Tag: 上海419论坛BF

The Current State of Maternal Health in Nepal

first_imgPosted on December 29, 2017January 2, 2018By: Amrit Banstola, Public Health Practitioner, NepalClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)In November 2017, the most recent Nepal Demographic and Health Survey (NDHS) was published with national data from 2016. The 2016 NDHS is one of the most comprehensive demographic and public health reports released by the Nepalese Ministry of Health in the last five years. Below are some highlighted findings from the report that illustrate the current state of maternal health in Nepal, progress made so far and gaps to address moving forward.Maternal mortalityThe maternal mortality ratio (MMR) in Nepal decreased from 539 maternal deaths per 100,000 live births to 239 maternal deaths per 100,000 live births between 1996 and 2016. In 2016, roughly 12% of deaths among women of reproductive age were classified as maternal deaths.Antenatal careIn 2016, 84% of pregnant women had at least one antenatal care (ANC) contact with a skilled provider—defined as either a doctor, nurse or midwife/auxiliary nurse midwife—which was a 25% increase from 2011. The percentage of women who had four or more ANC visits increased steadily from 50% in 2011 to 69% in 2016.Although the report showed increases in skilled ANC utilization, only 49% of women received counselling on five critical components during ANC: use of a skilled birth attendant (SBA), facility-based delivery, information about danger signs during pregnancy, where to go in case of danger signs and the benefits of postnatal care. Utilization of ANC services was a significant predictor of place of delivery and SBA-assisted births.Women in the highest wealth quintile with a high education level and those residing in urban areas were much more likely to have four or more ANC contacts from a skilled provider compared to women of lower socioeconomic status and education and those living in rural areas.Place of delivery and skilled birth attendanceAmong the notable findings in this year’s report was the rise in facility-based delivery and the use of SBAs. Between 2011 and 2016, there was a 22% increase in both the proportion of institutional deliveries (from 35% to 57%) and births assisted by SBAs (from 36% to 58%). Doctors assisted 31% of total deliveries, and nurses and midwives/auxiliary nurse midwives assisted 27%. While the percentage of deliveries attended by traditional birth attendants decreased from 11% in 2011 to 5% in 2016, the home birth rate remained high at 41%. Many women in Nepal still deliver with no one present or with an untrained friend or relative.There were large socioeconomic disparities in this area as well. While 90% of women in the highest wealth quintile delivered in a health facility, the same was true for only 34% of women in the lowest quintile. 89% of the wealthiest women delivered with an SBA, but only 34% of the poorest women did so. Similarly, the percentage of births attended by SBAs was 85% among women who had secondary or higher education and 38% among women without a formal education. Rates of facility-based delivery and the use of SBAs also varied among different provinces.Postnatal careThe percentage of women who received a postnatal care (PNC) assessment within two days following delivery rose from 45% in 2011 to 57% in 2016. 81% of women who delivered in a health facility and 13% of women who delivered elsewhere received PNC within two days of delivery. However, there were significant socioeconomic disparities in PNC utilization: 81% of women in the highest wealth quintile had an early PNC visit compared to only 37% among women in the lowest wealth quintile.The way forwardOverall, Nepal has made substantial progress in improving maternal health care access and utilization. However, disparities remain according to women’s socioeconomic status, education level and place of residence. Additionally, efforts are needed to improve the quality of maternal health care to end preventable maternal deaths.Nepal has committed to doing its part to achieve Sustainable Development Goal (SDG) target 3.1 of reducing the global MMR to less than 70 maternal deaths per 100,000 live births by 2030. To achieve this ambitious target, Nepal will need to reduce its MMR by at least 7.5% annually addressing severe inequities in maternal health access, utilization and quality.—Learn more about maternal mortality under the SDGs.Explore data on maternal and newborn health care coverage in countries across the globe on the Countdown to 2030 website.Are you interested in writing for the Maternal Health Task Force blog? Check out our guest post guidelines.Share this: ShareEmailPrint To learn more, read:last_img read more

Report Emphasizes Racial Data in Police Shootings

first_imgShare9TweetShare6Email15 SharesHands Up Don’t Shoot Buttons / Paul SablemanFebruary 11, 2017; NBC News and the International Business TimesOver the past eight years, the Department of Justice (with some notable bipartisan support) has helped move issues ranging from police and court reforms to improved incarceration practices to center stage. However, as Jeff Sessions takes over as U.S. Attorney General, the job of criminal justice reform has become ever more clearly seated at the state level. The job of local advocates is to build or maintain momentum in state legislatures and municipalities.Some significant accomplishments and experiments have indeed taken place at the state level. However, when centrally important data emerges, we long for a central presence, a role that may need for now to be picked up by philanthropy and nonprofits—some representing communities, and others made up of law enforcement personnel.“Fatal Shootings By U.S. Police Officers in 2015: A Bird’s Eye View,” using a database developed by the Washington Post to examine shootings of unarmed victims, found that “black men accounted for about 40 percent of the unarmed people fatally shot by police and, when adjusted by population, were seven times as likely as unarmed white men to die from police gunfire.”Justin Nix, an assistant professor of criminal justice at the University of Louisville and one of the leaders of the study, told the International Business Times that this disparity remained even after refining the raw data to account for other factors that might affect the outcomes: “Black suspects were more than twice as likely as white suspects to have been unarmed. And that’s after we controlled for things like mental illness, threat level, age, etc.”From Nix’s perspective, “A shooting of an unarmed person could be considered a threat perception failure on the part of the police. Police shoot unarmed people when they fail to accurately assess a threat, which could be due to implicit racial bias, or bias that arises from subtle unconscious assumptions, as opposed to overt racism. “If you can accept that assumption, then we showed that the citizen’s race is predictive of those threat perception failures, which we think is evidence of bias, and presumably implicit bias, although it’s impossible to tell.”The study’s analysis goes beyond the individual tragedies that too often dominate our newsfeeds. Its findings are in unfortunate harmony with the recent U.S. Department of Justice reviews of policing in Baltimore and Chicago, which illustrated patterns of racial bias.The report noted that officers may unconsciously develop biases over time. “In other words, the police—who are trained in the first place to be suspicious—become conditioned to view minorities with added suspicion,” according to the report. The authors said the findings have policy and practical implications, and researchers suggested that police departments should better train officers on how to reduce bias. The researchers also suggested that departments invest in body cameras to increase transparency.But, who will take such information and enforce a solution under a federal administration that appears to have a very different take on race and criminal justice? Again, many of these battles will need to be waged at the state level and with nonprofit leadership. C.J. Ciaramella writes for Reason that some large foundations and nonprofits haven’t lost a beat: “The American Civil Liberties Union is beefing up its Campaign for Smart Justice with the goal of reducing incarceration by 50 percent by 2020. In the coming months, the ACLU will roll out a roadmap for reducing incarceration by half in each of the 50 states.”Some readers may recall that the ACLU received $50 million from the Open Society Foundations to work on criminal justice reform in 2014, and that campaign has only grown.“States were ground zero for the battle against mass incarceration before the election and ground zero after the election of Donald Trump,” Udi Ofer, the director of the ACLU campaign, told reporters in press briefing last month. “This a battle that must be waged and won at the state level.”— Martin LevineShare9TweetShare6Email15 Shareslast_img read more