Induction of labour practices at Botshabelo District Hospital: Assessing the institutional guidelines

Induction of labour (IOL) is defined as an artificial stimulation administered to initiate the delivery process before the onset of spontaneous labour. Setting-adapted guidelines need to be developed to promote safe maternal and neonatal care in line with the needs of a specific institution. This study aimed to describe and assess the current IOL practices at Botshabelo District Hospital, focusing on incidence, indications, induction methods, complications, and outcomes. A retrospective-descriptive study included all relevant data from IOL cases over six months between July and December 2017. From 168 attempted inductions of labour, 153 files were retrieved. The majority of cases (69.7%) were for post-dates. Normal vaginal delivery (NVD) was achieved in most patients (69.3%), while one patient had an assisted delivery. Thus, 30.1% of inductions failed and required caesarean sections. The incidence, indications, methods of induction, complications, and outcomes of IOL in BDH are in line with international guidelines; however, including the sweeping of membranes at term and balloon catheters as methods could improve the current guidelines.

Objective understanding of five front-of-pack labels among consumers in Nelson Mandela Bay, South Africa

Objective: This study aimed to assess the objective understanding of five front-of-pack label formats, namely the Reference Intake, Multiple Traffic Light label, Nutri-Score, health endorsement logo and warning label, among consumers in Nelson Mandela Bay, South Africa. Design: This was a cross-sectional, exploratory study. Setting: Interviewer-administered surveys were conducted at 12 randomly selected food retail outlets in an urban setting.Subjects: A total of 359 adult participants were included in this study. Outcome measures: Objective understanding was measured by asking participants to rank food products according to their nutritional quality, using the displayed front-of-pack label. Results: The type of front-of-pack label significantly influenced ranking ability (p < 0.00001). All the evaluative front-of-pack labels significantly improved the participants' ability to identify healthier food products compared with the no-label control. The reductive Reference Intake, however, showed no significant impact on consumer understanding. Conclusion: Evaluative front-of-pack labels significantly improved the participants' ability to identify healthier food products, when compared with the Reference Intake and no-label control. Future research should test the objective understanding of culturally diverse groups in South Africa, particularly among rural populations.

Progress on the Health-related MDGs in the African Region

Progress towards the achievement of the health-related MDGs in the African Region is slow. Currently six African countries are on track to achieve the MDG target of reducing child mortality. There is no progress on the MDG target on reducing maternal mortality. Eleven countries have started to observe declines or stabilization in HIV prevalence trends among the 13 countries that have complete trend data. A third of the population with advanced HIV infection had access to antiretroviral drugs in 2007. There were increases in the proportions of children under fi ve sleeping under insecticide treated bednets between 1999 and 2006 in all 18 countries with trend data; although coverage rates were lower than 50. Few countries have shown suffi cient progress on targets related to reducing hunger; use of improved water and sanitation facilities. Countries and their partners should increase resources significantly to strengthen health systems; maternal and child health services; combat HIV/AIDS; malaria; and TB; tackle the broader determinants of health. Measures to monitor country progress towards the MDGs should also be improved by a major effort at strengthening data sources and capacity for data management

Progress in Implementing the Child Survival Strategy in the African Region

Under-five mortality rate in the African Region was estimated at 145/1;000 live births in 2007. These deaths were the result mainly of preventable or treatable conditions. A child survival strategy for the African Region was developed by WHO; UNICEF and World Bank and adopted by the fifty-sixth WHO Regional Committee in 2006 to address this high mortality rate.1 This report; which is a review made using reports and the results of a questionnaire sent to countries; summarizes progress in implementing the strategy as at December 2009 and proposes next steps for action. Significant achievement has been made in the areas of policy; strategy and plandevelopment; capacity building; partnerships and communication strategies; operations research; documentation and monitoring and evaluation. Also in scalingup of child survival interventions such as measles vaccination coverage; insecticidetreated nets use in children and provision of antiretroviral drugs to prevent motherto-child transmission of HIV. Currently; 21 countries are implementing the Integrated Management of Childhood Illness strategy in more than 75of the districts. Despite the achievements in some areas; coverage of some eff ective interventions remains low. Various health system challenges hamper the progress of child survival. These include inadequate country-level funding for scaling-up effective interventions; inadequate monitoring of coverage of interventions and human resource limitations. In order to increase coverage of eff ective child survival interventions and accelerate progress in implementation of the regional child survival strategy; the paper recommends several actions including the improvement of coverage of key child survival interventions and mobilization and allocation of resources to implement national child survival scale-up strategies and plans

The Effort to Attain Measles Pre-elimination Targets by 2012 and to Eliminate Measles in the African Region by 2020

Reduction in measles mortality contributes significantly towards attaining the Millennium Development Goal 4 (MDG 4); which aims to reduce overall under-five childhood deaths by two thirds by 2015; compared with 1990 levels. Routine measles immunization coverage is a key indicator for measuring progress towards attainment of this goal. Implementation of measles mortality reduction strategies in the African Region has led to major achievements; notably a reduction of estimated measles deaths by 92between 2000 and 2008. Despite the progress made; renewed commitment by countries is required to attain the pre-elimination targets and subsequently reach the ultimate goal of measles elimination by 2020. Countries will need to strengthen their immunization systems through ensuring that quality immunization services reach the hard-to-reach populations in addition to scaling up implementation of proven approaches and strategies such as the Reaching-Every-District approach. Gaps in the mobilization of resources have had a negative impact on the ability of countries to attain and sustain a high level of routine immunization and supplemental immunization activities coverage. Countries will also need to adopt a stepwise approach towards achieving the measles elimination goal by 2020; beginning with the attainment by 2012 of the proposed pre-elimination targets

What can be Done to Improve Women's Health Region?

Women constitute a key link in the chain of development actions worldwide. For women to be able to fulfi ll their role in society; however; they need to be in a state of adequate physical; mental and social well-being. Unfortunately; the huge majority of African women are still unaware of their fundamental rights to health; education and life; and suffer from ill-health and sub-standard living condition. Global leaders; including African ministers of health; have adopted a number of resolutions to improve women's health. However; the health situation of women in Africa continues to be poor; with 57of women in the African Region lacking access to assistance by qualified staff during childbirth; one out of twenty-six women being at risk of dying from birth-related complications; to mention a couple of significant indicators. Given that the issues of women's health are complex; this paper calls for multisectoral and concerted action involving the public and private sectors; nongovernmental organizations; communities and families. For this; it proposes that countries set up a multidisciplinary technical team composed of experts in health; gender and human rights to identify priority interventions for eff ective scaling up and resource mobilization for women's health at national level. Among the ways forward proposed in the paper are scaling up women's health-related interventions; using the primary health care approach in line with the Ouagadougou Declaration to effectively deliver women's health interventions; strengthening the capacity of women; families and communities to prevent diseases; and empowering them economically to enable them to take appropriate decisions related to their health and sexuality