Weekend Reading

Friday, April 29th, 2011 by Christopher Lindahl

This week on the MHTF blog:

  1. We wrote about the connection between malaria and maternal health
  2. A film about maternal health will be featured by The Economist Film Project
  3. Reports from a hospital in Libya
  4. More on stillbirths from The Lancet
  5. A post about stillbirths and maternal mental health

Some reading for the weekend:

  1. Reducing maternal mortality in remote settings
  2. Using information and data to improve health
  3. Attempting to understand the lives of the poor
  4. A number of takes on family planning and US foreign policy
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Stillbirth and maternal mental health

Friday, April 29th, 2011 by Christopher Lindahl

We’ve written before on GlobalMama (free registration required) about the mental health aspect of maternal health and how mental health is missing from the global health agenda. The recent Lancet stillbirth series should bring the issue of maternal mental health because for every stillborn child, there is a mother who has lost a child. Also, many stillbirths result from traumatic births, meaning many mothers are exposed to additional risk factors.

 

A simple internet search for “stillbirth and maternal mental health” returns more results for, what one might consider, the opposite relationship, namely, the link between a mother’s mental health prior to birth and the birth outcome rather than the impact of a stillbirth on a mother’s mental health. A 2008 study suggests that women who suffer from mental illness are more likely to experience stillbirth than women without a history of mental illness. However, the researchers conclude that it is not necessarily the mental illness itself that causes the relationship: “Higher risk of perinatal loss may be linked to factors associated with maternal psychiatric illness in general, such as insufficient attendance for antenatal care and unhealthy lifestyles rather than the maternal mental illness itself.”

 

Fortunately, some of the Google Scholar results look into the impact of stillbirth or infant death on a mother’s mental health. Also, select results on PubMed Central address the issue, but in general, there is a lack of data available, particularly in the developing world where most stillbirths and traumatic births occur.

 

Researchers at the University of Michigan Medical School are currently looking into this exact question, receiving a grant to study “Maternal Mental and Physical Health Outcomes after Stillbirth and Infant Death.” They are studying women in the US “to improve mental health care and outcomes of bereaved mothers after stillbirth and infant death.” More studies, such as these, are needed, with a particular focus on developing countries in order to fully address the spectrum of maternal health, including mental health needs after stillbirth or delivery in general.

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Richard Horton on Stillbirths

Thursday, April 28th, 2011 by Christopher Lindahl

Earlier this month, The Lancet published a series on stillbirths to shed light on a health issue that is often ignored. Many of the causes of stillbirth also can lead to poor maternal outcomes, and many of the solutions and interventions to address stillbirth and maternal health are the same. Richard Horton, Editor-in-Chief of The Lancet discusses the Stillbirth Series below:

 

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How are mothers being affected in Libya?

Wednesday, April 27th, 2011 by Christopher Lindahl

Maternal health in post-conflict or post-crisis settings is a topic that we’ve discussed here on the blog before. However, it is often hard to find data, or even anecdotal, that explains how mothers are impacted by an unfolding crisis. Reports from Benghazi, Libya suggest that the war there is having devastating effects on women. Problems such as a lack of supplies, increasing number of patients, pre-term deliveries, and miscarriages have seemingly increased at Al-Jamahiriya Hospital:

The exhaustion of the nurses and midwives is eclipsed by the frightful spike in caesarians, premature births, intra-uterine deaths and miscarriages the staff have witnessed since February 17, when things turned violent…The hospital has dealt with 450 miscarriages since mid-February, an average of eight a day, compared with just two previously when “bad days” registered four to five cases “at the most.” The nurses have also observed and documented an increase in pre-term deliveries..

 

Read the full article to find out more about the impacts of war on maternal and child health in Libya

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MH film chosen to debut for launch of The Economist Film Project

Tuesday, April 26th, 2011 by Christopher Lindahl

From The Economist:

New York, NY–The Economist Film Project, which presents documentary films that reflect the types of issues The Economist is known for covering, announced today that The Edge of Joy will be the initiative’s debut film. Directed by Chicago-based filmmaker Dawn Sinclair Shapiro, The Edge of Joy takes the viewer right into the midst of a busy maternity ward and closely follows an ensemble cast of Nigerian doctors, midwives and families to the frontlines of maternal care. An excerpt of the documentary will air in a special segment on PBS NEWSHOUR on April 28.

 

Inside the maternity ward, the film chronicles distressed labors, deaths, and miraculous survival. In April 2010, The Lancet published a worldwide study on maternal mortality conducted by The Institute for Health Metrics and Evaluation (IHME) at Washington University. For the first time in decades, researchers are reporting a significant drop in the number of women dying each year from pregnancy and childbirth, from total maternal deaths of roughly 525,000 in 1980 to about 342,900 in 2008. In The Edge of Joy, Ms. Shapiro explores some of the factors that might be contributing to the drop, including new technologies like an anti-shock garment that slows hemorrhaging, to community health initiatives like maternity-only blood banks.

 

Read the rest of this entry »

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World Malaria Day

Monday, April 25th, 2011 by Christopher Lindahl

 

Today is World Malaria Day. As with many other health issues, such as neglected tropical diseases, HIV/AIDS, and nutrition, there are intricate links between malaria and maternal health.

 

A 2010 paper by Dellicour et al. estimates that over 50 million pregnancies occur in areas with stable transmission of P. falciparum malaria (the most lethal strain). The authors also estimate that 10,000 pregnant women die as a result of malaria infection each year. While this represents only a small percentage of all maternal deaths, they are largely preventable. Not only does malaria threaten the life of a mother, but also it “increases the risk of maternal anemia; stillbirth; spontaneous abortion; low birth weight; [and] neonatal death,” according to the World Health Organization.

 

A 2007 paper from The Lancet Infectious Diseases estimates from a meta-analysis that preventing malaria infections in pregnancy “reduces the risk of severe maternal anaemia by 38%, low birthweight by 43%, and perinatal mortality by 27% among paucigravidae [women in their first or second pregnancies].” The low birth weight for infants results in an estimated 100,000 infant death per year in Africa alone.

 

Given the linkages between maternal health and malaria, on World Malaria Day, let’s hope maternal health experts are thinking about the impact of malaria and vice versa.

 

More on malaria and maternal health:
Malaria in Pregnancy Consortium
Malaria in Pregnancy Resource Package (JHPIEGO)
Roll Back Malaria
Global Malaria Action Plan
Malaria Policy Center
Op-Ed: On World Malaria Day, renewing our commitment to maternal health and fighting malaria

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Weekend Reading

Friday, April 22nd, 2011 by Christopher Lindahl

This week on the MHTF blog:

  1. We posted about an upcoming USAID Maternal Health Technical Series
  2. We commented on the World Bank-IMF Global Monitoring Report
  3. There was a Maternal Health Policy Dialogue on accessing care in urban slums
  4. Mama was launched by the Women’s Refugee Commission and Marketing for International Development
  5. Today is the deadline to apply for the Women Bloggers Deliver

Some reading for the weekend:

  1. Scaling up post abortion care
  2. A scorecard for identifying risk in Mumbai
  3. Misoprostol trials showing results in Senegal
  4. The impact of performance-based payment for health providers in Rwanda
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The WHO World Medicines Situation Report

Friday, April 22nd, 2011 by Christopher Lindahl

The World Health Organization (WHO) published this week some chapters of the World Medicines Situation Report 2011. According to the WHO:

The third edition of the World Medicines Situation Report brings together new data on 24 key topics relating to pharmaceutical production and consumption, innovation, regulation and safety – in one place.

 

Topics include selection, procurement, supply management, rational use, financing and pricing. Cross-cutting chapters cover household medicines use, access and human rights, good governance, human resources and national medicines policies.

 

Each chapter of this report is written by a different author. Chapters are being published electronically, in batches, between April and December 2011. The new report updates the 1988 and 2004 reports.

 

Only select chapters have been published, but more are expected in June and the entire report will be available in December. If medicines relating to maternal health are of interest to you, be sure to check out our communities of practice on Maternal Health Supples and Uterotonics.

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Mama: Together for Safe Births in Crises

Thursday, April 21st, 2011 by Christopher Lindahl

The following post is contributed by the Women’s Refugee Commission (WRC) who launched the Mama project. To read a blog post by Marketing for International Development (M4ID), who worked with the WRC to design the platform, click here. This post was originally posted on the WRC blog and is posted here with permission.

 

One thousand women and girls die every day from pregnancy-related causes—that’s about one every 90 seconds. And the overwhelming majority of the countries with the highest rates of maternal mortality are conflict-affected. Yet, the numerous campaigns and programs working to reduce our staggering global maternal mortality numbers don’t reach the health care providers working in these dangerous and isolated areas. Working in a relative vacuum with little peer interaction, doctors, nurses, midwives and other health care workers in crisis-affected settings face tremendous challenges without the peer support, information, skills-building opportunities and training that they desperately need.

 

Mama: Together for Safe Births in Crises, a new initiative designed by the Women’s Refugee Commission and social media and development company M4ID, will be launched April 21. Mama is designed to improve maternal health care and reduce maternal death and disability in crisis-affected settings specifically by using social networking to open up new channels of communication—to connect frontline providers in disparate areas to one another and to give them access to training and advice from experts.

 

Though in remote locations, these health care providers told the Women’s Refugee Commission that they use SMS text messaging as their main means of communication and use Facebook fairly regularly. The Mama initiative connects the two in a way never before attempted—for example, allowing texts from a member of the Mama community to stream directly to a Facebook page and for responses posted on the Facebook page that receive at least three “thumbs up” to be streamed back to the person who sent the original query. The campaign also includes Mama Mentors, technical experts who visit the virtual community on a monthly basis to share their medical expertise, professional development advice and words of encouragement. Once a member of the Mama community, a health care provider is no longer alone—he or she will receive peer support and guidance in the most convenient manner possible. At the same time, we’re keeping the threshold for their participation low to encourage use and maximize the benefits to the community.

 

The Women’s Refugee Commission feels strongly that it’s time to go beyond policy to focus on finding ways for maternal health care professionals on the ground to work to improve their skills. Social networking and technology provide vast unexplored ways in which to do just that and we’re excited to take this groundbreaking first step.

 

Check out the campaign!

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New project links Facebook+SMS in support of maternal health in crises settings

Thursday, April 21st, 2011 by Christopher Lindahl

The following post is contributed by Mari Tikkanen, Managing Director of Marketing for International Development (M4ID), which designed the platform for the Mama project with the Women’s Refugee Commission (WRC). To read a blog post from the WRC on Mama, click here. This post also appears on M4ID’s blog and is posted here with permission.

 

A new M4ID-designed Facebook and SMS communications initiative, Mama: Together for Safe Births in Crises, was launched today in New York by the Women’s Refugee Commission. The project addresses an important information gap for maternal health workers in emergencies, as identified by WRC research.

 

Through Mama, health workers are now able to identify themselves as maternal health champions within humanitarian organizations or in the field and to join a community of practice. Maternal health practitioners will, though five innovative applications, be able to seek advice from fellow members, share best practices and lessons learned, assess their own practices/skills level and test their knowledge of the MISP (minimal initial service package). Mama also offers rewards through digital badges for actions taken as well as a ‘Lives Saved Counter’ application through which the community can register when they enabled a safe birth, showing the positive impact of their work.

 

Mama is also an unprecedented initiative as it addresses the isolation faced by many health workers in the field through the use of new technology. For the first time, practitioners who may not have access to the Internet or smart phones will be able to send their questions/comments about maternal health to the Facebook community via SMS. This text message is posted to the Mama Facebook wall through a Facebook application. The other community members can reply to the question and the answer is sent as a text message back to the practioner. The answer is filtered by the community before it is sent back, and has to be recommended by three members before it is sent.

 

The project also involves Mama Mentors who provide knowledge on technical updates and answer specific questions. The community will focus on different technical/programmatic themes each month and new mentors will be invited to join in and support discussions.

 

We are very proud of this innovative project and look forward to providing continued support to Mama and WRC!

 

Picture Mama

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