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Articles 1 - 30 of 57
Full-Text Articles in Medicine and Health Sciences
Full Breastfeeding Protection Against Common Enteric Bacteria And Viruses: Results From The Mal-Ed Cohort Study, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Murray-Kolb, Gagandeep Kang, Aldo A M. Lima, Estomih Mduma, Margaret N. Kosek, Elizabeth T Rogawski Mcquade, Eric R. Houpt, Zulfiqar Ahmed Bhutta
Full Breastfeeding Protection Against Common Enteric Bacteria And Viruses: Results From The Mal-Ed Cohort Study, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Murray-Kolb, Gagandeep Kang, Aldo A M. Lima, Estomih Mduma, Margaret N. Kosek, Elizabeth T Rogawski Mcquade, Eric R. Houpt, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Breastfeeding is known to reduce risk of enteropathogen infections, but protection from specific enteropathogens is not well characterized.
Objective: To estimate the association between full breastfeeding (days fed breast milk exclusively or with non-nutritive liquids) and enteropathogen detection.
Design: 2,145 newborns were enrolled in eight sites, of whom 1,712 had breastfeeding and key enteropathogen data through 6 months. We focused on eleven enteropathogens: adenovirus 40/41, norovirus, sapovirus, astrovirus, and rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter spp, and typical enteropathogenic E. coli as well as entero-aggregative E. coli, Shigella and Cryptosporidium. Logistic regression was used to estimate the risk of …
Sustainable Developmental Goals Interrupted: Overcoming Challenges To Global Child And Adolescent Health, Zulfiqar Ahmed Bhutta, Kathryn M. Yount, Quique Bassat, Caitlin E. Moyer
Sustainable Developmental Goals Interrupted: Overcoming Challenges To Global Child And Adolescent Health, Zulfiqar Ahmed Bhutta, Kathryn M. Yount, Quique Bassat, Caitlin E. Moyer
Woman and Child Health
No abstract provided.
The Ability And Safety Of Community-Based Health Workers To Safely Initiate Lifesaving Therapies For Pre-Eclampsia In Ogun State, Nigeria: An Analysis Of 260 Community Treatments With Mgso4 And/Or Methyldopa, Akinmade A. Adepoju, Marianne Vidler, Adebayo A. Akadri, Ebun Jaiyesimi, Chimaobi C. Nwankpa, Oluwafayokemi O. Odubena, Sumedha Sharma, Larry Li, Domena Tu, Zulfiqar Ahmed Bhutta
The Ability And Safety Of Community-Based Health Workers To Safely Initiate Lifesaving Therapies For Pre-Eclampsia In Ogun State, Nigeria: An Analysis Of 260 Community Treatments With Mgso4 And/Or Methyldopa, Akinmade A. Adepoju, Marianne Vidler, Adebayo A. Akadri, Ebun Jaiyesimi, Chimaobi C. Nwankpa, Oluwafayokemi O. Odubena, Sumedha Sharma, Larry Li, Domena Tu, Zulfiqar Ahmed Bhutta
Woman and Child Health
Objectives: To evaluate community-based health workers' ability to identify cases of hypertension in pregnancy, safely deliver methyldopa and magnesium sulphate and make referrals when appropriate.
Study design: This was part of Nigeria Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial (NCT01911494). Community-based Health Workers (CHW) recruited pregnant women from five Local Government Areas (clusters) and used mobile health aid for clinical assessment of pre-eclampsia.
Main outcome measures: The primary outcome was the number of adverse events that occurred after the administration of magnesium sulphate and/or methyldopa to pregnant women by CHWs.
Findings: Of 8790 women receiving mobile …
Risk Of Infection And Transmission Of Sars-Cov-2 Among Children And Adolescents In Households, Communities And Educational Settings: A Systematic Review And Meta-Analysis, Omar Irfan, Jiang Li, Kun Tang, Zhicheng Wang, Zulfiqar Ahmed Bhutta
Risk Of Infection And Transmission Of Sars-Cov-2 Among Children And Adolescents In Households, Communities And Educational Settings: A Systematic Review And Meta-Analysis, Omar Irfan, Jiang Li, Kun Tang, Zhicheng Wang, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: There is uncertainty with respect to SARS-CoV-2 transmission in children (0-19 years) with controversy on effectiveness of school-closures in controlling the pandemic. It is of equal importance to evaluate the risk of transmission in children who are often asymptomatic or mildly symptomatic carriers that may incidentally transmit SARS-CoV-2 in different settings. We conducted this review to assess transmission and risks for SARS-CoV-2 in children (by age-groups or grades) in community and educational-settings compared to adults.
Methods: Data for the review were retrieved from PubMed, EMBASE, Cochrane Library, WHO COVID-19 Database, China National Knowledge Infrastructure (CNKI) Database, WanFang Database, Latin …
Direct Maternal Morbidity And The Risk Of Pregnancy-Related Deaths, Stillbirths, And Neonatal Deaths In South Asia And Sub-Saharan Africa: A Population-Based Prospective Cohort Study In 8 Countries, Imran Ahmed, Shabina Ariff, Zulfiqar Ahmed Bhutta, Muhammad Ilyas, Fyezah Jehan, Usma Mehmood, Karim Muhammad, Muhammad Imran Nisar, Sajid Bashir Soofi, Yaqub Wasan, Anita K. M. Zaidi
Direct Maternal Morbidity And The Risk Of Pregnancy-Related Deaths, Stillbirths, And Neonatal Deaths In South Asia And Sub-Saharan Africa: A Population-Based Prospective Cohort Study In 8 Countries, Imran Ahmed, Shabina Ariff, Zulfiqar Ahmed Bhutta, Muhammad Ilyas, Fyezah Jehan, Usma Mehmood, Karim Muhammad, Muhammad Imran Nisar, Sajid Bashir Soofi, Yaqub Wasan, Anita K. M. Zaidi
Woman and Child Health
Background: Maternal morbidity occurs several times more frequently than mortality, yet data on morbidity burden and its effect on maternal, foetal, and newborn outcomes are limited in low- and middle-income countries. We aimed to generate prospective, reliable population-based data on the burden of major direct maternal morbidities in the antenatal, intrapartum, and postnatal periods and its association with maternal, foetal, and neonatal death in South Asia and sub-Saharan Africa.
Methods and findings: This is a prospective cohort study, conducted in 9 research sites in 8 countries of South Asia and sub-Saharan Africa. We conducted population-based surveillance of women of reproductive …
Economic And Cost-Effectiveness Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials In India, Pakistan And Mozambique, Jeffrey N. Bone, Asif R. Khowaja, Marianne Vidler, Beth A. Payne, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Ashalata A. Mallapur, Khatia Munguambe, Rahat Qureshi, Zulfiqar Ahmed Bhutta
Economic And Cost-Effectiveness Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials In India, Pakistan And Mozambique, Jeffrey N. Bone, Asif R. Khowaja, Marianne Vidler, Beth A. Payne, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Ashalata A. Mallapur, Khatia Munguambe, Rahat Qureshi, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: The Community-Level Interventions for Pre-eclampsia (CLIP) trials (NCT01911494) in India, Pakistan and Mozambique (February 2014-2017) involved community engagement and task sharing with community health workers for triage and initial treatment of pregnancy hypertension. Maternal and perinatal mortality was less frequent among women who received ≥8 CLIP contacts. The aim of this analysis was to assess the incremental costs and cost-effectiveness of the CLIP intervention overall in comparison to standard of care, and by PIERS (Pre-eclampsia Integrated Estimate of RiSk) On the Move (POM) mobile health application visit frequency.
Methods: Included were all women enrolled in the three …
Multiple-Micronutrient Supplementation In Pregnant Adolescents In Low- And Middle-Income Countries: A Systematic Review And A Meta-Analysis Of Individual Participant Data, Emily C. Keats, Nadia Akseer, Pravheen Thurairajah, Simon Cousens, Zulfiqar Ahmed Bhutta, Global Young Women’S Nutrition Investigators’ Group
Multiple-Micronutrient Supplementation In Pregnant Adolescents In Low- And Middle-Income Countries: A Systematic Review And A Meta-Analysis Of Individual Participant Data, Emily C. Keats, Nadia Akseer, Pravheen Thurairajah, Simon Cousens, Zulfiqar Ahmed Bhutta, Global Young Women’S Nutrition Investigators’ Group
Woman and Child Health
Context: Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy.
Objective: The aim of this systematic review and meta-analysis was to assess the following: (1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes, and mortality outcomes, (2) the effects of MMN supplementation in adolescents compared with the effects in adult women, and (3) the effect modification, if any, of MMN …
Heterogeneous Contributions Of Change In Population Distribution Of Body Mass Index To Change In Obesity And Underweight, Ncd Risk Factor Collaboration (Ncd-Risc), Maria Lc Iurilli, Bin Zhou, James E. Bennett, Rodrigo M. Carrillo-Larco, Marisa K. Sophiea, Andrea Rodriguez-Martinez, Honor Bixby, Bethlehem D. Solomon, Zulfiqar Ahmed Bhutta
Heterogeneous Contributions Of Change In Population Distribution Of Body Mass Index To Change In Obesity And Underweight, Ncd Risk Factor Collaboration (Ncd-Risc), Maria Lc Iurilli, Bin Zhou, James E. Bennett, Rodrigo M. Carrillo-Larco, Marisa K. Sophiea, Andrea Rodriguez-Martinez, Honor Bixby, Bethlehem D. Solomon, Zulfiqar Ahmed Bhutta
Woman and Child Health
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape …
Oral Rehydration Therapies In Senegal, Mali, And Sierra Leone: A Spatial Analysis Of Changes Over Time And Implications For Policy, Kirsten E. Wiens, Lauren E. Schaeffer, Samba O. Sow, Babacar Ndoye, Carrie Jo Cain, Mathew M. Baumann, Kimberly B. Johnson, Paulina A. Lindstedt, Brigette F. Blacker, Zulfiqar Ahmed Bhutta
Oral Rehydration Therapies In Senegal, Mali, And Sierra Leone: A Spatial Analysis Of Changes Over Time And Implications For Policy, Kirsten E. Wiens, Lauren E. Schaeffer, Samba O. Sow, Babacar Ndoye, Carrie Jo Cain, Mathew M. Baumann, Kimberly B. Johnson, Paulina A. Lindstedt, Brigette F. Blacker, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes.
Methods: We used a Bayesian geostatistical model and …
Non-Communicable Diseases Among Adolescents: Current Status, Determinants, Interventions And Policies, N Akseer, S Mehta, J Wigle, R Chera, Z J. Brickman, S Al-Gashm, B Sorichetti, A Vandermorris, D B. Hipgrave, N Schwalbe, Zulfiqar Ahmed Bhutta
Non-Communicable Diseases Among Adolescents: Current Status, Determinants, Interventions And Policies, N Akseer, S Mehta, J Wigle, R Chera, Z J. Brickman, S Al-Gashm, B Sorichetti, A Vandermorris, D B. Hipgrave, N Schwalbe, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Addressing non-communicable disease (NCDs) is a global priority in the Sustainable Development Goals, especially for adolescents. However, existing literature on NCD burden, risk factors and determinants, and effective interventions and policies for targeting these diseases in adolescents, is limited. This study develops an evidence-based conceptual framework, and highlights pathways between risk factors and interventions to NCD development during adolescence (ages 10-19 years) and continuing into adulthood. Additionally, the epidemiologic profile of key NCD risk factors and outcomes among adolescents and preventative NCD policies/laws/legislations are examined, and a multivariable analysis is conducted to explore the determinants of NCDs among adolescents …
Trends And Determinants Of Newborn Mortality In Kyrgyzstan: A Countdown Country Case Study, Mahdis Kamali, James E. Wright, Nadia Akseer, Hana Tasic, Kaitlin Conway, Saman Brar, Cholpon Imanalieva, Gerrit Maritz, Arjumand Rizvi, Zulfiqar Ahmed Bhutta
Trends And Determinants Of Newborn Mortality In Kyrgyzstan: A Countdown Country Case Study, Mahdis Kamali, James E. Wright, Nadia Akseer, Hana Tasic, Kaitlin Conway, Saman Brar, Cholpon Imanalieva, Gerrit Maritz, Arjumand Rizvi, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Kyrgyzstan has made considerable progress in reducing child mortality compared with other countries in the region, despite a comparatively low economic standing. However, maternal mortality is still high. Given the availability of an established birth registration system, we aimed to comprehensively assess the trends and determinants of reproductive, maternal, newborn, and child health in Kyrgyzstan.
Methods: For this Countdown to 2030 country case study, we used publicly available data repositories and the national birth registry of Kyrgyzstan to examine trends and inequalities of reproductive, maternal, and newborn health and mortality between 1990 and 2018, at a national and subnational …
Early Marriage And Early Childbearing In South Asia: Trends, Inequalities, And Drivers From 2005 To 2018, Samuel Scott, Phuong Hong Nguyen, Sumanta Neupane, Priyanjana Pramanik, Priya Nanda, Zulfiqar Ahmed Bhutta, Kaosar Afsana, Purnima Menon
Early Marriage And Early Childbearing In South Asia: Trends, Inequalities, And Drivers From 2005 To 2018, Samuel Scott, Phuong Hong Nguyen, Sumanta Neupane, Priyanjana Pramanik, Priya Nanda, Zulfiqar Ahmed Bhutta, Kaosar Afsana, Purnima Menon
Woman and Child Health
Early marriage (EM) and early childbearing (ECB) have far-reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years. We report the percentage of ever-married women aged 20-24 years (n = 105,150) married before 18 years (EM) and with a live birth before 20 years (ECB). Relative trends were examined using average annual rate of reduction (AARR). Inequalities were examined by geography, marital household wealth, residence, and education. Sociodemographic drivers of changes for EM were assessed using regression decomposition analyses. We …
Mitigating Toxic Stress In Children Affected By Conflict And Displacement, Anushka Ataullahjan, Muthanna Samara, Theresa S. Betancourt, Zulfiqar Ahmed Bhutta
Mitigating Toxic Stress In Children Affected By Conflict And Displacement, Anushka Ataullahjan, Muthanna Samara, Theresa S. Betancourt, Zulfiqar Ahmed Bhutta
Woman and Child Health
Anushka Ataullahjan and colleagues describe the myriad stressors related to conflict and displacement experienced by children and how best to reduce their negative effect
Revisiting Child And Adolescent Health In The Context Of The Sustainable Development Goals, Zulfiqar Ahmed Bhutta, Kathryn M. Yount, Quique Bassat, Artur A. Arikainen
Revisiting Child And Adolescent Health In The Context Of The Sustainable Development Goals, Zulfiqar Ahmed Bhutta, Kathryn M. Yount, Quique Bassat, Artur A. Arikainen
Woman and Child Health
No abstract provided.
Adversity In Childhood Is Linked To Mental And Physical Health Throughout Life, Charles A. Nelson, Richard David Scott, Zulfiqar Ahmed Bhutta, Nadine Burke Harri, Andrea Danes, Muthanna Samara
Adversity In Childhood Is Linked To Mental And Physical Health Throughout Life, Charles A. Nelson, Richard David Scott, Zulfiqar Ahmed Bhutta, Nadine Burke Harri, Andrea Danes, Muthanna Samara
Woman and Child Health
The prevalence of “toxic stress” and huge downstream consequences in disease, suffering, and financial costs make prevention and early intervention crucial, say Charles A Nelson and colleagues.
Evaluating Implementation Of "Management Of Possible Serious Bacterial Infection (Psbi) When Referral Is Not Feasible" In Primary Health Care Facilities In Sindh Province, Pakistan, Maria Asif Bhura, Shabina Ariff, Shamim Ahmad Qazi, Zaitoon Qazi, Imran Ahmed, Yasir Bin Nisar, Zamir Suhag, Abdul Wahab Soomro, Sajid Bashir Soofi
Evaluating Implementation Of "Management Of Possible Serious Bacterial Infection (Psbi) When Referral Is Not Feasible" In Primary Health Care Facilities In Sindh Province, Pakistan, Maria Asif Bhura, Shabina Ariff, Shamim Ahmad Qazi, Zaitoon Qazi, Imran Ahmed, Yasir Bin Nisar, Zamir Suhag, Abdul Wahab Soomro, Sajid Bashir Soofi
Woman and Child Health
Background: The World Health Organization (WHO) launched a guideline in 2015 for managing Possible Serious Bacterial Infection (PSBI) when referral is not feasible in young infants aged 0-59 days. This guideline was implemented across 303 Basic Health Unit (BHU) Plus primary health care (PHC) facilities in peri-urban and rural settings of Sindh, Pakistan. We evaluated the implementation of PSBI guideline, and the quality of care provided to sick young infants at these facilities.
Methods: Thirty (10%) out of 303 BHU Plus facilities were randomly selected for evaluation. A survey team visited each facility for one day, assessed the health system …
Drivers Of Stunting Reduction In Peru: A Country Case Study, Luis Huicho, Elisa Vidal-Cárdenas, Nadia Akseer, Samanpreet Brar, Kaitlin Conway, Muhammad Islam, Elisa Juarez, Aviva Rappaport, Hana Tasic, Tyler Vaivada, Jannah Wigle, Zulfiqar Ahmed Bhutta
Drivers Of Stunting Reduction In Peru: A Country Case Study, Luis Huicho, Elisa Vidal-Cárdenas, Nadia Akseer, Samanpreet Brar, Kaitlin Conway, Muhammad Islam, Elisa Juarez, Aviva Rappaport, Hana Tasic, Tyler Vaivada, Jannah Wigle, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Peru reduced its under-5 child stunting prevalence notably from 31.3% in 2000 to 13.1% in 2016.
Objectives: We aimed to study factors and key enablers of child stunting reduction in Peru from 2000-2016.
Methods: Demographic and Health Surveys were used to conduct descriptive analyses [height-for-age z scores (HAZ) means and distributions, equity analysis, predicted child growth curves through polynomial regressions] and advanced regression analyses. An ecological (at department level) multilevel regression analysis was conducted to identify the major predictors of stunting decline from 2000 to 2016, and Oaxaca-Blinder decomposition was conducted to identify the relative contribution of each factor …
Stunting In Childhood: An Overview Of Global Burden, Trends, Determinants, And Drivers Of Decline, Tyler Vaivada, Nadia Akseer, Selai Akseer, Ahalya Somaskandan, Marianne Stefopulos, Zulfiqar Ahmed Bhutta
Stunting In Childhood: An Overview Of Global Burden, Trends, Determinants, And Drivers Of Decline, Tyler Vaivada, Nadia Akseer, Selai Akseer, Ahalya Somaskandan, Marianne Stefopulos, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Progress has been made worldwide in reducing chronic undernutrition and rates of linear growth stunting in children under 5 y of age, although rates still remain high in many regions. Policies, programs, and interventions supporting maternal and child health and nutrition have the potential to improve child growth and development.
Objective: This article synthesizes the available global evidence on the drivers of national declines in stunting prevalence and compares the relative effect of major drivers of stunting decline between countries.
Methods: We conducted a systematic review of published peer-reviewed and gray literature analyzing the relation between changes in key …
The Intertwined Relationship Between Malnutrition And Poverty, Faareha Siddiqui, Rehana Salam, Zohra S. Lassi, Jai K. Das
The Intertwined Relationship Between Malnutrition And Poverty, Faareha Siddiqui, Rehana Salam, Zohra S. Lassi, Jai K. Das
Woman and Child Health
Despite social and economic development, the burden of malnutrition across the globe remains unacceptably high. A vital relationship exists between nutritional status, human capital, and economic standing. Malnutrition adversely affects the physiological and mental capacity of individuals; which in turn hampers productivity levels, making them and their respective countries more susceptible to poverty. A two-way link exists between malnutrition and poverty, creating a vicious cycle with each fueling the other. Malnutrition produces conditions of poverty by reducing the economic potential of the population and likewise, poverty reinforces malnutrition by increasing the risk of food insecurity. The aim of the paper …
The Community-Level Interventions For Pre-Eclampsia (Clip) Cluster Randomised Trials In Mozambique, Pakistan, And India: An Individual Participant-Level Meta-Analysis, Peter Von Dadelszen, Zulfiqar Ahmed Bhutta, Sumedha Sharma, Jeffrey Bone, Joel Singer, Hubert Wong, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Tang Lee, Rahat Qureshi, Clip Trials Working Group
The Community-Level Interventions For Pre-Eclampsia (Clip) Cluster Randomised Trials In Mozambique, Pakistan, And India: An Individual Participant-Level Meta-Analysis, Peter Von Dadelszen, Zulfiqar Ahmed Bhutta, Sumedha Sharma, Jeffrey Bone, Joel Singer, Hubert Wong, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Tang Lee, Rahat Qureshi, Clip Trials Working Group
Woman and Child Health
Background: To overcome the three delays in triage, transport and treatment that underlie adverse pregnancy outcomes, we aimed to reduce all-cause adverse outcomes with community-level interventions targeting women with pregnancy hypertension in three low-income countries.
Methods: In this individual participant-level meta-analysis, we de-identified and pooled data from the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised controlled trials in Mozambique, Pakistan, and India, which were run in 2014-17. Consenting pregnant women, aged 12-49 years, were recruited in their homes. Clusters, defined by local administrative units, were randomly assigned (1:1) to intervention or control groups. The control groups continued local standard of …
Community-Level Interventions For Pre-Eclampsia (Clip) In Pakistan: A Cluster Randomised Controlled Trial, Rahat Qureshi, Sana Sheikh, Zahra Hoodbhoy, Sumedha Sharma, Marianne Vidler, Beth A. Payne, Imran Ahmed, J Mark Ansermino, Jeffrey Bone, Zulfiqar Ahmed Bhutta
Community-Level Interventions For Pre-Eclampsia (Clip) In Pakistan: A Cluster Randomised Controlled Trial, Rahat Qureshi, Sana Sheikh, Zahra Hoodbhoy, Sumedha Sharma, Marianne Vidler, Beth A. Payne, Imran Ahmed, J Mark Ansermino, Jeffrey Bone, Zulfiqar Ahmed Bhutta
Woman and Child Health
Objectives: To reduce all-cause maternal and perinatal mortality and major morbidity through Lady Health Worker (LHW)-facilitated community engagement and early diagnosis, stabilization and referral of women with preeclampsia, an important contributor to adverse maternal and perinatal outcomes given delays in early detection and initial management.
Study design: In the Pakistan Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial (NCT01911494), LHWs engaged the community, recruited pregnant women from 20 union councils (clusters), undertook mobile health-guided clinical assessment for preeclampsia, and referral to facilities after stabilization.
Main outcome measures: The primary outcome was a composite of maternal, fetal and …
Effect And Feasibility Of District Level Scale Up Of Maternal, Newborn And Child Health Interventions In Pakistan: A Quasi-Experimental Study, Zahid Memon, Shah Muhammad, Sajid Bashir Soofi, Nimra Khan, Nadia Akseer, Atif Habib, Zulfiqar Ahmed Bhutta
Effect And Feasibility Of District Level Scale Up Of Maternal, Newborn And Child Health Interventions In Pakistan: A Quasi-Experimental Study, Zahid Memon, Shah Muhammad, Sajid Bashir Soofi, Nimra Khan, Nadia Akseer, Atif Habib, Zulfiqar Ahmed Bhutta
Woman and Child Health
Introduction: Pakistan has a high burden of maternal, newborn and child morbidity and mortality. Several factors including weak scale-up of evidence-based interventions within the existing health system; lack of community awareness regarding health conditions; and poverty contribute to poor outcomes. Deaths and morbidity are largely preventable if a combination of community and facility-based interventions are rolled out at scale.
Methods and analysis: Umeed-e-Nau (UeN) (New Hope) project aims is to improve maternal, newborn and child health (MNCH) in eight high-burden districts of Pakistan by scaling up of evidence-based interventions. The project will assess interventions focused on, first, improving the quality …
Delivering Water, Sanitation And Hygiene Interventions To Women And Children In Conflict Settings: A Systematic Review, Daina Als, Sarah Meteke, Marianne Stefopulos, Michelle F. Gaffey, Mahdis Kamali, Mariella Munyuzangabo, Shailja Shah, Reena P. Jain, Amruta Radhakrishnan, Fahad J. Siddiqui, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta
Delivering Water, Sanitation And Hygiene Interventions To Women And Children In Conflict Settings: A Systematic Review, Daina Als, Sarah Meteke, Marianne Stefopulos, Michelle F. Gaffey, Mahdis Kamali, Mariella Munyuzangabo, Shailja Shah, Reena P. Jain, Amruta Radhakrishnan, Fahad J. Siddiqui, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Access to safe water and sanitation facilities and the adoption of effective hygiene practices are fundamental to reducing maternal and child morbidity and mortality globally. In armed conflict settings, inadequate water, sanitation and hygiene (WASH) infrastructure poses major health risks for women and children. This review aimed to synthesise the existing information on WASH interventions being delivered to women and children in conflict settings in low-income and middle-income countries (LMICs) and to identify the personnel, sites and platforms being used to deliver such interventions.
Methods: We conducted a systematic search for publications indexed in four databases, and grey literature …
Delivery Of Sexual And Reproductive Health Interventions In Conflict Settings: A Systematic Review, Mariella Munyuzangabo, Dina Sami Khalifa, Michelle F. Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Sarah Metek, Shailja Shah, Reena P. Jain, Daina Als, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta
Delivery Of Sexual And Reproductive Health Interventions In Conflict Settings: A Systematic Review, Mariella Munyuzangabo, Dina Sami Khalifa, Michelle F. Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Sarah Metek, Shailja Shah, Reena P. Jain, Daina Als, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: It is essential to provide comprehensive sexual and reproductive health (SRH) interventions to women affected by armed conflict, but there is a lack of evidence on effective approaches to delivering such interventions in conflict settings. This review synthesised the available literature on SRH intervention delivery in conflict settings to inform potential priorities for further research and additional guidance development.
Methods: We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to conflict, women and children, and SRH. We searched websites of 10 humanitarian organisations for relevant grey literature. Publications reporting on conflict-affected populations in low-income and middle-income countries …
Impact Of Conflict On Maternal And Child Health Service Delivery: A Country Case Study Of Afghanistan, Mohammed Shafiq Mirzazada, Zahra Ali Padhani, Sultana Jabeen, Malika Fatima, Arjumand Rizvi, Uzair Ansari, Jai K. Das, Zulfiqar Ahmed Bhutta
Impact Of Conflict On Maternal And Child Health Service Delivery: A Country Case Study Of Afghanistan, Mohammed Shafiq Mirzazada, Zahra Ali Padhani, Sultana Jabeen, Malika Fatima, Arjumand Rizvi, Uzair Ansari, Jai K. Das, Zulfiqar Ahmed Bhutta
Woman and Child Health
Introduction: Since decades, the health system of Afghanistan has been in disarray due to ongoing conflict. We aimed to explore the direct effects of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing these services.
Method: We conducted a quantitative analysis of secondary data on RMNCAH&N indicators and undertook a supportive qualitative study to help understand processes and contextual factors. For quantitative analysis, we stratified the various provinces of Afghanistan into minimal-, moderate- and severe conflict categories based on battle-related deaths from Uppsala Conflict Data Program (UCDP) and …
Intergrowth-21st Project International Inter-Nda Standards For Child Development At 2 Years Of Age: An International Prospective Population-Based Study, Michelle Fernandes, José Villar, Alan Stein, Eleonora Staines Urias, Cutberto Garza, Cesar G. Victora, Fernando C. Barros, Enrico Bertino, Manorama Purwar, Maria Carvalho, Zulfiqar Ahmed Bhutta
Intergrowth-21st Project International Inter-Nda Standards For Child Development At 2 Years Of Age: An International Prospective Population-Based Study, Michelle Fernandes, José Villar, Alan Stein, Eleonora Staines Urias, Cutberto Garza, Cesar G. Victora, Fernando C. Barros, Enrico Bertino, Manorama Purwar, Maria Carvalho, Zulfiqar Ahmed Bhutta
Woman and Child Health
Objectives: To describe the construction of the international INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) standards for child development at 2 years by reporting the cognitive, language, motor and behaviour outcomes in optimally healthy and nourished children in the INTERGROWTH-21st Project.
Design: Population-based cohort study, the INTERGROWTH-21st Project.
Setting: Brazil, India, Italy, Kenya and the UK.
Participants: 1181 children prospectively recruited from early fetal life according to the prescriptive WHO approach, and confirmed to be at low risk of adverse perinatal and postnatal outcomes.
Primary measures: Scaled INTER-NDA domain scores for cognition, language, fine and gross motor skills and behaviour; vision outcomes measured …
C'Est Vraiment Compliqué: A Case Study On The Delivery Of Maternal And Child Health And Nutrition Interventions In The Conflict-Affected Regions Of Mali, Anushka Ataullahjan, Michelle F. Gaffey, Moctar Tounkara, Samba Diarra, Seydou Doumbia, Zulfiqar Ahmed Bhutta, Diego G. Bassani
C'Est Vraiment Compliqué: A Case Study On The Delivery Of Maternal And Child Health And Nutrition Interventions In The Conflict-Affected Regions Of Mali, Anushka Ataullahjan, Michelle F. Gaffey, Moctar Tounkara, Samba Diarra, Seydou Doumbia, Zulfiqar Ahmed Bhutta, Diego G. Bassani
Woman and Child Health
Background: Mali is currently in the midst of ongoing conflicts which involve jihadist groups, rebels, and the state. This conflict has primarily centered in the North of the country. Humanitarian actors delivering services in these geographies must navigate the complex environment created by conflict. This study aimed to understand how humanitarian actors make decisions around health service delivery within this context.
Methods: The current case-study utilized a mixed methods approach and focused on Mopti, Mali's fifth administrative region and fourth largest in population. Latent content analysis was used to analyze interview transcripts guided by our research objectives and new concepts …
Understanding The Factors Affecting The Humanitarian Health And Nutrition Response For Women And Children In Somalia Since 2000: A Case Study, Zahra Ahmed, Anushka Ataullahjan, Michelle F. Gaffey, Mohamed Osman, Chantal Umutoni, Zulfiqar Ahmed Bhutta, Abdirisak A. Dalmar
Understanding The Factors Affecting The Humanitarian Health And Nutrition Response For Women And Children In Somalia Since 2000: A Case Study, Zahra Ahmed, Anushka Ataullahjan, Michelle F. Gaffey, Mohamed Osman, Chantal Umutoni, Zulfiqar Ahmed Bhutta, Abdirisak A. Dalmar
Woman and Child Health
Background: Somalia has been ravaged by more than two decades of armed conflict causing immense damage to the country's infrastructure and mass displacement and suffering among its people. An influx of humanitarian actors has sought to provide basic services, including health services for women and children, throughout the conflict. This study aimed to better understand the humanitarian health response for women and children in Somalia since 2000.
Methods: The study utilized a mixed-methods design. We collated intervention coverage data from publically available large-scale household surveys and we conducted 32 interviews with representatives from government, UN agencies, NGOs, and health facility …
Impact Of Conflict On Maternal And Child Health Service Delivery - How And How Not: A Country Case Study Of Conflict Affected Areas Of Pakistan, Jai K. Das, Zahra Ali Padhani, Sultana Jabeen, Arjumand Rizvi, Uzair Ansari, Malika Fatima, Ghulam Akbar, Wardah Ahmed, Zulfiqar Ahmed Bhutta
Impact Of Conflict On Maternal And Child Health Service Delivery - How And How Not: A Country Case Study Of Conflict Affected Areas Of Pakistan, Jai K. Das, Zahra Ali Padhani, Sultana Jabeen, Arjumand Rizvi, Uzair Ansari, Malika Fatima, Ghulam Akbar, Wardah Ahmed, Zulfiqar Ahmed Bhutta
Woman and Child Health
Introduction: In conflict affected countries, healthcare delivery remains a huge concern. Pakistan is one country engulfed with conflict spanning various areas and time spans. We aimed to explore the effect of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing the prioritization and implementation in conflict affected areas of Pakistan (Balochistan and FATA).
Method: We conducted a secondary quantitative and a primary qualitative analysis. For the quantitative analysis, we stratified the various districts/agencies of Balochistan and FATA into the conflict categories of minimal-, moderate- and severe based on …
Investigating The Delivery Of Health And Nutrition Interventions For Women And Children In Conflict Settings: A Collection Of Case Studies From The Branch Consortium, Anushka Ataullahjan, Michelle F. Gaffey, Samira Sami, Neha S. Singh, Hannah Tappis, Robert E. Black, Karl Blanchet, Ties Boerma, Ana Langer, Paul B. Spiegel, Ronald J. Waldman, Paul H. Wise, Zulfiqar Ahmed Bhutta
Investigating The Delivery Of Health And Nutrition Interventions For Women And Children In Conflict Settings: A Collection Of Case Studies From The Branch Consortium, Anushka Ataullahjan, Michelle F. Gaffey, Samira Sami, Neha S. Singh, Hannah Tappis, Robert E. Black, Karl Blanchet, Ties Boerma, Ana Langer, Paul B. Spiegel, Ronald J. Waldman, Paul H. Wise, Zulfiqar Ahmed Bhutta
Woman and Child Health
Globally, the number of people affected by conflict is the highest in history, and continues to steadily increase. There is currently a pressing need to better understand how to deliver critical health interventions to women and children affected by conflict. The compendium of articles presented in this Conflict and Health Collection brings together a range of case studies recently undertaken by the BRANCH Consortium (Bridging Research & Action in Conflict Settings for the Health of Women and Children). These case studies describe how humanitarian actors navigate and negotiate the multiple obstacles and forces that challenge the delivery of health and …