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Search Results: 1 - 10 of 6244 matches for " Jennifer Requejo "
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Measuring Coverage in MNCH: Challenges and Opportunities in the Selection of Coverage Indicators for Global Monitoring
Jennifer Harris Requejo ,Holly Newby,Jennifer Bryce
PLOS Medicine , 2013, DOI: 10.1371/journal.pmed.1001416
Abstract: Global monitoring of intervention coverage is a cornerstone of international efforts to improve reproductive, maternal, newborn, and child health. In this review, we examine the process and implications of selecting a core set of coverage indicators for global monitoring, using as examples the processes used by the Countdown to 2015 for Maternal, Newborn and Child Survival and the Commission on Accountability for Women's and Children's Health. We describe how the generation of data for global monitoring involves five iterative steps: development of standard indicator definitions and measurement approaches to ensure comparability across countries; collection of high-quality data at the country level; compilation of country data at the global level; organization of global databases; and rounds of data quality checking. Regular and rigorous technical review processes that involve high-level decision makers and experts familiar with indicator measurement are needed to maximize uptake and to ensure that indicators used for global monitoring are selected on the basis of available evidence of intervention effectiveness, feasibility of measurement, and data availability as well as programmatic relevance. Experience from recent initiatives illustrates the challenges of striking this balance as well as strategies for reducing the tensions inherent in the indicator selection process. We conclude that more attention and continued investment need to be directed to global monitoring, to support both the process of global database development and the selection of sets of coverage indicators to promote accountability. The stakes are high, because these indicators can drive policy and program development at the country and global level, and ultimately impact the health of women and children and the communities where they live.
Measuring Coverage in MNCH: Evaluation of Community-Based Treatment of Childhood Illnesses through Household Surveys
Elizabeth Hazel ,Jennifer Requejo,Julia David,Jennifer Bryce
PLOS Medicine , 2013, DOI: 10.1371/journal.pmed.1001384
Abstract: Community case management (CCM) is a strategy for training and supporting workers at the community level to provide treatment for the three major childhood diseases—diarrhea, fever (indicative of malaria), and pneumonia—as a complement to facility-based care. Many low- and middle-income countries are now implementing CCM and need to evaluate whether adoption of the strategy is associated with increases in treatment coverage. In this review, we assess the extent to which large-scale, national household surveys can serve as sources of baseline data for evaluating trends in community-based treatment coverage for childhood illnesses. Our examination of the questionnaires used in Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 2005 and 2010 in five sub-Saharan African countries shows that questions on care seeking that included a locally adapted option for a community-based provider were present in all the DHS surveys and in some MICS surveys. Most of the surveys also assessed whether appropriate treatments were available, but only one survey collected information on the place of treatment for all three illnesses. This absence of baseline data on treatment source in household surveys will limit efforts to evaluate the effects of the introduction of CCM strategies in the study countries. We recommend alternative analysis plans for assessing CCM programs using household survey data that depend on baseline data availability and on the timing of CCM policy implementation.
High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention
Moke Magoma, Jennifer Requejo, Oona MR Campbell, Simon Cousens, Veronique Filippi
BMC Pregnancy and Childbirth , 2010, DOI: 10.1186/1471-2393-10-13
Abstract: Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed.The Maasai and Watemi women's preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all women during routine antenatal visits. Husbands typically serve as gatekeepers of women's reproductive health in the two groups - including decisions about where they will deliver- yet they are rarely encouraged to attend antenatal sessions. While husbands are encouraged to participate in programs to prevent maternal-to-child transmission of HIV, messages about the importance of skilled delivery care for all women are not given emphasis.Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care Package in Ngorongoro depends upon improved training and monitoring of health care providers, and greater family participation in antenatal care visits.Three core health sector strategies are identified within the maternal health community as critical for reducing maternal and early neonatal deaths. These include comprehensive reproductive health care; skilled care for all pregnant women, especially during delivery; and emergency obstetric care for all women and infants with life-threatening complications [1]. Political commitment to maternal and newborn health has historically been low, however, and most women in developing countries do not receive these recommended aspects of care. Maternal mortality remains high in the developing world and contrasts sharply with the low levels of maternal mortality in developed countries. Comparison of the lifetime
How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania
Moke Magoma, Jennifer Requejo, Mario Merialdi, Oona MR Campbell, Simon Cousens, Veronique Filippi
BMC Pregnancy and Childbirth , 2011, DOI: 10.1186/1471-2393-11-64
Abstract: The study was conducted in 16 health units (eight units in each arm of the trial). We observed, timed, and audio-recorded ANC consultations to assess the total time providers spent with each woman and the time spent for the delivery of each component of care. T-test statistics were used to compare the total time and time spent for the various components of ANC in the two arms of the trial. We also identified the topics discussed during the counselling and health education sessions, and examined the quality of the provider-woman interaction.The mean total duration for initial ANC consultations was 40.1 minutes (range 33-47) in the intervention arm versus 19.9 (range 12-32) in the control arm p < 0.0001. Except for drug administration, which was the same in both arms of the trial, the time spent on each component of care was also greater in the intervention health units. Similar trends were observed for subsequent ANC consultations. Birth plans were always discussed in the intervention health units. Counselling on HIV/AIDS was also prioritized, especially in the control health units. Most other recommended topics (e.g. danger signs during pregnancy) were rarely discussed.Although the implementation of birth plans in the intervention health units improved provider-women dialogue on skilled delivery attendance, most recommended topics critical to improving maternal and newborn survival were rarely covered.Antenatal care (ANC) visits provide an opportunity to reach pregnant women with important preventive and treatment interventions as well as counselling on a variety of topics such as birth and complication readiness and the importance of skilled delivery and immediate postnatal care [1]. An additional benefit of regular ANC visits includes the development of a strong provider-woman relationship that can result in improved obstetric outcomes[2].The amount of time spent on health education, advice and counselling during ANC consultations is key to the effectiveness of AN
Measuring Coverage in MNCH: New Findings, New Strategies, and Recommendations for Action
Jennifer Bryce ,Fred Arnold,Ann Blanc,Attila Hancioglu,Holly Newby,Jennifer Requejo,Tessa Wardlaw,the CHERG Working Group on Improving Coverage Measurement
PLOS Medicine , 2013, DOI: 10.1371/journal.pmed.1001423
Abstract: Considerable progress has been made in reducing maternal, newborn, and child mortality worldwide, but many more deaths could be prevented if effective interventions were available to all who could benefit from them. Timely, high-quality measurements of intervention coverage—the proportion of a population in need of a health intervention that actually receives it—are essential to support sound decisions about progress and investments in women's and children's health. The PLOS Medicine “Measuring Coverage in MNCH” Collection of research studies and reviews presents systematic assessments of the validity of health intervention coverage measurement based on household surveys, the primary method for estimating population-level intervention coverage in low- and middle-income countries. In this overview of the Collection, we discuss how and why some of the indicators now being used to track intervention coverage may not provide fully reliable coverage measurements, and how a better understanding of the systematic and random error inherent in these coverage indicators can help in their interpretation and use. We draw together strategies proposed across the Collection for improving coverage measurement, and recommend continued support for high-quality household surveys at national and sub-national levels, supplemented by surveys with lighter tools that can be implemented every 1–2 years and by complementary health-facility-based assessments of service quality. Finally, we stress the importance of learning more about coverage measurement to strengthen the foundation for assessing and improving the progress of maternal, newborn, and child health programs. Please see later in the article for the Editors' Summary
Pluralismo cultural e cidadania democrática
Requejo, Ferran;
Lua Nova: Revista de Cultura e Política , 1999, DOI: 10.1590/S0102-64451999000200006
Abstract: on the basis of an examination of the question of "multiculturalism" from the perspective of pluralism in democratic societies the tension intrinsic to the combination of these terms is discussed in its normative dimension. finally, the institutional dimension of the problem is addressed.
El fuste de la democracia liberal sigue siendo demasiado recto - The Timber of Liberal Democracy is Still Too Straight
Ferran Requejo
Foro Interno : Anuario de Teoría Política , 2010,
Abstract: This article analyzes the difficulties that liberal democracies face in accommodating a diversity of values, interests and identities in contexts of national pluralism (plurinational states). The first section analyzes the fallacy of abstraction and the distortions of the concept of pluralism that occur in enlightenment-based theories. The second section begins with a brief description of three classic institutional solutions for accommodating plurinational societies in liberal democracies: federalism, consociationalism and secession. A comparative analysis of nineteen decentralized federal or regional democracies is then discussed in order to evaluate the adequacy of federalism in regulating political recognition and accommodation in contexts of national pluralism. My conclusion suggests that these two objectives can only be achieved by means of plurinational federalism or partnership, which may also include consociational processes that regulate the possible secession of minority nations.
Ferran Requejo
Revista d'Estudis Autonòmics i Federals , 2007,
Abstract: This article examines the topic of multi-national democracies and their possiblepolitical adaptation via federal models. The analysis has two main centresof focus. First, it discusses some of the elements of the theoretical dialogueon legislation in liberal democracies on such topics as national and culturalpluralism. Secondly, it carries out a comparative analysis of the federationsand of some regional states in the context of their uni-national and multi-nationalcharacter, their degree of federalism, their degree of decentralisationand the regulation of legal asymmetries or lack thereof. The article concludesby pointing out the possibilities and limits of federal models in multinationalbackdrops, advocating instead the model characterised as “multi-nationalfederalism” based on three normative conditions: explicit political andconstitutional recognition of national pluralism of the federation, a high degreeof self-governance in five areas of application on behalf of national minorities,and the establishment of mechanisms for participation and conditions.All of these call for the institutional regulation of both the positiveand negative collective freedoms that allow legitimate and stable politicaland constitutional accommodation in the multi-national democracies.
Algunos comentarios sobre el VIII congreso de la WFITN (World Federation of Interventional and Therapeutic Neuroradiology)
Flavio Requejo
Revista Argentina de Neurocirugía , 2006,
The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity
Beck,Stacy; Wojdyla,Daniel; Say,Lale; Betran,Ana Pilar; Merialdi,Mario; Requejo,Jennifer Harris; Rubens,Craig; Menon,Ramkumar; Look,Paul FA Van;
Bulletin of the World Health Organization , 2010, DOI: 10.1590/S0042-96862010000100012
Abstract: objective: to analyse preterm birth rates worldwide to assess the incidence of this public health problem, map the regional distribution of preterm births and gain insight into existing assessment strategies. methods: data on preterm birth rates worldwide were extracted during a previous systematic review of published and unpublished data on maternal mortality and morbidity reported between 1997 and 2002. those data were supplemented through a complementary search covering the period 2003-2007. region-specific multiple regression models were used to estimate the preterm birth rates for countries with no data. findings: we estimated that in 2005, 12.9 million births, or 9.6% of all births worldwide, were preterm. approximately 11 million (85%) of these preterm births were concentrated in africa and asia, while about 0.5 million occurred in each of europe and north america (excluding mexico) and 0.9 million in latin america and the caribbean. the highest rates of preterm birth were in africa and north america (11.9% and 10.6% of all births, respectively), and the lowest were in europe (6.2%). conclusion: preterm birth is an important perinatal health problem across the globe. developing countries, especially those in africa and southern asia, incur the highest burden in terms of absolute numbers, although a high rate is also observed in north america. a better understanding of the causes of preterm birth and improved estimates of the incidence of preterm birth at the country level are needed to improve access to effective obstetric and neonatal care.
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