International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · Jan 2017
ReviewA systematic review of implementation strategies to deliver guidelines on obstetric care practice in low- and middle-income countries.
Healthcare measures to prevent maternal deaths are well known. However, effective implementation of this knowledge to change practice remains a challenge. ⋯ CRD42014010310.
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The February 2016 WHO declaration that congenital Zika virus syndrome constitutes a Public Health Emergency of International Concern reacted to the outbreak of the syndrome in Brazil. Public health emergencies can justify a spectrum of human rights responses, but in Brazil, the emergency exposed prevailing inequities in the national healthcare system. ⋯ The emergency also illuminates the harm of restrictive abortion legislation, and the potential violation of human rights regarding women's health and under the UN Conventions on the Rights of the Child and on the Rights of Persons with Disabilities. Suggestions have been proposed by which the government can remedy the widespread healthcare inequities among the national population that are instructive for other countries where congenital Zika virus syndrome is prevalent.
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Int J Gynaecol Obstet · Dec 2016
ReviewStrengthening accountability for improved maternal and newborn health: A mapping of studies in Sub-Saharan Africa.
To describe the types of maternal and newborn health program accountability mechanisms implemented and evaluated in recent years in Sub-Saharan Africa, how these have been implemented, their effectiveness, and future prospects to improve governance and MNH outcomes. ⋯ There are few accountability mechanisms in MNH in Sub-Saharan Africa between decision-makers and those affected by those decisions with both the power and the will to enforce answerability. Increasing accountability depends not only on how mechanisms are enforced but also, on how providers and managers understand accountability.
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Int J Gynaecol Obstet · Dec 2016
Effect of combined spinal-epidural analgesia in labor on frequency of emergency cesarean delivery among nulliparous Chinese women.
To determine whether combined spinal-epidural analgesia (CSEA) during labor increases the frequency of emergency cesarean delivery among Chinese nulliparous women. ⋯ Among Chinese nulliparous women, use of CSEA for labor pain was associated with an increased risk of emergency cesarean delivery; moreover, this effect was maintained after adjustment for other potential obstetric risk factors.
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Int J Gynaecol Obstet · Dec 2016
Using advocacy and data to strengthen political accountability in maternal and newborn health in Africa.
Accountability mechanisms help governments and development partners fulfill the promises and commitments they make to global initiatives such as the Millennium Development Goals and the Global Strategy on Women's and Children's health, and regional or national strategies such as the Campaign for the Accelerated Reduction in Maternal Mortality in Africa (CARMMA). But without directed pressure, comparative data and tools to provide insight into successes, failures, and overall results, accountability fails. The analysis of accountability mechanisms in five countries supported by the Evidence for Action program shows that accountability is most effective when it is connected across global and national levels; civil society has a central and independent role; proactive, immediate and targeted implementation mechanisms are funded from the start; advocacy for accountability is combined with local outreach activities such as blood drives; local and national champions (Presidents, First Ladies, Ministers) help draw public attention to government performance; scorecards are developed to provide insight into performance and highlight necessary improvements; and politicians at subnational level are supported by national leaders to effect change. Under the Sustainable Development Goals, accountability and advocacy supported by global and regional intergovernmental organizations, constantly monitored and with commensurate retribution for nonperformance will remain essential.