China has achieved a substantial reduction in maternal mortality over the past three decades, from 88·8 deaths per 100 000 livebirths in 1990 to 21·7 deaths per 100 000 livebirths in 2014, down by 75·6%.1 The Article by Yanqiu Gao and colleagues2 in The Lancet Global Health is a valuable and welcome opportunity to present progress and discuss how maternal health can be improved in developing countries facing similar issues. The results of this study will help contribute to the implementation of the Sustainable Development Goals (SDGs) for health by 2030.
Author Archives: Lancet Global Health
Despite remarkable progress in maternal survival in China, substantial disparities remain, especially for the poor, less educated, and ethnic minority groups in remote areas in western China. Whether China’s highly medicalised model of maternity care will be an answer for these populations is uncertain. A strategy modelled after China’s immunisation programme, whereby care is provided close to the women’s homes, might need to be explored, with township hospitals taking a more prominent role.
Speakman EM, McKee M, Coker R. If not now, when? Time for the European Union to define a global health strategy. Lancet Glob Health 2017; 5: e392–93—The corresponding email address should have been Elizabeth.email@example.com and the following sentence has been removed from the acknowledgments: “Research for this commentary was conducted as part of the PANDEM project funded by the European Commission under the Horizon 2020 programme.” These changes have been made to the online version as of March 16, 2017.
In a setting with high baseline immunisation coverage levels, SMS reminders coupled with incentives significantly improved immunisation coverage and timeliness. Given that global immunisation coverage levels have stagnated around 85%, the use of incentives might be one option to reach the remaining 15%.
Despite progress during the 2003–15 malaria programme, ACT treatment for children with malaria remains unacceptably low. More work is needed at the country level to understand how health-care access, service delivery, and ACT supply might be improved to ensure appropriate treatment for all children with malaria.
Cerebral palsy, a syndrome of motor impairment resulting from a lesion in the developing brain, has a worldwide prevalence of 1·0–3·5 per 1000 livebirths.1,2 A life-course perspective needs to be adopted as more children live into their adolescence and adulthood. Individuals’ participation in life and availability of family-centred services are very important and differ between countries.3 In low-income countries, most treatments are provided by families and multidisciplinary assessment is done in rural clinics.
The use of teleradiology in war zones dates back to the wars of Afghanistan and Iraq.1 However, the practice of teleradiology during the Syrian crisis presents a new challenge to the international medical community given the repeated attacks on medical personnel and health-care facilities.2–5
The Millennium Development Goals on health have expanded access to basic health interventions to millions of people in low-income and middle-income countries (LMICs). However, access alone will not be sufficient to meet the Sustainable Development Goals (SDGs) if health systems cannot provide high quality care—ie, care that improves health outcomes and provides value to people. Emerging data show that many LMIC health systems struggle to consistently provide good quality of care.1,2 Yet change is possible.
Numerous guidelines frame the proper conduct and reporting of medical research. The Helsinki Declaration1 exists to safeguard the health, safety, autonomy, and privacy of research participants. Other guidelines define how research should be reported in scientific journals.2 However, these norms are not applied equally to other forms of scientific reporting, such as conference presentations. Particularly worrying is an increasing trend in the use of photographic images that we believe violate patients’ trust and privacy.
In the past year, migration to Europe from Africa and the Middle East has reached unprecedented levels. In 2016, 181 405 migrants reached the shores of Italy and more than 5000 died trying to reach the southern coasts of Europe.1–3 Many migrants seek to escape war, poverty, persecution, or ill treatment in their countries of origin. However, migrants are often victims of torture and sexual violence during their journey or time in Libyan prisons. Several studies and international organisations have highlighted that migrants from sub-Saharan Africa are at a high risk of sexual victimisation and that many women are forced to pay for their migration through prostitution or are subject to brutal sexual exploitation and torture along the journey.
The Comment by Louise Ivers (November, 2016)1 references a supposed debate in cholera control between investing in universal access to water and sanitation and a multidisciplinary approach focused on cholera vaccination with specific evidence-based water, sanitation, and hygiene (WASH) interventions.
These are dark times for the European Union (EU). The Brexit vote, coupled with the rise of Eurosceptic parties, was a reminder that many Europeans view the EU as an irritant, with little understanding of its positive role. The election of Donald Trump shows that this retreat into isolationism is not limited to Europe.
The USA has engaged in international health activities for more than a century. With a budget request proposal of US$10·3 billion in 2017 in specified funding for global health, the USA is the world’s largest source of global health financing and implementer of global health programmes.1,2 Under President George W Bush, the US government’s funding for global health increased markedly, spawning major US funding initiatives, such as the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI),3,4 as well as support for the multilateral Global Fund to Fight AIDS, Tuberculosis and Malaria, which receives its largest proportion of funding from the US government.
Routine childhood immunisation is one of the most successful and cost-effective public health interventions that have considerably reduced global child morbidity and mortality.1 However, annually, an estimated 18·7 million children under 1 year of age do not receive basic vaccination as part of an expanded programme of immunisation (EPI) worldwide, and millions of children die from vaccine-preventable diseases.2 Because of social issues and insufficient appreciation for immunisation, parents and caregivers forget or ignore the importance of immunisation or completing the entire series of vaccines.