ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hos...ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hospitals(maternal and child health care hospitals)in Hubei province from 2012 to 2019 were collected.The indicators related to antimicrobial drug use included the utilization rate of different grades of antimicrobial drugs,the intensity of antimicrobial agent use,the rational use of prophylactic antimicrobial agents before class I surgical incision,and pathogenic detection and consultation rates before antimicrobial drug use.ResultsSince the implementation,the purchase of antimicrobial agents in hospitals has been maintained within the prescribed range,and the defined daily dose system(DDDs)of antimicrobial agents has been reduced,prophylactic use and accurate treatment of antimicrobial agents related to class I surgical incision have been more reasonable.With the implementation of ASPs,the detection rate of imipenem-resistant Acinetobacter baumannii,cefotaxime-resistant Escherichia coli,and methicillin-resistant Staphylococcus aureus has been decreased in China from national bacterial resistance surveillance data.ConclusionASPs have positive effects on antibiotic use and drug resistance in 85 maternity hospitals(maternal and child health care hospitals).展开更多
Background:Nearly 300 children and 20 mothers die from preventable causes daily,in Uganda.Communities often identify and introduce pragmatic and lasting solutions to such challenging health problems.However,little is ...Background:Nearly 300 children and 20 mothers die from preventable causes daily,in Uganda.Communities often identify and introduce pragmatic and lasting solutions to such challenging health problems.However,little is known of these solutions beyond their immediate surroundings.If local and pragmatic innovations were scaled-up,they could contribute to better health outcomes for larger populations.In 2017 an open call was made for local examples of community-based solutions that contribute to improving maternal and child health in Uganda.In this article,we describe three top innovative community-based solutions and their contributions to maternal health.Main text:In this study,all innovations were implemented by non-government entities.Two case studies highlight the importance of bringing reproductive health and maternal delivery services closer to populations,through providing accessible shelters and maternity waiting homes in isolated areas.The third case study focuses on bringing obstetric imaging services to lower level rural health facilities,which usually do not provide this service,through task-shifting certain sonography services to midwives.Various health system and policy relevant lessons are highlighted.Conclusions:The described case studies show how delays in access to health care by pregnant women in rural communities can be systematically removed,to improve pregnancy and delivery outcomes.Emphasis should be put on identification,capacity building and research to support the scale up of these community-based health solutions.展开更多
In India, women and children continue to experience food insecurity. The purpose of this study is to evaluate whether the Rajasthan Nutrition Project (RNP) led to changes in 1) dietary habits and nutrition, and 2) ind...In India, women and children continue to experience food insecurity. The purpose of this study is to evaluate whether the Rajasthan Nutrition Project (RNP) led to changes in 1) dietary habits and nutrition, and 2) indicators of gender equality, female autonomy, and empowerment. This study surveyed women belonging to self-help groups who were pregnant or who had young children. Over the course of the intervention, significant improvements were seen in the following indicators: breastfeeding within one hour of birth, exclusively breastfeeding for the first six months, food insecurity of children and mothers, household decision-making, communication, mobility, and domestic violence. These findings suggest that the RNP is a promising intervention for improving nutrition and female autonomy in Rajasthan, India. Additional research is needed to determine if the RNP would be equally as effective in other regions of India, or in populations outside of India.展开更多
Background and objective:To provide good health and well-being as established by the Sustainable Development Goal(SDG)3,access to digital technologies can act as conduits to achieve such progress in a population.As gu...Background and objective:To provide good health and well-being as established by the Sustainable Development Goal(SDG)3,access to digital technologies can act as conduits to achieve such progress in a population.As guided by the World Health Organization,antenatal care(ANC)attendance is one of the measures promoted to curtail the global health burden of maternal and infant mortality.ANC services are seldom utilized to their full potential in Zimbabwe.This study explores if any of the women's digital technology characteristics were associated with antenatal care visits.Methods:The study analyzed population-based cross-sectional data with a subsample of 1932 women aged 15-49 years from the 2019 Zimbabwe Multiple Indicator Cluster Survey.Test of associations with chi-square test,bivariate,and multivariate multinomial logistic regression analyses were used to examine the predictors of adequate(4-7)and optimal(≥8)ANC visits relative to undesirable(1-3)antenatal care visits among women who had given births 2 years before the survey.Results:The results indicate that 64.5%(1246/1932)of the women attained adequate ANC while about 9.8%(189/1932)attained optimal ANC.Reading a newspaper/magazine at least once a week(odds ratio[OR] 1.73,β'=0.551,t=2.030,P=0.043)and watching television at least once a week(OR 1.72,β=0.545,t=2.454,P=0.015),listening to the radio less than once a week(OR 1.28,β'=0.247,t=1.750,P=0.080),and owning a mobile phone(OR 1.48,β'=0.394,t=3.020,P=0.003)were positively associated with adequate ANC.Optimal ANC was significantly associated with women being able to read a newspaper at least once a week(OR 2.93,β'=1.074,t=3.120,P=0.002),listen to the radio less than 0nce a week(OR 2.07,p'=0.73,t=2.700,P=0.007)and have ownership of a mobile phone(OR 1.88,β'=0.631,t=2.620,P=0.009).Conclusion:Access to a newspaper,radio,television,and mobile phone were important predictors of a woman's ability to achieve her ANC attendance.Policies to improve the knowledge of ANC packages can be facilitated using digital technology to achieve adequate and preferably optimal ANC in Zimbabwe.It is important to improve digital infrastructure to support digital technologies in providing ANC services.展开更多
基金supported by the Natural Science Foundation of Hubei Province(No.2021CFB348).
文摘ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hospitals(maternal and child health care hospitals)in Hubei province from 2012 to 2019 were collected.The indicators related to antimicrobial drug use included the utilization rate of different grades of antimicrobial drugs,the intensity of antimicrobial agent use,the rational use of prophylactic antimicrobial agents before class I surgical incision,and pathogenic detection and consultation rates before antimicrobial drug use.ResultsSince the implementation,the purchase of antimicrobial agents in hospitals has been maintained within the prescribed range,and the defined daily dose system(DDDs)of antimicrobial agents has been reduced,prophylactic use and accurate treatment of antimicrobial agents related to class I surgical incision have been more reasonable.With the implementation of ASPs,the detection rate of imipenem-resistant Acinetobacter baumannii,cefotaxime-resistant Escherichia coli,and methicillin-resistant Staphylococcus aureus has been decreased in China from national bacterial resistance surveillance data.ConclusionASPs have positive effects on antibiotic use and drug resistance in 85 maternity hospitals(maternal and child health care hospitals).
基金The Social Innovation in Health Initiative(SIHI)Uganda received funding from the Special Programme for Research and Training in Tropical Diseases(TDR)to conduct this research.
文摘Background:Nearly 300 children and 20 mothers die from preventable causes daily,in Uganda.Communities often identify and introduce pragmatic and lasting solutions to such challenging health problems.However,little is known of these solutions beyond their immediate surroundings.If local and pragmatic innovations were scaled-up,they could contribute to better health outcomes for larger populations.In 2017 an open call was made for local examples of community-based solutions that contribute to improving maternal and child health in Uganda.In this article,we describe three top innovative community-based solutions and their contributions to maternal health.Main text:In this study,all innovations were implemented by non-government entities.Two case studies highlight the importance of bringing reproductive health and maternal delivery services closer to populations,through providing accessible shelters and maternity waiting homes in isolated areas.The third case study focuses on bringing obstetric imaging services to lower level rural health facilities,which usually do not provide this service,through task-shifting certain sonography services to midwives.Various health system and policy relevant lessons are highlighted.Conclusions:The described case studies show how delays in access to health care by pregnant women in rural communities can be systematically removed,to improve pregnancy and delivery outcomes.Emphasis should be put on identification,capacity building and research to support the scale up of these community-based health solutions.
文摘In India, women and children continue to experience food insecurity. The purpose of this study is to evaluate whether the Rajasthan Nutrition Project (RNP) led to changes in 1) dietary habits and nutrition, and 2) indicators of gender equality, female autonomy, and empowerment. This study surveyed women belonging to self-help groups who were pregnant or who had young children. Over the course of the intervention, significant improvements were seen in the following indicators: breastfeeding within one hour of birth, exclusively breastfeeding for the first six months, food insecurity of children and mothers, household decision-making, communication, mobility, and domestic violence. These findings suggest that the RNP is a promising intervention for improving nutrition and female autonomy in Rajasthan, India. Additional research is needed to determine if the RNP would be equally as effective in other regions of India, or in populations outside of India.
文摘Background and objective:To provide good health and well-being as established by the Sustainable Development Goal(SDG)3,access to digital technologies can act as conduits to achieve such progress in a population.As guided by the World Health Organization,antenatal care(ANC)attendance is one of the measures promoted to curtail the global health burden of maternal and infant mortality.ANC services are seldom utilized to their full potential in Zimbabwe.This study explores if any of the women's digital technology characteristics were associated with antenatal care visits.Methods:The study analyzed population-based cross-sectional data with a subsample of 1932 women aged 15-49 years from the 2019 Zimbabwe Multiple Indicator Cluster Survey.Test of associations with chi-square test,bivariate,and multivariate multinomial logistic regression analyses were used to examine the predictors of adequate(4-7)and optimal(≥8)ANC visits relative to undesirable(1-3)antenatal care visits among women who had given births 2 years before the survey.Results:The results indicate that 64.5%(1246/1932)of the women attained adequate ANC while about 9.8%(189/1932)attained optimal ANC.Reading a newspaper/magazine at least once a week(odds ratio[OR] 1.73,β'=0.551,t=2.030,P=0.043)and watching television at least once a week(OR 1.72,β=0.545,t=2.454,P=0.015),listening to the radio less than once a week(OR 1.28,β'=0.247,t=1.750,P=0.080),and owning a mobile phone(OR 1.48,β'=0.394,t=3.020,P=0.003)were positively associated with adequate ANC.Optimal ANC was significantly associated with women being able to read a newspaper at least once a week(OR 2.93,β'=1.074,t=3.120,P=0.002),listen to the radio less than 0nce a week(OR 2.07,p'=0.73,t=2.700,P=0.007)and have ownership of a mobile phone(OR 1.88,β'=0.631,t=2.620,P=0.009).Conclusion:Access to a newspaper,radio,television,and mobile phone were important predictors of a woman's ability to achieve her ANC attendance.Policies to improve the knowledge of ANC packages can be facilitated using digital technology to achieve adequate and preferably optimal ANC in Zimbabwe.It is important to improve digital infrastructure to support digital technologies in providing ANC services.
