Antenatal care

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  • Care for pregnant women differs fundamentally from most other medical endeavours. ‘Routine’ care during pregnancy and birth interferes in the lives of healthy people, and in a process which has the potential to be an important life experience. It is diffi cult to measure the extent to which our efforts may, for example, disturb the development of a confi dent, nurturing relationship between mother and baby. The harmful effects we measure in randomised trials are limited to those we have predicted may occur.

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  • Doctors or midwives carry out an examination of all newborn infants within 24–48 hours of life. The purpose of the examination is to exclude major congenital abnormalities and reassure the parents that their baby is healthy. Examination of the Newborn provides a practical, step-by-step guide for midwives and other practitioners undertaking this role. It also encourages the reader to view each mother and baby as unique, taking into account their experiences preconceptually, antenatally and through childbirth. Examination of the Newborn covers:...

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  • Although the number of new infections among children has decreased sharply over the past several years (as noted previously in this report), greater efforts are needed to ensure that progress continues. Most cases of HIV infection among infants and children stem from insufficient information and counselling provision among women in regards to HIV/AIDS and sexual and reproductive rights and the lack of adequate antenatal care during pregnancy. Respondents consider all new cases to be inexcusable given the broad prevention mechanisms currently available.

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  • In argentina many pregnant women do not visit health centres until late in their pregnancy. There is no gender-specific HIV strategy within the government’s HIV prevention program, and most cases of HIV infection among infants stem from the lack of antenatal care and insufficient information and counselling provided to women on HIV/ AIDS and sexual and reproductive rights. Health care access varies widely across the country, and stigma and discrimination from health care workers impedes service utilization.

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Task shifting in maternal and newborn care: a non-inferiority study examining delegation of antenatal counseling to lay nurse aides supported by job aids in Benin

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  • This guideline has been developed to advise on the clinical management of and service provision for antenatal and postnatal mental health. The guideline recommendations have been developed after careful consideration of the best available evidence by a multidisciplinary team of healthcare professionals, women who have experienced mental health problems in the antenatal or postnatal period and guideline methodologists.

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  • Access to skilled birth attendance is one measure of inequity in maternal health. Differences in socioeconomic aspects account for about two-thirds (61%) of inequalities in skilled birth attendance, of which household wealth accounts for 24%, mother’s education 16% and living in rural areas 12%. 12 When examining the relationship between utilization patterns and offer of skilled care during delivery, women who did not receive valid antenatal care (at least four visits to a health professional during pregnancy) were more likely to deliver without professional care.

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  • The main objective of the 2010 RDHS was to obtain current information on demography, family planning, maternal mortality, infant and child mortality, and health related information such as breastfeeding, antenatal care, delivery, children’s immunization, and childhood diseases. In addition, the survey was designed to evaluate the nutritional status of mothers and children, to measure the prevalence of anemia among women and children, and to measure the prevalence of HIV infection among the male and female adult population.

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  • Proper care during pregnancy and delivery are important for the health of both the mother and baby. Women who had given birth in the five years preceding the survey were asked a number of questions about maternal health care. For the last live birth in that period, mothers were asked whether they had obtained antenatal care during the pregnancy, whether they had received tetanus toxoid injections, and what type of assistance they received at the time of delivery and where the delivery took place. Tables 7.1 and 7.2 present the information on these key maternal care indicators.

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  • There is a large volume of good quality evidence indicating that appropriate screening helps the detection and treatment of alcohol problems (see Annex 2 for a list of alerts). This evidence has consistently shown that screening using the Alcohol Use Disorders Identification Test (AUDIT) is effective within primary care, A&E, pre- and antenatal settings.

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  • More than one in five deaths among children under five occurs during the first week of life, most due to malnutrition in the mother and fetus leading to low birth weights, and compounded by poor antenatal care and lack of skilled birth attendants. Regional estimates of U5MR in 2003 vary from a low of nine per 1000 live births for developed countries to a high of 172 per 1000 live births in sub- Saharan Africa (see Figure 3). In relation to the goal, the difference between regions in the reduction of U5MR over the period 1990-2003 is striking.

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  • The selection of twelve variables for eliciting the composite index for ranking of 569 districts seems to be arbitrary in the sense that some of the important dimensions of reproductive and child health which have a direct bearing on infant and maternal mortality have been altogether omitted from the list of available RCH indicators in the survey reports. The extent of utilization of Antenatal care has often been emphasized as having a direct bearing on maternal and infant health and mortality, especially the neonatal component of infant mortality.

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  • In some countries, adolescents are less likely than adults to obtain skilled care before, during and after childbirth. 8,9 WHO’s recommendations for increasing the use of skilled antenatal, childbirth and postpartum care are informed by one graded study, one ungraded study, existing WHO guidelines and the collective experience and judgment of a panel of experts. The studies were conducted in Chile and India. One intervention was a home visit programme for adolescent mothers. Another was a cash transfer scheme contingent upon health facility births.

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  • In morocco access to antenatal services is limited and many HIV- positive pregnant women are not identified for lack of HIV testing, especially in rural areas. The fear of stigma and discrimination is a major barrier for women to get tested, both at home and in health care settings. Breast-feeding is contraindicated by the Ministry of Health (an outdated recommendation), but formula is provided in only three cities and only 56 percent of the rural population has access to safe drinking water.

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  • Coordination means, at a minimum, that programming within and among U.S. agencies takes advantage of each agency’s strengths, avoids duplication, and increases the efficiency and effectiveness of each dollar spent. Better coor- dination of programs and delivery platforms provides opportunities to strengthen the integration of health services at the point of delivery to meet more of the health care needs of individuals, as well as ensure satisfaction with and increase demand for those services.

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  • The TAHSEEN project in Egypt took advantage of local leaders’ great influence and power for positive change by training them to be positive influences for change in RH/FP practices.

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  • This programmatic update indicates that Options B and specifically B+ are likely to prove preferable to Option A for operational, programmatic and strategic reasons. While Option A has been successfully implemented in a number of highburden countries, generally it has been difficult to implement in many low-resource settings due to the changes in drugs delivered across the care continuum (antenatal, delivery and postpartum) and the requirement for timely CD4 testing to determine which women should initiate ART for their own health.

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  • Now a new, third option (Option B+) proposes further evolution—not only providing the same triple ARV drugs to all HIV-infected pregnant women beginning in the antenatal clinic setting but also continuing this therapy for all of these women for life. Important advantages of Option B+ include: further simplification of regimen and service delivery and harmonization with ART programmes, protection against mother-to-child transmission in future pregnancies, a continuing prevention benefit against sexual transmission to serodiscordant partners, and avoiding stopping and starting of ARV drugs.

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  • Easier implementation could expand services. Reported difficulties with implementing PMTCT programmes, including the challenge of providing ARV treatment in MCH settings and at the primary care level, highlight the importance of simplifying drug regimens and operational delivery, as exemplified by Options B and B+. Easier implementation should facilitate expansion of services and more effective programmes. This will, however, require strengthened antenatal services, task-shifting, more effective ARV service delivery in MCH settings and direct linkages with ART programmes.

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  • A student magazine asserts that a key action towards sustainability is ‘don’t have kids’ (Anon. 2008: 29). Another ‘green’ magazine for parents points out that ‘in the US, even having just one child creates a carbon legacy almost six times greater than each parent’s own lifetime carbon emissions’ (McAleer 2009). Sustainability and birthing human children are figured as mutually exclusive. So how do we get an edited collection of essays in a book with both the words ‘sustainability’ and ‘birth’ in the title?...

    pdf265p mnemosyne75 02-02-2013 13 2   Download


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