ABSTRACT
This review summarizes the potential for polypill therapies for stroke prevention. While a number of studies applying different approaches regarding polypill have been performed, none of them has had a focus on stroke as the main outcome. A combination pill containing drugs such as statins, diuretics, and other antihypertensives is currently available in various formats. Estimates focusing mostly on primary prevention show that using such a combination drug a reduction in the 5-year stroke incidence by 50% can be achieved - especially in low- and middle-income countries with a high prevalence of risk factors even among people at young ages. A combination of a large supporting population-wide program with a registry-based quality control is the most likely perspective and can be achieved within a reasonable time frame and potentially have significant influence in young stroke populations.
Subject(s)
Cardiovascular Agents/therapeutic use , Drug Combinations , Polypharmacy , Population Groups , Stroke/drug therapy , Humans , Medication Adherence , Primary Prevention , Randomized Controlled Trials as Topic , Risk Factors , Stroke/epidemiologyABSTRACT
OBJECTIVES: To describe the situation of midwifery education, regulation and association in six South Asian countries: Afghanistan, Bangladesh, Bhutan, India, Nepal, and Pakistan. METHODS: Data were collected via three questionnaires, constructed by the International Confederation of Midwives (ICM) and United Nations Population Fund (UNFPA) Investing in Midwives Programme, used at a regional workshop in Bangladesh, 2010. Selected for the purpose of this study were 55 out of 134 questions of which two were open-ended. The answers from structured closed-ended questions were analyzed with descriptive statistics and the open ended answers with a qualitative content analysis. RESULTS: There was a variation in midwifery education across South Asia, in terms of entry level, competencies and requirements for teachers. None of the countries had national legislation that recognized midwifery as an autonomous profession. Four of the countries had a midwifery association. Two countries had a curriculum based on ICM's essential competences for basic midwifery practice. Main recommendations for improving formal midwifery education across the countries were development of legislation, strengthened formal midwifery education, strengthened professional value, and an improved learning environment. CONCLUSIONS: The findings might benefit the future midwifery profession in South Asia and is an important step in addressing the MDGs to reduce maternal and newborn morbidity and mortality in the region. With assistance, the area of South Asia will be able to create autonomous midwives that comply with ICM's global standards for midwifery education and regulation.