Maternal Health

Task shifting and sharing in Tigray, Ethiopia, to achieve comprehensive emergency obstetric care

Amanuel Gessessew
Gebre Ab Barnabas
Ab Barnabas
Ndola Prata
Karen Weidert
2011

Objective: To assess the contribution of nonphysician clinicians (NPCs) to comprehensive emergency obstetric care (CEmOC) in Tigray, Ethiopia. Methods: We conducted a retrospective review of the obstetric records of all women treated from January 1, 2006, to December 31, 2008, at the 11 hospitals and 2 health centers with CEmOC status in Tigray. Data were collected using 2 questionnaires, one concerning the facility and the other concerning the patient. Results: During the studied period 25,629 deliveries and 11,059 obstetric procedures (3369 of which were major surgical interventions)...

Microcredit participation and nutrition outcomes among women in Peru

Lia Fernald
Rita Hamad
2010

Microcredit services-the awarding of small loans to individuals who are too poor to take advantage of traditional financial services-are an increasingly popular scheme for poverty alleviation. Several studies have examined the ability of microcredit programmes to influence the financial standing of borrowers, but only a few studies have examined whether the added household income improves health and nutritional outcomes among household members. This study examined the hypothesis that longer participation in microcredit services would be associated with better nutritional status in women....

Criticism of misguided Chu et al. article

Malcolm Potts
Caitlin Gerdts
Ndola Prata
Friday Okonofua
Nuriye Hodoglugil
Nap Hosang
Karen Weidert
Ashley Fraser
Suzanne Bell
2012

Chu, Brhlikova and Pollock’s article suggests the WHO rethink its decision to include misoprostol on the Essential Medi- cines List. Their paper is a sad example of workers in an elite setting advocating policies with the potential to endanger the lives of thousands of vulnerable women in low-resource settings.

Published in Journal of the Royal Society of Medicine 2012: 105(11), 454.

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Evaluation of a traditional birth attendant training programme in Bangladesh

Ndola Prata
Paige Passano
Tami Rowen
2011

Background and context: the 1997 Safe Motherhood Initiative effectively eliminated support for training traditional birth attendants (TBAs) in safe childbirth. Despite this, TBAs are still active in many countries such as Bangladesh, where 88% of deliveries occur at home. Renewed interest in community-based approaches and the urgent need to improve birth care has necessitated a re-examination of how provider training should be conducted and evaluated.

Objective: to demonstrate how a simple evaluation tool can provide a quantitative measure of knowledge...

Do Economists Have Frequent Sex?

Malcolm Potts
Martha Campbell
2012

Last year a member of the World Bank professional staff gave a lecture on development in Africa on the UC Berkeley campus. His audience asked him about rapid population growth in that continent. He immediately dismissed the question, saying that population growth did not need any special attention. It would look after itself. He was voicing an uncritical interpretation of the demographic transition, a “theory” which has as much evidence to support it as the fictitious Da Vinci Code, and like the Da Vinci Code it remains perennially popular.

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Misoprostol for postpartum hemorrhage prevention at home birth: an integrative review of global implementation experience to date

Jeffrey Michael Smith
Rehana Gubin
Martine M Holston
Judith Fullerton
Ndola Prata
2013

BACKGROUND: Hemorrhage continues to be a leading cause of maternal death in developing countries. The 2012 World Health Organization guidelines for the prevention and management of postpartum hemorrhage (PPH) recommend oral administration of misoprostol by community health workers (CHWs). However, there are several outstanding questions about distribution of misoprostol for PPH prevention at home births.

METHODS: We conducted an integrative review of published research studies and evaluation reports from programs that distributed misoprostol at the...

The role of private providers in maternal health

Priya Agrawal
Oona M R Campbell
Ndola Prata
2014

Every day, nearly 800 women die from complications of pregnancy and childbirth. A great many of these deaths are preventable; however, there is no single, straightforward solution. Because identification of every woman who will have a life-threatening complication during pregnancy or childbirth is impossible, saving of women’s lives during pregnancy and childbirth needs a systems approach with on-call structures in place that can respond immediately and effectively to these complications, around the clock. This challenge is daunting for most of the countries where the burden of maternal...

New hope: community-based misoprostol use to prevent postpartum haemorrhage

Ndola Prata
Paige Passano
Suzanne Bell
Tami Rowen
Malcolm Potts
2012

The wide gap in maternal mortality ratios worldwide indicates major inequities in the levels of risk women face during pregnancy. Two priority strategies have emerged among safe motherhood advocates: increasing the quality of emergency obstetric care facilities and deploying skilled birth attendants. The training of traditional birth attendants, a strategy employed in the 1970s and 1980s, is no longer considered a best practice. However, inadequate access to emergency obstetric care and skilled birth attendants means women living in remote areas continue to die in large numbers from...

Training traditional birth attendants on the use of misoprostol and a blood measurement tool to prevent postpartum haemorrhage: lessons learnt from Bangladesh

Ndola Prata
Suzanne Bell
Paige Passano
Daniel Bohl
Arshadul Islam
2015

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum...

Assessing political priority for reproductive health in Ethiopia

Ndola Prata
Anna Summer
2016

Ethiopia is among the top six countries contributing to the highest numbers of maternal deaths globally. The Ethiopian total fertility rate was estimated at 4.8 in 2011, and the use of contraceptives by married women was 29%. Lack of knowledge, cultural stigma surrounding abortion, and barriers to access of services contribute to persistently high rates of unsafe abortion and abortion-related mortality. This study seeks to assess the generation and institutionalization of political priority for reproductive health within the political systems of Ethiopia. Interviews with key policy makers...