newborn health

Women visit the SDSH-supported Marmont clinic in Haiti’s Central Plateau. {Photo credit: C. Gilmartin/MSH.}Photo credit: C. Gilmartin/MSH.

Late one April night in 2012, 19-year-old Ilionelle was struggling to give birth at her home in rural northwest Haiti. After several hours, she began having seizures, a clear indication of eclampsia, a severe medical disorder that can lead to the death of the mother and/or baby.

Ilionelle’s situation is not uncommon in Haiti, which has the highest maternal mortality rate in the Western hemisphere with 630 deaths per 100,000 live births. Fortunately, Tilma, the traditional birth attendant helping Ilionelle, quickly identified these life-threatening symptoms and arranged for her transport to Beraca Hospital for emergency obstetric care. After being carried on a stretcher for four hours along a steep and treacherous road, Ilionelle arrived at Beraca Hospital where she safely delivered a healthy baby boy. “If it wasn’t for Tilma, both my son and I could have died,” Ilionelle said.

Tilma is among thousands of Haitians working to improve their nation’s health after recent years of misfortune.

When I worked in Smallpox eradication in the mid-1970s, I traveled all over northern India and Bangladesh. I never took malaria prophylaxis, because malaria had been cleared from those areas. Likewise, I did not take malaria prophylaxis when I worked in the Brazilian Amazon in the late-1970s. At that time, malaria was found only in gold miners in isolated tributaries of the Amazon. Now, due to our financial inability to continue high levels of malaria eradication activities worldwide in that time period, emergence of both anti-malarial and insecticide resistance, and spread of the mosquito vectors, all of these are heavily malaria endemic areas with a high mortality rate for pregnant women and children.

The World Health Organization (WHO) recently released the World Malaria Report 2012, summarizing 2011 data from 104 malaria-endemic countries and citing progress and challenges toward the eradication of malaria.

Immaculée, seated, holding her twin boys. Thanks to the intervention of the center’s midwife, at left, both of these babies are now in good health. {Photo credit: IRC.}Photo credit: IRC.

Thirteen newborns die every hour in Democratic Republic of the Congo (DRC). So on July 23, when 25-year old Immaculée went into labor with twins at the Monvu Reference Health Center in the Idjwi Health Zone, and her first twin was born without signs of life, the chances of survival were not in his favor.

The odds are stacked against newborns in the DRC: neonatal mortality hovers around 97 deaths for every 1,000 live births, and has done so for years, explaining the acute need for intervention in this area.

Recognizing this need, the USAID-funded DRC-Integrated Health Project (DRC-IHP), in conjunction with the Church of Latter Day Saints and the Ministry of Public Health, organized a “Helping Babies Breathe” training in Kinshasa in April 2012, to build the capacity of health providers who oversee labor and delivery.

Helping Babies Breathe is an evidence-based neonatal resuscitation approach designed for resource-limited areas, which teaches health workers how to handle newborns’ breathing in their first minute of life, a critical period known as the “Golden Minute.”

Democratic Republic of the Congo {Photo credit: MSH.}Photo credit: MSH.

Last night, while in the Democratic Republic of the Congo (DRC) visiting our programs, I attended a US election-eve gathering of mostly Congolese people in Kinshasa. The DRC is one of those “distant nations” President Obama was referring to in his early morning acceptance speech today, where people are, “risking their lives just for… the chance to cast their ballots like we did today.”

Fragile, conflict-ridden nations, such as the DRC, struggle with leadership and governance. Its people have been victims of horrific violence, stunning gender inequality, and some of the worst health conditions in the world. They deserve better.

The United States reelected President Barack Obama to lead not only our country, but also to lead on addressing global health and other global development challenges such as those faced by the DRC.

Management Sciences for Health (MSH), a global non-profit organization dedicated to saving lives and improving health for the poorest and most vulnerable in the world, has long been a partner with the US government, foundations, and other donors, working in more than 140 countries to build stronger and more sustainable health care systems.

Uganda. {Photo credit: Paydos/MSH.}Photo credit: Paydos/MSH.

The Ugandan government launched a new prevention of mother-to-child HIV transmission (PMTCT) strategy on September 12.

Uganda will transition from an approach based on the World Health Organization's (WHO) Option A --- which is contingent on an HIV-positive pregnant woman’s CD4 count --- to WHO's newest PMTCT strategy, Option B+.

Option B+ — whereby HIV-positive pregnant women receive lifelong treatment, regardless of their CD4 levels — originated in 2010 when the Malawian government decided to combine antiretroviral therapy (ART) with PMTCT in response to the challenges of providing reliable CD4 testing in remote settings.

The WHO updated its PMTCT guidelines with Option B+ in April of this year.

Blog post updated Dec. 27, 2011.

Taj Bibi learns how to use zinc and oral rehydration salts to treat her child. Photo credit: BASICS/Afghanistan, MSH.

Taj Bibi sits nursing her 5-month-old baby in the kitchen of her home in the village of Sartal in Takhar province in Afghanistan’s north. The room is dark; the only natural light comes from the doorway to the dusty courtyard outside. The sound of her children playing echoes across the small family compound.

Bibi’s first two children died -- one of them from severe diarrhea -- because the family could not afford to take them to the doctor. “Now, if our children get diarrhea or any other illness, I take them to the community health worker,” she said.

Community health workers (CHWs) are the building blocks of the Afghan health system, bringing basic health services to villages across the country.

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