Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.317
Filtrar
1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47814

RESUMO

Página temática do portal do Centro Colaborador para Qualidade e Segurança do Paciente – Proqualis, intitulada 'Parto e Nascimento'. Criada com a finalidade de reunir conteúdos e evidências científicas relacionados ao tema da qualidade do cuidado e segurança do paciente no parto e nascimento. Recentes estudos científicos sobre o tema, diretrizes, aulas e ferramentas de apoio estão disponíveis para acesso na página.


Assuntos
Tocologia , Qualidade da Assistência à Saúde , Segurança do Paciente , Serviços de Saúde Materno-Infantil
2.
Washington; Organización Panamericana de la Salud; ago. 13, 2020. 8 p.
Não convencional em Espanhol | LILACS | ID: biblio-1117103

RESUMO

Estudios y resultados de la vigilancia de COVID-19 publicados recientemente indicaron un mayor riesgo de la mujer embarazada de presentar formas graves de COVID-19 y por ende de ser hospitalizadas y admitidas a Unidades de Cuidados Intensivos. La Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS/OMS) solicita a los Estados Miembros a redoblar esfuerzos para asegurar el acceso a los servicios de atención prenatal, así como también a implementar medidas preventivas para reducir la morbilidad y mortalidad asociada a la COVID-19 en todos los niveles del sistema de salud, manteniendo los logros y el compromiso de reducir la mortalidad materna y perinatal.


Assuntos
Feminino , Gravidez , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/mortalidade , Cuidado Pré-Natal/organização & administração , Infecções por Coronavirus/epidemiologia , Serviços de Saúde Materno-Infantil/organização & administração , Pandemias/prevenção & controle , Betacoronavirus , América/epidemiologia
3.
Lancet Glob Health ; 8(8): e1061-e1070, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32710862

RESUMO

BACKGROUND: Although gains in newborn survival have been achieved in many low-income and middle-income countries, reductions in stillbirth and neonatal mortality have been slow. Prematurity complications are a major driver of stillbirth and neonatal mortality. We aimed to assess the effect of a quality improvement package for intrapartum and immediate newborn care on stillbirth and preterm neonatal survival in Kenya and Uganda, where evidence-based practices are often underutilised. METHODS: This unblinded cluster-randomised controlled trial was done in western Kenya and eastern Uganda at facilities that provide 24-h maternity care with at least 200 births per year. The study assessed outcomes of low-birthweight and preterm babies. Eligible facilities were pair-matched and randomly assigned (1:1) into either the intervention group or the control group. All facilities received maternity register data strengthening and a modified WHO Safe Childbirth Checklist; facilities in the intervention group additionally received provider mentoring using PRONTO simulation and team training as well as quality improvement collaboratives. Liveborn or fresh stillborn babies who weighed between 1000 g and 2500 g, or less than 3000 g with a recorded gestational age of less than 37 weeks, were included in the analysis. We abstracted data from maternity registers for maternal and birth outcomes. Follow-up was done by phone or in person to identify the status of the infant at 28 days. The primary outcome was fresh stillbirth and 28-day neonatal mortality. This trial is registered with ClinicalTrials.gov, NCT03112018. FINDINGS: Between Oct 1, 2016, and April 30, 2019, 20 facilities were randomly assigned to either the intervention group (n=10) or the control group (n=10). Among 5343 eligible babies in these facilities, we assessed outcomes of 2938 newborn and fresh stillborn babies (1447 in the intervention and 1491 in the control group). 347 (23%) of 1491 infants in the control group were stillborn or died in the neonatal period compared with 221 (15%) of 1447 infants in the intervention group at 28 days (odds ratio 0·66, 95% CI 0·54-0·81). No harm or adverse effects were found. INTERPRETATION: Fresh stillbirth and neonatal mortality among low-birthweight and preterm babies can be decreased using a package of interventions that reinforces evidence-based practices and invests in health system strengthening. FUNDING: Bill & Melinda Gates Foundation.


Assuntos
Mortalidade Infantil/tendências , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Serviços de Saúde Materno-Infantil/organização & administração , Melhoria de Qualidade/organização & administração , Natimorto/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Quênia/epidemiologia , Masculino , Gravidez , Uganda/epidemiologia
6.
Bull World Health Organ ; 98(6): 394-405, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32514213

RESUMO

Objective: To investigate whether sub-Saharan African countries have succeeded in reducing wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions. Methods: We analysed survey data from 36 countries, grouped into Central, East, Southern and West Africa subregions, in which at least two surveys had been conducted since 1995. We calculated the composite coverage index, a function of essential maternal and child health intervention parameters. We adopted the wealth index, divided into quintiles from poorest to wealthiest, to investigate wealth-related inequalities in coverage. We quantified trends with time by calculating average annual change in index using a least-squares weighted regression. We calculated population attributable risk to measure the contribution of wealth to the coverage index. Findings: We noted large differences between the four regions, with a median composite coverage index ranging from 50.8% for West Africa to 75.3% for Southern Africa. Wealth-related inequalities were prevalent in all subregions, and were highest for West Africa and lowest for Southern Africa. Absolute income was not a predictor of coverage, as we observed a higher coverage in Southern (around 70%) compared with Central and West (around 40%) subregions for the same income. Wealth-related inequalities in coverage were reduced by the greatest amount in Southern Africa, and we found no evidence of inequality reduction in Central Africa. Conclusion: Our data show that most countries in sub-Saharan Africa have succeeded in reducing wealth-related inequalities in the coverage of essential health services, even in the presence of conflict, economic hardship or political instability.


Assuntos
Disparidades em Assistência à Saúde/economia , Serviços de Saúde Materno-Infantil/organização & administração , África , África ao Sul do Saara , Conflitos Armados , Humanos , Serviços de Saúde Materno-Infantil/economia , Política , Pobreza , Fatores de Tempo
10.
PLoS One ; 15(6): e0234573, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32525931

RESUMO

BACKGROUND: Globally, the under-10 years of age mortality has not been comprehensively studied. We applied the life-course perspective in the analysis and interpretation of the event history demographic and verbal autopsy data to examine when and why children die before their 10th birthday. METHODS: We analysed a decade (2005-2015) of event histories data on 22385 and 1815 verbal autopsies data collected by Iganga-Mayuge HDSS in eastern Uganda. We used the lifetable for mortality estimates and patterns, and Royston-Parmar survival analysis approach for mortality risk factors' assessment. RESULTS: The under-10 and 5-9 years of age mortality probabilities were 129 (95% Confidence Interval [CI] = 123-370) per 1000 live births and 11 (95% CI = 7-26) per 1000 children aged 5-9 years, respectively. The top four causes of new-born mortality and stillbirth were antepartum maternal complications (31%), intrapartum-related causes including birth injury, asphyxia and obstructed labour (25%), Low Birth Weight (LBW) and prematurity (20%), and other unidentified perinatal mortality causes (18%). Malaria, protein deficiency including anaemia, diarrhoea or gastrointestinal, and acute respiratory infections were the major causes of mortality among those aged 0-9 years-contributing 88%, 88% and 46% of all causes of mortality for the post-neonatal, child and 5-9 years of age respectively. 33% of all causes of mortality among those aged 5-9 years was a share of Injuries (22%) and gastrointestinal (11%). Regarding the deterministic pattern, nearly 30% of the new-borns and sick children died without access to formal care. Access to the treatment for the top five morbidities was after 4 days of symptoms' recognition. The childhood mortality risk factors were LBW, multiple births, having no partner, adolescence age, rural residence, low education level and belonging to a poor household, but their association was stronger among infants. CONCLUSIONS: We have identified the vulnerable groups at risk of mortality as LBW children, multiple births, rural dwellers, those whose mother are of low socio-economic position, adolescents and unmarried. The differences in causes of mortalities between children aged 0-5 and 5-9 years were noted. These findings suggest for a strong life-course approach in the design and implementation of child health interventions that target pregnant women and children of all ages.


Assuntos
Causas de Morte , Mortalidade da Criança , Mortalidade Infantil , Adolescente , Adulto , Criança , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Feminino , Humanos , Lactente , Saúde do Lactente/estatística & dados numéricos , Recém-Nascido , Masculino , Saúde Materna/estatística & dados numéricos , Serviços de Saúde Materno-Infantil/estatística & dados numéricos , Anamnese/estatística & dados numéricos , Fatores Socioeconômicos , Uganda
11.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-47359

RESUMO

O Mapa apresenta as evidências sobre efetividade clínica da Shantala sistematizada a partir de 38 estudos de revisões. A maioria das evidências concentra-se em massagem terapia aplicada em recém-nascidos internados por profissionais de saúde para os seguintes desfechos: redução de dor, melhora do crescimento, desenvolvimento neuropsicomotor, tempo de internação hospitalar, imunidade, estresse e qualidade do sono. El mapa presenta evidencia sobre la efectividad clínica de Shantala sistematizada a partir de 38 estudios de revisión. La mayor parte de la evidencia se concentra en la terapia de masaje aplicada a los recién nacidos hospitalizados por profesionales de la salud para los siguientes resultados: reducción del dolor, mejora en el crecimiento, desarrollo neuropsicomotor, duración de la estadía en el hospital, inmunidad, estrés y calidad del sueño. The Map presents evidence on the clinical effectiveness of Shantala systematized from 38 review studies. Most of the evidence is concentrated on massage therapy applied to newborns hospitalized by health professionals for the following outcomes: pain reduction, improvement in growth, neuropsychomotor development, length of hospital stay, immunity, stress and quality of sleep.


Assuntos
Medicina Tradicional do Leste Asiático/instrumentação , Serviços de Saúde Materno-Infantil/tendências , Resultado do Tratamento , Medicina Baseada em Evidências/instrumentação , Desenvolvimento Infantil , Massagem/instrumentação
14.
Artigo em Inglês | MEDLINE | ID: mdl-32410913

RESUMO

In January 2020, China reported a cluster of cases of pneumonia associated with a novel pathogenic coronavirus provisionally named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). Since then, Coronavirus Disease 2019 (COVID-19) has been reported in more than 180 countries with approximately 6.5 million known infections and more than 380,000 deaths attributed to this disease as of June 3rd , 2020 (Johns Hopkins University COVID map; https://coronavirus.jhu.edu/map.html) The majority of confirmed COVID-19 cases have been reported in adults, especially older individuals with co-morbidities. Children have had a relatively lower rate and a less serious course of infection as reported in the literature to date. One of the most vulnerable pediatric patient populations is cared for in the neonatal intensive care unit. There is limited data on the effect of COVID-19 in fetal life, and among neonates after birth. Therefore there is an urgent need for proactive preparation, and planning to combat COVID-19, as well as to safeguard patients, their families, and healthcare personnel. This review article is based on the Centers for Disease Control and Prevention's (CDC) current recommendations for COVID-19 and its adaptation to our local resources. The aim of this article is to provide basic consolidated guidance and checklists to clinicians in the neonatal intensive care units in key aspects of preparation needed to counter exposure or infection with COVID-19. We anticipate that CDC will continue to update their guidelines regarding COVID-19 as the situation evolves, and we recommend monitoring CDC's updates for the most current information.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Fidelidade a Diretrizes , Controle de Infecções/organização & administração , Unidades de Terapia Intensiva Neonatal/organização & administração , Serviços de Saúde Materno-Infantil , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Complicações Infecciosas na Gravidez/virologia , Adulto , Aleitamento Materno , Extração de Leite , Defesa Civil , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Salas de Parto , Feminino , Higiene das Mãos/normas , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Urbanos , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Comunicação Interdisciplinar , Serviços de Saúde Materno-Infantil/organização & administração , Cidade de Nova Iorque/epidemiologia , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/terapia , Visitas a Pacientes
16.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47320

RESUMO

O Portal de Boas Práticas em Saúde da Mulher, da Criança e do Adolescente é uma iniciativa do Instituto Nacional de Saúde da Mulher, da Criança e Adolescente Fernandes Figueira (IFF), da Fundação Oswaldo Cruz (Fiocruz), do Ministério da Saúde (MS). O conteúdo do portal está estruturado por eixos temáticos: Atenção ao Recém Nascido; Atenção às Mulheres; Atenção ao Adolescente e Atenção à Criança. Encontramos sessões como: Encontro com o Especialista, Acontece no Portal, Notícias e Biblioteca.


Assuntos
Serviços de Saúde Materno-Infantil , Saúde da Mulher , Saúde da Criança , Saúde do Adolescente , Assistência Integral à Saúde
17.
J Obstet Gynecol Neonatal Nurs ; 49(3): 315-326, 2020 05.
Artigo em Inglês | MEDLINE | ID: covidwho-47734

RESUMO

An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of a new National Academy of Medicine report on planned place of birth and implications during the SARS-CoV-2 pandemic and commentaries on reviews focused on anorectal sexually transmitted infections and feeding methods following cleft lip repair in infants.


Assuntos
Infecções por Coronavirus/epidemiologia , Prática Clínica Baseada em Evidências , Recursos em Saúde , Serviços de Saúde Materno-Infantil , Pandemias , Pneumonia Viral/epidemiologia , Feminino , Humanos , Lactente , Gravidez , Estados Unidos/epidemiologia
18.
Pediatrics ; 145(Suppl 1): S5-S12, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32238526

RESUMO

OBJECTIVES: To provide an overview and quantitatively demonstrate the reach of the Health Resources and Services Administration's Maternal and Child Health Bureau autism research program. METHODS: We reviewed program reports and internal data from 59 autism research grantees. The US federal Interagency Autism Coordinating Committee's strategic plan questions were used as a framework to highlight the contributions of the autism research program in advancing the field. RESULTS: The autism research program grantees advance research in several ways. Grantees have strengthened the evidence for autism interventions by conducting 89 studies at 79 distinct research sites. A total of 212 708 participants have enrolled in autism research program studies and 361 researchers have contributed to furthering autism research. The program addresses topics that align with the majority of the Interagency Autism Coordinating Committee's priority topic areas, including advancements in treatments and interventions, services and supports, and identifying risk factors. Grantee products include 387 peer-reviewed publications, 19 tools, and 13 practice guidelines for improving care and intervention practices. CONCLUSIONS: The autism research program has contributed to medical advances in research, leveraged innovative training platforms to provide specialized training, and provided access to health services through research-based screening and diagnostic procedures. Autism research program studies have contributed to the development of evidence-based practice guidelines, informed policy guidelines, and quality improvement efforts to bolster advancements in the field. Although disparities still exist, the Health Resources and Services Administration's Maternal and Child Health Bureau can reduce gaps in screening and diagnosis by targeting interventions to underserved populations including minority and rural communities.


Assuntos
Transtorno Autístico , Pesquisa Biomédica , Avaliação de Programas e Projetos de Saúde , United States Health Resources and Services Administration , Transtorno Autístico/diagnóstico , Transtorno Autístico/terapia , Criança , Humanos , Serviços de Saúde Materno-Infantil , Estados Unidos
19.
PLoS One ; 15(4): e0230340, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236118

RESUMO

CONTEXT: The person-centred approach (PCA) is a promising avenue for care improvement. However, health professionals in Burkina Faso (hereafter referred to as caregivers) seem unprepared for taking into consideration patients' preferences and values in the context of healthcare provision. OBJECTIVE: To understand the meaning attributed to PCA in the Burkina Faso context of care and to identify the challenges related to its adoption from the perspective of caregivers and women service users (hereafter referred to as patients). METHODS: An ethnographic qualitative research design was used in this study. We conducted 31 semi-directed interviews with caregivers and patients from Koudougou (Burkina Faso) healthcare facilities. We also carried out direct observation of consultations. Data thematic analyses are based on the person-centred approach analysis framework. RESULTS: According to the caregivers and patients interviewed, the PCA in maternal and child healthcare in Burkina Faso includes the following five components used in our analytical framework: i) pregnancy follow-up consultations extend beyond examining physical health issues (biopsychosocial component), ii) healthcare professionals' mood affects the caregiver-patient relationship as well as care delivery (the healthcare professional as a person), iii) patients expect to be well received, listened to, and respected (the patient as a person), iv) healthcare professionals first acknowledge that both themselves and patients have power, rights but also responsibilities (sharing power, rights and responsibilities of professionals and patients), and v) healthcare professionals who are open to involving patients in decision-making about their care and patients asking to have a say in the organization of services (therapeutic alliance). Implementing each of these themes comes with challenges, such as i) talking about health problems in the presence of other women, especially those related to sexuality, even though they are common to parturient women (biopsychosocial component); ii) offering psychotherapy to healthcare professionals (healthcare professional as a person); iii) taking into consideration patients' cultural and linguistic differences (the patient as a person); iv) raising awareness among patients about their right to ask questions and healthcare professionals' duty to answer them (sharing power, and rights and responsibilities of professionals and patients); v) accepting the presence of birth attendants while avoiding traditional practices that are contrary to scientific recommendations (therapeutic alliance). CONCLUSION: Despite some context-specific particularities, the PCA is not new in the context of health care in Burkina Faso. However, its implementation can pose a number of challenges. There is a need to train healthcare professionals with a view to being sensitive to these particularities. This may also require organizational adjustments so as to create the physical and sociocultural environments that are conducive to taking into account the patient's perspective.


Assuntos
Pessoal de Saúde/psicologia , Serviços de Saúde Materno-Infantil/tendências , Assistência Centrada no Paciente/tendências , Relações Profissional-Paciente , Burkina Faso , Pessoal de Saúde/educação , Humanos , Pesquisa Qualitativa , Encaminhamento e Consulta
20.
J Obstet Gynecol Neonatal Nurs ; 49(3): 315-326, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32294453

RESUMO

An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of a new National Academy of Medicine report on planned place of birth and implications during the SARS-CoV-2 pandemic and commentaries on reviews focused on anorectal sexually transmitted infections and feeding methods following cleft lip repair in infants.


Assuntos
Infecções por Coronavirus/epidemiologia , Prática Clínica Baseada em Evidências , Recursos em Saúde , Serviços de Saúde Materno-Infantil , Pandemias , Pneumonia Viral/epidemiologia , Feminino , Humanos , Lactente , Gravidez , Estados Unidos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA