Below are extracts from a blog on the Maternal Health Task Force.

‘For decades, the medical and global health communities have viewed magnesium sulphate (MgSO4) as the gold standard for PE/E prevention and treatment [*see note below]. We know it works faster and better than other anticonvulsants like diazepam, but in many settings diazepam is still administered instead of MgSO4. So, why then, are the women who need it unable to get it? The reasons are many, but one is the lack of capacity among the existing health workforce. If more health providers – those based at primary and secondary health facilities – could administer MgSO4, more women and babies would survive PE/E…

‘To minimize this gap and improve maternal and newborn health outcomes, including those related to PE/E, the WHO recommends task shifting…

‘We have seen this be successful in many aspects of sexual and reproductive health. Skilled and traditional birth attendants in Madagascar and Mozambique were able to prevent death from hemorrhage when guidelines were changed to allow them to administer misoprostol. Unintended pregnancies are reduced when midwives can insert contraceptive implants and intrauterine devices (IUD) and when pharmacists can provide contraceptive injections. If frontline health workers such as nurses and midwives can provide these clinical services, then surely they can administer a loading dose of MgSO4 and refer PE/E patients to secondary facilities for further management.’

The full text is here: https://www.mhtf.org/2017/02/27/task-shifting-the-key-to-increasing-access-to-essential-maternal-health-services/?utm_source=MHTF+Subscribers&utm_campaign=2bb39ca9ca-RSS_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_8ac9c53ad4-2bb39ca9ca-183808905

It’s interesting that traditional birth attendants in Madagascar and Mozambique are trained to use misoprostol for complications of delivery, given that in other countries TBAs are  banned altogether from attending deliveries (although in reality these latter countries may well simply be driving TBAs underground, leading to even worse results for individual TBA-assisted deliveries than countries where TBAs are more accepted and supported.)

*Note: I am not an expert, but I think this sentence needs qualification: my understanding is that MsSO4 is not used for the prevention of pre-eclampsia. Rather, it is used for prevention of eclampsia (in a patient who is already in pre-eclampsia) and treatment of eclampsia. I stand to be corrected…

—

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org  

Joint statements in support of WHO’s updated recommendations on standards of quality care for mothers and newborns

From the Healthy Newborn Network:

http://www.healthynewbornnetwork.org/resource/joint-statements-support-whos-updated-recommendations-standards-quality-care-mothers-newborns/

Health care professional associations at the launch of the Network for Improving Quality of Care for Maternal, Newborn and Child Health [http://www.who.int/maternal_child_adolescent/topics/quality-of-care/network/en/ ], have endorsed four joint statements calling all their member associations to assume a critical leadership role in advocating and implementing the actions outlined in the joint statements.

Joint Statement: Improving Quality of Maternal and Newborn Care in Low- and Middle-Income Countries

http://www.healthynewbornnetwork.org/resource/improving-quality-maternal-newborn-care-low-middle-income-countries/

Below are extracts from the Commitment to Action:

At the Global and Regional Levels

• Foster international partnerships between HCPAs and transfer knowledge, increase training opportunities, and build the organizational capacity and skills of professional associations to take a leadership role in improving maternal and newborn care in their respective countries;…
• Produce and distribute resource materials on key issues affecting the professions, including practical tools for human resource development;
• Promote linkages with international and national academic institutions through existing networks to undertake research, and monitoring and evaluation the quality of maternal and newborn care.

At the National Level

Engage in advocacy…

• Establish regular access to the press and media to influence public opinion and governments to adopt or adapt relevant MNH policies and serve as a knowledge hub for results dissemination as an important means of creating stakeholder buy-in and mobilizing resources toward maternal and newborn survival.
• Support the development of policy and regulatory tools in collaboration with government
• Assist in the development of evidence-based standards of quality and excellence, including licensing, accreditation, certification standards and clinical protocols;
• Shape and support an appropriate scope of practice for each cadre of health worker to promote best use of each group’s expertise and improve availability of skilled MNH care; 
• Build professional knowledge, skills and competencies of care providers
• Identify knowledge gaps and needed competencies for maternal and newborn care providers and support training, upgrading of skills and provision of competency-based education within respective professional groups;
• Assist with developing and updating the education programs/curricula emphasizing best practices based on scientific evidence at all levels of education (pre-service, in-service and continuous professional development);
• Incorporate quality improvement into the education of all health care workers supporting MNH, at all levels and train and mentor leaders and providers to make quality improvement part of the culture of health care
• Facilitate knowledge sharing through workshops, seminars, and technical and regulatory updates in their respective profession.
• Support update, dissemination and use of clinical guidelines and protocols
• Develop and maintain strong partnership with international HCPAs in their respective profession to support sharing of important clinical updates at the national and local level;
• Support development, regular update and dissemination of evidence-based clinical practice guidelines, locally-relevant protocols and summary updates on the recent evidence for MNH;
• Integrate updated clinical practice recommendations in preservice, in-service and continuous professional development programs;
• Support care providers to access evidence-based literature by sharing information on recognized open access sources and securing institutional licenses for their members;
• Support training and skills-building of members of professional associations on searching and critically apprising the medical literature in terms of strength of evidence and applicability of the recommendations to their local health care settings…

The HIFA vision aligns strongly with the above and we look forward to the possibility of collaboration with the new Network for Improving Quality of Care as it evolves.

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa.org

The government plans a National Health Insurance (NHI) fund this year that would start with maternal health services, improved psychiatric care and services for the elderly and disabled, and may be partially financed by a reduction in the tax subsidy currently given to medical scheme members, Finance Minister Pravin Gordhan announced.

Business Day reports that this is the first strong signal of progress on the NHI from Treasury since last year’s budget when Gordhan said it would soon issue a financing proposal for the policy, which promises sweeping reforms to South Africa’s healthcare system. That proposal has yet to materialise, partly because work is still under way to refine the NHI White Paper put out by Health Minister Aaron Motsoaledi in 2015. …more

Twice a week more than 50 elderly people from Ha-Mabila and surrounding villages, outside of Sibasa in Limpopo gather at a local sports ground to play football and perform traditional dances.

According to Violent Sirwali, who is their co-ordinator and coach, the football fun together with the dancing helps keep the village grannies healthy and fit.

The group gatherings were started in 2012 by a community-based organisation known as MAHE. They realised the need for a social gathering for senior citizens after finding that increasing numbers of them were drinking excessive amounts of traditional beer. …more

There has been a significant increase in deaths from diabetes, which is now South Africa’s second biggest killer.

Diabetes is the number one killer of women and people living in the Western Cape.

This is according to StatsSA, which yesterday (28 Feb) released a report on the causes of death in 2015.

Tuberculosis remains the country’s biggest single killer, claiming 7,2% of all deaths followed by diabetes, which was responsible for 5,4% of deaths.

In 2013, diabetes was the country’s fifth biggest killer and health experts say that poor diet and obesity is behind its meteoric rise.

“Excessive calorie consumption and sedentary lifestyles are the main contributors to the development of diabetes,” according to endocrinologist Dr Sundeep Ruder, who said 7% of South Africans aged 21 to 79 (3.85 million people) have diabetes. …more

Statistics South Africa says 460 236 deaths were recorded in 2015 which marks a 3% decline compared with the previous period.

Statistician-General Pali Lehohla released the latest report on mortality rates and causes of death in South Africa in Pretoria on Tuesday.

The report states that the three leading causes of death for 2015 in South Africa were tuberculosis, diabetes and cerebrovascular disease. …more

The planned sub-AltX retail market will help small entrepreneurs, such as spaza shops, raise capital.  The JSE planned to launch a sub-AltX retail market to help small entrepreneurs, such as spaza shops, raise capital and to attract more retail investors, said CEO Nicky Newton-King.

The new market, Umnotho, had been in development for three years and was partly a response to Gauteng Premier David Makhura’s challenge to mobilise finance for township entrepreneurs, she said…..more

To use an MDI:

1. Shake the inhaler well before use (3 or 4 shakes)
2. Remove the cap
3. Breathe out, away from your inhaler
4. Bring the inhaler to your mouth. Place it in your mouth between your teeth and close you mouth around it.
5. Start to breathe in slowly. Press the top of you inhaler once and keep breathing in slowly until you have taken a full breath.
6. Remove the inhaler from your mouth, and hold your breath for about 10 seconds, then breathe out.

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South Africa’s increasingly business-orientated land reform programme has opened the door for “elite capture” with businesses – often white owned and multinational – becoming the real winners, while black “beneficiaries” languish without any formal rights to the land.

New research indicates President Jacob Zuma’s renewed promises to do away with the “willing seller, willing buyer” principle this year – something first promised at the 2005 National Land Summit – obscure the enormous problems that crop up once the state owns the land……more

Acne is the most common skin condition in the United States. Although it’s common, accurate information about acne can be scarce. This can make it difficult to get clearer skin. The information on this site can help you understand acne and how to successfully treat it.

Why treat acne?

Myths about acne are as common as the skin problem. One common myth is that you have to let acne run its course.

Dermatologists know that letting acne runs its course is not always the best advice.

Here’s why:

• Without treatment, dark spots and permanent scars can appear on the skin as acne clears.
• Treating acne often boosts a person’s self-esteem.
• Many effective treatments are available.

More women getting acne

Not just teens have acne. A growing number of women have acne in their 30s, 40s, 50s, and beyond. Dermatologists are not sure why this is happening. But dermatologists understand that adult acne can be particularly frustrating. ….more

Some doctors in Nigeria use candlelight to perform operations due to the dearth of funding for the sector, a medical practitioner told a Senate panel during a public hearing on the 2017 budget.

Business Day quotes Benjamin Anyele, chair, Health Sector Reform Coalition, as saying: “It has gotten so bad that Nigerians are running mental without knowing, nurses use candlelight to assist in carrying out operations.” Arguing for increased funding for the health sector, Anyele decried the dearth of funding for primary healthcare centres in Nigeria, saying “it portends grave danger for national development.”

The report says Nigeria’s 2017 budget allocated N252.87bn ($79.77bn) for recurrent and N51bn ($160.8m) capital expenditure representing a mere 4.1% of the entire budget. This allocation falls short of the 15% agreed by AU countries in the 2001 Abuja Health declaration…..more

National director-general of Health Precious Matsoso this week personally intervened with a large police contingent to secure access to a Pretoria ‘private mortuary’ where relatives of the Life Esidemeni tragedy had had to scrabble through piled up bodies to find their family.

According to a Health-e News report,  Phumzile and Zandile Mashego had found the body of their brother – an ex-patient from Life Esidimeni – in a pile along with other unclaimed bodies in a rundown building in Atteridgeville.

They say the place looked as if it was once a butchery, but it is now registered as a private mortuary with the Tshwane municipality. “After we heard that Solly had passed away, we were told that he was at the funeral home called ‘Put U 2 Rest’ but his body was not there,” said Phumzile. “They directed us to this place that looked like old butchery.”….more

The World Bank Group and the Islamic Development Bank published the first Global Report on Islamic Finance, which details the prospects for the global Islamic finance industry and its potential to help reduce worldwide income inequality, enhance sharing prosperity, and achieve the Sustainable Development Goals.

Subtitled “A Catalyst for Shared Prosperity?”, the report provides an overview of trends in Islamic finance, identifies major challenges hindering the industry’s growth, and recommends policy interventions to leverage Islamic finance for promoting shared prosperity.

Islamic finance advocates for just fair and equitable distribution of income and wealth. With a strong link to the real economy as well as risk-sharing financing, Islamic finance can help improve the stability of the financial sector. It can also bring into the formal financial system people who are currently excluded from it due to cultural or religious reasons. Unlike conventional finance, Islamic finance is based on risk-sharing and asset-based financing. By making people direct holders of real assets in the real sector of the economy, it reduces their aversion to risk…..more

Finance Minister Pravin Gordhan has announced hard-hitting increases in personal income tax of R16.5bn for 2017-18, as economic growth stutters and revenue collection falls short of expectations.

These increases are part of a total R28bn package of tax hikes.

Tax revenue has deteriorated by a further R7bn since the medium-term budget policy statement in October and is now forecast to be R30.4bn lower than the 2016-17 budget estimate, indicating a deterioration in economic growth and tax buoyancy.

This is the largest underperformance since the 2009 recession and Gordhan told journalists at a media briefing ahead of his budget speech in the National Assembly on Wednesday that he was concerned about the state of revenue collection in the country and had been engaging with senior management of the South African Revenue Service (SARS) about this.

In his speech the minister warned SA was “at a crossroads” and “tough choices” had had to be made….more

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HIV stands for human immunodeficiency virus. It weakens a person’s immune system by destroying important cells that fight disease and infection. No effective cure exists for HIV. But with proper medical care, HIV can be controlled. Some groups of people in the United States are more likely to get HIV than others because of many factors, including their sex partners, their risk behaviors, and where they live. This section will give you basic information about HIV, such as how it’s transmitted, how you can prevent it, and how to get tested for HIV. ….more

Six days after the Gupta family infamously “fled” South Africa last year on a late-night flight, a second Gupta plane tried to leave with a box believed to have been full of diamonds.

On April 13, a Gupta business jet with tail number ZS-AKG was preparing to depart Fireblade Aviation’s VVIP (very, very important person) terminal at OR Tambo International Airport when X-ray scanners picked up something suspicious inside a suitcase belonging to the departing party.

In the suitcase was a box containing what looked like stones – more precisely, diamonds.

When Fireblade security asked to see what was inside, a Gupta security staffer refused, took the bag from the counter and left.

This version of events was provided by three independent sources – two close to Fireblade and one a senior member of South Africa’s security establishment.

The latter claimed the principal passenger was one of the three Gupta brothers…..more

The country has emerged as a primary target in the White House’s global offensive against Western liberal culture, writes Shannon Ebrahim. The Trump administration is targeting South Africa as a destination in need of its Alt-Right ideology. If Trump decides to send South African Joel Pollak, the editor-at-large of Breitbart news as the new US Ambassador to South Africa, then the agenda of the White House in South Africa is clear.The primary reason to send one of Trump’s most valuable ideological weapons to South Africa would be the perceived need to overturn a ruling party which is a pillar in the world of progressive left wing and inclusive politics. The goal would be for one of Breitbart’s foremost ideologists – Joel Pollak – to lay the foundations for a right wing party in South Africa to take power at the next elections, which could eventually buy into Trump’s far right worldview. ….more

About 17 000 jobs have been created in Joburg in the fourth quarter of 2016.

This was revealed in the StatsSA Quarterly Labour Force Survey (QLFS), released earlier this week.

City of Joburg mayor Herman Mashaba said that whilst the progress in the city’s employment figures is welcomed, “we cannot afford to be complacent as there are still over 800 000 unemployed residents in our city and it is essential that job creation remains the top priority of my administration.”

Said the mayor: “The status quo is simply not good enough. Our residents who continue to suffer the effects of sluggish economic growth will not be satisfied with marginal gains – particularly the city’s youth and nor should we. When the residents of this city voted for change, they demanded an administration that would release the full potential of this city,” he said.

Joburg has set itself the task of attaining minimum of 5% economic growth and reducing unemployment to under 20% by 2021…..more