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Improving the survival chances and quality of life of women, newborns, and children remains an urgent global challenge. Since 2012, substantial progress has been made in reducing maternal and under-5 deaths, and a only handful of countries are on target to meet the SDG targets in 2030. Yet, 5 millio
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n children still die each year under the age of 5, and nearly half of those are newborns less than a month old. Worse still, the global maternal mortality ratio is going in the wrong direction.
A Decade of Progress and Action for the Future will examine the tenacity and innovation that helped us make gains, the lessons learned through monitoring, country-led adaptation and leadership, analysis, and reflection, as well as the approaches we must take to reinvigorate the momentum and global commitment to improving maternal and child survival. Increasing coverage, strengthening the quality of care, and enhancing equity will be tantamount to our global progress.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observat
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ions are as follows:
In 2018, 487 (12.5%) of the 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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At the threshold of Sustainable Development Goals (SDG) era, this document captures the remarkable achievements by Member States towards achieving MDGs 4 and 5. It acknowledges new opportunities in the post-2015 phase shaped by the SDGs and the Global Strategy for women’s, children’s and adoles
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cents’ health and presents an advanced state of preparedness in the Region. This also highlights the region’s renewed commitment for a more inclusive and more dynamic flagship action for ending preventable maternal, newborn and child mortality as well as to improve women’s, children’s and adolescents’ health and wellbeing in the South-East Asia Region.
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The leishmaniases are a group of diseases caused by Leishmania spp., which occur in cutaneous, mucocutaneous and visceral forms. They are neglected tropical diseases (NTDs), which disproportionately affect marginalized populations who have limited access to health care. HIV co-infected patients with
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Leishmania infection are highly infectious to sandflies, and an increase in the coinfection rate in an endemic area is likely to increase the effective infective reservoir.
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Financing Global Health 2017: Funding Universal Health Coverage and the Unfinished HIV/AIDS Agenda
Institute for Health Metrics and Evaluation (IHME)
Institute for Health Metrics and Evaluation (IHME)
(2018)
C2
In 2017, $37.4 billion of development assistance was provided to low- and middleincome countries to maintain or improve health. This amount is down slightly compared to 2016, and since 2010, development assistance for health (DAH) has grown at an annualized
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rate of 1.0%. While global development assistance for health has seemingly leveled off, global health spending continues to climb, outpacing economic growth in many countries. Total health spending for 2015, the most recent year for which data are available, was estimated to be $9.7 trillion (95% uncertainty interval: 9.7–9.8)*, up 4.7% (3.9–5.6) from the prior year, and accounted for 10% of the world’s total economy. With some sources of health spending growing and other types remaining steady, and with major variations in spending from country to country, it is more important than ever to understand where resources for health come from, where they go, and how they align with health needs. This information is critical for planning and is a necessary catalyst for change as we aim to close the gap on the unfinished agenda of the Millennium Development Goals (MDGs) and move forward toward universal health coverage (UHC) in the Sustainable Development Goals (SDGs) era.
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Saving Lives Through Safe Surgery (SaLTS)
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
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e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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For health care providers.
Sub-Saharan Africa has the highest maternal mortality in the world. According to estimates by the United Nations Maternal Mortality Estimation Inter-Agency Group (UN MMEIG)1 in September 2017, while the African Region had recorded a significant decline in maternal mortali
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ty rate (MMR) of 37.8% between 2000 and 2017, 66% of the 295 000 maternal deaths reported globally occurred in sub-Saharan Africa. The African Region is also noted to have an extremely high MMR, estimated at 542 per 100000 livebirths, with an average annual rate of reduction of 2.9%.
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Over the period 2015 to 2019, scaling up a package of selected nutrition-specific and nutrition sensitive interventions to cover 90 per cent of Sudan would:
- Reduce the under-five mortality rate to 49/1,000 live births
- Reduce the preva ... lence of stunting to 25 per cent
- Reduce the prevalence of wasting (global acute malnutrition – GAM) to 6 per cent
- Increase exclusive breastfeeding to 63 per cent
- Reduce iron deficiency anaemia among pregnant women to 26 per cent. more
- Reduce the under-five mortality rate to 49/1,000 live births
- Reduce the preva ... lence of stunting to 25 per cent
- Reduce the prevalence of wasting (global acute malnutrition – GAM) to 6 per cent
- Increase exclusive breastfeeding to 63 per cent
- Reduce iron deficiency anaemia among pregnant women to 26 per cent. more
Induced abortion is permitted in Burkina Faso only to save the life and protect the health of a
pregnant woman, or in cases of rape, incest, and severe fetal impairment. As a result, the vast
majority of women who end unintended pregnancies do so in secrecy, out of fear of prosecution
and to avoi
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d the social stigma that surrounds this practice. Most clandestine abortions are carried
out in unsafe conditions that jeopardize women’s health and sometimes their lives. This report
presents estimates of the number and rate of induced abortions that occurred in Burkina Faso in
2008 and 2012; reports levels of unintended pregnancy (the major reason that women seek
abortions in the first place); and describes some of the adverse consequences of unsafe abortion
for women, their families and society.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan
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ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Level of stunting among Bangladeshi children <5years declined from 51% in 2004 to 36% and underweight from 41% in 2007 to 33% (BDHS 2014). But the decrease in wasting rate is not as expected, which is only from 17% to 14.3 % over last decade. Approx
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imately 3.1 % (BDHS 2014) of under-5 children suffering from SAM only by weight-for-length or height z-score (WHZ) <-3 criterion and estimated to be a total of ~ 450,000. Because, there are no national information on prevalence of SAM using mid upper arm circumference (MUAC) and presence of bipedal oedema in under-5 children, thus the actual number of children suffering from SAM could be much higher than the current estimate.
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The FCHV program focuses on family planning, maternal/neonatal and child health.
Vitamin A distribution program. The activity of FCHV is contributing to Nepal’s goal of reducing the total fertility rate and under five mortality a
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nd maternal mortality rates.
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