Finland’s two-year test of universal basic income has concluded that it doesn’t seem to disincentivise working, and improves recipients’ mental and financial well-being
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The third meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19), took place on Thursday, 30 April 2020, from 12:00 to 17:45 Geneva
time (CEST).
Proceedings of the meeting
Members and advisors of the Emergency Committee were convened by teleconference. Membership of the Emergency Committee was expanded
to reflect the nature of the pandemic and the need to include additional areas of expertise.
The Director-General welcomed the Committee, thanked them for their commitment to enhancing global public health, and provided an overview of the major achievements in the COVID-19 response since the last Emergency Committee meeting on 30 January 2020.
Representatives of the legal department and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities.
The Ethics Officer from CRE provided the members and advisers with an overview of the WHO Declaration of Interest process. The members and advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests
of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and
the work of the committee. Only those committee members and advisers who were not considered to have any perceived or direct conflict of interest participated in the meeting.
The Secretariat turned the meeting over to the Chair, Professor Houssin. He also welcomed the Committee and reviewed the objectives and agenda of the meeting.
The WHO Regional Emergency Directors and the Executive Director of the WHO Health Emergencies Programme (WHE) provided regional and the global situation overview. After ensuing discussion, the Committee unanimously agreed that the outbreak still constitutes
a public health emergency of international concern (PHEIC) and offered advice to the Director-General.
The Director-General declared that the outbreak of COVID-19 continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.
The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work.
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New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.
The
results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world.
Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization.
Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world.
Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.
The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.
Few
previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.
GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.
The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.
GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
which are not usually recorded as maternal sepsis, including post-abortion and indirect infections.
The result is a more complete understanding of the frequency and impact of maternal infections in health facilities.
GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk.
Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management.
Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.
Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
haemorrhage.
This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.
Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.
GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively.
For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.
GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.
This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
providers to manage the frequency and outcome of maternal infections.
GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives.
WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
on 5 May which celebrates the central role played by nurses and midwives in clean health care.
In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
2017
WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.
Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.
WHO recommendations for prevention and treatment of maternal peripartum infections
WHO Clinical practice handbook for safe abortion
Global guidelines on the prevention of surgical site infection
WHO statement on maternal sepsis
Infection Prevention and Control
SAVE LIVES: Clean Your Hands 5 May 2020
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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.
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.
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.
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 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.
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The father is the head of the home.—The character of the home determines the character of the church, society and the nation. The home is the most important of all earthly institutions. The problems of society, the church and the nation, if ever solved, must be largely solved in the home. The home is both a civil and divine institution. Civil and divine law place the husband and father at the head of the home. No teacher sustains a more vital relation toeacher sustains a more vital relation to society, no minister to his congregation, no king to his empire, or president to his republic, than does the conscientious father, who does his best to build an ideal home. He is truly serving God and his country, in the highest sense. In the work of building a home, he is serving society and the church in a higher sense than he would be, were he neglecting his family, by writing books, teaching school, delivering lectures or preaching sermons.
His relation to his wife.—The relation of husband and wife is a partnership affair. In every sense they are equal partners. Their rights and privileges are equal. Their part in building a home is not, in all respects, the same. The service of one is as important as the other. Neither can build a home without the other. Their service is incomparable.
He is to furnish financial support.—Nature has fitted man mentally and physically for devising means of earning a support for his family. Whatever occupation, calling or profession he may engage in, he should put forth the best effort of which he is capable to produce an income that will support his family decently.
The amount of money he can furnish his wife, will depend upon his earnings. They should talk over this matter as partners. One has as much right to the income as the other. They should not spend more than is produced. If the income is small, both should economize. They should endeavor to save something each year, even if the income is small. Money is stored-up human energy. If the income is large, they should be more liberal in the use of it, but it is always a sin to waste money. The husband has no right to cause his wife to beg him for money, to meet her personal expenses or the expenses of the children. The money is not exclusively his own. Home building is a partnership in which every member of the home is interested in every dollar produced. Legally the father may spend his money on his selfish indulgences. Morally{ he has no right to spend the home company money in a way that will not benefit each member of the home. For a father to annually spend fifty or more dollars on tobacco or drink and refuse corresponding amounts to his wife and children to be spent needlessly by them, is as dishonest, as for a member of a firm, or the president of a bank to misappropriate the funds of a partner or a depositor.
He is to furnish moral support.—For a man to build a reputation for honesty, truthfulness, sobriety and virtue and to possess a good character are of more value to his wife and children, as a home builder, than to be able to produce large earnings and to be free with the same. When a man assumes the responsibility of building a home, his family have a right to demand of him honesty, integrity, sobriety and virtue. He has no more right to rob them of one than the other.
He is to love his wife.—While the romance of courtship and the honeymoon cannot be continued for life, yet he should always show her a deep respect, a manly courtesy, a true love and absolute loyalty to his marriage vow.
The relation of the father to his children.—Each child born into the home is a new member added to the partnership. The children have financial, social and moral rights that should be respected by the parents. While civil law and God place the father at the head of the home, this does not give him special rights and privileges, or constitute him a boss or ruler, but he should so conduct himself that the family will regard him as their protector, supporter and adviser. He should not swear, tell vulgar stories, use tobacco or indulge in strong drink unless he is willing for each member of his family to follow his example. As partners in the home, they have the same moral rights as himself. He should be to his children a chum, a friend, a companion. He should constantly endeavor to make the children happy. There are times, in the home, when the father’s decision must be law. He must support his family. The law holds him responsible for their support and for their deportment as citizens. As long as they are under age, if they contract a debt or damage property, the law holds the father responsible. This responsibility makes it necessary for him to decide some things, in a way that a child may not wish to coincide. This should be done in a dignified and pleasant way.
The father should never allow himself to become angry or to use hasty and abusive language in correcting a child. If he does, he demonstrates his own weakness and inability to be a real father. Punishment of some natural kind is sometimes necessary, but corporal punishment, as a rule, is brutal.
The father should so conduct himself as to command the respect, reverence and love of his children. He should be sociable and gentle, as well as dignified and strong. He should have their complete confidence, so they will come to him with their problems and troubles. The sacred service of a true father in the home, can only be equaled by the service of the mother. The fathers who toil long and late, study and strive to support, educate and train a family of children to become good citizens and devoted Christians, will receive a rich reward here and a royal welcome yonder.
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The average blog reader views 77% more pages than an average user, and believe it or not, those blog readers are likely to have an average income of $75,000 or more according to Clickz. Well that sounds like a great target audience, but with over 50 million blogs out there, how do you get your blog to stand out of the woodwork and get noticed? We’ve been doing some research of our own in an effort to redesign the new Mequoda Daily 2.0 and here’s some fun stuff that research has shown us…
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MALACCA: The Malacca Zoo has created a special fund for donations to help pay for food supplies during the Movement Control Order (MCO) period.
President of the Hang Tuah Jaya Municipal Council (MPHTJ) Shadan Othman said the Malacca Zoo Donation Fund was launched on April 4 and has so far collected about RM6,000.
“The MCO period has been challenging for us to manage Malacca Zoo as it is not open to visitors in order to protect public safety and that of the animals, whereas part of its income is derived from ticket sales.
“Just for food alone, we need RM180,000 a day for 650 animals,….., we hope the public can contribute to the zoo through this fund,” he told reporters after visiting the zoo here today.
Also present were director of Malacca Zoo and Bird Park, Zanariah Khamis, and head of the zoology department, Azman Ghazali.
Shadan said the public who want to contribute to the fund can do so through the Zoo Malacca CIMB account, with the name Zoo MPHTJ and account number 8009600869.
He also urged private companies, government bodies and private individuals to adopt the animals in the zoo so that they get adequate supply of food and medicine, and are properly managed.
He said even during the MCO period, the zoo is managed as usual while the sanitisation and cleansing processes are conducted every three to four days.
The Malacca Zoo, which has 32 zoo keepers, was started in 1963 and is the second largest zoo in the country, with about 650 animals of 150 species from around the world.
It is also a conservation, research and educational centre. — Bernama
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KUALA TERENGGANU: Terengganu Menteri Besar Dr Ahmad Samsuri Mokhtar today extended assistance to part-time journalists in the state whose income are affected by the Covid-19 pandemic.
The RM10,000 contribution under the state Covid-19 Emergency Aid Fund was presented to the Terengganu Journalists Club (Kawat) for distribution to the affected members.
The contribution was handed over by Ahmad Samsuri’s press secretary Adram Musa to Kawat president Khairul Azlam Mohamad at Wisma Darul Iman, here.
Khairul Azlam said the contribution would definitely help ease the burden of part-time journalists who did not have a fixed income.
Normally, they would be paid based on the number of news they produced he said adding that the current situation of the Movement Control Order had made it difficult for them to generate income. – Bernama
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PETALING JAYA: Fifa Rahman (pix) who’s a board member for the NGO Unitaid, pointed out on Twitter that the Malaysian Health Ministry’s outreach to the poor is far greater than the UK.
“Truly remarkable outreach by Malaysian health workers to low-income families. We’re not seeing this kind of outreach in Yorkshire, not sure about the rest of the UK,” Fifa tweeted yesterday.
Replying to her tweet was parliamentarian Sivarasah Rasiah and Religious Affairs Minister Zulkifli Mohamad Al-Bakri. “Fifa, the DG’s strategy seems to be to focus mass testing in areas where clusters of cases appear. Level of lockdown for the area is increased together with intensive testing and comtact tracing. Seems to be effective in bringing down the rate of increase of cases,” Sivarasah said.
“TQVM for your concern. On my side, agencies under my ministry are helping the foreign workers as much as possible by giving them foods and dry goods since the beginning of MCO. Yesterday, we went to Kongsi Cyberjaya 10.” Zulkifli replied to Fifa.
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