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  • br Unacceptably high rates of adverse outcomes persist for

    2019-05-08


    Unacceptably high rates of adverse outcomes persist for childbearing women and infants, including maternal and newborn mortality, stillbirth, and short-term and long-term morbidity. In light of the challenges to achieve the UN Sustainable Development Goals, it is timely to reconsider priorities for research in maternal and newborn health. Are we asking the right questions? Recent evidence indicates the importance of seeking knowledge beyond the treatment of complications, to inform better ways of providing sustainable, high quality care, including preventing problems before they occur. The 2014 publication of \'s Series on Midwifery presented a unique opportunity to generate future areas of inquiry by drawing on the most extensive examination to date of evidence on the care that all women and newborn infants need across the continuum from pre-pregnancy, birth, postpartum, and the early weeks of life. The series summarised the evidence 12-O-tetradecanoyl phorbol-13-acetate 12-O-tetradecanoyl phorbol-13-acetate for quality maternal and newborn care in a new framework that focuses on the needs of women, infants, and families and differentiates between care is provided, it is provided, and by . These are concepts that are often confused or ignored in existing studies. Midwifery was identified as a cost-effective and fundamentally important element of quality care, with the potential to improve over 50 different maternal and newborn outcomes including mortality and morbidity. However, there are substantive barriers to proper implementation and integration of midwifery into health systems. We adapted the Child Health and Nutrition Research Initiative (CHNRI) methodology to score competing future research topics on quality maternal and newborn care and the contribution of midwifery to that care. This method has been used to set health research priorities for infant and childhood conditions, reduction of maternal and perinatal mortality, and preterm birth and stillbirths. A team representing expertise in maternal and newborn health research, including authors from \'s Series on Midwifery, contributors from WHO, UNFPA, the International Confederation of Midwives, and a representative of or advocate for service users conducted the work. The team identified 30 research topics based on an analysis of gaps in the evidence presented in the 2014 Series on Midwifery. Stakeholders were asked to consider the potential research topics in terms of their relevance, significance, and potential future implementation based on five criteria: answerability, community involvement, sustainability, equity, and maximal impact. The 30 research topics and scoring criteria were distributed in English, French, and Spanish online surveys to 1191 stakeholders, including constituents of the global Partnership for Maternal, Newborn, and Child Health (PMNCH) and representatives from all WHO regions. Stakeholders were asked to score each of the 30 research topics as 1·0 (yes), 0·5 (informed but undecided answer), or (no) on whether they met each of the five criteria. It was possible to omit a score if a respondent did not feel confident to decide on a criterion; these were regarded as missing data and not part of the denominator. Summary scores for each criterion and an overall score were then computed as the sum of the scores divided by the number of actual scorers.
    Sept 28 is the tenth annual . It is a date that commemorates the anniversary of the 1895 death of Louis Pasteur, who developed the first human rabies vaccine. Modern effective vaccines, combined with other interventions, the necessary political will, and community awareness make the disease 100% preventable. Yet, an estimated 59 000 people still die from the disease every year. World Rabies Day is thus an uncomfortable reminder for the global health community of the ongoing neglect of this disease. The theme for 2016 is “Educate. Vaccinate. Eliminate”, a slogan that emphasises the pillars of rabies prevention and the vision to end human rabies deaths.