Reflections and a call for action after a two-year exploration of emergency response in acute conflicts
There is general consensus that the humanitarian sector is failing to mount timely and adequate responses in the acute phase of conflict-related emergencies, according to the two-year Emergen...cy Gap Project by Médecins Sans Frontières (MSF).
The Project has explored what works for or against effective emergency responses. Its final report, Bridging the emergency gap, draws on the Project’s thematic papers and case studies, and consultations with more than 150 senior-level representatives from 60 key organisations across the humanitarian sector.
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In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data collection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in ...all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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The aim of this report is to: (1) synthesize the findings from selected maternal and newborn related studies in Nepal conducted during 2011-2014, (2) identify areas of improvement in existing interventions, and (3) recommend possible strategies to fulfill such gaps.
Case study
An emergency WASH gap exists – there is little disagreement on this point within the humanitarian sector. There is a paucity of emergency WASH capacity, but a surplus of complacency. This report provides an overview of both historical trends and current challenges in emergency WASH pro...gramming.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem...ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Nepal has performed exceptionally in improving reproductive, maternal and child health outcomes over the past two decades. In this article, we discuss these achievements and outline a vision for the future of maternal, newborn and child survival in Nepal after the era of the Millennium Development G...oals. On the pathway towards quality universal health care services for all, we propose strengthening of health information systems, gradual health system reforms, improvement of existing facility based services, development of integrated service delivery models, improved technical and managerial capacity at district and facility levels. Elimination of all preventable causes of maternal, newborn and child deaths in Nepal should be our collective aspirational goal.
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Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35000 Nepali children die before their fifth birthday, with almost two-thirds of these deaths occurr...ing in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding.
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Nigeria is committed to end preventable newborn deaths, making life-saving interventions available to all mothers and babies who need them.
The Newborn Situational Analysis reports of 2009 and 2011, as well as the “Bottleneck analysis on neonatal health” of 2013, culminated in the Nigeria launch of “Call to action on Newborn health” at the first National Newborn Health Conference in 2014. This call to action provided the framewo...rk for the development of the Nigeria Every Newborn Action
Plan (NiENAP). The NiENAP lays out a vision to end preventable stillbirths and newborn deaths by accelerating progress and scaling up evidence- based high-impact and cost effective interventions. The plan is guided by the principles of country-leadership, integration, accountability, equity, human rights, innovation and research. This blue print outlines our commitment as government and stakeholders to repositioning newborn health as we implement approaches that impact on the lives of newborns for improved health outcome.
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During the implementation of the National Strategic Plan 2009–2012 on HIV and AIDS, Rwanda has continued its progress towards universal access to HIV and AIDS services. The new HIV and AIDS National Strategic Plan July 2013–June 2018 (thereafter referred to as ‘the NSP’) presented here is se...t on pursuing the same objective, with inspiration from the global targets of “zero new HIV infections, zero HIV-related deaths and zero stigma and discrimination due to HIV”.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 112
The Essential Health Benefit (EHB) is known as Essential Health Care Package (EHCP) in Swaziland. This desk review provides evidence on the experience of EHCPs in Swaziland and includes available po...licy documents and research reports.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric...t and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
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The State of the World's Midwifery
The UNFPA Zambia 2017 Annual Report highlights key milestones and achievements recorded with UNFPA support towards improving the health and well-being of women and young people in Zambia.
A survey of prevention, testing and treatment policies and practices
The UNICEF-GAIN Partnership Project
The report notes that iodine deficiency is a leading cause of preventable brain damage worldwide. Insufficient iodine during pregnancy and infancy results in neurological and psychological deficits, reducing a child’s IQ by 8 to 10 points. This translates ...into major losses in the cognitive capital of entire nations and thus their socio-economic development.
The report outlines urgent steps to reduce the risk of mental impairment to babies’ growing brains:
• Integrate salt iodization into national plans to support children’s nutrition and brain development in early childhood;
• Align salt iodization and salt reduction agendas;
• Establish surveillance systems to identify unreached populations;
• Strengthen regulatory systems to enforce existing legislation on salt iodization;
• Recognize the growing importance of fortified foods as potential sources of iodized salt.
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This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expec...ted health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally. A necessary first step is to monitor whether a broad range of stakeholders are acting to prevent outbreaks from becoming epidemics, whether their capacities to respond to epidemics are robust, and whether preparedness to respond to pandemics and limit the resulting economic and health damage is improving. Analyzing the adequacy of these efforts is vitally important for the decisions of policymakers to invest in the public health and disaster-risk management capacities. Early and effective control of disease outbreaks prevents substantial health and economic costs whether or not the disease can spread globally and become a pandemic.
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The current SEARVAP (South-East Asia regional vaccine action plan) describes a set of regional goals and objectives for immunization and control of vaccine-preventable diseases for 2016 – 2020 and highlights priority actions, targets and indicators that address the specific needs and challenges of... countries in the Region.
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The WHO Framework Convention on Tobacco Control (WHO FCTC) is an evidence-based treaty that reaffirms the right of all people to the highest standard of health and was developed in response to the globalization of the tobacco epidemic. Member States of the WHO South-East Asia Region have made... attempts to implement the demand and supply reduction strategies for tobacco control as recommended by the treaty. While recognizing the need to accelerate implementation of the WHO FCTC in the Region, this document has been developed to support the Member States in implementing the treaty using a ‘PRACTICAL’ Approach which pertains to identified demand and supply reduction strategies under the treaty.
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