Racial Disparity in Severe Maternal Morbidity Associated with Hypertensive Disorders in Washington State: A Retrospective Cohort Study
by Albright C.M. et al.The objective of the study was to evaluate the relationship between hypertensive (HTN) disorders and severe maternal morbidity (SMM). To understand whether there is differential prevalence of HTN disorders by race and whether the relationship between HTN disorders and SMM is modified by race and ethnicity. Findings suggest that in Washington, HTN disorders are associated with SMM in a dose-dependent fashion with the greatest impact among Black individuals.
The Racial Disparity of Severe Maternal Morbidity Across Weeks of Gestation: A Cross-Sectional Analysis of the 2019 National Inpatient Sample
by Hales EDS. et al.Severe maternal morbidity (SMM) is increasing in the United States. Black women experience the highest rates of SMM and also of preterm births, which are associated with SMM. The racial disparity of SMM across weeks of gestation has not been well-studied. The objective of this study was to evaluate differences in SMM between Black and White birthing people by week of gestation. Findings suggest that black women experience a substantially higher rate of SMM at preterm gestations (22-36 weeks) in addition to higher rates of preterm delivery. Even when accounting for age, medical comorbidities, and social determinants, Black birthing people have a higher odds of SMM throughout pregnancy.
Racial disparities in adequacy of prenatal care during the COVID-19 pandemic in South Carolina, 2018-2021
by Julceus EF. et al.Findings from this study suggests that compared to pre-pandemic, the odds of not receiving adequate prenatal care in South Carolina was increased by 10% for White women and 26% for Black women during the pandemic, highlighting the needs to develop individual tailored interventions to reverse this trend.
Racial Inequities in Drug Tests Ordered by Clinicians for Pregnant People Who Disclose Prenatal Substance Use
by Olaniyan A. et al.Findings from this study suggests that when pregnant people disclosed drug use, clinicians were more likely to order urine drug testing for Black pregnant people compared with their White counterparts, suggesting clinician racial bias. Current practice patterns and protocols such as urine drug testing in pregnancy care deserve review to identify and mitigate areas of potential clinician discrimination.
Understanding ethnic inequalities in stillbirth rates: a UK population-based cohort study
by Matthews R et alThe objective of this study was to investigate inequalities in stillbirth rates by ethnicity to facilitate development of initiatives to target those at highest risk. Findings suggest that stillbirth rates declined in the UK, but substantial excess risk of stillbirth persists among babies of black and Asian ethnicities. The combined disadvantage for black, Pakistani and Bangladeshi ethnicities who are more likely to live in most deprived areas is associated with considerably higher rates. Key causes of death were congenital anomalies and placental causes. Improved strategies for investigation of stillbirth causes are needed to reduce unexplained deaths so that interventions can be targeted to reduce stillbirths.
The broader goal of this study is to assess any association between individual and demographic characteristics of the COVID-19 patients and the risk and severity of the diseases. This cross-sectional study will synthesize the COVID-19 surveillance data and actively collect data on additional variables. The sample would comprise of all the reported cases irrespective of age and gender of COVID-19 in Sindh, Punjab and Balochistan.
Measuring health inequalities in the context of sustainable development goals
by Hosseinpoor et alThe World Health Organization has developed a multistep approach to health inequality monitoring consisting of: (i) determining the scope of monitoring; (ii) obtaining data; (iii) analysing data; (iv) reporting results; and (v) implementing changes. This paper presents some technical considerations for developing or strengthening health inequality monitoring, with the aim of encouraging more robust, systematic and transparent practices. It discusses key aspects of measuring health inequalities that are relevant to steps (i) and (iii).
This is a great video of a talk given at the Oxford Martin School by Professor Kevin Marsh.
Health research capacity development in low and middle income countries: reality or rhetoric?
by The Editorial TeamThere has been steady progress in LMIC health research capacity, but major barriers to research persist and more empirical evidence on development strategies is required.
This Week in Global Health or TWiGH presents Global Health Out Loud with Sulzhan Bali & Jessica Taaffe.
East African Leaders Join Together to Develop Country-Specific Plans for Point-of-Care Testing.
New Public Management (public sector reforms which draw on business ideology) are increasingly seen in African ministries of health. This talk concentrates on the effects of NPM reform on Ethiopian hospitals and how efforts to be 'more business-like' have many unintended consequences for hospitals and patients.
Professor Mike English explains how KEMRI-Wellcome are ''working with government to generate patient level data from a network of Kenyan hospitals as a platform for research'.
In celebration of Global Health Trials' fifth birthday (May 11th 2015) Professor Trudie Lang, Principal Investigator of the programme, talks to us about why Global Health Trials was started, why people should share their experience, and what the future holds.
This guide, developed by the WHO and released in December 2013, aims to facilitate implementation research in LMICs.
India, with a population of more than 1.21 billion, has the highest maternal mortality in the world (estimated to be 56000 in 2010); and adolescent (aged 15–19) mortality shares 9% of total maternal deaths. Addressing the maternity care needs of adolescents may have considerable ramifications for achieving the Millennium Development Goal (MDG)–5. This paper assesses the socioeconomic differentials in accessing full antenatal care and professional attendance at delivery by adolescent mothers (aged 15–19) in India during 1990–2006.
Health data include many gaps, particularly relating to poorer areas of the world, so complex estimation techniques are needed to get overall global pictures. Estimates of population health, however, carry their own uncertainties and may be flawed in some instances. Here we present a range of reflections on the Global Burden of Disease 2010 estimates, highlighting their strengths as well as challenges for potential users. In the long term, there can be no substitute for properly counting and accounting for all the world's citizens, so that complex estimation techniques are not needed.
Evaluation of Nutrition Surveys in Flood-affected Areas of Pakistan: Seeing the Unseen!
by rehanasalamIn 2010 Pakistan experienced the worst floods recorded in its history; millions of people were affected and thousands lost their lives. Nutrition assessment surveys led by UNICEF were conducted in flood-affected areas of Punjab and Sindh provinces to assess the nutrition status of children between 6–59 months while Aga Khan University (AKU) undertook a parallel assessment including micronutrient status in their project areas within Balochistan, Sindh and Punjab.
Grand Challenges: Integrating Maternal Mental Health into Maternal and Child Health Programmes
by Jai K DasIntegrating maternal mental health care will help advance maternal and child health (MCH) status. This paper is the second in a series of five articles providing a global perspective on integrating mental health.
Measuring Coverage in MNCH: New Findings, New Strategies, and Recommendations for Action
by Jai K DasThe PLOS Medicine “Measuring Coverage in MNCH” Collection of research studies and reviews presents systematic assessments of the validity of health intervention coverage measurement based on household surveys, the primary method for estimating population-level intervention coverage in low- and middle-income countries. This is the first paper of the collection
Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street-connected children and young peopleNumbers of street-connected children and young people run into many
by Jai K DasThis systematic review summarises the effectiveness of interventions for street-connected children and young people that promote inclusion and reintegration and reduce harms. It also explores the processes of successful intervention and models of change in this area, and to understand how intervention effectiveness may vary in different contexts.
Translating Coverage Gains into Health Gains for All Women and Children: The Quality Care Opportunity
by Jai K DasThe health outcomes of women and children have not matched expectations from the gains in the coverage of care. Robust evidence exists for one explanatory factor: the poor–rich gaps in coverage found along the continuum of care for women and children, and particularly for the crucial period around childbirth. The more-neglected explanation for the mismatch between coverage and health outcomes is the quality of the care provided to women and children. The following paper is structured around a key cause and a consequence of the neglect of quality—weak measurement and poor evidence for action—and concludes with priorities for seizing the quality care opportunity.