WHAT'S NEW THIS SUNDAY: IMB REPORT, POLIO ERADICATION; ANTENATAL & POSTNATAL CARE IN ETHIOPIA; ALL TIME HITS, 2008-2011

Saturday, 18th of February 2012

.WHAT’S NEW THIS SUNDAY

REPORT OF THE INDEPENDENT MONITORING BOARD, GLOBAL POLIO ERADICATION INITIATIVE

Full text is at http://www.polioeradication.org/Portals/0/Document/Aboutus/Governance/IMB/5IMBMeeting/IMBReport_January2012.pdf

EXECUTIVE SUMMARY

1. There are 10 months to go to hit the World Health Assembly’s goal of stopping global polio transmission by the end of 2012. Currently the eradication programme is not on track to meet this goal.

2. Success in India – one of the four polio endemic countries – shows that unswerving political commitment, outstanding public health leadership, clear lines of accountability, intolerance of weak performance and the systematic enforcement of best practice can stop polio.

3. Elsewhere in affected countries, programmes are falling short in most, if not all, of the areas where India has excelled.

4. In these next 10 months every drop of vaccine will count, every vaccinator will count, every team leader will count, every laboratory specimen will count, every piece of data will count, every parent will count, but most of all every child will count.

5. Science has delivered to human civilisation the chance to eliminate one of the malevolent forces of nature, an invisible enemy that obliterates childhoods, maims bodies and scars families and communities. For only the second time in history, the world is poised to rid itself of a disease that has destroyed millions of lives. This opportunity must not be lost.

6. If the programme can make the shift in performance from good to great – drawing on the analysis in this and our earlier reports – then the next 10 months will be looked back on by future generations as the countdown to the final knock-out blow to the polio virus.

7. The programme’s 2010-12 Strategic Plan aimed to stop transmission in two endemic countries by end-2011. Its success in India was magnificent. By sharp contrast, the other three endemic countries each had more polio cases in 2011 than in 2010.

8. Transmission was supposed to be stopped by end-2010 in the four ‘re-established’ countries. This failed in Angola, Chad and DR Congo. A year on, polio retains a powerful grip in at least the latter two of these.

9. More positively, the plan aimed to stop outbreaks within six months. The programme has successfully done so in every case but one.

10. Six countries still have persistent transmission:Nigeria’s 2011 emergency plan had no meaningful impact. Its 2012 plan must be of a different order entirely. This needs urgent attention

Pakistan has deep problems, but has recently strengthened its approach

Afghanistan has not got to grips with how to reach enough children in insecure areas

Angola looks promising, with no polio case since July 2011

Chad’s programme is building visibly but slowly from a very low baseline

DR Congo moved in the right direction in 2011 but we retain substantial concerns, particularly

about Katanga.

11. The reason that polio will not be eradicated on the programme’s present trajectory is straightforward: performance is of variable quality and consistently falls below best practice in all the polio affected areas.

12. There is no single or simple solution to this problem of sub-standard performance but three big actions would transform the prospects of the elimination goal being met:Greater use of the key strategies of change management, including much greater emphasis on ‘people factors’

Identifying and finding definitive solutions to systemic problems that are barriers to success

Taking to heart and fully adopting the lessons learned from India’s success

13. Our previous reports have discussed these issues extensively. The programme’s partners are starting to demonstrate that they understand these points and can act on them.

14. The programme continues to provide illustrations of the fact that it needs to persist with this change in thinking. As just one example: in the 18 months of our existence we have heard little strategic discussion of a key component of the polio eradication workforce: the humble vaccinator. In contrast, we know from multiple sources, and from firsthand experience, that too many of these workers are underrated, rarely thanked, frequently criticised, often under-paid, poorly motivated, and weakly-skilled. Being an excellent vaccinator means being well-organised, a good communicator, and having the tenacity to track down every last child. It is the programme’s responsibility to value, train and inspire this immensely important group of people, arguably the most important in the programme. Their collective actions can drive the eradication effort to failure or elevate it to success.

15. The body of our report provides a number of other examples.

16. WHO’s Executive Board has declared polio eradication a “programmatic emergency for global public health”. These are strong words, but justified. Countries, partners and all who have a stake in polio eradication need to understand the severity of the situation. The impact of an emergency response will not come from what they say, but from what they now do.

ANTENATAL AND POSTNATAL CARE SERVICE UTILIZATION IN SOUTHERN ETHIOPIA

Best viewed at

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260999/?tool=pubmed

Afr Health Sci. 2011 September; 11(3): 390–397.

PMCID: PMC3260999

Antenatal and postnatal care service utilization in southern Ethiopia: a population-based study

N Regassa

Institute of Environment, Gender and Development, Hawassa Univerity, Hawassa, SNNPR, Ethiopia

* Correspondence author Nigatu Regassa Institute of Environment, Gender and Development Hawassa University P. O. Box 679 Hawassa, SNNPR Ethiopia Phone 251-46-2203801 Email: negyon@yahoo.com

Background

Access to antenatal care (ANC) and postnatal care (PNC) services has a great deal of impacts on major causes of infant death and significantly affects trends of mortality in a population. Antenatal care may play an indirect role in reducing maternal mortality by encouraging women to deliver with assistance of a skilled birth attendant or in a health facility. In most rural settings of Ethiopia, there are challenges in increasing such health care service utilization mainly due to the fact that the decisions that lead women to use the services seem to occur within the context of their marriage , household and family setting.

Objective

Examining the prevalence and factors associated with antenatal Care (ANC) and Postnatal Care (PNC) service utilizations.

Methods

This was a cross-sectional population based study undertaken in 10 rural villages of the Sidama zone, southern Ethiopia. The data were collected from a representative sample of 1,094 households drawn from the study population using a combination of simple random and multistage sampling techniques. Two dependent variables were used in the analysis: The ANC, measured by whether a woman got the service (at least once) from a health professional or not during her last pregnancy and PNC which was approximated by whether the last born child completed the required immunization or not. Household and women's characteristics were used as explanatory variables for both dependent variables.

Results

The study revealed that the level of ANC and PNC service utilizations is 77.4 % and 37.2% respectively. The predicted probabilities, using logistic regression, showed that women who are literate, have exposure to media, and women with low parity are more likely to use both ANC and PNC services.

Conclusion

Antenatal care service utilization was generally good while the postnatal care given to new born children was very low compared to other population groups in the region. Promoting women's education and behavioral change communication at grass root level, provision of the services at both home and health facilities, and improving the quality and capacity of the health providers are some of the recommendations forwarded.

ALL TIME HITS, 2008-2011

Going back through the archives from 2008 through 2011, I find the following 36 items were viewed 1000 times or more.

Interestingly, the most often viewed was a reader comment, 'Polio compared to measles,' not a published article.

To view any item, type the title into the search engine in the upper right hand corner of this page.

Good reading.

BD

TITLE OF THE ITEM POLIO COMPARED TO MEASLES	NUMBER OF VIEWS 1828
COCHRANE REVIEW: THE IMPACT OF USER FEES ON ACCESS TO HEALTH SERVICES IN LOW- AND MIDDLE-INCOME COUNTRIES -- A COCHRANE REVIEW	1822
SEASONALITY AND THE PERSISTENCE AND INVASION OF MEASLES	1772
EQUALITY OF ACCESS FOR MEASLES VACCINATION/ AEROSOL VACCINATION AGAINST MEASLES	1760
GLOBAL MEASLES UPDATE	1742
CSU 4/2011: SELF LEARNING COURSES IN PUBLIC HEALTH	1742
CSU 71/2010: NEW VACCINES FOR TUBERCULOSIS	1531
WHAT'S NEW THIS WEEKEND: CDC MALARIA POSITIONS, PREDICTORS OF CHILD SURVIVAL, SIMPLIFIED ARV DELIVERY MODELS, USE OF LAY PERSONNEL FOR ROUTINE IMMUNIZATION	1306
CSU 25/2008: ANTIMALARIAL MONOTHERAPY IN THE MOST SEVERELY MALARIOUS PARTS OF AFRICA	1297
MEASLES PRE-ELIMINATION GOAL, WHO/AFRO	1248
MEASLES ELIMINATION IN AUSTRALIA AND 17 EUROPEAN COUNTRIES/ GENETIC DIVERSITY OF MEASLES VIRUS IN EUROPE	1208
REVIEW ON AEROSOL MEASLES VACCINES/ FEASIBILITY OF GLOBAL MEASLES ERADICATION	1208
CSU 10/2009: ALLIANCE FOR MALARIA PREVENTION	1187
CSU 28/2008: PNEUMONIA	1178
CSU 11/2008: GATES FOUNDATION ON MALARIA ERADICATION	1159
CSU 24/2008: PREVENTING CHILD MALARIA BY PROTECTING ADULTS WITH BED NETS	1148
CSU 52/2010: FOUR ON POLIO: BILL GATES, POLIO IN TAJIKISTAN	1129
CSU 20/2008: TWO ON MEASLES/BOOK REVIEW/READER FEEDBACK (2)	1127
CSU 33/2008: BCG AND LEPROSY PROTECTION	1127
CSU 18/2008: HIB VACCINATION IN UGANDA	1126
CSU 36/2008: THE CASE FOR UNIVERSAL HEP B VACCINATION	1115
CSU 27/2010: POLIO ERADICATION WITHIN FIVE YEARS	1114
CSU 48/2008: PERSISTENCE OF HEP B PROTECTION IN VACCINEES AFTER 15 YEARS	1110
CSU 3/2009: VACCINE DERIVED POLIOVIRUS	1108
CSU 19/2008: LIMITS AND INTENSITY OF FALCIPARUM /READER FEEDBACK	1104
49/2008: READER FEEDBACK/SEX RATIOS IN MUMBAI	1103
CSU 37/2008: QUERY TO READERS/READER FEEDBACK/EPI TRAINING	1091
SELF-INSTRUCTIONAL PUBLIC HEALTH TRAINING ONLINE/ RESEARCH CAPACITY IN AFRICA	1088
CSU 31/2008: FUTURE GLOBAL POLICIES FOR MANAGING POLIOVIRUSES	1086
CSU 51/2008: THREE ON MALARIA	1075
COCHRANE REVIEW:: CASH INCENTIVES FOR CHILD HEALTH	1071
CSU 38/2009: HORSTMANN ON POLIO/ NATHANSON ET AL ON US POLIO SURVEILLANCE, 1956 / THE CUTTER INCIDENT	1069
CHILD SURVIVAL UPDATE 8/2009: THE FINAL PUSH TOWARDS POLIO ERADICATION	1068
CSU 47/2010: PROGRESS AGAINST POLIO	1059
CSU 16/2008: INTERVENTIONS FOR MATERNAL & CHILD UNDERNUTRITION & SURVIVAL	1020
CSU 2/2011: WHO WEBSITES/ UPDATED TOP HITS OF 2010: COCHRANE MAKES THE TOP 10	1016
CSU 10/2008: THE GLOBAL IMPACT OF VACCINATION	1009