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A Systematic Review Of The Treatment And Management Of Pre-Eclampsia And Eclampsia In Bangladesh, Karen Kirk, Amy Dempsey

Reproductive Health

By 2015, at the conclusion of the Millennium Development Goals, Bangladesh had achieved a reduction in maternal deaths, however, despite the progress, there are still between 5,000 and 6,000 maternal deaths every year, with 20 percent the result of pre-eclampsia and eclampsia (PE/E). To fully understand the key challenges, gaps, and interventions related to the prevention and treatment of PE/E at the national level, Ending Eclampsia conducted a systematic review of papers in Bangladesh published between 2000 and 2015 specifically looking at issues around the quality of care, gaps in the evidence, and barriers to accessing PE/E services. The main …

Access To Reproductive Health And Hiv Services Among Young Mothers In Tanzania, Francis Obare, Annette Almeida, George Odwe, Jamilla Mwanga, Chi-Chi Undie, Maurice Hiza, Feddy Mwanga

Reproductive Health

This report presents findings from a Population Council study that examined the experiences of young mothers in Tanzania with accessing reproductive health and HIV services during pregnancy, delivery/pregnancy termination, and the postpartum period. The overall objective of the study was to generate evidence on access to reproductive health and HIV services among young mothers aged 12–19 years in Tanzania in order to inform programming and actions to better meet their needs. It specifically examined their experiences with accessing reproductive health (safe motherhood and contraception) and HIV (testing and counseling, PMTCT, antiretroviral therapy, and early infant diagnosis) services as well as …

Findings From Landscape Analysis In Nigeria On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. The Population Council conducted a landscape analysis on PE/E in 2015 in seven states in Nigeria. This brief details the findings on national policy awareness, service provider knowledge and skills, facility capacity and preparedness, quality of care and community knowledge and perceptions. The brief concludes with recommendations based on these findings.

Findings From Landscape Analysis In Bangladesh On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia are preventable, yet in Bangladesh PE/E is the second most common direct cause of maternal mortality, after postpartum hemorrhage. To appreciate the enormity of this problem, at national and district levels, in 2015 the Population Council conducted a landscape analysis in four districts. This brief details the findings on national policy awareness, service provider knowledge and skills, facility capacity and preparedness, and community knowledge and perceptions. The brief concludes with recommendations based on these findings.

Findings From Landscape Analysis In Kogi On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Kogi. It is clear from the findings that at the state policy level, there is limited knowledge of what has been developed nationally; there is confusion about how policies, guidelines, and protocols reach not only the …

Findings From Landscape Analysis In Sokoto On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Sokoto. This landscape analysis identified the gaps in facilities’ and providers’ capacities for preventing, detecting, and managing PE/E. The brief concludes that a multi-pronged approach is required to address the systems issues that create barriers to …

Assessing Maternal And Newborn Health Commodities In Bangladesh, Population Council

Reproductive Health

The UN Commission on Life-Saving Commodities for Women and Children aims to increase access to 13 commodities in 50 countries. As part of this global effort, the Population Council conducted a landscape analysis in Bangladesh to review policies, guidelines, availability, and use of these commodities. The landscaping exercise had two objectives: 1) to provide a comprehensive description of maternal and newborn health (MNH) commodity issues from policy to point of care; and 2) to engage stakeholders in rolling out the UN Commission recommendations. Based on its findings the analysis recommends: stronger advocacy with pharmaceutical companies to manufacture a single loading …

Findings From Landscape Analysis In Ebonyi On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Ebonyi which identified the gaps in facilities’ and providers’ capacities for preventing, detecting, and managing PE/E; assessing community awareness, beliefs, and experiences of PE/E; and determined priority areas for research and programs to improve access to …

A Systematic Review Of The Treatment And Management Of Pre-Eclampsia And Eclampsia In Nigeria, Karen Kirk, Ishita Chattopadhyay

Reproductive Health

Throughout the development of a pregnancy, there are many opportunities when pre-eclampsia and eclampsia (PE/E) can be prevented, detected, and managed; based on the literature, certain gaps exist along this continuum of care. To fully appreciate the enormity of the problem at the country level, the Population Council conducted a systematic review of published papers on PE/E in Nigeria from 2000–15 in order to understand the key challenges, gaps, and interventions related to the prevention and treatment of PE/E. In order to have the most impact, this report recommends a multi-level set of interventions that increase community awareness of symptoms …

Findings From Landscape Analysis In Cross River On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for Cross River State and details findings on facility capacity and preparedness, service provider knowledge and skills, quality of care, community knowledge and perceptions, and survivors’ experiences. The brief recommends increasing community awareness of the condition, improving antenatal care quality, and …

Findings From Landscape Analysis In Ondo On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Ondo. This landscape analysis identified the gaps in facilities’ and providers’ capacities for preventing, detecting, and managing PE/E. The brief concludes that a multi-pronged approach is required to address the systems issues that create barriers to …

Landscape Analysis Report On Pre-Eclampsia And Eclampsia In Pakistan, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood, Karen Kirk, Amy Dempsey, Charlotte E. Warren

Reproductive Health

This report presents the findings of a landscape analysis of the policy, programming, and service environment around prevention and treatment of pre-eclampsia and eclampsia (PE/E) in Pakistan. The primary aim of the landscape analysis was to identify the policy and program level of activities, as well as gaps and challenges around prevention and treatment of PE/E and the use of magnesium sulphate at the provincial and district levels in Pakistan. The study was carried out by the Population Council in 2016, with the support of the United States Agency for International Development (USAID) as part of the Project entitled “Ending …

Operationalizing National Protocol For Preventing And Managing Pe/E In Community Facilities In Bangladesh, Population Council

Reproductive Health

Considering the maternal deaths associated with pre-eclampsia and eclampsia (PE/E), the Bangladesh Ministry of Health and Family Welfare, with technical assistance from the Obstetrical and Gynecological Society of Bangladesh, developed a national protocol allowing community providers to provide a magnesium sulphate (MgSO4) loading dose. With the approval of the National Technical Committee of the Directorate General of Family Planning, this study operationalized and assessed the ability of community providers to detect and treat PE/E, and administer the loading dose of MgSO4 before referral to higher-level facilities. The study results presented in this brief indicate that with national protocol, training, and …

Findings From Landscape Analysis In Bauchi On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for Bauchi State and details findings on facility capacity and preparedness, service provider knowledge and skills, quality of care, community knowledge and perceptions, and survivors’ experiences. This landscape analysis identified the gaps in facilities’ and providers’ capacities for preventing, detecting, and …

Findings From Landscape Analysis In Katsina On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Katsina and recommends many areas of opportunity to prevent maternal death associated with PE/E throughout pregnancy, and different approaches to make the most of these opportunities. Maternal and newborn deaths due to PE/E are preventable: by …

Increasing Access To Magnesium Sulphate In Nigeria, Population Council

Reproductive Health

The World Health Organization recommends magnesium sulphate (MgSO4) as the most effective, safe, and low-cost drug for treating pre-eclampsia and eclampsia. To increase access to and use of MgSO4 in Kano State, Nigeria the Population Council trained lower-cadre healthcare providers in antenatal clinics to detect pre-eclampsia early and institute timely and appropriate management by administering the loading dose of MgSO4 and referring for follow-up care. This brief reports that the intervention, which was supported by the John D. and Catherine T. MacArthur Foundation, reduced the maternal mortality rate due to PE/E by 40 percent in project sites. Moving forward, the …

Promoting Respectful Maternity Care Resource Package—Alternative Dispute Resolution: Resolving Incidents Of Disrespect And Abuse, Population Council

Reproductive Health

Alternative Dispute Resolution (ADR) is a process whereby an independent and impartial third party facilitates negotiation between disputing parties, in this case to resolve incidents of disrespect and abuse (D&A) in a health care setting. In Kenya, ADR was originally used to settle land disputes and inheritance issues at the community level. The voluntary ADR mechanism brings the aggrieved parties together with an opportunity to solve problems in a locally acceptable way. ADR supports both providers’ and clients’ rights and obligations by ensuring each side is heard. This Respectful Maternity Care (RMC) resource provides guidance on the sequence of steps …

Progesterone Vaginal Ring: Safe For Mothers And Babies, Population Council

Reproductive Health

This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding on ovulation and extending postpartum amenorrhea. The PVR is an effective and safe contraceptive for mothers, their babies, and their sexual partners. This method vastly expands the range of contraceptive choices available for nursing women.

Anneau Vaginal À Progestérone: Évite Les Grossesses, Population Council

Reproductive Health

Cette fiche de renseignements fournit des informations sur l’utilisation de l’anneau contraceptif vaginal à la progestérone pour prévenir la grossesse. L'anneau vaginal à progestérone (AVP) offre une nouvelle manière de fournir un moyen de contraception. Il a été prouvé qu'il s'agit d'une méthode contraceptive sûre et efficace pour les femmes qui allaitent. Utilisé par ces femmes, l'AVP évite les grossesses en inhibant la croissance folliculaire et, par conséquent, empêchant l'ovulation; renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation; étendant l'aménorrhée post-partum; et épaississant la glaire cervicale, et donc en empêchant les spermatozoïdes d'atteindre l'ovule. L'AVP donc étend la gamme …

Promoting Respectful Maternity Care Resource Package—Maternity Open Days: Clarifying Misconceptions About Childbirth, Population Council

Reproductive Health

Fear of disrespect and abuse along with misconceptions about procedures required to assist women during childbirth often negatively influence the decision to seek care at a health facility. Maternity Open Days provide an opportunity for pregnant women and their families to interact with health care providers and visit maternity units to demystify birthing practices and mitigate fears regarding childbirth in a facility. Such an approach brings together women, their families, and providers to enable pregnant women to understand what happens in a maternity unit. This brief is part of a Respectful Maternity Care Resource Package developed by the Kenya Heshima …

Anneau Vaginal À Progestérone: Aussi Sûr Pour Maman Que Pour Bébé, Population Council

Reproductive Health

Cette fiche d'information fournit des informations de base sur l'innocuité et l'efficacité de l'anneau contraceptif vaginal à la progestérone (AVP). Son effet contraceptif fonctionne en renforçant les effets inhibiteurs de l'allaitement maternel sur l'ovulation, et en étendant l'aménorrhée post-partum. L'AVP est un contraceptif sûr et efficace pour les mamans, leurs bébés et leurs partenaires sexuels. Cette méthode étend largement le gamme de contraceptifs à la disposition des femmes qui allaitent.

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This fact sheet provides basic information on the safety and effectiveness of the progesterone vaginal contraceptive ring. It works as a contraceptive by reinforcing the inhibitory effect of breastfeeding …

Promoting Respectful Maternity Care Resource Package—Implementing Respectful Maternity Care In Kenya, Population Council

Reproductive Health

The Respectful Maternity Care (RMC) Resource Package was developed by the Heshima project as part of the USAID Translating Research into Action (TRAction) project. The resource package is designed to be used by program managers, supervisors, trainers, technical advisors, and others who organize or facilitate RMC training workshops on sexual and reproductive health as well as skills training in emergency obstetric and newborn care. The resource package provides experienced facilitators with background information, materials, instructions, and tips for promoting respectful care in reproductive, maternal, and newborn health services in both facilities and communities. The resource package also includes tools for …

Delivering Contraceptive Vaginal Rings: Review Of Postpartum And Postnatal Care Programs In Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku

Reproductive Health

Postpartum family planning is a major component of postpartum care services. The Population Council is working to introduce an additional method of contraception in Nigeria—the Progesterone Contraceptive Vaginal Ring (PCVR). The PCVR is administered vaginally but acts systemically to inhibit ovulation. The PCVR contains natural progesterone and is meant for breastfeeding women to augment lactational amenorrhea. As the Council conducts a series of activities as a prelude to eventual introduction of the PCVR in sub-Saharan Africa, including Nigeria, the detailed evaluation of the postpartum program environment is very important. Understanding the prevailing postpartum and postnatal care landscapes will be crucial …

Delivering Contraceptive Vaginal Rings: Review Of Postpartum Service Packages In Kenya, Wilson Liambila, Saumya Ramarao, Heather Clark

Reproductive Health

The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time, yet this is the most neglected period for the coverage and provision of quality care. The building blocks of the WHO health systems model were applied in describing the status and health system structures that support the provision of postpartum and postnatal care (PNC) services in Kenya. Many opportunities exist for facilitating the delivery of the Population Council’s Progesterone Contraceptive Vaginal Rings (PCVR) within PNC services in Kenya, such as integration with other primary health care …

Promoting Respectful Maternity Care Resource Package—Debriefing Sessions: Caring For The Carers, Population Council

Reproductive Health

Caring for the Carers is an activity aimed at reducing work-related stress—a major driver of disrespect and abuse (D&A) during facility-based childbirth. Pregnancy, labor, and delivery are expected to be joyous moments for the mother, her family, and the service providers. However, this is not always the case due to maternal complications or even death. Maternity units often have high workloads. This, coupled with lack of professional support for staff and providers, and poor governance and leadership, may lead to work-related stress. These critical incidents can accumulate and contribute to staff stress and emotional exhaustion, which ultimately prevents provision of …

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Facilitator’S Guide, Population Council

Reproductive Health

This training guide was produced by the Population Council as part of the Respectful Maternity Care (RMC) Resource Package developed by the Kenya Heshima Project. The Heshima Project, as part of the USAID Translating Research into Action (TRAction) project, was tasked with determining the manifestations, types, and prevalence of disrespect and abuse (D&A) in childbirth; identifying and exploring the potential drivers of D&A; and designing, implementing, monitoring, and evaluating the impact of interventions for reducing D&A including generating lessons for scale-up. The Resource Package is based on the most effective interventions, and provides practical, low-cost, and easily adaptable strategies for …

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Participant's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. Workshop objectives outlined in the Participant’s Guide: Outline current status of maternal and neonatal health in relation to respectful care. Discuss key RMC concepts, terminology, legal and rights-based approaches related to respectful maternity care and …

Promoting Respectful Maternity Care (Rmc) At Birth: Orientation For Facility-Based Workshops, Population Council

Reproductive Health

The goal of “Promoting Respectful Maternity Care (RMC) at Birth: Orientation for Facility-Based Workshops” is to orient service providers on the RMC concept along with a set of evidence-based interventions to promote RMC. Objectives of the workshop as indicated in this slide deck are: Outline the current status of maternal and neonatal health in relation to respectful care. Discuss key RMC concepts, terminology, legal and rights-based approaches related to RMC and the RMC Resource Package. Demonstrate knowledge and use of Values Clarification and Attitude Transformation (VCAT) theory and practice. Discuss selected evidence-based strategies that reduce disrespect and abuse. Discuss participants’ …

Promoting Respectful Maternity Care (Rmc) At Birth: Orientation For Community-Based Workshops, Population Council

Reproductive Health

The goal of “Promoting Respectful Maternity Care (RMC) at Birth: Orientation for Community-Based Workshops” is to orient community-health workers on the RMC concept. Objectives of the workshop as indicated in this slide deck are: Outline the current status of maternal health in relation to RMC. Discuss rights-based approaches related to RMC. Discuss selected strategies that reduce disrespect and abuse (D&A). Discuss the role of the community in promoting RMC. Demonstrate knowledge and use of the Alternative Dispute Resolution mechanism. Develop action plans to support the implementation of RMC interventions at the community level. Summary: D&A deters facility-based childbirth and Skilled …

Promoting Respectful Maternity Care: A Training Guide For Community-Based Workshops—Community Facilitator's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. The Community Facilitator’s Guide, designed to be used by facilitators to promote respectful maternity care at the community level, can be adapted to educate a variety of stakeholders in community settings (i.e., Community Health Extension …