Abstract：
OBJECTIVE:Delivery by a skilled birth attendant (SBA) serves as an indicator of progress towards reducing maternal mortality worldwide -- the fifth Millennium Development Goal. Though WHO tracks the proportion of women delivered by SBAs, we know little about their competence to manage common life-threatening obstetric complications. We assessed SBA competence in five high maternal mortality settings as a basis for initiating quality improvement. METHODS:The WHO Integrated Management of Pregnancy and Childbirth (IMPAC) guidelines served as our competency standard. Evaluation included a written knowledge test, partograph (used to record all observations of a woman in labour) case studies and assessment of procedures demonstrated on anatomical models at five skills stations. We tested a purposive sample of 166 SBAs in Benin, Ecuador, Jamaica and Rwanda (Phase I). These initial results were used to refine the instruments, which were then used to evaluate 1358 SBAs throughout Nicaragua (Phase II). FINDINGS:On average, Phase I participants were correct for 56% of the knowledge questions and 48% of the skills steps. Phase II participants were correct for 62% of the knowledge questions. Their average skills scores by area were: active management of the third stage of labour -- 46%; manual removal of placenta -- 52%; bimanual uterine compression -- 46%; immediate newborn care -- 71%; and neonatal resuscitation -- 55%. CONCLUSION:There is a wide gap between current evidence-based standards and provider competence to manage selected obstetric and neonatal complications. We discuss the significance of that gap, suggest approaches to close it and describe briefly current efforts to do so in Ecuador, Nicaragua and Niger.
journal_name
Bull World Health Organjournal_title
Bulletin of the World Health Organizationauthors
Harvey SA,Blandón YC,McCaw-Binns A,Sandino I,Urbina L,Rodríguez C,Gómez I,Ayabaca P,Djibrina S,Nicaraguan Maternal and Neonatal Health Quality Improvement Group.doi
10.2471/blt.06.038455subject
Has Abstractpub_date
2007-10-01 00:00:00pages
783-90issue
10eissn
0042-9686issn
1564-0604pii
S0042-96862007001000015journal_volume
85pub_type
杂志文章abstract：:Two, 30-cluster, retrospective surveys of deaths from neonatal tetanus in Indonesia were conducted during 1982. The first survey, in the city of Jakarta, identified 16 deaths from neonatal tetanus among 2310 live births, giving a mortality rate of 6.9 per 1000 live births. The second survey covered 19 of Indonesia's 2...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：:An influenzavirus of swine origin (swine/Taiwan/7310/70) antigenically closely related to the human A/Hong Kong/68 virus readily infected human volunteers. Those infected developed antihaemagglutinin and antineuraminidase antibodies to the human A/Hong Kong/68 virus as well as to the swine/Taiwan virus. The clinical r...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1972-01-01 00:00:00
abstract：:In November 1999, Dr Amadou Diarra was appointed senior director of Bristol-Myers Squibb's Secure the Future Initiative. Launched 18 months ago, this public-private partnership is seeking, together with the governments of nine African countries, innovative ways of reducing the transmission and the impact of HIV/AIDS, ...
journal_title：Bulletin of the World Health Organization
pub_type： 面试
doi：
更新日期：2001-01-01 00:00:00
abstract：PROBLEM:In 1999, a tuberculosis (TB) crisis was declared in the Western Pacific Region. APPROACH:In response, WHO established the Stop TB Special Project, which sought to halve 2000 levels of TB prevalence and mortality by 2010 through first reaching the global 2005 TB targets. LOCAL SETTING:Particular issues in the ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：10.2471/blt.06.038521
更新日期：2007-05-01 00:00:00
abstract：OBJECTIVE:To quantify long-term health service use (HSU) following non-fatal injury in adults. METHODS:A retrospective, population-based, matched cohort study identified an inception cohort (1988-91) of injured people who had been hospitalized (ICD-9-CM 800-995) aged 18-64 years (n = 21 032) and a matched non-injured ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：10.2471/blt.06.030833
更新日期：2006-10-01 00:00:00
abstract：:The success of primary health care programmes in Thailand over the past three decades can be attributed not only to medical advances but to the role of community health volunteers. Buddhist monks and their temples have been strongly involved in health promotion and education, particularly in remote, rural communities....
journal_title：Bulletin of the World Health Organization
pub_type： 新闻
doi：10.2471/blt.08.010108
更新日期：2008-01-01 00:00:00
abstract：:Since an excellent candidate strain (M) for live virus vaccination of swine against Japanese encephalitis was developed, a number of large vaccination programmes have been implemented in Japan with the aim of controlling Japanese encephalitis epidemics in man by reducing the population size of nonimmune swine. Encoura...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1972-01-01 00:00:00
abstract：:Health care reform in Europe is discussed in the light of the Ljubljana Charter, with particular reference to progress made in Estonia and Lithuania. ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：:A national cross-sectional survey of the heights and weights of Kuwaiti preschool-age children of 0-5 years was conducted on a stratified multistage sample of 2554 subjects from high and low socioeconomic levels. The collected data were used to compare the nutritional status of these children with their American count...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:Modern vector control campaigns cannot be conducted efficiently and economically unless the organization is staffed with personnel having a high standard of training. Both professional and non-professional personnel are employed at different levels in the organization and the type of training they require depends upon...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1963-01-01 00:00:00
abstract：:Single-radial-diffusion techniques are proposed as possible alternatives to tests based on agglutination of erythrocytes for the assay of the haemagglutinin content of influenza vaccines. Two test procedures (microtest and macrotest) and the use of reference reagents to assay vaccines using these tests are described. ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1975-01-01 00:00:00
abstract：:The biological effects of tuberculin in an organism infected with tubercle bacilli are due to an unknown number of different substances, which are present in varying concentrations in different tuberculin preparations. Consequently, the response to tuberculin tests with various products is likely to vary with the biol...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1964-01-01 00:00:00
abstract：:A survey of the sandfly population of Iran was conducted in the interests of providing further knowledge of the biology of these vectors of leishmaniasis, sandfly fever and kalaazar. The search for specimens was carried out in the Tabriz, Sarab, Caspian Sea, Teheran and Kazerun areas, both inside buildings and in natu...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1961-01-01 00:00:00
abstract：:Rabbits have commonly been used for testing the blood-level duration limit of penicillin, but have proved not to be entirely suitable. Experiments reported in this paper on the use of sheep suggest that these animals can be successfully used for the testing of procaine benzylpenicillin with aluminium monostearate (PAM...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1961-01-01 00:00:00
abstract：:Investigators using questionnaires are usually confronted with an enormous number of different responses whose significance with respect to a particular characteristic is not immediately clear. This paper presents a simple computational technique for determining the relative merits of each question and a score for eac...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1972-01-01 00:00:00
abstract：:The plaque-neutralization method developed by Dulbecco and co-workers for the study of the virus of western equine encephalomyelitis in cultures of chick fibroblasts, though probably unequalled for accuracy, has not been adopted for general use in laboratories engaged in research on the arthropod-borne viruses, for tw...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1960-01-01 00:00:00
abstract：:This article provides an overview of managed health care in the USA--what has been achieved and what has not--and some lessons for policy-makers in other parts of the world. Although the backlash by consumers and providers makes the future of managed care in the USA uncertain, the evidence shows that it has had a posi...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章,评审
doi：
更新日期：2000-01-01 00:00:00
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journal_title：Bulletin of the World Health Organization
pub_type： 临床试验,杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：:This article describes laboratory evaluations, followed by field tests, of the effectiveness of sodium pentachlorophenate against Australorbis glabratus, the intermediate host of Schistosoma mansoni. Results within a range of different concentrations and at various periods of exposure were assessed in relation to both...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1957-01-01 00:00:00
abstract：:Individual patient care and programme evaluation are pivotal for the success of antiretroviral treatment programmes in resource-limited countries. While computer-aided documentation and data storage are indispensable for any large programme, several important issues need to be addressed including which data are to be ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：10.2471/blt.04.019307
更新日期：2006-02-01 00:00:00
abstract：OBJECTIVE:We sought to assess the current status of global data on death registration and to examine several indicators of data completeness and quality. METHODS:We summarized the availability of death registration data by year and country. Indicators of data quality were assessed for each country and included the tim...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：/S0042-96862005000300009
更新日期：2005-03-01 00:00:00
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journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1971-01-01 00:00:00
abstract：:With a view to developing a schedule for the ambulatory treatment of Schistosoma haematobium infection with sodium antimony dimercaptosuccinate (TWSb), a trial was conducted in Tanzania of the comparative effectiveness of daily and weekly injections of TWSb in schoolchildren. In-patients received five daily injections...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1965-01-01 00:00:00
abstract：:The ultrastructure of the trophozoite of Entamoeba histolytica cultivated in vitro on artificial media is described from electron-microscope studies made by the authors and from other published accounts. The authors point out that the description does not present a complete picture of the trophozoite of this species o...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1970-01-01 00:00:00
abstract：:In order to study the role of genetic factors in susceptibility to leprosy infection, the prevalence of leprosy in 118 pairs of Burmese villages different distances apart was investigated. The distribution pattern of the correlation coefficients for leprosy rates was compared with that known to occur for genetic marke...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1973-01-01 00:00:00
abstract：:Sexually transmitted diseases (STD) are now the commonest group of notifiable infectious diseases in most countries, particularly in the age group of 15 to 50 years and in infants. Their control is important considering the high incidence of acute infections, complications and sequelae, their socioeconomic impact, and...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章,评审
doi：
更新日期：1990-01-01 00:00:00
abstract：:Hut and village-scale trials with solid and liquid-type dichlorvos dispensers were carried out in 1961 in the vicinity of Lagos, Nigeria, by the WHO Insecticide Testing Unit. Bioassay results indicated that with a single application satisfactory mortalities of caged mosquitos could be obtained for a period of 12-13 we...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1963-01-01 00:00:00
abstract：:All sewage and water treatment processes remove or destroy viruses. Some treatment methods are better than others, but none is likely to remove all of the viruses present in sewage or in raw water. Primary settling of solids probably removes a great many of the viruses in sewage because viruses are largely associated ...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章,评审
doi：
更新日期：1973-01-01 00:00:00
abstract：:The nature of psychiatric disorders in tropical regions is affected much more by the effect on the patient of certain environmental and cultural factors than by any specific features of tropical diseases. In places where the standards of health care and health education are not yet fully developed, abnormalities of ph...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:Measurements of spermatheca diameter and wing length were made on 8 East African mosquito populations comprising Anopheles merus and A. gambiae species A, species B, and the "Bwamba cytotype" (=species D). The results showed that, on average, the spermatheca in species A females is larger than in species B. In each of...
journal_title：Bulletin of the World Health Organization
pub_type： 杂志文章
doi：
更新日期：1972-01-01 00:00:00
