Family-centered care for newborns: a global perspective and review.

Person-centered models of care built on newborn and family needs and rights, such as nonseparation immediately after birth and during the care process, can address the complex needs of the newborn, family, and health system. This is particularly important in low- and middle-income countries, where cost-effective modalities are highly needed to accelerate the survival of newborn babies. We conducted a systematic review to explore country experiences on implementation and challenges to implement and scale-up family-centered newborn care models of care. MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched to identify studies on patient-centered care and newborns between 1990 and 2023. Studies meeting our predefined inclusion criteria were quality assessed and relevant data extracted. We utilized the World Health Organization framework on integrated people-centered health services to summarize and analyze findings while highlighting patterns. Forty-one studies were included for review (including approximately 60% from low- and middle-income countries). Different research conducted over time highlighted how immediate and uninterrupted skin-to-skin care facilitates a series of critical processes for newborns, parents, and health system, including breastfeeding initiation and exclusivity rates, reduced incidence of post-partum depression, and prevention of infection and hospitalization. Thanks to the close contact of the kangaroo position or skin-to-skin contact, parents recount becoming more and more attached to and familiar with their baby, easily establishing a relationship. Overall, countries could transform the newborn care service in terms of family center care by adopting three simple rules: (i) minimizing mother-child separation; (ii) involving fathers; (iii) empowering parents from the time of birth. A paradigm shift is required to change the conventional model of provider-centric care to one of person-centered neonatal health care. Such an approach is feasible in diverse country settings and should be facilitated through political commitment and policies enabling early focus on the maternal-infant relationship. This could, in turn, help achieve improved dignity of care and help create a more efficient and responsive health system and society.

Iron deficiency anaemia and low BMI among adolescent girls in India: the transition from 2005 to 2015.

OBJECTIVE: The current study explored changes in trend of anaemia and BMI among currently pregnant nullipara adolescent women against socio-economic determinants in India from 2005 through 2015. The association between anaemia in currently pregnant nullipara adolescent women v. currently pregnant nullipara older women of reproductive age was also explored. DESIGN: We used the 2005 and the 2015 nationally representative Indian Demographic and Health Surveys (DHS). The outcomes of interest, anaemia and BMI, were measured based on the DHS methodology following WHO standards and indicators. Place of residence, educational attainment and wealth quintiles were used as determinants in the analysis. SETTING: India. PARTICIPANTS: In total, 696 adolescent girls from the India 2005 DHS and 3041 adolescent girls from the India 2015 DHS. RESULTS: The 10-year transition from 2005 to 2015 showed differences between the least and most wealthy sections of society, with heaviest gains in anaemia reduction over time among the latter (from 50·0 to < 40·0 %). The odds of anaemia were significantly higher among the adolescent population when compared with adult women both in 2005 and in 2015 (OR = 1·2). CONCLUSIONS: Despite an overall improvement in the prevalence of both BMI < 18·5 and anaemia among adolescents nullipara in India, the adjusted risk of anaemia in the latter category was still significantly higher as compared with their adult counterparts. Since the inequalities evidenced during the first round of DHS remained unchanged in 2015, more investments in universal health care are needed in India.

Place of birth for unintended pregnancies in six former Soviet Union countries.

OBJECTIVE: This paper aims at exploring the association between unintended pregnancies and place of birth in six Former Soviet Union (FSU) countries. MATERIAL AND METHODS: A secondary analysis of the latest cross-sectional Demographic and Health Surveys of six FSU countries from 2005 through 2012 was conducted. Prevalence of institutional births and unintended pregnancies was estimated by country and for the pooled population. Odds ratio (OR) and 95% confidence interval (CI) were calculated to measure the country and pooled association between pregnancy intention and institutional birth. RESULTS: Institutional births occurred in 90.4% of the overall study population and ranged from 78.2% in Tajikistan to 99.7% in Ukraine Demographic and Health Survey. Around one out of 10 pregnancies resulted unintended. In the pooled analysis, unintended pregnancies were significantly associated with giving births outside health facility (aOR1.2; 95% CI 1.0-1.6). CONCLUSION: Based on the study findings we suggest that increase awareness of benefit of skilled delivery care is needed among women with poor access to family planning.

Severe acute respiratory syndrome coronavirus-2 medical solid waste treatment: A need for efficient and effective strategies in low-resourced settings.

Understanding infections related to handling healthcare waste products is of critical importance and the application of simple and low-cost strategies remain a priority in low-income and middle-income countries to protect healthcare workers. We examined the potential effect of relative humidity (RH), air temperature and ultraviolet irradiation (UI) to establish an efficient and effective way to facilitate disposal of medical waste. Literature is emerging on the effect of high RH and high temperature, which would increase airborne mass deposition and decrease the viability of viruses in both airborne particles and on surfaces. On the other hand, severe acute respiratory syndrome coronavirus-2 has been proven to be susceptible to UI when suspended in air like other coronaviruses. An innovative approach utilizing environmental conditions might represent an effective and efficient way to ensure better and sustainable protection of the healthcare workers in low-resourced settings.

Global Health priorities: repositioning routine immunization for infants.

The first year of the Coronavirus disease (COVID-19) pandemic registered the highest number of children under the age of one year who did not receive basic vaccines since 2009. The pronounced rise in vaccine-preventable diseases in 2020 and 2021 was largely attributable to the disruption of the vaccine schedule for children around the world. Routine vaccinations were missed in consideration of movement restrictions to prevent the spread of COVID-19. On the other hand, health resources were re-allocated to COVID-19, resulting in strained health care systems and the marginalization of essential health services like routine vaccination campaigns. The COVID-19 pandemic has clearly illustrated the potential of vaccines in saving lives and preventing disabilities. The unequal roll-out of vaccination programmes has simultaneously deepened the existing gaps between high and low-income countries. Disruption in other key life-saving immunization programmes is driving these inequalities even further. Prompt and sustainable investments in routine immunization programmes, including catch-up vaccination strategies, are essential to avert the impact of years of neglect of this important public health issue. In particular, the recent declining trends in vaccination coverage are putting decades of progress at risk.

Are "cases", "waves", "tests" and "modeling" deceiving indicators to describe the COVID-19 pandemic?

This commentary elaborates on different methodological aspects complicating the interpretation of epidemiological data related to the current COVID-19 pandemic, thus preventing reliable within and across-country estimates. Firstly, an inaccuracy of epidemiological data maybe arguably be attributed to passive surveillance, a relatively long incubation period during which infected individuals can still shed high loads of virus into the surrounding environment and the very high proportion of cases not even developing signs and/or symptoms of COVID-19. The latter is also the major reason for the inappropriateness of the abused "wave" wording, which gives the idea that health system starts from scratch to respond between "peaks". Clinical data for case-management on the other hand often requires complex technology in order to merge and clean data from health care facilities. Decision-making is often further derailed by the overuse of epidemiological modeling: precise aspects related to transmissibility, clinical course of COVID-19 and effectiveness of the public health and social measures are heavily influenced by unbeknownst and unpredictable human behaviors and modelers try to overcome missing epidemiological information by relying on poorly precise or questionable assumptions. Therefore the COVID-9 pandemic may provide a valuable opportunity to rethink how we are dealing with the very basic principles of epidemiology as well as risk communication issues related to such an unprecedented emergency situation.