{"id":54633,"date":"2022-07-13T17:44:10","date_gmt":"2022-07-13T21:44:10","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?p=54633"},"modified":"2022-07-15T12:14:20","modified_gmt":"2022-07-15T16:14:20","slug":"in-kashmir-pregnant-women-were-denied-care-over-covid-19-fears","status":"publish","type":"post","link":"https:\/\/www.healthynewbornnetwork.org\/blog\/in-kashmir-pregnant-women-were-denied-care-over-covid-19-fears\/","title":{"rendered":"In Kashmir, Pregnant Women Were Denied Care over COVID-19 Fears"},"content":{"rendered":"

This article was\u00a0originally\u00a0published\u00a0by\u00a0Global\u00a0Health\u00a0NOW.<\/a><\/em><\/p>\n

\n

By: Aliya Bashir<\/p>\n

ANANTNAG, KASHMIR\u2014Ruqiya Javed received treatment at a private clinic throughout her pregnancy\u2014but when she went into labor, her private doctor refused to see her, because she came from a red COVID-19 containment zone in the Kharpora Larnoo village in South Kashmir. The family banged on the doctor\u2019s door for hours, but no one came out to see her.<\/p>\n

Javed was ultimately taken to the district\u2019s Maternity and Child Care hospital, where she delivered\u00a0 stillborn twin sons in May 2020.<\/p>\n

At the hospital, her husband, Javed Ahmed Padroo, says that as soon as hospital workers learned that they came from the red zone, they kept her alone in a room with a female family member, leaving her unattended for hours. \u201cMy wife couldn\u2019t take the stress. She was gasping for breath and could hardly speak,\u201d says Padroo.<\/p>\n

She died hours after her delivery, 35 years old and survived by 2 young daughters.<\/p>\n

\u201cThe hospital authorities treated us as untouchables,\u201d says Padroo.<\/p>\n

Currently, the situation has improved, thanks to vaccines. People are much more aware, prepared and able to handle COVID-19 now, compared to the early days of the pandemic. But Kashmir\u2019s health system, battered by conflict and neglect, was not ready to manage maternal health amid COVID-19\u2019s disruptions, especially during the first 2 months of the pandemic, and mothers endured many complications, says Bashir Ahmad Bhat, an associate professor at the University of Kashmir.<\/p>\n

A study by Bhat\u2019s Population Research Centre on the impact of COVID-19 on the utilization of maternal and child health services in India (which has been submitted to the government but not yet made public) found that most patients still registered for their antenatal check-ups at public health facilities during the pandemic. But transportation challenges, the high cost of medicines and delivery charges, and caesarian sections all increased, he says,\u00a0creating more obstacles for the mothers of an estimated 120,000 babies born in Kashmir each year.<\/p>\n

Meanwhile, specialized care for already-stressed pregnant women was nonexistent. \u201cWomen in advanced stages of labor have been refused treatment, referrals have been delayed and they have been pushed to travel several kilometers to deliver,\u201d according to one frontline community health worker\u2014an accredited social health activist (ASHA)\u2014from the Kokernag area, who requested anonymity out of fear of reprisal.<\/p>\n

In April 2020, the Directorate of Health Services in Kashmir issued a statement, threatening \u201cstrict action\u201d against government servants who criticize the government\u2019s efforts to combat the pandemic on social media or in the press. Still, in some instances, ASHA workers had to protest and argue with the nurses and doctors during the pandemic over treatment delays.<\/p>\n

\u201cIn so many cases, we saw women were afraid of institutional deliveries due to the lack of respect and care,\u201d the ASHA from Kokernag says. \u201cBut, those with poorer backgrounds have no option other than to avail public health institutions, especially in rural areas.\u201d<\/p>\n

As women limited their regular visits during the pandemic, ASHAs tried to provide services and education at home, according to Bashir Ahmad Bhat. \u201cPostpartum care suffered a lot as women were discharged almost within 2 days after their deliveries to avoid infection,\u201d he says, rather than the usual stay of 3 days. \u201cWomen with high-risk pregnancies became more vulnerable, and many developed complications.”<\/p>\n

Private hospitals during the peak of the lockdown mostly denied treatment to pregnant women or for any post-delivery complications for mother or child, according to another ASHA from the Pulwama district (who also requested anonymity). In one case, she said, a woman went into labor and was denied treatment until the hospital received her COVID-negative test.<\/p>\n

\u201cIt was her sheer luck that we collected the report by hand and submitted it to the hospital immediately,\u201d says the health worker. \u201cLater, when her child developed complications, there was a delay in referral and we again had to intervene and literally threaten the ambulance driver to ferry us fast to the children\u2019s hospital.\u201d<\/p>\n

As for Javed, hospital records list postpartum hemorrhage and cardiac arrest as the underlying conditions that caused her death. There is no mention of any COVID-positive test in her records. The family couldn\u2019t follow-up with any legal investigation, as their area was kept under COVID-19 lockdown containment for more than 3 months\u2014and they did not receive any official medical record for Javed.<\/p>\n

Despite weeks of attempts to reach the Kashmir Directorate of Health Services as well as health officials in Anantnag, the authorities refused to answer any questions on the record. However, an official from the directorate office, on the condition of anonymity, says that due to a lot of criticism from the media and frequent protests by the local population, they prefer not to comment on sensitive issues. He admitted, though, that due to gaps in timely health services, people have suffered. Some common complaints include the lack of transport, delay, and denial of maternal health care.<\/p>\n

Padroo says that the media reported his wife\u2019s case as COVID-positive\u2014but later, a sample showed she was negative along with every family member.<\/p>\n

\u201cShe died because she was treated as a positive case and didn\u2019t receive any treatment,\u201d Padroo says. \u201cThe entire hospital staff was heartless, and they let her die.\u201d<\/p>\n

Ed. Note: This article and Part 1,\u00a0<\/em>In Kashmir, Coronavirus Pushed Already-Broken Maternal Health over the Brink<\/em><\/a>, are\u00a0part of\u00a0<\/em>Global Health NOW\u2019s Local Reporting Initiative<\/em><\/a>, made possible through the generous support of loyal GHN readers.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

This article was\u00a0originally\u00a0published\u00a0by\u00a0Global\u00a0Health\u00a0NOW. By: Aliya Bashir ANANTNAG, KASHMIR\u2014Ruqiya Javed received treatment at a private clinic throughout her pregnancy\u2014but when she went into labor, her private doctor refused to see her, because she came from a red COVID-19 containment zone in the Kharpora Larnoo village in South Kashmir. The family banged on the doctor\u2019s door for … Continued<\/a><\/p>\n","protected":false},"author":7211,"featured_media":54634,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"acf":[],"yoast_head":"\nHealthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/blog\/in-kashmir-pregnant-women-were-denied-care-over-covid-19-fears\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"In Kashmir, Pregnant Women Were Denied Care over COVID-19 Fears - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"This article was\u00a0originally\u00a0published\u00a0by\u00a0Global\u00a0Health\u00a0NOW. 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International Health draws on all public health disciplines for application in global settings and emphasizes master's and doctoral training programs for students with international and cross-cultural interests. 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Unless stimulation and efforts to resuscitate are begun immediately, many of these babies quickly die of birth asphyxia.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">570<\/span>k<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456246957513{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">estimated number of annual newborn deaths attributable to childbirth complications<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">1.3<\/span>m<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690478685637{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">estimated number of intrapartum stillbirths (2015)<br \/>\n<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">80<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690476768268{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of women who give birth in a health facility globally from 2015 - 2021<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-green\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10<\/span>m<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456247366820{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">estimated number of newborns that do not breathe at birth<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"What can be done?\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]Most outcomes associated with complications of childbirth are preventable. The proportion of term deliveries that end in death during or shortly after labor is a sensitive and responsive measure of the quality of labor and delivery care. It is important in and of itself, but it also reflects readiness for managing other important complications for the mother or newborn.<\/p>\n<p>Pregnant women need a good assessment late in pregnancy to anticipate problems and ensure they receive any needed special care.Teaching expectant mothers about the importance of seeking healthcare can also prevent adverse birth outcomes. Giving birth in a center where assisted delivery or caesarian section can be provided quickly can also save a baby\u2019s life. Good monitoring of the mother and fetus throughout labor ensures that prompt action can be take to prevent conditions from evolving to a life-threatening state.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]Ending dangerous practices, like augmenting labor with oxytocin under unsafe conditions or applying pressure on the mother\u2019s belly during labor, can prevent fetal deaths.<\/p>\n<p>And for those cases in which the baby emerges in a very stressed state and is unable to start breathing, competent action taken within the \u201cgolden minute\u201d can keep the baby alive until breathing begins. Finally, suitable equipment needs to be kept at the ready for all births, and provisions in place to ensure that health workers attending births are regularly practicing to maintain their resuscitation skills.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_text_separator title=\"Key Resources\"][vc_column_text]<\/p>\n<ul>\n<li><a href=\"https:\/\/www.who.int\/tools\/essential-newborn-care-training-course\">Essential Newborn Care Course (WHO)<\/a> - interim version of the second edition (2022)<\/li>\n<li><a href=\"https:\/\/www.aap.org\/en\/aap-global\/helping-babies-survive\/enc-now\/\" target=\"_blank\" rel=\"noopener\">ENC Now! (American Academy of Pediatrics (AAP) and Laerdal Global Health)<\/a> \u2013 a digital version of the new WHO Essential Newborn Care 1 Basic Course (ENC) (formerly Helping Babies Breathe).<\/li>\n<li><a href=\"https:\/\/shop.laerdalglobalhealth.com\/product\/neonatalie-live\/\" target=\"_blank\" rel=\"noopener\">Neonathalie Live<\/a> \u2013 Newborn Ventilation Trainer<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/MCPC-2nd-ed.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">WHO guidelines Managing complications in pregnancy and childbirth: A guide for midwives and doctors <\/a>(2017)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/every-newborn-action-plan\/\">Every Newborn Action Plan<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452735746534{padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>Helping Babies Survive<\/h4>\n<p><img class=\"alignnone size-full wp-image-352\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/small-helpingbabiesbreathe.jpg\" alt=\"small-helpingbabiesbreathe\" width=\"570\" height=\"252\" \/><\/p>\n<p><a href=\"https:\/\/www.aap.org\/en\/aap-global\/helping-babies-survive\/\">Helping Babies Survive<\/a> is a package of evidence-based training programs designed to teach the necessary skills to reduce neonatal mortality in resource-limited environments. The first program Helping Babies Breathe (HBB) was developed in 2010 by the American Academy of Pediatrics (AAP) in keeping with WHO recommendations. Studies have shown that it can reduce neonatal mortality by up to 47%; saving thousands of asphyxiated newborns. The success of HBB led to a global request for additional programs (such as Essential Care for Every Baby, Essential Care for Small Babies, and Improving Care of Mothers and Babies) addressing other leading causes of newborn death by equipping providers with the necessary skills and competencies to deliver high quality care to newborns during and after birth.\u200b<\/p>\n<p>The partnership is not only providing competency-based, hands-on training to service providers but working with ministries of health and their partners to provide functional resuscitation equipment for all health facilities where babies are born.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>Essential Newborn Care Course<\/h4>\n<p><img class=\"wp-image-1614 size-full alignnone\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/small-essentialnewborncare2.jpg\" alt=\"\" width=\"570\" height=\"230\" \/><\/p>\n<p><em>Please note this section will be updated in 2022. See <a href=\"https:\/\/www.who.int\/tools\/essential-newborn-care-training-course\" target=\"_blank\" rel=\"noopener\">interim version of the second edition of the Essential Newborn Care Course (ENCC)<\/a> for more information.\u00a0<\/em><\/p>\n<p>The Essential Newborn Care Course (ENCC) is a WHO training program that works to ensure that health workers have the skills and knowledge to provide appropriate care at the most vulnerable period in a baby's life. Health workers are taught how to use the <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241549356?msclkid=05ffb757d06d11ec8a219bb5009124b0\" target=\"_blank\" rel=\"noopener\">WHO's Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice.<\/a><\/p>\n<p>In particular, the course focuses on the sections concerned with newborn care, which provide up-to-date evidence-based information and management of babies with a range of needs in the initial newborn period. The course includes:[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]<\/p>\n","post_title":"Complications during childbirth","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"complications-during-childbirth","to_ping":"","pinged":"","post_modified":"2023-07-27 13:25:43","post_modified_gmt":"2023-07-27 17:25:43","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=116","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":49497,"post_author":"7211","post_date":"2021-08-04 20:35:27","post_date_gmt":"2021-08-05 00:35:27","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column][vc_column_text]\r\n<h2>COVID-19 disease<\/h2>\r\nAccording to the World Health Organization, the COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. Current evidence indicates that COVID-19 does not appear to directly impact newborns. Few novel coronavirus infections have been reported in newborns, and these were almost uniformly asymptomatic. The few that had symptoms were reported to have mild illness.\r\n<h2><strong>There is no evidence of vertical mother-to-newborn transmission during pregnancy or via breastfeeding.<\/strong><\/h2>\r\n[\/vc_column_text][vc_column_text]\r\n<h2>Indirect adverse effects of COVID-19 on pregnancy and newborns<\/h2>\r\nWhereas the <strong>direct effects of COVID-19 on pregnancy and newborns are minimal, indirect adverse effects are becoming increasingly apparent<\/strong> and important areas of concern. These include potential disruptions of routine maternal and newborn health (MNH) care that is essential for the health and survival of mothers and newborns. Countries\u2019 responses to the pandemic \u2013 such as social distancing measures \u2013 can pose threats to continuing best practices by health care providers, as well as to home caregiver practices that are essential to newborn health and survival. Leading <strong>examples of these threats to best MNH practices<\/strong> include:\r\n<ul>\r\n \t<li>separation of mothers and newborns instead of promoting immediate skin-to-skin contact and rooming in, in facilities, and<\/li>\r\n \t<li>immediate and exclusive <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/breastfeeding-and-feeding-of-small-and-sick-newborns\/\">breastfeeding<\/a>, and <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/kangaroo-mother-care\/\">Kangaroo Mother Care (KMC)<\/a> for preterm and small babies.<\/li>\r\n<\/ul>\r\nThus, pandemic mitigation by social distancing should not result in unintended harm to mothers and their newborns.\r\n\r\nThere is also a risk to mothers and babies that pandemic responses limit needed psychosocial support to mothers during pregnancy, delivery, and in the postpartum period. Additionally, the economic toll of the pandemic response poses serious risks to many families \u2013 especially mothers and newborns \u2013 living in poverty or near-poverty. Policies and programs must recognize and take steps to prevent or ameliorate these important risks which may otherwise be overlooked. These can include food insecurity, loss of livelihoods, misinformation, and lockdown-induced social isolation and loss of vital community\/family support.\r\n\r\nThe World Health Organization (WHO) and partners continue to monitor the evidence and provide guidance accordingly.[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_column_text]<strong>Key Resources:<\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-clinical-2021-2\">Living guidance for clinical management of COVID-19<\/a>\u00a0(WHO)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/questions-and-answers-covid-19-vaccines-and-pregnancy\/\">Questions and Answers: COVID-19 vaccines and pregnancy<\/a> (WHO)<\/li>\r\n \t<li><a href=\"https:\/\/www.unicef.org\/coronavirus\/navigating-pregnancy-during-coronavirus-disease-covid-19-pandemic\">Navigating pregnancy during the COVID-19 pandemic \u2013 How to best protect yourself and your baby<\/a> (UNICEF)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/event\/maintaining-essential-mnch-services-during-the-covid-19-pandemic-lessons-from-19-countries\/\" target=\"_blank\" rel=\"noopener\">Maintaining essential MNCH services during the COVID-19 pandemic: Lessons from 19 countries<\/a> (WHO)<\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/technical-guidance\">View WHO Technical and Country Guidance<\/a> (WHO)<\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/question-and-answers-hub\/q-a-detail\/q-a-on-covid-19-pregnancy-and-childbirth\">COVID-19, pregnancy & childbirth<\/a> (WHO)<\/li>\r\n \t<li><a href=\"https:\/\/www.thelancet.com\/action\/showPdf?pii=S1473-3099%2820%2930157-2\">Guideline for pregnant women with suspected SARS-CoV-2 infection<\/a> (Lancet)<\/li>\r\n \t<li><a href=\"https:\/\/www.thelancet.com\/coronavirus?dgcid=kr_pop-up_tlcoronavirus20\">Covid-19 Resource Center\u00a0<\/a>(Lancet)<\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/question-and-answers-hub\/q-a-detail\/q-a-on-covid-19-and-breastfeeding\">COVID-19 & breastfeeding<\/a> (WHO)<\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/news-room\/commentaries\/detail\/breastfeeding-and-covid-19\">Breastfeeding and COVID-19 Scientific Brief<\/a> (WHO)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/guidelines-for-continued-newborn-healthcare-during-the-covid-19-pandemic\/\">Guidelines for continued newborn healthcare during the COVID-19 pandemic: compiled programmatic information for implementers and project managers<\/a> (WHO)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/covid-19-technical-brief-for-antenatal-care-services\/\">COVID-19 Technical Brief for Antenatal Care Services<\/a> (UNFPA)<\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/covid-19-technical-brief-for-maternal-services\/\">COVID-19 Technical Brief for Maternal Service<\/a> (UNFPA)<\/li>\r\n \t<li><a href=\"https:\/\/www.advancingnutrition.org\/news-events\/2020\/04\/24\/infant-and-young-child-feeding-recommendations-when-covid-19-suspected-or\">Infant and Young Child Feeding Recommendations When COVID-19 is Suspected or Confirmed<\/a> (USAID, UNICEF & IFE)<\/li>\r\n \t<li><a href=\"https:\/\/resourcecentre.savethechildren.net\/library\/iycf-tools-context-covid-19\">Infant and Young Child Feeding Tools in the Context of COVID-19<\/a> (Save the Children)<\/li>\r\n \t<li>Additional resources are regularly updated on the <a href=\"https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\">WHO website<\/a>.<\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"COVID-19","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"covid-19","to_ping":"","pinged":"","post_modified":"2022-09-30 17:57:07","post_modified_gmt":"2022-09-30 21:57:07","post_content_filtered":"","post_parent":0,"guid":"https:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=49497","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":124,"post_author":"7211","post_date":"2015-10-21 15:18:57","post_date_gmt":"2015-10-21 15:18:57","post_content":"<p>[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]<\/p>\n<h2>In order to meet our maternal and newborn health objectives, we need health professionals and community health workers that:<\/h2>\n<ul>\n<li>Are readily available where and when needed<\/li>\n<li>Have the necessary knowledge and skills for the services they are providing<\/li>\n<li>Are appropriately motivated to provide the needed service<\/li>\n<li>Are adequately supported and enabled with supervision, support systems (supply chain and\u00a0information systems), necessary infrastructure (space, water, electricity, and communications), and more<\/li>\n<\/ul>\n<p>Ensuring that this set of conditions is met depends on adequate human resources policy and management.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">82<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1691004009799{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of global births that were assisted by suitably qualified health workers between 2016 and 2021<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">66<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1691004076215{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of women in least developed countries that were assisted by suitably qualified health workers during birth between 2016 and 2021<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"More information\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]Over the past decade and a half, considerable emphasis within global maternal-newborn health programs has been placed on \u201cskilled birth attendance,\u201d i.e., births assisted by suitably qualified health workers. This reflects the observation that for women delivering at home without ready access to emergency obstetrical care, support from traditional birth attendants proved inadequate to substantially reduce risk of death for the mother or newborn. Considerable effort has been expended in many settings to help ensure that women give birth with the assistance of qualified human resources, specifically a health worker, and generally in a health facility.<\/p>\n<p>However, in many instances there has not\u00a0been equal attention given to the actual substance of the care provided or the necessary supports to enable health workers to provide adequate care. In recent years, there has been increasing attention in program work to the quality and content of maternal-newborn services, particularly around the time of birth. This is reflected in current work at the World Health Organization on improving quality of maternal-newborn health care.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]Part of what is implied in the \u201cskilled birth attendance\u201d strategy is that assisting in childbirth does not necessarily require a physician. Many interventions related to maternal-newborn health can be competently delivered by categories of health workers with comparatively modest training.<\/p>\n<p>Accordingly, certain maternal-newborn services can be provided by categories of health workers labelled as \u201ccommunity health workers\u201d (CHWs). This is a broad designation that includes:<\/p>\n<ul>\n<li>Health auxiliaries with training sometimes approaching that of registered nurses<\/li>\n<li>Paid full-time workers with several months of basic training<\/li>\n<li>Non-salaried but financially \u201cincentivized\u201d workers, typically working less than full-time<\/li>\n<li>Volunteers providing services on a periodic or intermittent basis with little or no financial incentives<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_single_image image=\"13796\" add_caption=\"yes\" alignment=\"center\" css_animation=\"appear\"][vc_column_text]In some settings, there is more than one tier of CHWs.\u00a0When robustly supported (as they can be under project conditions), non-salaried and volunteer CHWs have been demonstrated as effective for various maternal- and newborn-related services. There are fewer examples of such work being effectively delivered at national scale, under non-project conditions. A very important but frequently neglected factor is the supports needed for effective programs.<\/p>\n<p>The issue is not so much,<\/p>\n<ul>\n<li><em><strong>can <\/strong>CHWs be effective for a particular service?<\/em><\/li>\n<\/ul>\n<p>But rather,<\/p>\n<ul>\n<li><em><strong>what supports are necessary<\/strong> for effectiveness?<\/em><\/li>\n<\/ul>\n<p>And,<\/p>\n<ul>\n<li><em><strong>are such supports feasible at scale<\/strong> under normal, non-project conditions?<\/em><\/li>\n<\/ul>\n<p>Program efforts commonly address health worker knowledge and skills. This is typically done primarily by training. Motivation is less often given focused attention. Certainly, some aspects of performance can be positively affected by financial incentives, although such incentives can also have unintended negative consequences. However, motivation is more than just a matter of incentives.<\/p>\n<p>In many settings, legitimate and illegitimate absences from work significantly undermine reliable access to services. This can be a consequence, for example, of frequent off-site trainings. There are also many settings where health workers are either frequently away from their posts without authorization or where they offer services only for very limited periods of time each day.<\/p>\n<p>Even when health workers are at their posts, their practices are affected not only by material they may have been exposed to in training but also by other influences on what they consider appropriate care. For example, health workers may be well aware of what treatments are recommended or authorized in national treatment guidelines but may -- for any number of reasons -- prefer to offer treatments not reflected in official protocols. For human resources program efforts to be effective in ensuring availability of appropriate care, they need to respond to the actual factors influencing health worker practices.<\/p>\n<p>Supervision is often mentioned as an important performance factor in health worker practices. Certainly under project conditions, there are numerous examples of \u201csupportive technical supervision\u201d or \u201cmentoring\u201d that appear to have made a positive contribution to quality of care. There are, however, far fewer examples of this function being effectively delivered under non-project conditions. Health-facility-level quality improvement efforts can serve a somewhat similar function, whereby groups of health staff work collectively to improve performance, holding each other accountable.[\/vc_column_text][vc_column_text]<strong>Key resources<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/77764\">WHO Recommendations: Optimizing health worker roles for maternal and newborn health<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","post_title":"Human resources for health","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"human-resources","to_ping":"","pinged":"","post_modified":"2023-08-02 15:22:01","post_modified_gmt":"2023-08-02 19:22:01","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=124","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":15762,"post_author":"7211","post_date":"2019-12-10 11:18:26","post_date_gmt":"2019-12-10 16:18:26","post_content":"<p>[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]Across the world, many women, newborns and their families experience disrespectful, abusive, or neglectful treatment during childbirth, and this extends to the postpartum period. In recent years, the Respectful Maternity Care movement has focused more attention on newborn care as it was seen as a gap in the care and well-being of women\u2019s and children\u2019s rights and health.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/4\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1575989047925{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">universal rights of women and newborns identified in the Respectful Maternity Care Charter<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/4\"][vc_column_text css_animation=\"none\"]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">25<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1690998319718{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of children under the age 5 without birth registration (2011-2021)<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"What can be done?\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]A small but growing amount of evidence suggests that newborns also do not always receive respectful, evidence-based care, which could have lasting implications on their health, and discourage their families from seeking subsequent care. This is especially important for small and sick newborns, who are at the highest risk of morbidity and mortality. Newborns\u2019 experiences with caregivers can have significant and lasting impact\u2014 newborn babies feel pain and discomfort, and can experience emotional distress, particularly when separated from their families in the first hours of life. Good early care, including attachment and breastfeeding, has a lasting positive impact on the health and well-being of newborns throughout their lives. More research is needed to determine how widespread these issues are, how to better define mistreatment of newborns, and how to provide better care for all families as well as support to health care providers.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]In October 2019, the Global Respectful Maternal Care Council, convened by the White Ribbon Alliance, launched <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/respectful-maternity-care-charter-universal-rights-of-women-and-newborns\/\">Respectful Maternal Care Charter: the universal rights of women and newborns<\/a>. The charter and new set of advocacy materials builds on the 2011 charter by emphasizing the shared needs of the maternal-child dyad, including zero separation between parents and newborns without consent, as well as recognizing newborn-specific elements such as the right to birth registration.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text]<strong>Key resources:<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/respectful-maternity-care-charter-universal-rights-of-women-and-newborns\/\" target=\"_blank\" rel=\"noopener noreferrer\">Respectful Maternity Care Charter: Universal Rights of Women and Newborns<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/recommendations-intrapartum-care-positive-childbirth-experience\/\">WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience<\/a> (2018)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/recommendations-antenatal-care-positive-pregnancy-experience\/\">WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience<\/a> (2016)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/defining-disrespect-abuse-newborns-review-evidence-expanded-typology-respectful-maternity-care\/\" target=\"_blank\" rel=\"noopener noreferrer\">Defining disrespect and abuse of newborns: a review of the evidence and an expanded typology of respectful maternity care<\/a><\/li>\n<li><a href=\"https:\/\/nurturing-care.org\/?msclkid=595ce85acfd011ec85db28c2dbb4104b\">Nurturing Care Framework<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/survive-and-thrive-transforming-care-for-every-small-and-sick-newborn\/\">Survive and Thrive Report<\/a><\/li>\n<li><a href=\"https:\/\/www.ohchr.org\/en\/instruments-mechanisms\/instruments\/convention-rights-child\" target=\"_blank\" rel=\"noopener noreferrer\">Convention on the Rights of the Child<\/a><\/li>\n<\/ul>\n<p><strong>Other resources:<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/childbirth-a-bill-of-rights\/?msclkid=4ba1811ccfd111eca764c60460add5eb\">FIGO Statement: Childbirth: A Bill of Rights<\/a> (2021)<\/li>\n<li><a href=\"https:\/\/whiteribbonalliance.org\/stories\/movements\/respect-campaign\/\" target=\"_blank\" rel=\"noopener noreferrer\">WRA respectful maternity care resources<\/a><\/li>\n<li><a href=\"https:\/\/www.everypreemie.org\/twg-sept-26-2017\/\" target=\"_blank\" rel=\"noopener noreferrer\">Every Preemie meeting on Respectful Newborn Care<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","post_title":"Respectful care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"respectful_care","to_ping":"","pinged":"","post_modified":"2023-08-02 13:44:51","post_modified_gmt":"2023-08-02 17:44:51","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=15762","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":136,"post_author":"7211","post_date":"2015-10-21 15:21:03","post_date_gmt":"2015-10-21 15:21:03","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Integrating postpartum family planning services and counseling into childbirth care is vital to newborn and maternal health and survival.<\/h2>\r\nOffering contraceptive counselling and a wide range of modern methods along the continuum of childbirth care has shown to increase contraception use, which enables women to choose when and if to have a baby. Family planning use is considered postpartum if the woman initiates and uses a method in the first twelve months after childbirth. Postpartum reproductive health and family planning also includes services initiated after miscarriage or abortion. Pregnancies that are spaced by at least two years after a live birth and six months after a miscarriage or induced abortion can reduce the risk of complications and adverse newborn outcomes. Maternal survival is also impacted as women who practice healthy timing and spacing of pregnancies are less likely to die in childbirth or from pregnancy complications. Integrating contraception counseling and services into quality antenatal, postnatal, and newborn care is a <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/immediate-postpartum-family-planning\/\">proven intervention<\/a> and should be included in both facility and community based services.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">163<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666117399105{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of women with <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(22)00936-9\/fulltext\">unmet need for modern contraception services in 2019<\/a><\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">1.7<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1667922548234{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of fewer newborn deaths annually if <a href=\"https:\/\/www.guttmacher.org\/fact-sheet\/investing-sexual-and-reproductive-health-low-and-middle-income-countries\">unmet contraceptive need is met <\/a>in LMICs<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">700<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1667922954092{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of stillbirths that could be averted annually if <a href=\"https:\/\/www.guttmacher.org\/report\/adding-it-up-investing-in-sexual-reproductive-health-2019\">unmet contraceptive need is met<\/a> in LMICS<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"More on Family Planning\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]<strong>Family planning methods:<\/strong> There are <a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/family-planning-contraception\">many methods available<\/a>, under many different brand names. Modern methods include oral contraception pills, implants, injectable, intrauterine devices (IUDs), emergency contraception, male and female condoms, male and female sterilization, and lactational amenorrhea method (LAM). Additional methods include withdrawal, the calendar or rhythm method, and other fertility based methods. Some are more effective than others, and many rely on proper use to ensure effectiveness. Most of these contraceptives can be <a href=\"https:\/\/postpartumfp.srhr.org\/\">safely used immediately postpartum<\/a>; the rest can be initiated shortly after delivery, within a few weeks to six months.\r\n\r\nThe lactational amenorrhea method (LAM) is <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9678098\/\">98% effective<\/a> for the first six months postpartum. LAM prevents pregnancy while the mother is exclusively breastfeeding. It becomes less effective when other foods and liquids, like formula, are included, so women who are unable to exclusively breastfeed should consider other methods.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<strong>Spacing of pregnancy:<\/strong>\u00a0Use of family planning helps achieve healthy spacing of pregnancies, which is critical to a healthy pregnancy and delivery and to newborn survival. When pregnancies are too close together (less than 24 months between the last live birth and the next pregnancy), the risk of low birth weight, preterm birth, and newborn death increases; when pregnancy begins within six months of the last live birth, these complications are even more likely. Furthermore, when a mother who is still nursing an infant of any age becomes pregnant again, it is difficult to meet the nutritional needs of the mother, nursing baby, and fetus.\r\n\r\n<strong>Timing of pregnancy:<\/strong>\u00a0Studies have shown that both newborns and mothers have the healthiest outcomes when pregnancies occur after age 18. When mothers are <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4562289\/\">younger than 18<\/a>, they and their infants face increased risk of birth\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/complications-during-childbirth\/\">complications<\/a>, including stillbirth, low birth weight, and preterm birth. When possible, it is recommended to time pregnancies appropriately, especially by delaying first pregnancy until at least age 18. Adolescents, regardless of marital status, should have access to contraceptive methods to delay pregnancy.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_single_image image=\"56227\" add_caption=\"yes\"][vc_text_separator title=\"Key resources\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/training-resource-package-for-family-planning\/\">Training Resource Package for Family Planning\u00a0<\/a><\/li>\r\n \t<li><a href=\"https:\/\/fphandbook.org\/\">Family Planning Global Handbook for Providers<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/immediate-postpartum-family-planning\/\">High Impact Practices for Family Planning \u2013 Immediate Postpartum Family Planning<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/negative-effects-of-short-birth-interval-on-child-mortality-in-low-and-middle-income-countries-a-systematic-review-and-meta-analysis\/\">Negative effects of short birth interval on child mortality in low and middle income countries: a systematic review and meta analysis<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/family-planning-contraception\">WHO Family planning\/contraception methods<\/a><\/li>\r\n \t<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9678098\/\">Postpartum contraception: the lactational amenorrhea method<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Reproductive health & family planning","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"reproductive-health-family-planning","to_ping":"","pinged":"","post_modified":"2023-02-07 16:00:38","post_modified_gmt":"2023-02-07 21:00:38","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=136","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":251,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Asia","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"asia","to_ping":"","pinged":"","post_modified":"2016-02-11 21:51:07","post_modified_gmt":"2016-02-11 21:51:07","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&p=251","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":184,"post_author":"7211","post_date":"2015-10-21 21:58:21","post_date_gmt":"2015-10-21 21:58:21","post_content":"[vc_row][vc_column css=\".vc_custom_1453305596740{padding-top: 30px !important;padding-bottom: 30px !important;}\"][vc_text_separator title=\"Leading causes of neonatal deaths in India (2020)\" el_class=\"transform:upperclass\"][vc_row_inner][vc_column_inner][vc_round_chart type=\"doughnut\" stroke_width=\"1\" stroke_color=\"custom\" values=\"%5B%7B%22title%22%3A%221%25%20Diarrhoea%22%2C%22value%22%3A%221%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%220%25%20Tetanus%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%23cec2ab%22%7D%2C%7B%22title%22%3A%227%25%20Pneumonia%22%2C%22value%22%3A%227%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2239%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2239%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2221%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2221%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%225%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%225%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%229%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%229%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2218%25%20Other%20conditions%22%2C%22value%22%3A%2218%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686158564827{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&source=gmail&ust=1551964625737000&usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158668744{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">19.1<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158653873{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">4<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158622111{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">62<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158639136{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">12.2<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158578078{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">89.4\r\n<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1651070613999{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">57<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698696298715{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">13<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births <37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158608753{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">103<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1453307990481{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"India","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"india","to_ping":"","pinged":"","post_modified":"2023-10-30 16:03:36","post_modified_gmt":"2023-10-30 20:03:36","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&p=184","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"about_the_author":"<p><em>Aliya Bashir is a freelance journalist based in New Delhi and Kashmir.<\/em><\/p>\n","author_image":false},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/54633"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=54633"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/posts\/54633\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/54634"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=54633"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/categories?post=54633"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/tags?post=54633"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}