Professional Documents
Culture Documents
2008
2009
333
2010
No data yet
WHO (300/100,000)
TARGET 2014 (HDACC) 50 (10% reduction) 36 (10% reduction) 12 (10% reduction) TARGET 2014 270 (reverse increasing trend and achieve 10% reduction)
3
OPPORTUNITIES
CARMMA in South Africa (Campaign for the Accelerated Reduction of Maternal & Child Mortality in Africa) under the auspices of the African Union. Aim: To accelerate the reduction of maternal and child morbidity and mortality through accelerated implementation of evidence-based interventions essential to improve maternal health and child survival.
CARMMA priorities
Contraception Early booking and improving the quality of antenatal care Prevention of Mother-to-child-transmission of HIV Dedicated Obstetric ambulances Establishment of Maternity Waiting Homes Training in ESMOE Essential Steps in the Management of Obstetric Emergencies & EOST (Emergency Simulation Training). Skilled birth attendants including additional midwives
10
HHAPI
5 Hs
hospitals Hospital CEOs to ensure that there is no rotation of nursing staff providing neonatal care Knowled Train all health care workers providing maternity and ge and neonatal care in the ESMOE programme.
skills of Train health care workers who deal with pregnant women in health HCT & initiation of ART. Train all health care workers in care correct management of intrapartum care (use of the providers
Deaths due to asphyxia: A birth attendant skilled in neonatal resuscitation can reduce deaths to hypoxia by up to 40%.
Every woman in labour must be monitored appropriately by a skilled birth attendant All birth attendants must be skilled in at least bag and mask ventilation of the neonate The partogram must be used to monitor labour according to prescribed norms All complicated and obstructed labours must have access to Caesarean Section
Deaths due to prematurity: The use and application of nasal CPAP at a district hospital can reduce mortality of this group by up to 40%.
Corticosteroids must be given where possible to every woman in preterm labour Antibiotics must be given to every woman with prolonged rupture of membranes All hospitals (especially district hospitals) must have staff skilled in the use of nasal CPAP All mothers of premature infants must have easy access to Kangaroo Mother Care
Deaths Strict adherence to basic hygiene in labour wards and nurseries. Hand washing. Alcohol due to sprays, soap, clean water and paper towels infection must be available in all nurseries as essential consumables. Case management of neonatal sepsis, meningitis and pneumonia. As breast milk provides the best nutrition and protection for the preterm baby, districts should provide breast milk (not preterm formulae) to preterm babies by the establishment of human milk banks. Infection dashboard introduced in all neonatal nurseries to reduce infections by heightening awareness and surveillance of infection rates.
19
PMTCT
New guidelines ie fixed dose combination (FDC) triple therapy of Tenofovir, Emtricitabine & Efavirenz implemented in April 2013 to further reduce MTCT to < 1%. Regardless of CD4 count; ARVs for all pregnant HIV positive women & those breast feeding for the duration of B/F. Lifelong ART if CD4<350.
KEY STEPS FOR OPERATIONALIZING HHAPI-NeSS. Start with the worst performing districts and expand.
Develop costed evidence based plan & training plan tailored to context
Implement Plan
Key challenges
Community education & demand for services. Access to care Essential Equipment Quality care Training of Health Care Providers Monitoring and evaluation
THANK YOU