Global Health Weekly Nwes Round-Up

Politics and Policies:

• Dutch government has announced that it will ban the mild narcotic drug khat (Source: http://www.bbc.co.uk/news/world-middle-east-16508238 ).
• The Ministry of Health of Malaysia is monitoring orange imported from Brazil (Source: http://www.nst.com.my/latest/health-ministry-monitoring-orange-juice-from-brazil-1.32264 ).

Programs

• European Commission (EU) has given support of 52 million euros to      Ghana to reduce maternal mortality and achieve the MDG 5 targets (Source: http://www.ghana.gov.gh/index.php/news/general-news/10232-eu-gives-additional-funds-for-maternal-health ).
• The International Committee of the Red Cross (ICRC) has temporarily      suspended aid to more than one million people in central and southern      Somalia (Source: http://www.voanews.com/english/news/ICRC-Suspends-Food-Aid-to-11-Million-Somalis-137172743.html ).
• India marks major milestone in global fight to eradicate polio. The      World Health Organization has warned India to prevent such virus from      being re-imported. (Sources: http://www.care2.com/causes/india-marks-major-milestone-in-global-fight-to-eradicate-polio.html, http://www.vancouversun.com/news/canada-in-afghanistan/India+needs+cautious+about+polio+milestone/5993029/story.html  ).

Research

• Gene      responsible for Atopic Dermatitis identified. The researchers found an      association between ORAI1 Genetic Polymorphisms and the susceptibility of      this disease in Japanese and Taiwanese populations (Source: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0029387;jsessionid=5147EF5A0C05A18FB235EFD5B5B40274      ).
• Four      genomic areas associated with the increase risk for exudative age-related      macular degeneration (AMD) in Japanese individuals identified by a      research team led by Michiaki Kubo at RIKEN Center for Genomic Medicine in      Yokohama (Japan) (Source: http://esciencenews.com/sources/physorg/2012/01/13/keeping.eye.japanese.genome      ).
• Researchers      reveal the benefits for aspirin therapy for those suffering from a heart      disease or stroke but not for those who may have symptoms and not any history      of these diseases (Source: http://topnews.net.nz/content/220872-aspirin-therapy-heart-disease-stroke-prevention-not-everyone      ).
• A study      reveals that remission of cancer may be linked to chemotherapy drugs used      for its treatment (Source: http://articles.timesofindia.indiatimes.com/2012-01-13/health/30623236_1_cancer-relapse-cancer-cells-dna-damage      ).
• Signs of      changes in brain in people who are dependent online are similar to people      who are addicted to alcohol and cocaine (Source: http://www.telegraph.co.uk/technology/internet/9009125/Internet-addiction-affects-the-brain-like-a-drink-or-drug-problem.html      ).
• A blood      test for the detection of mad cow disease (Source: http://topnews.net.nz/content/220887-blood-test-could-help-diagnose-deadly-mad-cow-disease      ).
• A possible      link between germ-fighting preservatives in cosmetics and breast cancer      found (Source: http://yourlife.usatoday.com/health/healthcare/studies/story/2012-01-13/Does-deodorant-ingredient-affect-breast-cancer-risk/52528952/1      ).
• Rare but      recurrent mutation in gene linked to prostate cancer (Source: http://www.foxnews.com/health/2012/01/17/genetic-testing-for-prostate-cancer/      ).
• An      Australian report says women over diagnosed with cancer due to mammograms (Source:      http://www.foxnews.com/health/2012/01/16/women-over-diagnosed-with-breast-cancer-researchers-say/      ).
• Researchers      from NASA’s Goddard Institute for Space Studies (GISS) in New York City      identified measures to reduce global warming by 2050 and improve human      health and agriculture (Source: http://www.greencarcongress.com/2012/01/shindell-20120113.html      ).

Diseases & Disasters

• About 70% milk samples picked up by a government agency in New Delhi failed to confirm to standards. About 48% milk in Chandigarh is adulterated (Source: http://articles.timesofindia.indiatimes.com/2012-01-10/india/30611460_1_samples-milk-powder-central-food-laboratory, http://articles.timesofindia.indiatimes.com/2012-01-11/chandigarh/30615932_1_milk-powder-milk-samples-pure-milk  ).
• A massive epidemic of incurable form of tuberculosis which cannot be cured with any combination of the World Health Organization recommended drug has emerged in India (Source: http://www.theglobeandmail.com/news/world/india-struck-by-budding-strain-of-incurable-tuberculosis/article2300929/?from=sec431 ).

 

Global Health News Last Week

SECTION NEWS

The following announcement, from Eric Williams, calls for any IH section members interested in assisting efforts to address federal global health and HIV/AIDS funding.  Please see the text of the announcement below.  Eric can be contacted by e-mail at ericwms@gmail.com.

Dear Colleagues,

I’m writing to request assistance in a “grasstops” effort to address federal global health and HIV/AIDS funding. As you are likely well aware, there have been serious threats and concerns regarding global health funding over the last several years. There is a real need to mobilize influential members of our community in an effort to ensure that Congress does not backtrack on our global health commitments.

I am doing some consulting work with amfar and they want to identify experts, donors, high-profile individuals and/or organizations in select states who can reach out to key Senate leadership. We need these individuals/organizations to show and voice their support for continued and sustained commitments for global health.

States of focus include Nevada (Sen. Harry Reid), Iowa (Sen. Tom Harkin), and Washington (Sen. Patty Murray). We believe these senators are in key positions to influence appropriations decisions and sure up support for global health.

The aim of this effort is to:

1. identify grasstop individuals/organizations and
2. plan, coordinate, and carry out outreach efforts to Senate leadership in a variety of ways, including state-level meetings, Hill visits, op-eds, sign-on letters, and so forth.

If you are interested or able to provide assistance in helping to identify and/or reach out to the above stakeholders, I would be very interested in speaking. If there is strong support for this I would be happy to facilitate a conference call to discuss in full.

---

August 19 was World Humanitarian Day.

POLITICS AND POLICY

• The CDC has made updates to its flu vaccination recommendations aimed at children and people with egg allergies.
• The United Nations has released a list of 248 organizations from 48 nations that are accredited to attend the UN High Level Meeting (HLM) on non-communicable diseases (NCDs) during September 19-20, 2011.  Meanwhile, as has been widely reported (including here and here), negotiations have stalled over an “outcomes document” that is to be approved at the meeting.
• The World Health Organization is calling for a ban on a common blood test for TB, saying the test is unreliable.
• Twenty-two children in Kancheepuram, Indiawho were not allowed to go to school because they are HIV positive have been ordered to return to school after a court ruled in favor of the students.
• International funding for HIV fell by 10 percent in 2010 from the previous year, according to the Kaiser Family Foundation and UNAIDS; activists worry that a continued reduction will undermine progress in global HIV prevention and treatment efforts.

PROGRAMS

• A study from Senegal published in the Lancet at the beginning of this month raises doubts over Gates’ plant to beat malaria, blaming mosquitoes’ growing resistance to insecticide and decreased immunity to malaria among the local population.
• The Bill & Melinda Gates Foundation and the Japan International Cooperation Agency have announced a strategic partnership to ensure continued progress in the fight against polio, including an innovative financing agreement to support polio-eradication efforts in Pakistan.
• USAID announced the expansion of its Indoor Residual Spraying program. The $189 million, there-year contract awarded by USAID to Abt. Associates will cover the implementation of IRS activities in Angola, Benin, Burkina Faso, Ethiopia, Ghana, Liberia, Madagascar, Mali, Mozambique, Nigeria, Rwanda, Senegal, Zambia, and Zimbabwe.
• WHO has released Psychological First Aid: Guide for Fieldworkers, a guide intended to provide field workers the tools to provide psycho-social support to themselves and those affected by a disaster or humanitarian crisis.
• The first comprehensive etiology study of childhood pneumonia in 3 decades has been launched. Pneumonia Etiology Research for Child Health (PERCH) will be a collaboration between sites in Africa, Asia and the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health.

RESEARCH

• USAID has announced a partnership with the Infectious Disease Research Institute that will provide support for the research of a malaria vaccine at Walter Reed Army Institute of Research.
• UNDNJ researchers have discovered a link between TB and parasitic worms which act to thwart the body’s natural defenses against Mycobacterium tuberculosis.
• A Canadian study has found that a pregnant woman suffering from depression can lead to brain changes in their children.
• Researchers have identified 17 new antibodies with broad activity against HIV; some of which are 10 times more potent than previously discovered antibodies.
• The recent news about hiding vegetables by puréeing them and then adding them to recipes may make meals healthier, but if children don’t know they are eating vegetables, they won’t know to seek out those foods and eat them in future, says Isobel Hoskins on the CABI Global Health blog.
• Microcalorimeters may be the key to achieving TB diagnosis in a quicker and cheaper manner, say researchers in a recently published article in the Journal of Applied Microbiology.
• According to a recent UN study, 9 million lives can be saved over the next 10 years if average global salt consumption levels dropped by 15%.

DISEASES AND DISASTERS

• The WHO Says Libya is facing a medical supply crisis.
• The United Nations food agency called on Thursday for long-term aid for farmers in the Horn of Africa, saying constant crises in the region should shame the world.
• A report by the National Institute of Malaria research in Delhi has found that climate change will enable malaria to move to new areas.
• New research finds that radiation from the nuclear plant accident in Japanin March reached Californiawithin days, showing how quickly air pollution can travel, but scientists say the radiation will not hurt people.
• According to an article published in Science, 19 August, cases of Chagas disease are rising outside Latin America, because large numbers of people who are already infected are migrating fromLatin America.
• Len Rubenstein comments on the attacks on healthcare personnel inBahrain and the recent progress made to protect healthcare workers in conflict zones.

INFOGRAPHICS AND OTHER INTERESTING VISUALS

• Sarah Arnquist at the Global Health Hub has put together an open source timeline of global health milestones from the past century.
• The GAVI Alliance has released this infographic on the importance of childhood vaccines.
• This infographic on maternal mortality from Maternal Health Taskforce has caught the attention of Jen Quraishi at Mother Jones for the choice of data used to fill it out. She argues that comparing total maternal deaths rather than per capita rates makes it hard to assess nations side by side.

Thanks to Tom Murphy and Mark Leon Goldberg, Larry Johnson (filling in for Tom Paulson), Isobel Hoskins, and Jeff Meer.

A Golden Moment: Global Partners Unite to Expand Access to Skilled Birth Attendants

Guest Contributor: Conrad Person, Director of Corporate Contributions, Johnson & Johnson
As a record-setting 3,000 delegates from more than 111 countries gathered last week in Durban, South Africa for the 2011 International Confederation of Midwives Congress, I believe that we are witnessing a “golden moment” for the global campaign to realize the right of every woman to have access to the best possible health care during pregnancy and childbirth.

Two things give me hope. First, a new analysis from the United Nations Population Fund verifies what we’ve known for decades – only by expanding access to quality midwifery services, especially in the world’s most needy countries, can we curb maternal and newborn mortality. Second, the groundbreaking Millennium Cities Initiative (MCI) is demonstrating what is possible when we focus on improving health in the world’s poorest cities.

This “golden moment” was on full display on a recent blazing hot afternoon in the Jamestown section of Accra, Ghana. With the Jamestown Lighthouse looming in the background, I was reminded that this Ga fishing community was once the heart of historic Accra. But now, it is a poor neighborhood in a city where the mean household income is less than $4 U.S. a day. In a brick courtyard, about 300 women wearing the distinctive colors and patterns of West Africa sat beneath a canvas tent. While Ga drummers, famous the world over, quickly attracted an overflow crowd and the First Lady of Ghana and Accra’s Mayor also inspired the audience, the stars of the show were the babies these women held in their arms.

Five of the midwives took their places in the center of the courtyard. One pretended to be in labor and from beneath a blanket another extracted a mannequin baby. “The baby is not breathing,” she announced. The team quickly went into action to resuscitate the baby.

At this point a regional director for MCI, Abenaa Akuamoa-Boateng, whispered into my ear, “This is the golden minute. Success depends on acting swiftly.” In a minute or so, the mannequin seemed to give a cry like a lamb’s bleat. Even with babies in their arms, the audience clapped.

Each year, an estimated one million babies die from birth asphyxia, or the inability to breathe right after delivery. But skilled birth attendants can change that. More golden moments would be successful if more midwives and skilled attendants had the authority and support of their government to attend these births. MCI is working to tackle one aspect of this global campaign – bringing critical health care services to the most vulnerable mothers and newborns in the world’s poorest urban centers.

Much is made, rightly, of the plight of rural women and children, but MCI makes the case that the urban poor represent a great challenge as well. MDGs 4 and 5 simply can’t be achieved if major African population centers have persistently poor health outcomes for mothers and babies.

MCI addresses this problem through a Neonatal Survival Program, piloted during the past year in Accra and Kumasi, Ghana. This program has incorporated training for 120 frontline caregivers in neonatal resuscitation and infant care with follow-up outreach to and health education of more than 1,500 new mothers, demonstrably saving newborn lives. This program has had the support of Johnson & Johnson, AmeriCares, the American Academy of Pediatrics and local and national health agencies. Statistically, it’s all but certain that without this program, some of those 1,500 children would not have survived.

I left Jamestown with the strong conviction that if we are to meet the MDGs, we must treat every minute that we have left as a “golden minute.” I hope we take full advantage of this unique – and critical – moment to act.

Global Health News Last Week

POLITICS AND POLICY

• Attacks on aid workers are on the increase and one writer believes this largely due to the current “integrated mission” focus of the UN and other donors.
• If the Global Fund is to avoid further adverse media coverage and further consequent donor nervousness, it must urgently implement a more effective and fine-tuned approach to the issues of corruption and transparency.
• The families of two women who died in childbirth are starting a legal action against the government of Uganda, alleging that the inadequate care and facilities provided for pregnant women caused the deaths and violates their country’s constitution and women’s rights to life and health.
• The results of a recent bombshell study revealing the impact of taking ARVs and the spread of HIV has the Obama administration doing some serious pondering over the impact of a policy change.
• The elimination of mother-to-child transmission has become the focus of Rwanda’s ministry of health for reducing the rate of HIV.
• The states in India have been directed by the central government to provide free healthcare to pregnant women and sick neonatal children effective June 1.
• The Global Fund to Fight AIDS, Tuberculosis and Malaria has frozen payments on hundreds of millions of dollars worth of disease-fighting grants to China, one of the charity’s biggest recipients, in a dispute over China’s management of the grants and its hostility toward involving grass-roots organizations in public health issues.
• Government think-tanks in China and India have recommended a jointly funded initiative to strengthen traditional medicine innovations in both countries.

PROGRAMS

• In Ghana, the Oxytocin Initiative Project has begun testing whether community health workers can safely and effectively prevent postpartum hemorrhage.
• ‘Tupange’ is the name of a new outreach program in Kenya that hopes to increase and sustain contraceptive use among urban women.

RESEARCH

• Researchers discuss the new developments in vaccines for HIV/AIDS, malaria and TB in the scientific journal Nature.
• Vuvuzelas – the horns used by football fans celebrating last year’s World Cup – not only cause noise pollution but may also spread diseases, say experts. In crowded venues one person blowing a vuvuzela could infect many others with airborne illness like the flu or TB. Mercifully, organisers are considering whether to ban them at the 2012 London Olympics.
• Published by the Institute for Economics & Peace, the Global Peace Index tries to measure peace. This year has seen the world become less peaceful for the third year in a row – and highlights what it says is a continuing threat of terrorism.
• It may be against the law, but wealthier, better-educated families in India are choosing more and more often to abort pregnancies if the child is female, researchers in Canada and India report in the Lancet.
• Researchers at The University of Texas Health Science Center at Houston find that diabetics have a higher risk of contracting TB.
• Lancet once called it “potentially the most important medical advance of the 20th century.” But today, oral rehydration therapy (ORT) — a simple treatment often consisting of a home solution of sugar, salt and water — is under-used, causing untold deaths of children.

DISEASES AND DISASTERS

• Due to lack of adequate vaccinations worldwide, measles has exploded this year. Infectious disease doesn’t respect borders and many American parents opt out getting their kids vaccinated.
• Zimbabwe has recently experienced a sharp rise in tuberculosis cases, leaving the politically unstable nation ranked 17th out of the 22 countries with highest TB outbreaks in the world.

TOTALLY UNRELATED TO ANYTHING ELSE: Apparently, to Nigerians, Bill and Melinda Gates do not look like rich people.

Global Health News Last Week

SECTION NEWS

APHA’s 2011 Section elections are coming up soon! Online voting will open on May 16 and ends on June 20. Section members should receive an e-mail on May 16 (next Monday) which will include:

• Your online election validation number
• Your APHA membership ID number
• Voting instructions
• A direct link to your voting Web site

All you have to do is click on the direct link and VOTE!

APHA’s Trade and Health Forum has released its first newsletter! The Forum has established a quarterly APHA Trade & Health Forum Newsletter that includes brief reports from forum members regarding recent work and analyses of issues related to trade and health, as well as announcements for trade and health advocacy opportunities and events. The first spring issue can be viewed here (PDF).

---

David Sencer, the longest-serving director of the U.S. Centers for Disease Control and Prevention (CDC) and one of the leaders of the U.S. contribution to the smallpox campaign, passed away at age 86 on May 2.

May 5 was International Day of the Midwife.

POLICY

• The Association of Southeast Asian Nations (ASEAN) and the World Health Organization (WHO) have joined forces to assist Asia Pacific countries in identifying priority actions for dengue prevention and control.
• On May 11, dozens of countries around the world will kick off the first global Decade of Action for Road Safety, from 2011-2020.
• Starting last week, China’s Ministry of Health is strengthening its tobacco rules to require 28 types of businesses, including bars, coffee shops, hotels and stadiums to become 100 percent smoke-free.

PROGRAMS

• After a sensationalistic (and rather silly) report from the AP on corruption and graft, the Global Fund has assembled a high-level panel of independent experts to assess the risk of fraud in the current portfolio. The review should be concluded by mid-September
• Sri Lanka commemorated 100 years of its National Malaria Control Program, which has brought the death toll from malaria from 80,000 per year to 0, on May 5. In 2010, only 684 cases of malaria were reported in the country.
• Health officials in India have taken up a pilot project at taluka places to identify areas with less number of institutional deliveries to bring down maternal deaths.
• UNICEF has found that boreholes drilled in response to the Zimbabwe cholera outbreak in 2008 have not been adequately supported by the government in Harare.
• USAID announced that it will be launching a $10 million mobile health program which will deliver information and tips to mothers via SMS.

RESEARCH

• Protease inhibitors used to treat patients with HIV looks to provide an effective treatment to malaria as well and are being hailed as ‘superdrugs.’
• Headaches are the most common health disorders across the world, yet they remain neglected and under-treated, according to a UN study.
• Researchers warn that East African plants that could cure malaria could disappear before scientists have a chance to study them.

DISEASES AND DISASTERS

• India’s The Hindu provides a comprehensive article on the impact of TB in the country, and on women in particular.
• India achieved a major success on the global platform by pushing for inclusion of mental health in the list of non-communicable diseases.

Thanks, as usual, to the Healthy Dose and Humanosphere.

Global Health News Last Week (plus interest in a new working group!)

Attention IH Section Members: Dr. Kaja Abbas, MPH student at the University of Rochester, is gauging interest in forming a working group focused on using system science to improve global health, similar to the intitiaves being promoted by NIH. Her interests are in conducting system science research on global health policy by modeling population and disease dynamics and economic evaluation of public health interventions and systems, with a focus on HIV and TB. Dr. Malcolm Bryant, our section chair, has encouraged the expansion of our section’s activities in areas of technical expertise, and Dr. Abbas is enthusiastic about a working group within the section that promotes system science methodologies for global health solutions. She welcomes your thoughts and suggestions at kaja [dot] abbas [at] gmail [dot] com.

Global Health Delivery online’s HIV prevention community is hosting a “virtual expert panel” March 7-11 to continue the dialogue around PrEP as a novel approach to prevention. Panelists from Uganda, South Africa and the United States will lead the online discussion, highlighting various barriers and opportunities to implementing PrEP in clinical settings; how to encourage long-term adherence; and what additional research questions need to be answered. Panelists include (1) Douglas Krakower, MD, a fellow in Infectious Diseases at Beth Israel Deaconess Medical Center/Harvard Medical School, (2)Andrew Mujugira, MBChB, MSc, the East Africa regional medical director for the Partners PrEP study, and (3) Vivek Naranbhai, PhD, who was involved in CAPRISA microbicide gel study. All GHDonline members can participate in this online discussion. You can sign up here if you are not currently a member.

POLICY

• Paramount Chief Mpezeni of the Ngoni people in the Eastern Province of Zambia has urged his subjects to get circumcised in order to reduce the chances of spreading HIV/AIDS and other communicable diseases in his land.
• Britain is threatening to pull out of the Food and Agriculture Organization due to “patchy” performance.
• Due to uncertainty in past estimates, the Indian government has formed a 16-member expert group to determine the annual death rate caused by malaria in the country each year.
• The breakdown of the air conditioning in the plenary hall of the Philippines’ House of Representatives stalled the heated debate of a controversial reproductive health bill. The bill is vehemently opposed by the Catholic Church and pro-life groups and has caused a stir in the largely Catholic country.
• A massive demonstration rally was held in New Delhi to protest a free trade agreement between India and Europe, which many fear may threaten the production of low-cost generic drugs, particularly HIV medicines.

RESEARCH

• US researchers believe that half of men in the general population may be infected with human papillomavirus or HPV, the human wart virus that causes cervical and other cancers, strengthening the case for vaccinating boys against HPV.
• A recent study published in the WHO bulletin argues for the need to implement gender-specific tobacco control activites to curb the growing tobacco epidemic.
• The World Economic Forum in Geneva, Switzerland, announced the launch of the Global Health Data Charter, a project designed to improve global health by leveraging the collection and management of data.
• A new study by the Institute for Health Metrics and Evaluation found that the poorest in Thailand have significantly more difficulty accessing diabetes care than the general population.
• A research trial found that a microbicide gel with the ARV tenofovir, initially designed for vaginal use, may also be effective in stopping HIV transmission during anal sex.
• A report released by UNICEF, “The State of the World’s Children 2011,” highlighted India’s poor child and maternal health conditions.

PROGRAMS

• Dr. Bruce Aylward, head of the WHO’s Global Polio Eradication Initiative, discusses why it is so difficult to eradicate polio. Meanwhile, former US President Jimmy Carter is leading his own campaign to make guinea worm the second disease (after smallpox) to be eradicated.
• Amanda Glassman writes about Bangladesh’s success story in drastically lowering its maternal mortality rate.
• The International HIV/AIDS Alliance is expanding its project (which is funded by the UK’s Department for International Development) to reduce HIV-related maternal mortality in South Sudan.
• Prompted by Burma’s (Myanmar’s) transition to “civilian rule” after last November’s elections, the Global Fund has returned and is providing grants for HIV/AIDS, malaria, and TB programs.

DISEASES

• The WHO has declared Nepal polio-free after no infections were reported during a six-month period, while a new outbreak is spiking in the DRC.
• The massive flow of refugees fleeing violence in Libya has created a humanitarian crisis, as organizations struggle to provide for the basic needs of nearly 175,000 people who have crossed the border into Tunisia, Egypt, and Niger.
• After losing 4,500 lives to the cholera epidemic that raged through Haiti after the January 2009 earthquake, doctors in Port-au-Prince say they are bringing the disease under control. Unfortunately, health experts fear that the rainy season will cause a fresh outbreak in Nigeria.

Students: Internship in Maternal Mortality for Summer/Fall 2011

This opportunity was originally posted on the Maternal Mortality Daily blog.  Please contact the referenced individuals for details about the program.

The Safe Motherhood Program at UCSF is accepting applications for an upcoming internship opportunity in the Copper-belt of Zambia. The intern will spend the majority of their time in the labor and gynecology wards at a district hospital and several peri-urban clinics, gaining an understanding of front-line maternal health service delivery and research.
Position Description:

This internship is based in the Copperbelt Region of Zambia.  The intern will work on a study that aims to reduce maternal mortality and morbidities in Zambia and Zimbabwe caused by obstetric hemorrhage.  This is a cluster randomized control study that compares outcomes based on evidence from intervention and control clinics.  The intervention clinics in this study are the clinics that are using the NASG (Non-pneumatic Anti-Shock Garment) as a first aid device for patients suffering from hypovolemic shock caused by bleeding during pregnancy.

Some of the duties of the intern include:

-Providing logistic support for the local Zambian team – distributing supplies, copies, etc.
-Reviewing data collection forms
-Encouraging protocol adherence
-Conducting trainings with local hospital and clinic staff
-Visiting the study clinics
-Following up on cases
-Liaising with the San Francisco office and the in-country staff

Desired qualifications: Experience in international settings, interest in maternal health, research experience, familiarity with clinical environments.  Must be highly detail-oriented, be well organized and have excellent follow-through skills.

Time requirements: Must be able to commit a minimum of 2 months in the Copperbelt, although 3 months is preferred.

Compensation/Funding: Interns must secure their own funding for travel and lodging. There is no funding for these positions but it is valuable experience for someone who wants to make a huge difference in women’s lives.

To learn more about the NASG (Life Wrap), visit: www.lifewrap.org.

If interested, please send your CV and cover letter to Elizabeth Butrick at ebutrick@globalhealth.ucsf.edu, with a copy to Kathleen McDonald at kathleen.p.mcdonald@gmail.com

Despite successes in reducing global maternal mortality, Yemen still struggles to provide adequate maternal care

The Lancet grabbed the attention of global health advocates this week when it published a study recording a significant drop in maternal mortality between 1980 and 2008.  The global maternal mortality rate has declined approximately 1.3% per year, due to a combination of lower pregnancy rates, higher income, more education for women, and higher availability of skilled birth attendants.¹  Though progress toward the fifth Millennium Development Goal varied significantly by country, the news is encouraging, particularly in a field where there has been a perception of no progress.

An Oxfam-trained midwife cleans up a newborn at Sayoun General Hospital, Yemen. Photo courtesy of Abby Trayler-Smith/Oxfam.

However, this positive finding also brings a new sense of urgency to countries where maternal mortality remains high.  Yemen in particular has a depressing maternal and child health record.  According to UNICEF, each Yemeni woman has 5.2 children on average, and the adjusted maternal mortality ratio was 430 per 100,000 live births.  Only 47% of women were attended by skilled health personnel even once during pregnancy from 2003-2008 (only 11% were attended four times or more), and a mere 36% gave birth with a skilled attendant present.²  In 2005, 1 in 39 women died from childbirth or related complications.  And yet maternal care is only one area where women suffer in Yemen: the country, which has attracted recent media attention for “child brides,”^3,4,5 is ranked last in the World Economic Forum’s global gender gap index.³

In the face of such dismal statistics, one intervention, supported by the Extending Service Delivery project at Ibn Khaldoun Hospital in Lahej, is working to reduce maternal mortality.  This intervention has greatly improved care given to mothers and newborns over the past year by implementing eight best obstetric practices:

• family planning counseling for women immediately after delivery
• Vitamin A provision to mothers after labor
• infection prevention controls
• kangaroo mother care for premature babies
• exclusive and immediate breastfeeding
• active management of the third stage of labor
• tetanus and polio vaccines for newborns
• newborn resuscitation

Through a partnering program, progressive religious leaders preach the merits of family planning in mosques and midwives meet with women’s groups to discuss contraceptive choices.  Prior exposure to these issues then increases couples’ acceptance of the best practices when they arrive at the hospital.  Dr. Jamila Raebi, Yemen’s deputy minister of health, is championing the program and has developed a plan to scale-up the practices to health facilities throughout the country.

The global-scale progress in maternal health currently being made highlights the need for progress in countries struggling with MDG5.  Though these interventions have demonstrated promising results, all Yemeni women desperately need improvements to their country’s maternal health capabilities.