The Political Economy of Under-Nutrition in Pakistan
by Shehla ZaidiThis report and brief is based on the study 'The Political Economy of Under-Nutrition in Pakistan'. The authors highlight challenges faced for mainstreaming nutrition as an inter-sectoral development priority and provide strategic recommendations using Acosta and Fanzo’s nutrition governance framework.
Effect on Postpartum Hemorrhage of Prophylactic Oxytocin (10 IU) by Injection by Community Health Officers in Ghana: A Community-Based, Cluster-Randomized Trial
by Jai K DasOxytocin is the drug of choice for prevention of postpartum hemorrhage. Its use has generally been restricted to medically trained staff in health facilities. The authors in this paper assessed the effectiveness, safety, and feasibility of PPH prevention using oxytocin injected by peripheral health care providers without midwifery skills at home births.
The recent BMC Public Health supplement “The Lives Saved Tool in 2013: new capabilities and applications” has been published. The series comprise of 30 papers focusing on various domains of maternal child health with a special focus on the interventions reviewed for the prevention and management of childhood diarrhea and penumonia.
Scale-up plan for essential medicines for child health: Diarrhea, Pneumonia and Malaria in Pakistan
by Jai K DasWith an under-five mortality rate of 89 per 1000 live births, Pakistan is lagging behind the desired MDG 4. There is still a need to reduce the under-five mortality rate by 45 percentage points in order to achieve the MDG target by 2015. Each year around 91,000 and 53,300 children die from pneumonia and diarrhea respectively, in Pakistan. Diarrhea, pneumonia and malaria collectively contribute to around 50% of deaths in children. These three diseases, thus, represent a challenging but surmountable obstacle towards achieving the MDG 4 target. Implementation of large-scale interventions and scale-up plan focusing on these three major killers of children in Pakistan is essential. This report identifies the major barriers towards accessing essential medicines by care givers.
Micronutrient fortification of food and its impact on woman and child health: a systematic review
by Jai K DasThis systematic review of the current evidence assessed the effectiveness of food fortification with single micronutrients (iron, folic acid, vitamin A, vitamin D, iodine, zinc) as well as MMN when compared with no fortification on the health and nutrition of women and children.
A qualitative study exploring factors associated with mothers’ decisions to formula-feed their infants in Newfoundland and Labrador, Canada
by Jai K DasThe primary aim of this qualitative study was to examine individual factors that shaped mothers’ decisions to formula-feed their infants.
Opportunities for Africa's newborns: Practical data, policy and programmatic support for newborn care in Africa
by Jai K DasEach year at least 1.16 million newborns die in Sub-Saharan Africa. The African region has the highest rates of neonatal mortality in the world, and has shown the slowest progress so far in reducing neonatal deaths. However there is hope. Under the umbrella of the Partnership for Maternal, Newborn and Child Health (PMNCH), 9 organizations, 60 authors and over 40 reviewers, drawn from policymakers and programme leaders for MNCH in Africa, have been involved and contributed to this publication. The book provides an overview of the continuum of care through the lifecycle and opportunities to address gaps at all levels - family and community care, outreach services and health care facilities.
Despite the global initiative to eliminate mother-to-child transmission of HIV, 210,000 new pediatric infections were added worldwide in 2012 to the existing pool of 3.4 million children living with the virus.Children are more vulnerable to HIV infection and have higher morbidity and mortality. Without treatment, one half of those children infected will die before the age of 2 years, yet only one third of those eligible for treatment are currently receiving antiretroviral therapy. Current initiatives focus on interventions within the traditional prevention of mother-to-child transmission cascade, but the scope of the elimination agenda must be broadened in order to ensure access to care and treatment for all children living with HIV.
Effect of Facilitation of Local Maternal-and-Newborn Stakeholder Groups on Neonatal Mortality: Cluster-Randomized Controlled Trial
by Jai K DasFacilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. This study hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam.
Risk of Early-Onset Neonatal Infection with Maternal Infection or Colonization: A Global Systematic Review and Meta-Analysis
by Jai K DasNeonatal infections cause a significant proportion of deaths in the first week of life, yet little is known about risk factors and pathways of transmission for early-onset neonatal sepsis globally. This review aimed to estimate the risk of neonatal infection (excluding sexually transmitted diseases [STDs] or congenital infections) in the first seven days of life among newborns of mothers with bacterial infection or colonization during the intrapartum period.
Effect of Household-Based Drinking Water Chlorination on Diarrhoea among Children under Five in Orissa, India: A Double-Blind Randomised Placebo-Controlled Trial
by Jai K DasBoiling, disinfecting, and filtering water within the home can improve the microbiological quality of drinking water among the hundreds of millions of people who rely on unsafe water supplies. However, the impact of these interventions on diarrhoea is unclear. The aim of this study was to measure the effect of in-home water disinfection on diarrhoea among children under five.
India, with a population of more than 1.21 billion, has the highest maternal mortality in the world (estimated to be 56000 in 2010); and adolescent (aged 15–19) mortality shares 9% of total maternal deaths. Addressing the maternity care needs of adolescents may have considerable ramifications for achieving the Millennium Development Goal (MDG)–5. This paper assesses the socioeconomic differentials in accessing full antenatal care and professional attendance at delivery by adolescent mothers (aged 15–19) in India during 1990–2006.
Reproductive and Maternal Health in the Post-2015 Era: Cervical Cancer Must Be a Priority
by Jai K DasThe authors propose four arguments for why cervical cancer screening and treatment should be included when it comes to operationalizing these two goals and thus to improving reproductive and maternal health outcomes. Each of the four arguments is illustrative of a larger framework that has equity and socioeconomic, gender, public health, and health services dimensions.
Factors Affecting the Delivery, Access, and Use of Interventions to Prevent Malaria in Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
by Jai K DasMalaria in pregnancy has important consequences for mother and baby. Coverage with the World Health Organization–recommended prevention strategy for pregnant women in sub-Saharan Africa of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs) is low. This systematic review explores factors affecting delivery, access, and use of IPTp and ITNs among healthcare providers and women
Recent research has established linkages of preconception interventions with improved maternal, perinatal and neonatal health outcomes and it has been suggested that several proven interventions recommended during pregnancy may be even more effective if implemented before conception. The authors in this report have collated and synthesized relevant information on interventions available during the preconception period by using standard methods.
Risk Prediction for Breast, Endometrial, and Ovarian Cancer in White Women Aged 50 y or Older: Derivation and Validation from Population-Based Cohort Studies
by Jai K DasBreast, endometrial, and ovarian cancers share some hormonal and epidemiologic risk factors. While several models predict absolute risk of breast cancer, there are few models for ovarian cancer in the general population, and none for endometrial cancer. Using data on white, non-Hispanic women aged 50+ y from two large population-based cohorts, the authors estimated relative and attributable risks and combined them with age-specific US-population incidence and competing mortality rates.
A template for writing a research protocol
by Joby GeorgeGlobal Burden of Sickle Cell Anaemia in Children under Five, 2010–2050: Modelling Based on Demographics, Excess Mortality, and Interventions
by Jai K DasThe purpose of this study is to estimate trends in the future number of newborns with Sickle Cell Anemia (SCA) and the number of lives that could be saved in under-five children with SCA by the implementation of different levels of health interventions.
Presentations from D Groups
The Effect of Intermittent Antenatal Iron Supplementation on Maternal and Infant Outcomes in Rural Viet Nam: A Cluster Randomised Trial
by Jai K DasIntermittent antenatal iron supplementation is an attractive alternative to daily dosing; however, the impact of this strategy on infant outcomes remains unclear. This study compared the effect of intermittent antenatal iron supplementation with daily iron supplementation on maternal and infant outcomes in rural Viet Nam.