[afro-nets] Publication: Reviewing maternal deaths and complications

General afro-nets
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Beyond the Numbers: Reviewing maternal deaths and complications
to make pregnancy safer
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World Health Organization, Geneva, 2004

Available online as PDF file [150 pp. 2.61 MB!] at:
http://www.who.int/reproductive-health/publications/btn/btn.pdf

Avoiding maternal deaths is possible, even in resource-poor
countries, but it requires the right kind of information on
which to base programmes.

Knowing the level of maternal mortality is not enough; we need
to understand the underlying factors that led to the deaths.

Each maternal death or case of life-threatening complication has
a story to tell and can provide indications on practical ways of
addressing the problem.

A commitment to act upon the findings of these reviews is a key
prerequisite for success.

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Table of Contents

Preface

What is this guide about? - Who is this guide for? - What is the
structure of this guide? - How to use this guide?

Introduction - Background - The purpose of this document - Why
mothers die: a new approach - The importance of "telling the
story"

Learning lessons is a prerequisite for action

The approaches - Practical issues in implementing the approaches

Community-based surveys - Facility-based surveys

Definitions of maternal death - Identifying maternal deaths

Key principles for data collection

Translating findings into action - What sort of recommendations
should be made?

Disseminating findings and recommendations - Who to inform of
the results

Ensuring confidentiality and the legal and ethical framework

Legal considerations - Ethical considerations

Sources of further information

Verbal autopsies: learning from reviewing deaths in the commu-
nity

Facility-based maternal deaths review: learning from deaths oc-
curring in health facilities

What is a facility-based maternal deaths review?

The levels at which a review may take place

The history of maternal death reviews

The advantages and disadvantages of a facility-based maternal
deaths review

Step-by-step process for undertaking a maternal deaths review

Confidential enquiries into maternal deaths

Reviewing severe maternal morbidity: learning from survivors of
life-threatening complications

2

US defense contractors to supply AIDS drugs to Africa under PEPFAR
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Several (US) defense contractors to apply for US$ 7b PEPFAR
grant to supply HIV/AIDS drugs to developing countries, NPR Re-
ports - Source:
http://www.kaisernetwork.org/daily_reports/rep_hiv.cfm#26226

Several defense contractors, including Northrop Grumman -- the
second-largest government defense contractor and manufacturer of
the stealth bomber -- are considering a bid for a $7 billion
grant from the President's Emergency Plan for AIDS Relief to
supply antiretroviral drugs to developing countries, NPR's
"Morning Edition" reports. (Wilson, "Morning Edition," NPR,
10/14).

PEPFAR is a five-year, $15 billion program that directs funding
to 12 African nations -- Botswana, Ethiopia, Cote d'Ivoire,
Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tan-
zania, Uganda and Zambia -- as well as Haiti, Guyana and Viet-
nam.

NPR reports that the Bush administration currently is soliciting
proposals for the "largest contract for international health
services ever" to develop a supply system that would "quickly
scale up" the delivery of "vast quantities" of HIV/AIDS medica-
tions and medical supplies to two million people in the 15 coun-
tries. Although none of the companies considering a bid on the
contract would comment on record with NPR, Carl Stecker, direc-
tor of AIDS treatment programs for Catholic Relief Services,
said his agency has been visited by several defense contractors.

Stecker added that large-scale supply chain management projects,
such as purchasing and transporting millions of dollars worth of
drugs to remote clinics, are logistically "way out of the ...
league" of many relief agencies.

Dr. Mark Dybul, an AIDS researcher at NIH and chief medical of-
ficer of PEPFAR, said that a final version of the request for
proposals on the contract, which would provide $7 billion over
five years to procure, track and transport HIV/AIDS drugs, is
expected to be issued next week.

Although some HIV/AIDS advocates are not surprised that defense
companies are interested in the contract, some question whether
large defense contractors "are the right ones for the job" and
are "troubled" by the prospect of working with some of the de-
fense companies, NPR reports ("Morning Edition," NPR, 10/14).

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A. Odutola
mailto:chpss_abo2@yahoo.com