“Growing resistance to a key anti-malarial drug derived from a shrub used in traditional Chinese medicine is threatening to roll back gains made in combating the disease,” according to experts attending a U.N.-sponsored malaria conference that concluded on Friday in Sydney, Australia, the U.N. News Centre reports. Malaria “therapies based on artemisinin — an extract from the sweet wormwood bush used for centuries in Chinese medicine as a fever cure — were” formulated in combination with other antimalarials to form artemisinin-based combination therapies (ACTs) that the WHO thought would be effective for years, but resistance to the ACTs has begun to appear in some areas, the news service notes. “Specifically, [the Roll Back Malaria Partnership] noted, artemisinin resistance has been detected in Cambodia, Myanmar, Thailand and Vietnam,” the news service writes (11/2). Agence France-Presse examines efforts to fight drug-resistant malaria on the Thai-Myanmar border (Rook, 11/4).
Quality of Care
Central African Republic Town Struggling To Provide Health Care Since Withdrawal Of Foreign Companies, VOA Reports
VOA News examines how the 2009 withdrawal of foreign diamond-mining companies from the small town of Carnot in the Central African Republic (CAR) affected the local economy and access to health care for residents. Initially, Medecins Sans Frontieres (MSF) “ran emergency nutrition programs for the first year, but then discovered deeper health problems in the region, including a child mortality rate that is three times above what is considered an emergency level, as well as elevated rates of HIV and tuberculosis,” the news service writes.
“If [Republican presidential nominee Gov.] Mitt Romney and his vice-presidential running mate, Representative Paul Ryan, were to win next month’s election, the harm to women’s reproductive rights would extend far beyond the borders of the United States,” a New York Times editorial says. In the U.S., “they would support the recriminalization of abortion with the overturning of Roe v. Wade, and they would limit access to contraception and other services,” according to the editorial, which adds “they have also promised to promote policies abroad that would affect millions of women in the world’s poorest countries, where lack of access to contraception, prenatal care and competent help at childbirth often results in serious illness and thousands of deaths yearly.”
In this post on IntraHealth’s “Global Health Blog,” Pape Gaye, president and CEO of IntraHealth, discusses the organization’s commitment to providing quality training to Kenyan health care workers made at this year’s Clinton Global Initiative meeting. “We and our partners will use information technologies designed or adapted in Kenya to create and distribute training programs to Kenyan health workers. We are especially focusing on health workers who provide much-needed services in the remote Kenyan regions of Kitui and Kisumu,” Gaye writes. Noting that “one billion people in this world who may never come in contact with a health provider in their entire lives,” he continues, “I hope that by making the information and the training available where it’s needed the most, we are giving a chance to these people, a chance to get in contact with and receive services from a health worker” (10/9).
“Women working as female health care volunteers [FHCVs] often provide a vital service for the poorest in mountainous Nepal, and have contributed to a steady improvement in maternal and neonatal survival rates,” IRIN reports. In Nepal, 52,000 FHCVs work nationwide, often in remote regions, to refer women and children to health centers and help raise money for their trips, according to the news service. Many experts believe the FHCVs have played a key role in reducing Nepal’s maternal mortality ratio and increasing the proportion of births attended by a skilled birth attendant or that take place in a health facility, IRIN notes. “The FCHV program was launched in 1988 in 19 districts in the mid-west (Nepal’s poorest region), with the purpose of improving maternal and neonatal care, according to the Health Ministry,” IRIN writes, adding, “Despite being regarded as key to the state’s public health program, the government provides them with virtually no support” (10/5).
Experts Worried Political Commitment, Health Services Delivery Still Lacking Despite Efforts To Improve Family Planning In Uganda
“Family planning advocates in Uganda have scored some major financial and policy wins this year, but experts remain concerned that inadequate political commitment and poor health services will continue to impede women’s and girls’ access to contraceptives,” IRIN reports. With one of the fastest growing populations in the world, Uganda’s “President Yoweri Museveni announced that his government would increase its annual expenditure on family planning supplies from $3.3 million to $5 million for the next five years” and he “pledged to mobilize an additional $5 million from the country’s donors,” the news service writes. In addition, the “Ministry of Health has laid out a roadmap for providing universal access to family planning, involving the integration of family planning into other health services,” the news service notes.
Mobile phones and other SMS-based platforms are being used to improve health care systems worldwide and have “opened the gateway to establishing emergency triage systems, sending medication adherence reminders, enabling home-based antenatal care, tracking community immunization and dispatching mass announcements detailing satellite clinic schedules and locations,” Nadim Mahmud, co-founder of Medic Mobile, writes in a CNN opinion piece. “While I am focused on helping people in the developing countries, I am keenly aware that mobile health care innovations also impact people close to home,” he says.
“Morocco has made great strides in improving maternal health in recent years, decreasing its maternal mortality ratio by over 60 percent since 1990,” but “a wide maternal health gap” exists between women in urban and rural areas, where deliveries generally are attended by an experienced yet untrained family member, Women’s eNews reports. In 2010, according to a 2011 report from the U.N. Population Fund, the maternal mortality rate in urban areas was 73 deaths per 100,000 live births, compared with 148 deaths per 100,000 live births in rural areas, the news service notes. “[W]hen a [rural] woman runs into serious trouble … access to life-saving care is a two-hour walk away, on a rough mountainous path sometimes blocked by snow,” the news service writes, adding Abdelghani Drhimeur, head of communications at the Ministry of Health in Rabat, said, “Seventy percent of mothers who die do so on the way to the hospital.” Women’s eNews examines several organizations’ efforts to educate women about sanitation, hygiene, nutrition, and technical midwifery skills (Bhatia, 9/24).
Though the global community has “made incredible inroads” on the Millennium Development Goals (MDGs), “the majority of developing countries are still expected to fall short of the MDG targets for reducing maternal and child mortality by 2015,” Carole Presern, director of the Partnership for Maternal, Newborn & Child Health (PMNCH), writes in the Huffington Post’s “Global Motherhood” blog. A report released recently by PMNCH “sheds light on the reasons why more progress is not being made to end these needless deaths” by examining “commitments made to advance the Global Strategy for Women’s and Children’s Health” launched by U.N. Secretary-General Ban Ki-moon in 2010, she notes.
“Today about 12 percent of the health work force [in the U.S.] is foreign-born and trained, including a quarter of all physicians,” Kate Tulenko, senior director of health system innovation at IntraHealth International, writes in a New York Times opinion piece, adding, “That’s bad for American workers, but even worse for the foreign workers’ home countries, including some of the world’s poorest and sickest, which could use these professionals at home.” She says expensive schooling and strict credential requirements, which some foreign-trained workers do not have to meet, are keeping U.S. health workers from entering the workforce.