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What matters to women in the postnatal period?

The right to a positive maternity healthcare experience at every stage

Each pregnancy is unique and clinical needs can change across the pregnancy, childbirth and postnatal periods. One thing that never changes is the right to a positive experience at every stage.

Achieving the best possible physical, emotional, and psychological outcomes for every individual and newborn requires health systems to take a human rights-based approach: not only preventing maternal death and morbidity, but prioritising person-centred
care and well-being.

WHO is developing new guidelines for a positive experience of postnatal care, due to be published next year. To inform these guidelines and ensure that postnatal services can better meet the needs of women and their babies, WHO undertook a qualitative
systematic review on what matters to women in the postnatal period.

Joys and challenges in the postnatal period

There is limited research about values and preferences in the postnatal period, defined by WHO as the first six weeks after childbirth. Studies have often focused on the results of specific postnatal interventions, rather than on the individuals who use
them.

‘What matters to women in the postnatal period: A meta-synthesis of qualitative studies,’ published in PLOS ONE, gives long-overdue respect to the authority of women’s own experiences. The authors review first-hand data from 15 countries
and 36 studies published after the year 2000 relating to women’s beliefs, expectations and values at this significant time of life.

These studies affirm that a positive postnatal experience can result in joy, self-confidence and enhanced capacity to thrive as both a person and a parent.

They are also vocal about the potential challenges of adjusting to a ‘new normal’ following childbirth, including changes in self-identity, relationships, and sexual behaviour.

What is a positive postnatal experience?

A positive postnatal experience for a woman will be one that responds to her specific context and preferences.

It will provide the confidence, knowledge and skills women need in the weeks following childbirth, supporting them to adjust to any changes in their intimate relationships and build new family ones. Women will be better equipped to navigate physical and
emotional challenges and to experience the dynamic achievement of personal growth.

This should be a shared responsibility, not a solitary one. Community has a critical role in enabling a positive postnatal experience, including partners, family and elders.

It is crucial that healthcare providers meet each woman’s needs, as well as those of their babies.

Supporting choices and rights to improve postnatal health outcomes

There are an estimated 303 000 maternal deaths annually, according to recent WHO figures. Most of these deaths occur postnatally.

The postnatal period is therefore a vital opportunity to improve both maternal and neonatal health and wellbeing: supporting healthy behaviors, providing life-skills education, facilitating breastfeeding, counselling women about family planning options,
supporting good mental health, preventing and treating childbirth-related complications.

Health care systems that empower individuals by supporting their values, preferences and rights are fundamental to improving maternal and newborn health outcomes.

WHO’s guidance for positive maternity care

WHO has recently released recommendations on antenatal care for a positive pregnancy experience, and on intrapartum care for a positive childbirth experience.

These publications made important clinical updates, including an increase from four to eight recommended antenatal contacts, and a revision to the decision-making process for interventions to accelerate labour.

They also uphold every woman’s right to a positive maternity care experience: one where her pregnancy does not erase her competency, autonomy and right to participate in decision-making for her own care and the care of her newborn.

Women’s choices and rights to sexual and reproductive health care, including maternity care, should be respected at every stage of the continuum of maternal and newborn care. This is true across all income settings, as well as in humanitarian settings
and during public health emergencies.

When WHO’s postnatal guidelines are released next year, they will complete the maternity care series built around what matters to women.

Rather than dividing care into three periods of antenatal, intrapartum and postnatal, these publications can be used to establish a model in which health systems support women, their baby and wider network physically, psychologically, socially and emotionally
through this significant life event.

Other resources

WHO recommendations on antenatal care for a positive pregnancy experience

WHO recommendations: intrapartum care for a positive childbirth experience

Improving early childhood development: WHO guideline

Parenting in the time of COVID-19

Q&A on COVID-19, pregnancy, childbirth and breastfeeding

Clinical management of severe acute respiratory infection when COVID-19 is suspected

Evidence on mistreatment of women during childbirth

Related topic

Breastfeeding

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May 9, 2020
New Ebola case confirmed in the Democratic Republic of the Congo

A new case of Ebola virus disease was confirmed today in the city of Beni in the Democratic Republic of the Congo (DRC).

“While not welcome news, this is an event we anticipated. We kept response teams in Beni and other high risk areas for precisely this reason,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

As part of the active Ebola surveillance system in place to respond to this ongoing outbreak in DRC, thousands of alerts are still being investigated every day. An alert is a person who has symptoms that could be due to Ebola, or any death in a high risk area that could have been as result of Ebola.

As with all confirmed cases, efforts are already underway to find everyone who may have been in contact with the person in order to offer them the vaccine and monitor their health status.

“WHO has worked side by side with health responders from the DRC for over 18 months and our teams are right now supporting the investigation into this latest case,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Although the ongoing COVID-19 pandemic adds challenges, we will continue this joint effort until we can declare the end of this Ebola outbreak together.”

The news of the confirmed case came minutes after the conclusion of a meeting of the International Health Regulations Emergency Committee on Ebola in DRC. The Emergency Committee will reconvene next week in order to re-evaluate their recommendations in light of this new information.

Prior to this, the last person who was confirmed to have Ebola in DRC tested negative twice and was discharged from a treatment centre on 3 March 2020.

As of 10 April 2020, 3456 confirmed and probable cases and 2276 deaths have occurred as a result of the outbreak.

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https://www.who.int/news-room/detail/10-04-2020-new-ebola-case-confirmed-in-the-democratic-republic-of-the-congo

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April 11, 2020
MAEPS quarantine centre in Serdang to receive Covid-19 patients next week

KUALA LUMPUR: The Covid-19 Low-Risk Patient Quarantine and Treatment Centre at the Malaysia Agro Exposition Park Serdang (MAEPS) in Serdang near here is expected to receive patients next week.

Mardi Corp Group chief executive officer Zaidi Shahrim however said so far, it had no information on the exact date when the authorities would send the Covid-19 patients there for quarantine.

“MAEPS will receive low-risk Covid-19 patients from around the Klang Valley, Malacca and several areas in Perak,” he said last night in an interview via Skype that broadcast live on the Bernama 7.45 programme.

On the challenges faced throughout the process of transforming MAEPS into a quarantine centre in just a short period of time, Zaidi said said it was difficult to get supplies from contractors as many were ‘bound’ by the Movement Control Order (MCO).

“We received the instruction during the first phase of the MCO but Alhamdulillah, with the close cooperation between various government agencies such as the Ministry of Health (MOH), Nadma (the National Disaster Management Agency), the Fire and Rescue Department and private companies, we managed to realise it within four days,” he added.

Zaidi said MAEPS is equipped with hospital-like facilities such as beds, bathrooms, dressing room, toilet, lounge and so on.

Among the services provided at the centre are clinical services, ward for Covid-19 patients, resuscitation rooms to stabilise patients in emergency situations, ambulance, pharmacy, X-ray, and pathology laboratory services.

The quarantine centre which has the capacity to place up to 600 patients at any one time is coordinated by Nadma with the cooperation of the MOH, the Malaysian Armed Forces, the Fire and Rescue Department, the Civil Defence Force, the Social Welfare Department and the Public Works Department. — Bernama

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https://www.thesundaily.my/local/maeps-quarantine-centre-in-serdang-to-receive-covid-19-patients-next-week-MB2245538

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April 11, 2020
Accelerating Sales & Marketing with Web Collaboration

Thanks to the expanding global workforce, heightened competition and the continued need to cut costs and drive productivity, companies today are facing myriad new challenges. Because sales and marketing are key to maximizing growth, productivity and profits, those organizations are facing mounting pressure to create efficient, customercentric processes that provide increased reach and revenue while keeping costs under
control ? all as markets become more competitive and brands less distinguishable. To compete, companies must equip their sales and marketing teams with technology that can dramatically enhance productivity and drive innovation by improving the way they interact with customers, partners, suppliers and other employees. Web collaboration is increasingly becoming an indispensable tool in accelerating sales and marketing processes while simultaneously reducing costs.

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http://www.associationofmarketing.org/whitepapers/view.php?whitepaper_id=67

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April 10, 2020
Staying the course really matters

Vanguard CEO Tim Buckley and Managing Director Karin Risi discuss the challenges of timing the market and moving to cash.

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https://investornews.vanguard/staying-the-course-really-matters/

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April 10, 2020
A meeting on digital innovations, TB and implementation research organised by WHO and the European Respiratory Society

WHO’s Global Tuberculosis Programme (WHO/GTB) and the European Respiratory Society convened a technical meeting on digital innovations, TB and implementation research, in Geneva on 7 February 2020. This meeting brought together funders,
partners, representatives of national TB programmes, civil society and scientists to discuss the challenges and opportunities when evaluating, integrating and scaling up digital technologies under programmatic settings. Specifically, this meeting
sought to receive input on the elements of a toolkit on implementation research that is currently being developed by WHO/GTB and the Special Programme for Research and Training in Tropical Diseases (TDR) to support evidence-informed use of
digital technologies under programmatic settings. Th etoolkit will be launched in mid-2020. Considering that several countries are updating their national TB strategic plans and preparing funding proposals for submission to the Global Fund, this meeting
also sought to create mutual understanding on the importance of resourcing implementation science to bridge the divide between research and practice.

This present meeting, is the latest in a series of efforts by WHO/GTB to facilitate the meaningful use of digital technologies for TB prevention and care. It
was preceded by a one-day workshop on 6 February held at the same venue for partner agencies of the ASCENT project. ASCENT is a UNITAID-funded project that started in 2019 with the aim of increasing demand and adoption of affordable digital technologies for TB medication adherence. The project is led by KNCV in partnership with Aurum Institute for Health
Research, PATH and the London School of Hygiene and Tropical Medicine. Activities are running in Ethiopia, the Philippines, South Africa, Ukraine and Tanzania UR. This was the first in a series of annual meetings that will be coordinated by the WHO/GTB
to assess progress in implementation of country activities and results from the interventions.

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https://www.who.int/news-room/detail/26-04-2020-a-meeting-on-digital-innovations-tb-and-implementation-research-organised-by-who-and-the-european-respiratory-society

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April 10, 2020
COVID-19 And Nigeria’s Pathetic Leadership Deficit By Ugochukwu Ejinkeonye

There is no better warning about the growing confusion that seems to be gradually beclouding the federal government’s response to the coronavirus challenge than the belief it betrayed last week that, perhaps, all it needs to calm the fears and apprehensions of Nigerians about its ability to halt the spread of the virus is to reel out a catalogue of activities President Buhari was said to have undertaken so far concerning the pestilence, whether the people felt their impact or not.

Now, if your family is starving badly, do you solve the rumbling signs of biting hunger in their stomach with some wild tales of the efforts deployed by you so far to feed them, or just keep quiet, give them food, and they will see and feel for themselves that you have played your role responsively and effectively? Or if you must talk, tell them something you have done whose benefits they can readily verify and identify with.

Indeed, some Nigerians are beginning to achieve the conviction that there must be something about being in government in this country that seems to diminish the reasoning ability of people once they get in there and deprives them of the capacity to realize when they have stopped making sense or even become downright annoying. This is very pathetic.

And so, last week, presidential spokesperson, Mr. Femi Adesina, issued a document entitled: “COVID-19: What President Buhari Has Done And Is Doing.” And, I suppose that with the release of that handout, the virus immediately received a deadly blow and vanished from the country! Aren’t we so blessed? Why then are Nigerians not on the streets celebrating the unprecedented feat?

A prominent item on Mr. Adesina’s list is the president’s March 29 broadcast. And what exactly did the broadcast achieve? The two things I can readily remember now is that Gen Buhari had announced the continuation of the school feeding programme for pupils who are all at home now due to the closure of schools as part of the efforts to contain the spread of the coronavirus. Probably, nobody remembered to inform him and his speech writers that school children were on compulsory holidays, or are they going to send the food to them in their homes? Or, perhaps, somebody is trying to find a justification for the billions of naira we will be informed later was spent on the exercise?

Also, the president proclaimed the lockdown of Lagos and Ogun states and the Federal Capital Territory (FCT). And when he was through, he returned to his hideout – where only a few privileged eyes and ears see and hear from him, and then come out to tell us what they think he has said or done.

Now, what exactly was the lockdown meant to achieve? Okay, as social interactions are reduced, the chances of spreading the virus decrease. Yes, but what else? Has anyone seen any evidence that there were any plans to use the stay-at-home period to access the people and step up medical tests to determine how many people have become infected with the virus and how they could be attended to?

The government that was boasting that it was “adequately prepared” to tackle the virus was later to prove when the virus eventually arrived that it was only making empty claims as usual. A country of 200 million people has yet to demonstrate any capacity to test even a reasonable fraction of one percent of her population. And somebody is publishing a document to tell us what the president was supposed to have done or is doing. As if such boring tales will remove the cloud of gloom hovering over Nigeria?

Again, in a country where electric power is just an unaffordable luxury for many, how can a leader just lock down some states and return to his hideout to continue his “vacation” that was rudely interrupted by the loud, persistent and widespread demands that he should address his country even though some other presidents were doing daily briefings and leading the war against the virus from the front? As the markets closed and movements became restricted, how are those who could afford to buy and stock food items at home preserve them without electric power?

What of the greater population which depend on daily earnings for their survival? What is the government’s plan for them? Okay, we are hearing of palliatives that have been extended to this category of people and the billions of naira that have already been transferred to their accounts? Now, who has encountered the happy recipients of the twenty thousand naira (N20, 000) said to have been given to each of them? Are there really existing data showing the social and economic status of every Nigerian which is in the possession of the authorities? So, all the “poor and vulnerable” Nigerians now have bank accounts whose details are known to the government? So, why then are too many Nigerians very suspicious of these claims as shown in their social media comments? And why is such a rare display of kindness by this government not being celebrated? Or have the funds (if indeed any were shared) ended up in the hands of the same people who have more than enough to need them while those who are genuinely deprived remain terribly famished?

Already, the biting hunger out there is forcing a growing number of people to defy the no-movement decree and soon, the whole effort might be defeated, and the country will return to square one. Information Minister, Mr. Lai Mohammed, is threatening that the lockdown may be extended if Nigerians fail to behave themselves. But what he should rather have done is to hasten to school himself to realize that there is always a price to pay when leaders leave the country they claim to be governing in great disarray only to suddenly wake up when there is an emergency to grope for fix-quick solutions.

A few days after the president’s broadcast (that is, Tuesday, March 31), Daily Independent carried a front page lead story about 26 Americans who came into the country through the Murtala Mohammed International Airport and headed to Calabar without being screened. Now, who cleared their trip to the country and why were there no health officials available to screen them and ensure they were quarantined for 14 days before being allowed to fly to Calabar? Is it because they are Americans or clients of the Nigerian National Petroleum Corporation (NNPC) or both? Does that automatically exempt any of them from being a carrier of the virus which is presently ravaging their own country? What kind of government claims to be fighting a virus with one hand and using the other hand to be undermining the efforts being deployed to contain it?

Okay, the Minister of Health, Dr. Osagie Ehanire, has just announced that an 18-man Chinese team of medical “experts” will soon arrive the country to “assist” Nigeria in the fight against the coronavirus. Now, is it the federal government that asked China for help or was it China that volunteered their assistance? Indeed many Nigerians are vehemently opposed to this gesture at this time. Our own local medical experts have not shown any signs of being overburdened by the work, so what difference are these 18 Chinese doctors and nurses going to make? Will they, like the 26 privileged Americans, also be given express entry into the country or will they be isolated for 14 days as should be the case, before they would be allowed to start rendering their “assistance”?

Do we really need this Chinese gift now or is it that the government lacks the liver to politely decline their offer of help, despite the widespread apprehension among the citizenry about their involvement (since many Nigerians, habour strong fears that the gesture might turn out a Greek gift)? Even the umbrella body of Nigerian doctors, the Nigerian Medical Association (NMA), has come out to strongly oppose the coming of the Chinese medical team. Is it that our government is too intimidated to say NO to China’s offer probably because it has yoked itself so much with crushing debts due to its excessive borrowings from them – debts, whose positive effects on Nigerian lives many are yet to see?

I raise these points because, although, Nigeria has recorded one of the lowest deaths from coronavirus, it was the stubborn refusal of the government to close our borders when it became very necessary and urgent (and despite calls from well-meaning Nigerians) that led to the explosion in the number of confirmed cases that the country has recorded today. In saner climes, the government should have profusely apologized for that terrible miscalculation that is costing the nation so much now.

But it now has another opportunity now to gratify the yearning of Nigerians and reject the Chinese offer even if it is well-meaning and the fears about it are misplaced.

Now, what lessons is the government taking away from the scourge of coronavirus? Will they see the need to equip our hospitals this time and upgrade at least few of them to world standard now that they have realized the folly of always waiting to use public funds to send themselves and their families abroad to treat even minor ailments? For the first time in Nigeria, the naïve and largely misguided Nigerian leaders have found out that it is not always safe to seek solutions for health challenges outside the country and that there is afterall no place like home. This is hoping that the lesson will endure and be redemptive.

*Ugochukwu Ejinkeonye, is a Nigerian journalist and writer. (scruples2006@yahoo.com)

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April 9, 2020
Strategic Decision Making Using Real-Time News Patterns

To support executive decision-making, corporations need the proper strategic and marketing planning framework and informational processes, including a dynamic feedback loop which converts global news articles and other content into strategic intelligence which confirms or challenges corporate and business unit assumptions about the changing external environment.

This article describes a new integrated solution: A Real-Time Market Planning Management Solution which enables organizations to quickly build a robust planning framework aligned with a knowledge-building process.

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http://www.associationofmarketing.org/articles/view.php?article_id=5337

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April 9, 2020
Joint Leader’s statement – Violence against children: A hidden crisis of the COVID-19 pandemic

The COVID-19 pandemic is having a devastating impact across the world. Efforts to contain the coronavirus are vital to the
health of the world’s population, but they are also exposing children to increased risk of violence – including maltreatment,
gender-based violence and sexual exploitation.

As leaders of organisations committed to ending violence against children, we come together in solidarity to share our deep
concern, call for action and pledge our support to protect children from violence and reduce the impact of COVID-19 on
children in every country and community.

A third of the global population is on COVID-19 lockdown, and school closures have impacted more than 1.5 billion children.
Movement restrictions, loss of income, isolation, overcrowding and high levels of stress and anxiety are increasing the
likelihood that children experience and observe physical, psychological and sexual abuse at home – particularly those
children already living in violent or dysfunctional family situations. And while online communities have become central to
maintain many children’s learning, support and play, it is also increasing their exposure to cyberbullying, risky online behavior
and sexual exploitation.

The situation is aggravated by children’s lack of access to schoolfriends, teachers, social workers and the safe space and
services that schools provide. The most vulnerable children – including refugees, migrants, and children who are internally
displaced, deprived of liberty, living without parental care, living on the street and in urban slums, with disabilities, and living
in conflict-affected areas – are a particular concern. For many, growing economic vulnerability will increase the threat of child
labour, child marriage and child trafficking.

We must act now. Together, we call on governments, the international community and leaders in every sector to urgently
respond with a united effort to protect children from the heightened risk of violence, exploitation and abuse as part of the
broader response to COVID-19.

Governments have a central role to play. They must ensure that COVID-19 prevention and response plans integrate age
appropriate and gender sensitive measures to protect all children from violence, neglect and abuse. Child protection services
and workers must be designated as essential and resourced accordingly.

Working with and supporting governments, our collective response must include: maintaining essential health and social
welfare services, including mental health and psychosocial support; providing child protection case management and
emergency alternative care arrangements; ensuring social protection for the most vulnerable children and households;
continuing care and protection for children in institutions; and communicating with and engaging parents, caregivers and
children themselves with evidence-based information and advice. National helplines, school counsellors and other child-friendly
reporting mechanisms enable children in distress to reach out for help, and must be adapted to the challenges of COVID-19.

Given the heightened risks of online harms, technology companies and telecoms providers must do everything they can
to keep children safe online. This includes providing access to cost-free child helplines, age-appropriate services and safe
e-education platforms – and using their platforms to share child online safety advice. They must also do more to detect and
stop harmful activity against children online, including grooming and the creation and distribution of child sexual abuse
images and videos.

As global organisations working to end violence against children, we will continue to advocate for and invest in effective child
protection solutions. We will collectively develop and share technical resources and guidance for policymakers, practitioners,
parents, caregivers and children themselves. And we will support the courageous health, child protection and humanitarian
professionals working around the clock to keep children safe during these unprecedented times.

In recent years, the global community has made significant gains in protecting children from violence. We must not allow those
gains to be lost during the current turmoil. We must do all we can to keep children safe now. And we must plan ahead together,
so that once the immediate health crisis is over, we can get back on track towards the goal of ending all forms of violence,
abuse and neglect of children

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https://www.who.int/news-room/detail/08-04-2020-joint-leader-s-statement—violence-against-children-a-hidden-crisis-of-the-covid-19-pandemic

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April 9, 2020
Govt urged to help all companies, not just SMEs

PETALING JAYA: The government has been urged to look at the survival of all companies and not just Small and Medium Enterprises (SMEs).

SMEs have a strict definition by SME Corp Malaysia, and many companies fall out of this scope, Knight Frank Malaysia Managing Director Sarkunan Subramaniam said today.

Knight Frank LLP is a leading independent global property consultancy.

In welcoming the third stimulus package worth RM10 billion rolled out to mitigate the severe social and economic impacts arising from the Covid-19 pandemic and the on-going movement control order (MCO), he said SMEs contribute 40% to the national economy.

“The initiatives should be extended to all businesses that are badly affected during this economic slump and additional measures should be extended to the businesses involved in the hospitality, food and beverage, tourism and aviation sectors,” he said in a statement.

“With the exception of those categorised as ‘essential services’, all other business activities have literally slowed or grind to a halt during this month-long MCO, which may be further extended should the number of infected cases continue to rise daily.”

Sarkunan said SMEs operating at premises owned by government-linked companies (GLCs) could enjoy rent exemption or discounts, although the quantum of discounts or rental exemption for these SMEs are unclear at this moment.

He applauded the government’s direction of encouraging private property owners to provide at least 30% rental discounts to SMEs during the MCO and three months after it ends by granting these landlords equivalent tax deductions.

However, he pointed out that this creates an issue for landlords having to verify if their tenants are SMEs or not. It is better for this relief be extended to all businesses since the balance 60% contribution to the national economy is other than SMEs.

“We regret that this initiative is purely for SME tenants only and urged the government to extend it to all tenants as they also facing challenges in sustaining their businesses amid this unprecedented event. All companies, small or big, are important for the country’s economy, no one should be left out,” Sarkunan added.

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https://www.thesundaily.my/local/govt-urged-to-help-all-companies-not-just-smes-CX2231646

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April 8, 2020