures leads to a fairly rapid decline in the maternal mortality ratio (MMR), defined as the number of maternal deaths per 100,000 live births. The strategies of Malaysia and Sri Lanka changed over time, from an initial emphasis on expanding the provision of services, especially in underserved areas, to increasing utilization and, finally, to emphasizing the improvement of quality. Removing financial barriers to maternal care for clients was an important step in both countries. Professional midwives constitute the backbone of maternal care in Malaysia and Sri Lanka. The MMR reduction in developing countries is feasible with modest public expenditures when appropriate policies are adopted, focused wisely, and adapted incrementally in response to environmental conditions and systems capacity. [World Bank]
Sexually transmitted diseases, unintended pregnancies, infertility, and other reproductive problems are a growing concern around the world, especially in developing countries. Reproductive Health in Developing Countries describes the magnitude of these problems and what is known about the effectiveness of interventions in the following areas: Infection-free sex. Immediate priorities for combating sexually transmitted and reproductive tract diseases are identified. Intended pregnancies and births. The panel reports on the state of family planning and ways to provide services. Healthy pregnancy and delivery. The book explores the myths and substantive socio-economic problems that underlie maternal deaths. Healthy sexuality. Such issues as sexual violence and the practice of female genital mutilation are discussed in terms of the cultural contexts in which they occur. Addressing the design and delivery of reproductive health services, this volume presents lessons learned from past programs and offers principles for deciding how to spend limited available funds. Reproductive Health in Developing Countries will be of special interest to policymakers, health care professionals, and researchers working on reproductive issues in the developing world.