| 1. |
|
|
| 2. |
- Antonsson, Ann-Beth, et al.
(author)
-
Litteraturöversikt över aldehyders biologiska effekter, förekomst i arbetsmiljön och mätmetoder.
- 1985
-
Reports (other academic/artistic)abstract
- Formaldehyds allergiframkallande och ev cancerframkallande egenskaper har fäst uppmärksamheten på gruppen aldehyder, i vilken formaldehyd ingår. Gruppen aldehyder har det gemensamt att de flesta är irriterande för ögon och slemhinnor. Några av aldehyderna är dessutom allergiframkallande. För de flesta aldehyder finns inte tillräckliga kunskaper för att avgöra om de kan framkalla cancer eller fosterskador. Aldehyder används i de flesta branscher och ofta på ett sådant sätt att människor kommer i kontakt med aldehyder. Rapporten beskriver på ett lättbegripligt sätt - olika aldehyder och deras användningsområde, - biologiska effekter av aldehyder, - halter av aldehyder i arbetsmiljön, - gränsvärden, regler och normer. I rapportens sista kapitel anges vad man kan göra för att minska kontakten med aldehyder i arbetsmiljön.
|
|
| 3. |
- Cordova-Pozo, Kathya, et al.
(author)
-
Female genital mutilation: trends, economic burden of delay and basis for public health interventions.
- 2024
-
In: International Journal for Equity in Health. - 1475-9276. ; 23:1
-
Journal article (peer-reviewed)abstract
- Background: The practice of female genital mutilation (FGM) is a health and social problem. Millions of girls and women have undergone FGM or will soon, and more information is needed to effectively reduce the practice. The aim of this research is to provide an overview of the FGM trendlines, the inequality of its prevalence, and the economic burden. The findings shed light on 30-year trends and the impact of the pandemic on planned efforts to reduce FGM which helps with public health interventions. Methods: Temporal trend analysis, and graphical analysis were used to assess the change and inequality over the last 30 years. We included 27 countries in which FGM is prevalent. We calculated the extra economic burden of delayed interventions to reduce FGM like COVID-19. Results: For the 27 countries analyzed for temporal trendlines, 13 countries showed no change over time while 14 had decreasing trends. Among the 14, nine countries, Uganda, Togo, Ghana, Benin, Kenya, Nigeria, Central African Republic, Chad, and Ethiopia had high year-decrease (CAGR -1.01 and -10.26) while five, Côte d'Ivoire, Egypt, Gambia, Djibouti, and Mali had low year-decrease (CAGR>-1 and <0). Among these five are the highest FGM prevalence similar distribution regardless the wealth quintiles or residence. There is an economic burden of delay or non-decline of FGM that could be averted. Conclusion: Findings indicate that some countries show a declining trend over time while others not. It can be observed that there is heterogeneity and homogeneity in the FGM prevalence within and between countries which may indicate inequality that deserves further investigation. There is considerable economic burden due to delays in the implementation of interventions to reduce or eliminate FGM. These insights can help in the preparation of public health interventions.
|
|
| 4. |
- Frøen, J Frederik, et al.
(author)
-
FIGO good practice recommendations on the importance of registry data for monitoring rates and health systems performance in prevention and management of preterm birth.
- 2021
-
In: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. - : Wiley. - 1879-3479. ; 155:1, s. 5-7
-
Research review (peer-reviewed)abstract
- FIGO calls for strengthening of health information systems for reproductive, maternal, newborn, and child health services, co-designed with users, to ensure the timely accessibility of actionable high-quality data for all stakeholders engaged in preventing and managing preterm birth consequences. FIGO calls for strengthening of investments and capacity for implementing digital registries and the continuity of reproductive, maternal, newborn, and child health services in line with WHO recommendations, and strengthening of the science of implementation and use of registries-from local quality improvement to big data exploration.
|
|
| 5. |
- Möller, Ann-Beth, et al.
(author)
-
Are midwives ready to provide quality evidence-based care after pre-service training? Curricula assessment in four countries-Benin, Malawi, Tanzania, and Uganda.
- 2022
-
In: PLOS global public health. - : Public Library of Science (PLoS). - 2767-3375. ; 2:9
-
Journal article (peer-reviewed)abstract
- This research sought to map midwifery pre-service training curricula as part of the Action Leveraging Evidence to Reduce perinatal morTality and morbidity in sub-Saharan Africa (ALERT) project conducted in Benin, Malawi, Tanzania, and Uganda. We conducted the review in two phases. In the first phase, online interviews were performed with the lead project midwives in all four study countries to get an overview of midwifery care providers' pre-service training courses, registration, and licensing requirements. We performed a mapping review of midwifery care providers' pre-service training curricula from different training institutions in the four study countries during the second phase. Curricula were reviewed and mapped against the International Confederation of Midwives (ICM) Essential Competencies framework to assess whether these curricula included the minimum essential training components described in the ICM framework. We identified 10 different professional titles for midwifery care providers. The number of years spent in pre-service training varied from one and a half to four years. Ten pre-service curricula were obtained and the assessment revealed that none of the curricula included all ICM competencies. Main gaps identified in all curricula related to women-centred care, inclusion of women in decision making, provision of care to women with unintended or mistimed pregnancy, fundamental human rights of individuals and evidence-based learning. This review suggests that there are skills, knowledge and behaviour gaps in pre-service training curricula for midwifery care providers when mapped to the ICM Essential Competencies framework. These gaps are similar among the different training courses in participating countries. The review also draws attention to the plethora of professional titles and different pre-service training curricula within countries. Trial registration: PACTR202006793783148-June 17th, 2020.
|
|
| 6. |
- Möller, Ann-Beth, et al.
(author)
-
Assessment of midwifery care providers intrapartum care competencies, in four sub-Saharan countries: a mixed-method study protocol
- 2021
-
In: Reproductive Health. - : Springer Science and Business Media LLC. - 1742-4755. ; 18:1
-
Journal article (peer-reviewed)abstract
- Background We aim to assess competencies (knowledge, skills and attitudes) of midwifery care providers as well as their experiences and perceptions of in-service training in the four study countries; Benin, Malawi, Tanzania and Uganda as part of the Action Leveraging Evidence to Reduce perinatal mortality and morbidity in sub-Saharan Africa project (ALERT). While today more women in low- and middle-income countries give birth in health care facilities, reductions in maternal and neonatal mortality have been less than expected. This paradox may be explained by the standard and quality of intrapartum care provision which depends on several factors such as health workforce capacity and the readiness of the health system as well as access to care. Methods Using an explanatory sequential mixed method design we will employ three methods (i) a survey will be conducted using self-administered questionnaires assessing knowledge, (ii) skills drills assessing basic intrapartum skills and attitudes, using an observation checklist and (iii) Focus Group Discussions (FGDs) to explore midwifery care providers' experiences and perceptions of in-service training. All midwifery care providers in the study facilities are eligible to participate in the study. For the skills drills a stratified sample of midwifery care providers will be selected in each hospital according to the number of providers and, professional titles and purposive sampling will be used for the FGDs. Descriptive summary statistics from the survey and skills drills will be presented by country. Conventional content analysis will be employed for data analysis of the FGDs. Discussion We envision comparative insight across hospitals and countries. The findings will be used to inform a targeted quality in-service training and quality improvement intervention related to provision of basic intrapartum care as part of the ALERT project. Trial registration: PACTR202006793783148-June 17th, 2020.
|
|
| 7. |
- Möller, Ann-Beth, et al.
(author)
-
Midwifery care providers' childbirth and immediate newborn care competencies: A cross-sectional study in Benin, Malawi, Tanzania and Uganda.
- 2023
-
In: PLOS global public health. - 2767-3375. ; 3:6
-
Journal article (peer-reviewed)abstract
- Evidence-based quality care is essential for reducing sub-Saharan Africa's high burden of maternal and newborn mortality and morbidity. Provision of quality care results from interaction between several components of the health system including competent midwifery care providers and the working environment. We assessed midwifery care providers' ability to provide quality intrapartum and newborn care and selected aspects of the working environment as part of the Action Leveraging Evidence to Reduce perinatal morTality and morbidity (ALERT) project in Benin, Malawi, Tanzania, and Uganda. We used a self-administered questionnaire to assess provider knowledge and their working environment and skills drills simulations to assess skills and behaviours. All midwifery care providers including doctors providing midwifery care in the maternity units were invited to take part in the knowledge assessment and one third of the midwifery care providers who took part in the knowledge assessment were randomly selected and invited to take part in the skills and behaviour simulation assessment. Descriptive statistics of interest were calculated. A total of 302 participants took part in the knowledge assessment and 113 skills drills simulations were conducted. The assessments revealed knowledge gaps in frequency of fetal heart rate monitoring and timing of umbilical cord clamping. Over half of the participants scored poorly on aspects related to routine admission tasks, clinical history-taking and rapid and initial assessment of the newborn, while higher scores were achieved in active management of the third stage of labour. The assessment also identified a lack of involvement of women in clinical decision-making. Inadequate competency level of the midwifery care providers may be due to gaps in pre-service training but possibly related to the structural and operational facility characteristics including continuing professional development. Investment and action on these findings are needed when developing and designing pre-service and in-service training. Trial registration: PACTR202006793783148-June 17th, 2020.
|
|
| 8. |
- Möller, Ann-Beth
(author)
-
Midwifery care providers’ competencies in sub-Saharan Africa and global perinatal health outcomes
- 2024
-
Doctoral thesis (other academic/artistic)abstract
- Background: Maternal and newborn mortality and morbidity remain critical global health issues, particularly in sub-Saharan Africa where many countries are struggling to meet the maternal and newborn related Sustainable Development Goals targets. To improve survival and well-being of women and newborns, concerted effort needs to be made in the education of health workers to ensure quality care is provided. Furthermore, recruitment and equitable distribution of health workers must be prioritized to guarantee equal access to universal health coverage. Aim: Firstly, to assess midwifery care providers pre-service curricula according to the International Confederation of Midwives International Standards (Study I) and competencies of midwifery care providers in Benin, Malawi, Tanzania and Uganda (Study II) in order to inform the Action Leveraging Evidence to Reduce perinatal morTality and morbidity in sub- Saharan Africa (ALERT) project midwifery training package. Secondly, to assess the burden of perinatal adverse health outcomes focusing on preterm birth (Study III). Thirdly, to assess the relationship between health workforce densities, and maternal and perinatal health outcomes in the aforementioned countries (Study IV). Methods: Data were obtained by the following methods: mapping review and in-depth interviews (Study I), self-administered questionnaire and skills drills simulations (Study II), statistically derived preterm birth estimates (Study III) and comparative analysis of health workforce densities and maternal and perinatal outcomes (Study IV). Results: Study I identified significant gaps in the pre-service curricula of the study countries, while Study II found that providers in ALERT project facilities lacked important knowledge, skills and behaviours related to childbirth care. Study III estimated that the global prevalence of preterm birth was marginally higher in 2020 (9.9% of live births (95% credible intervals (CrI): 9.1-11.2)) compared to 2010 (9.8% (95% CrI: 9.0-11.0)). Study IV found that while the need to strengthen recruitment, capacity and motivation of health workers were heavily prioritized by all human resources for health policies, the workforce densities appear to have little to no effect on perinatal outcomes. Conclusion: Due to gaps in pre-service curricula, resource scarcity and poor organization of health systems, midwifery care providers lack the competencies required to provide quality care contributing to the continued high levels of adverse maternal and perinatal health outcomes.
|
|
| 9. |
- Ohuma, Eric O., et al.
(author)
-
National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis
- 2023
-
In: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 402, s. 1261-1271
-
Journal article (peer-reviewed)abstract
- Background: Preterm birth is the leading cause of neonatal mortality and is associated with long-term physical, neurodevelopmental, and socioeconomic effects. This study updated national preterm birth rates and trends, plus novel estimates by gestational age subgroups, to inform progress towards global health goals and targets, and aimed to update country, regional, and global estimates of preterm birth for 2020 in addition to trends between 2010 and 2020. Methods: We systematically searched population-based, nationally representative data on preterm birth from Jan 1, 2010, to Dec 31, 2020 and study data (26 March–14 April, 2021) for countries and areas with no national-level data. The analysis included 679 data points (86% nationally representative administrative data [582 of 679 data points]) from 103 countries and areas (62% of countries and areas having nationally representative administrative data [64 of 103 data points]). A Bayesian hierarchical regression was used for estimating country-level preterm rates, which incoporated country-specific intercepts, low birthweight as a covariate, non-linear time trends, and bias adjustments based on a data quality categorisation, and other indicators such as method of gestational age estimation. Findings: An estimated 13·4 million (95% credible interval [CrI] 12·3–15·2 million) newborn babies were born preterm (<37 weeks) in 2020 (9·9% of all births [95% CrI 9·1–11·2]) compared with 13·8 million (12·7–15·5 million) in 2010 (9·8% of all births [9·0–11·0]) worldwide. The global annual rate of reduction was estimated at –0·14% from 2010 to 2020. In total, 55·6% of total livebirths are in southern Asia (26·8% [36 099 000 of 134 767 000]) and sub-Saharan Africa (28·7% [38 819 300 of 134 767 000]), yet these two regions accounted for approximately 65% (8 692 000 of 13 376 200) of all preterm births globally in 2020. Of the 33 countries and areas in the highest data quality category, none were in southern Asia or sub-Saharan Africa compared with 94% (30 of 32 countries) in high-income countries and areas. Worldwide from 2010 to 2020, approximately 15% of all preterm births occurred at less than 32 weeks of gestation, requiring more neonatal care (<28 weeks: 4·2%, 95% CI 3·1–5·0, 567 800 [410 200–663 200 newborn babies]); 28–32 weeks: 10·4% [9·5–10·6], 1 392 500 [1 274 800–1 422 600 newborn babies]). Interpretation: There has been no measurable change in preterm birth rates over the last decade at global level. Despite increasing facility birth rates and substantial focus on routine health data systems, there remain many missed opportunities to improve preterm birth data. Gaps in national routine data for preterm birth are most marked in regions of southern Asia and sub-Saharan Africa, which also have the highest estimated burden of preterm births. Countries need to prioritise programmatic investments to prevent preterm birth and to ensure evidence-based quality care when preterm birth occurs. Investments in improving data quality are crucial so that preterm birth data can be improved and used for action and accountability processes. Funding: The Children's Investment Fund Foundation and the UNDP, United Nations Population Fund-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction.
|
|
| 10. |
- Welsh, J., et al.
(author)
-
Do in-service training materials for midwifery care providers in sub-Saharan Africa meet international competency standards? A scoping review 2000-2020
- 2022
-
In: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 22:1
-
Journal article (peer-reviewed)abstract
- Background Levels of maternal and neonatal mortality remain high in sub-Saharan Africa, with an estimated 66% of global maternal deaths occurring in this region. Many deaths are linked to poor quality of care, which in turn has been linked to gaps in pre-service training programmes for midwifery care providers. In-service training packages have been developed and implemented across sub-Saharan Africa in an attempt to overcome the shortfalls in pre-service training. This scoping review has aimed to summarize in-service training materials used in sub-Saharan Africa for midwifery care providers between 2000 and 2020 and mapped their content to the International Confederation of Midwives (ICM) Essential Competencies for Midwifery Practice. Methods Searches were conducted for the years 2000-2020 in Cumulative Index of Nursing and Allied Health Literature, PubMed/MEDLINE, Social Science Citation Index, African Index Medicus and Google Scholar. A manual search of reference lists from identified studies and a search of grey literature from international organizations was also performed. Identified in-service training materials that were accessible freely on-line were mapped to the ICM Essential Competencies for midwifery practice. Results The database searches identified 1884 articles after removing duplicates. After applying exclusion criteria, 87 articles were identified for data extraction. During data extraction, a further 66 articles were excluded, leaving 21 articles to be included in the review. From these 21 articles, six different training materials were identified. The grey literature yielded 35 training materials, bringing the total number of in-service training materials that were reviewed to 41. Identified in-service training materials mainly focused on emergency obstetric care in a limited number of sub-Saharan Africa countries. Results also indicate that a significant number of in-service training materials are not readily and/or freely accessible. However, the content of in-service training materials largely met the ICM Essential Competencies, with gaps noted in the aspect of woman-centred care and shared decision making. Conclusion To reduce maternal and newborn morbidity and mortality midwifery care providers should have access to evidence-based in-service training materials that include antenatal care and routine intrapartum care, and places women at the centre of their care as shared decision makers.
|
|
