“Morocco has made great strides in improving maternal health in recent years, decreasing its maternal mortality ratio by over 60 percent since 1990,” but “a wide maternal health gap” exists between women in urban and rural areas, where deliveries generally are attended by an experienced yet untrained family member, Women’s eNews reports. In 2010, according to a 2011 report from the U.N. Population Fund, the maternal mortality rate in urban areas was 73 deaths per 100,000 live births, compared with 148 deaths per 100,000 live births in rural areas, the news service notes. “[W]hen a [rural] woman runs into serious trouble … access to life-saving care is a two-hour walk away, on a rough mountainous path sometimes blocked by snow,” the news service writes, adding Abdelghani Drhimeur, head of communications at the Ministry of Health in Rabat, said, “Seventy percent of mothers who die do so on the way to the hospital.” Women’s eNews examines several organizations’ efforts to educate women about sanitation, hygiene, nutrition, and technical midwifery skills (Bhatia, 9/24).
Quality of Care
Though the global community has “made incredible inroads” on the Millennium Development Goals (MDGs), “the majority of developing countries are still expected to fall short of the MDG targets for reducing maternal and child mortality by 2015,” Carole Presern, director of the Partnership for Maternal, Newborn & Child Health (PMNCH), writes in the Huffington Post’s “Global Motherhood” blog. A report released recently by PMNCH “sheds light on the reasons why more progress is not being made to end these needless deaths” by examining “commitments made to advance the Global Strategy for Women’s and Children’s Health” launched by U.N. Secretary-General Ban Ki-moon in 2010, she notes.
“Today about 12 percent of the health work force [in the U.S.] is foreign-born and trained, including a quarter of all physicians,” Kate Tulenko, senior director of health system innovation at IntraHealth International, writes in a New York Times opinion piece, adding, “That’s bad for American workers, but even worse for the foreign workers’ home countries, including some of the world’s poorest and sickest, which could use these professionals at home.” She says expensive schooling and strict credential requirements, which some foreign-trained workers do not have to meet, are keeping U.S. health workers from entering the workforce.
A new pilot project in Cambodia is allowing more than 3,000 volunteer health workers to use a special mobile phone text messaging service to report new cases of malaria, in addition to providing no-cost testing and treatment “in remote parts of the impoverished nation, where access to health services can be difficult,” Agence France-Presse reports. When a person tests positive for malaria, health workers begin them on treatment immediately and send a text message with the patient’s age, gender, type of malaria, and location “to the district health center, provincial health officials and a national malaria database in the capital Phnom Penh — a process that used to take a month,” AFP notes. “The information is also fed into Google Earth to create a map of reported cases and of potential hotspots of [malaria drug] resistance,” a problem in western Cambodia, according to the news service. “Together, the data helps officials track each case and make sure the right treatment is available or that more medication is supplied when stocks are running low,” AFP writes, adding, “Some 230 volunteers have used the mobile phone service so far and there are plans to eventually include all volunteers in the project,” which is being implemented by the Malaria Consortium (Se, 9/17).
“The non-communicable disease [NCD] community always talks about the importance of prevention; many consider it the Holy Grail in the fight against NCDs. Why was it so hard to also accept treatment as part of the solution?” Princess Dina Mired, director general of the King Hussein Cancer Foundation in Amman, Jordan, asks in the Huffington Post “Impact” blog, noting only one target of the 2011 U.N. High-Level Meeting on NCDs “deals with treatment, the target on ‘essential medicines and basic technologies for treatment.'” She continues, “Treatment and prevention are heavily interrelated. The success of one is directly related to the other.” She adds, “A person in the developing world will not buy in to the importance of prevention if there is no treatment option available should that person get the disease.”
“Following criticism over a spate of patient deaths from adverse events during clinical trials, India has begun tightening up rules for clinical research and compensation as well as expanding its pool of medical experts,” SciDev.Net reports. A health ministry official said the ministry would submit to Parliament amendments to existing laws with the aim of strengthening the approval process for clinical trials, according to the news service. In addition, the Central Drugs Standard Control Organisation (CDSCO) is expanding its pool of experts, “has asked ethics committees for tougher inspection regimes,” and in August “issued guidelines on compensation to be paid in case of clinical trials-related death or injury,” the news service notes. According to SciDev.Net, “These steps follow the report of a parliamentary committee, in May 2012, which found that a large number of imported drugs had been cleared without trials,” “includ[ing] drugs that had failed to be cleared for use in the parent countries” (Sreelata, 9/12).
“As many as 200 million children across the world fail to reach their full potential because their early brain development is held back by poverty, disease and malnutrition, global health experts said on Thursday,” Reuters reports (Kelland, 9/13). The Canadian government-funded Grand Challenges Canada on Thursday “announced $11.8 million CAD [$12 million] in funding over two years for 11 bold ideas from innovators in the developing world, to address health conditions causing diminished cognitive potential and stunting,” according to a Grand Challenges Canada press release (9/13). The projects, which will be implemented in developing countries such as Thailand, Pakistan, Bangladesh, and Colombia, “include plans to encourage so-called ‘kangaroo mother care,’ where low-weight newborns are held skin to skin rather than put into incubators, and ways of combating maternal depression to boost interaction between mothers and babies,” Reuters notes (9/13).
The Center for Strategic and International Studies (CSIS) on Thursday hosted a panel discussion focusing on the policy implications of findings published by the Lancet in a special series on HIV/AIDS and men who have sex with men (MSM), the Center for Global Health Policy’s “Science Speaks” blog reports (Barton, 9/7). Chris Beyrer, a professor of international health at the Johns Hopkins Bloomberg School of Public Health and a contributor to the Lancet series, explained two factors are affecting the expansion of the HIV epidemic among MSM worldwide, according to Inter Press Service. First, HIV “is far more efficiently transmitted through the gut, hence leading to a far higher transmission probability in anal sex, for either a man or a woman — around 18 times more likely than through vaginal transmission,” the news service writes. Second, “because gay men can switch sexual roles in a way that is impossible among heterosexual couples — acting as both the acquisition and transmission partner — the efficiency of transmission among MSM networks appears to be far higher than previously understood,” IPS adds, noting, “These two factors, the new research suggests, account for a full 98 percent of the difference between HIV epidemics among MSM and heterosexual populations.”
Ugandan Parliamentarians Threaten To Hold Up National Budget Unless More Funding Committed To Health Care
In Uganda, where “there are fewer than two health workers for every 1,000 people — a level the World Health Organization defines as a severe shortage” — the nation’s parliamentary “social services committee, which has initial oversight of the country’s health budget, pushed a resolution through parliament last week threatening to hold up approval of the entire budget unless funding to recruit and retain new health workers is increased,” VOA News reports. “Committee members, with support from the Women’s Parliamentary Association, called for a specific increase of at least $103 million to the sector,” the news service notes. “In addition to the funding increase, the parliamentarians are calling for an end to a wage freeze for current employees and a ban on recruiting new health workers,” as well as “demanding a supplementary pool of money to improve health care in communities that are particularly short staffed,” according to the news service.
In a 200th anniversary article for the New England Journal of Medicine, Salmaan Keshavjee of the Department of Global Health and Social Medicine at Harvard Medical School and Paul Farmer of Partners in Health “seek to elucidate the reasons for the anemic response to drug-resistant tuberculosis [TB] by examining the recent history of tuberculosis policy,” they write. The authors outline the history of TB drug development and how the disease became resistant to myriad drugs, and write that by the 1970s, “[t]uberculosis, whether caused by drug-susceptible or drug-resistant strains, rarely made even medical headlines, in part because its importance as a cause of death continued to decline in areas in which headlines are written. They continue, “In the United States, federal funding for tuberculosis research was cut; consequently, drug discovery, development of diagnostics, and vaccine research ground almost to a halt.”