Though many pregnant women are aware that treatment could save their lives and the lives of their infants if they test HIV-positive during prenatal care, a new study and literature review have found that a “[f]ear of being stigmatized as an AIDS patient is still a major barrier to good medical care for pregnant young women in many countries,” the New York Times reports. The study, published last week in PLoS Medicine, was “based on a survey of 1,777 women in rural Nyanza Province in Kenya,” according to the newspaper, which adds, “Only 44 percent of mothers in the province delivered in clinics, and the study found that a major obstacle was that they feared HIV tests.” The study’s author, Janet Turan, a professor of public health at the University of Alabama at Birmingham, in July also published “a review of multiple studies in many countries” that documented multiple accounts of “stigmatizing behavior,” the newspaper notes (McNeil, 8/27).
Maternal, Newborn and Child Health
“For the first time researchers have discovered a link between overweight and obese mothers in sub-Saharan Africa and infant mortality,” Jennifer James, founder of Mom Bloggers for Social Good, writes in this post in the Bill & Melinda Gate’s “Impatient Optimists” blog, adding, “In a study published in The Lancet this month, researchers from the London School of Hygiene and Tropical medicine show a definitive correlation between maternal obesity and the prevalence of neonatal deaths (infants who die in the first 28 days of life) especially before two days of age.” She continues, “Now that there is growing maternal obesity in sub-Saharan Africa — albeit slow — this poses a stark contrast to the traditional indicators of neonatal deaths such as underweight mothers and lack of access to health services and trained health workers for pregnancy and delivery in developing countries” (8/24).
Highlighting a recent report by the Journal of the Royal Society of Medicine about the use of the drug misoprostol to prevent postpartum hemorrhage and the WHO’s inclusion of the drug on its Essential Medicine List, Guardian health editor Sarah Boseley writes in this post in her “Global Health Blog,” “Seldom has there been a drug that has excited as much controversy as misoprostol.” She continues, “Misoprostol causes the uterus to contract, which is why it can stop postpartum hemorrhage, the cause of around a quarter of maternal deaths,” but “there has been a huge fight over whether and how well it works, which in some quarters has been ideologically motivated, because misoprostol can also bring about an abortion.”
Study Finds 'Inconclusive' Evidence To Support Use Of WHO-Backed Drug To Prevent Hemorrhage During Labor
According to a study published Monday in the Journal of the Royal Society of Medicine, “[t]he World Health Organization [WHO] should review its approval of a drug used to prevent life-threatening bleeding in women in childbirth because there is not enough evidence that it is effective,” Reuters reports. The study finds that “the evidence to support the use of misoprostol is ‘at best inconclusive,’ yet it is increasingly used in poorer countries to prevent postpartum hemorrhage (PPH),” the news service writes, noting “researchers analyzed 172 previous studies on the use of misoprostol during labor and found that only six had enough information to say whether or not the drug was effective in preventing PPH in rural and community settings in poor countries” (Kelland, 8/20).
“Children in a refugee camp in South Sudan are dying at more than twice the rate internationally recognized as an emergency, according to new figures [.pdf] released by Medecins Sans Frontieres (MSF),” the Guardian reports. “On an average day in the Yusuf Batil camp â€¦ three or four children under the age of five will die,” but, “[i]n a ‘normal’ emergency situation, the number would be one or two deaths daily for every 10,000 children,” the news service writes. “The overall mortality rate, which takes into account adults and older children, is also substantially above the emergency threshold,” according to the Guardian, which adds, “About 58 percent of the camp’s reported deaths have been children under five, while more than 25 percent have been people over 50” (Copnall, 8/20).
In this post in Management Sciences for Health’s (MSH) “Global Health Impact” blog, Belkis Giorgis, senior technical advisor for the Leadership Management and Governance Project at MSH, reports on the International Protecting Girls by Preventing Child Marriage Act (House Resolution 6087), which “establishes a strategy to prevent child marriage and promote the empowerment of girls.” She writes, “If passed into law, the International Protecting Girls by Preventing Child Marriage Act must be implemented in a matter that views the long-term resolution of child marriage as ensuring that young girls are kept in school,” adding, “Most importantly, the legislation must provide effective means to enforce it, to ensure long-term health impact for young women and girls” (8/16).
In this post in the PLoS “Speaking of Medicine” blog, guest blogger Oliver Sabot, executive vice president of the Clinton Health Access Initiative, “reflects on the challenge and opportunity of scaling-up access to effective treatment for diarrhea, the second largest cause of child mortality globally.” In the post, Sabot “reflect[s] on a visit to a program to improve the use of zinc and oral rehydration salts to treat diarrhea in a rural area of the Indian state of Gujarat run by the nonprofit Family Health International 360” (8/15).
“In teaching nurses and midwives in the developing world to care for their patients, a core tenet is that respectful care is quality care,” Catherine Carr, senior maternal health advisor for the Jhpiego/MCHIP-Maternal and Child Health Integrated Program, writes in this post in Huffington Post’s “Global Motherhood” blog. “Around the globe, health-care workers are being trained in respectful, humanized care, because all patients, regardless of economic status or geographic location, deserve to be treated with reverence and consideration,” she continues, adding, “Unfortunately, there is still a huge gap between the maternal care a pregnant woman should receive and what she actually experiences.”
PM Cameron Discusses Foreign Aid, Nutrition Summit; Aid Agencies Deliver Petitions To Downing Street Calling For Government Action On Hunger
British Prime Minister David Cameron “has defended the government’s commitment to overseas aid funding at a time of recession, as he prepares to co-host a hunger summit in Downing Street on the closing day of the Olympics,” the Guardian reports. “Co-hosted with Michel Temer, the Brazilian vice-president, where the 2016 Games will take place, the event is designed to show that the Olympic family is aware of the gaping inequalities faced by competitors,” the newspaper notes, adding though the meeting is not aimed at raising funds, “[i]t is likely to set a target to reduce the number of children left stunted by malnourishment worldwide by as much as 17 million by 2016.” Cameron said on ITV1’s Daybreak program, “There are 170 million children who are malnourished. … I think most people recognize that when there are 170 million people around the world suffering from malnutrition, when there are millions of people living on less than a dollar a day, even at a tough time in Britain, we are right to meet our aid commitments,” according to the Guardian (Mulholland/Wintour, 8/10).
“Agriculture and nutrition are deeply intertwined. Not only does increasing agricultural productivity have the potential to improve rural families’ nutrition, but healthier and better-nourished farmers are more productive, earn more income, and contribute to further economic growth,” Gary Darmstadt, Sam Dryden, and Emily Piwoz of the Bill & Melinda Gates Foundation write in the foundation’s “Impatient Optimists” blog. The authors note they “recently developed a position paper that describes why and how the agriculture and nutrition strategies of the foundation intersect, highlighting ways that we will work together in the future to make complementary investments in order to improve the lives’ and health of families in developing countries.” They conclude, “Combating undernutrition requires contributions from many sectors, including both nutrition and agriculture” (8/9).