An account of 3 skills sharing workshops in South India.
The Lancet Series on Childhood Pneumonia and Diarrhoea, led by Aga Khan University, Pakistan, provides evidence for integrated control efforts for childhood pneumonia and diarrhoea.The series of four papers assesses the global burden of these two illnesses and identifies a set of highly cost-effective interventions that can prevent most diarrhoea deaths and nearly two thirds of pneumonia deaths by 2025, if delivered at scale. It also highlights the findings from consultations with several hundred frontline workers in high-burden countries and explores the barriers and enablers they face in dealing with these two diseases and potential ways forward. The final paper represents a call to action and discusses the global and country-level remedies needed to eliminate preventable deaths from these illnesses by 2025.
Despite published guidance on writing the abstract in the PRISMA Statement guiding the reporting of systematic reviews in general and elsewhere, evaluations show that reporting of systematic reviews in journal and conference abstracts is poor. Teh authors developed consensus-based reporting guidelines as an extension to the PRISMA Statement on good reporting of systematic reviews and meta-analyses in abstracts.
Young Children's Probability of Dying Before and After Their Mother's Death: A Rural South African Population-Based Surveillance Study
by Jai K DasThere is evidence that a young child's risk of dying increases following the mother's death, but little is known about the risk when the mother becomes very ill prior to her death. We hypothesized that children would be more likely to die during the period several months before their mother's death, as well as for several months after her death. Therefore the authors in this paper investigated the relationship between young children's likelihood of dying and the timing of their mother's death and, in particular, the existence of a critical period of increased risk.
In this article, the authors illustrate five basic statistical concepts that can significantly impact the interpretation of the medical literature and its application to the care of patients, drawing examples from the vaccine literature: (i) consider clinical and statistical significance separately, (ii) evaluate absolute risks rather than relative risks, (iii) examine confidence intervals rather than p values, (iv) use caution when considering isolated significant p values in the setting of multiple testing, and (v) keep in mind that statistically nonsignificant results may not exclude clinically important benefits or harms.
There have been significant improvements in the performance of the Expanded Programme on Immunization (EPI) in Africa since its inception in 1974. However, there exist wide inter- and intra-country differences.
The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis
by Jai K DasVitamin D insufficiency together with high serum levels of vitamin A increases the risk for osteoporosis in postmenopausal women
by Jai K DasThis is a cross-sectional study to evaluate the association between vitamin D deficiency/insufficiency and excess of vitamin A intake as an osteoporosis risk factor in healthy postmenopausal women.
Vitamin K Supplementation in Postmenopausal Women with Osteopenia (ECKO Trial): A Randomized Controlled Trial
by Jai K DasVitamin K has been widely promoted as a supplement for decreasing bone loss in postmenopausal women, but the long-term benefits and potential harms are unknown. This study was conducted to determine whether daily high-dose vitamin K1 supplementation safely reduces bone loss, bone turnover, and fractures.
Home fortification with multiple micronutrient powders for pregnant women-The Guidelines
by Jai K DasIt is estimated that 41.8% of pregnant women worldwide are anaemic. Approximately 60% of these cases in non-malarious areas, and 50% in malaria-endemic settings, are assumed to be due to iron deficiency. We share the WHO guideline providing global, evidence-informed recommendations on the use of multiple micronutrient powders for home fortification of foods consumed by pregnant women.
The use of mobile phones has grown exponentially in the last decade including in some of the most remote and low-resource regions of the world. The use of mobile technology in health care is known as mHealth. mHealth interventions are being used internationally to improve maternal and child health. Be it the use of a mobile phone to call for emergency transport, remote consultation, or large-scale short message service (SMS)-based community education programs, mHealth is demonstrating its utility in reproductive health programs throughout the world. This article describes the evolution and challenges of mHealth, discusses the role of mHealth in achieving Millennium Development Goals 4 and 5, and addresses the potential impact of mHealth for midwives
Critical issues in conducting non-commercially sponsored clinical research in South Africa: Meeting report 1st Feb 2013
by Elizabeth Allen - Regional Faculty Lead, Lesley Workman - Senior Contributor, Cordelia ReddyOn 1st February 2013, Global Health Trials Southern African Regional Faculy held the first of its Clinical Trials Skills-Sharing Workshops in South Africa, hosted by the University of Cape Town. Here you can find the presentations from the day.
Helminth infections impose a great burden on poor populations in the developing world – yet robust, low-cost and effective public health interventions are available to relieve that burden and provide a better quality of life for people in poor settings. We share the WHO Guidleines for the Preventive chemotherapy in human helminthiasis.
Clinical Trials in East Africa: a One-Day Skills Sharing Workshop Report
by George Mukalazi Miiro, Emily N KabuyeReport on a one-day skills sharing workshop for improved clinical trials and research in East Africa, hosted by UVRI/MRC, EACCR and Global Health Trials and held on 15th February 2013.
The universal coverage with the full package of these proven interventions at observed levels of program effectiveness could prevent about one quarter of child deaths under 36 months of age and reduce the prevalence of stunting at 36 months by about one third. I attach my recent review on the possible strategies to combat malnutrition include promotion of breastfeeding, dietary supplementation of micronutrients, prevention of protein-energy malnutrition, and hygiene of available weaning foods and how best topackage these intevrentions for universal scale-up.
In response to the unacceptable maternal health situation, WHO has developed the Pilot Edition of the Safe Childbirth Checklist, to support the delivery of essential maternal and perinatal care practices. The WHO Safe Childbirth Checklist contains 29 items addressing the major causes of maternal death (namely, haemorrhage, infection, obstructed labour and hypertensive disorders), intrapartum-related stillbirths (namely, inadequate intrapartum care), and neonatal deaths (namely birth asphyxia, infection and complications related to prematurity) in low-income countries. It was developed following a rigorous methodology and tested for usability in ten countries across Africa and Asia. Please have a look at the below link:
Translating Coverage Gains into Health Gains for All Women and Children: The Quality Care Opportunity
by Jai K DasThe health outcomes of women and children have not matched expectations from the gains in the coverage of care. Robust evidence exists for one explanatory factor: the poor–rich gaps in coverage found along the continuum of care for women and children, and particularly for the crucial period around childbirth. The more-neglected explanation for the mismatch between coverage and health outcomes is the quality of the care provided to women and children. The following paper is structured around a key cause and a consequence of the neglect of quality—weak measurement and poor evidence for action—and concludes with priorities for seizing the quality care opportunity.
These guidelines help address the urgent need to develop tests that can work in children, ideally using non-sputum based samples. It is vital that these reference standards are endorsed and implemented by the major donors, researchers and diagnostic developers.
Women of reproductive age are at increased risk of anaemia because of chronic iron depletion during the menstrual cycle. It is estimated that worldwide there are 469 million anaemic women of reproductive age. At least half of the cases are attributed to iron deficiency. We share the WHO guidleines for Intermittent iron and folic acid supplementation in menstruating women.
Maternal, newborn, and child health indices in Nigeria vary widely across geopolitical zones and between urban and rural areas, mostly due to variations in the availability of skilled attendance at birth. To improve these indices, the Midwives Service Scheme (MSS) in Nigeria engaged newly graduated, unemployed, and retired midwives to work temporarily in rural areas. This paper describes the structure, processes, challanges and the outcomes acheived through MSS.