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Monitoring childbirth in a new era for maternal health
WHO and HRP launch the Labour Care Guide to improve every woman’s experience of childbirth, and to help ensure the health and well-being of women and their babies.
The philosophy of labour and delivery care, and the recommended World Health Organization (WHO) approach, have developed significantly in the last decades.
The recognition that every birth is unique is now a cornerstone of the 2018 WHO recommendations on intrapartum care for a positive childbirth experience.
Over one third of maternal deaths, half of stillbirths and a quarter of neonatal deaths result from complications during labour and childbirth. The majority of these deaths occur in low-resource settings and are preventable through timely interventions. Knowing when to wait - and when to take life-saving action - is critical.
What is the new Labour Care Guide?The WHO Labour Care Guide is a new tool, which puts the WHO recommendations on intrapartum care into practice. It helps skilled health personnel to provide woman-centred, safe and effective care and to optimize the outcome and experience of childbirth for every woman and baby.
Launched alongside the WHO Labour Care Guide User’s Manual, the tool promotes a person-centred approach to monitoring a woman’s and her baby’s health and well-being from active first stage of labour to end of second stage of labour.
This creates a positive feedback and decision-making loop, as health personnel are encouraged to regularly:
- assess the well-being of the woman and her baby
- record their observations
- check for signs that breach thresholds for health and well-being as labour progresses
- plan what care may be required, in consultation with the woman.
The Guide and Manual recognize that every birth is unique - from a woman’s personal experience of care, to the speed at which her labour progresses.
“The new WHO Labour Care Guide strengthens the relationship between women and their healthcare providers during labour and childbirth, improving both individual experience and clinical outcome. It is a practical tool for a new era of maternal health, where women’s values and preferences are at the centre of their own care,” says Mercedes Bonet, Medical Officer in the WHO Department of Sexual and Reproductive Health and Research, including HRP, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.
Beyond the partographThe Labour Care Guide revises and replaces the traditional WHO partograph, a labour monitoring tool which is now inconsistent with the latest evidence about labour duration, triggers for clinical interventions and the importance of respectful maternity care.
Many women do not experience a labour that fits the expected rate of the original WHO partograph. For instance, there is no evidence supporting the use of a cervical dilatation rate of 1 cm/hour as a screening tool to trigger medical interventions or referral.
Instead, the Labour Care Guide includes updated, evidence-based reference ranges of labour progress. By recording and reviewing their observations against these references, health personnel are encouraged to think critically, avoid unnecessary interventions and act on warning signs.
They can also include each woman in decision-making about her own labour, part of the Labour Care Guide’s emphasis on the importance of a woman and her baby’s experiences of childbirth.
A revolution in maternal health quality of careThe Labour Care Guide has been evaluated in six countries, using a mixed-methods study recently published in BIRTH. It was found to be feasible and acceptable for use across different clinical settings, promoting woman‐centered care and improving outcomes.
“Using the Labour Care Guide, we show more care to our patients than before, we provided them what they needed. So we had less complications and less interventions [due to] early detection and decision making,” explained a midwife, who evaluated the tool in Nigeria.
Achieving the best possible physical, emotional, and psychological outcomes for every woman and child requires health systems to support a model of person-centred care which both empowers the user and enables health personnel.
In this way, the Labour Care Guide is much more than a technical tool for monitoring labour progress. It represents revolutionary steps towards evidence-based, individualized labour care.
World’s largest youth organizations, representing 250 million members, and WHO launch global mobilization to respond to disruptive impacts of COVID-19 on young people
Funding for community programmes, engaging youth in solutions to address COVID-19, and convening Global Youth Summit are key features of this new mobilization
A new ground-breaking global youth mobilization was launched today to invest in and scale up youth-led solutions and engagements in response to COVID-19. The initiative was launched by an alliance of the world’s largest youth movements and organizations, together with the World Health Organization (WHO) and the United Nations Foundation.
The “Global Youth Mobilization for Generation Disrupted” is being led by the Big 6 Youth Organizations (Young Men’s Christian Association, YMCA; World Young Women’s Christian Association, YWCA; World Organization of the Scout Movement; World Association of Girl Guides and Girl Scouts; International Federation of Red Cross and Red Crescent Societies, IFRC; and The Duke of Edinburgh’s International Award), which together actively involve more than 250 million young people, and aims to support young people to engage in and design efforts to turn around the impact of the pandemic.
The Global Youth Mobilization will feature the convening of a Global Youth Summit in April 2021, and a fund of US $5 million to support local and national youth organizations, including grants for youth-led solutions and an accelerator programme to scale up existing response efforts.
The leadership of the WHO, Big 6 and youth organizations around the world are calling on governments, businesses and policy makers to back the Global Youth Mobilization effort and commit to investing in the future of young people. These measures will directly support young people engaged at the grassroots level to tackle some of the most pressing health and societal challenges resulting from the pandemic.
“WHO is honoured to join this truly exciting and powerful global movement to mobilize and empower youth worldwide to be the driving force of the recovery to COVID-19,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Joining forces with the Big 6 and the United Nations Foundation provides WHO and the world a unique opportunity to learn from hundreds of millions of young people and be guided by their sustainable solutions to help communities build back better from the pandemic.”
While the direct health impacts of the pandemic on young people have been generally less severe, they are disproportionately affected by the long-lasting consequences of the pandemic. Such effects include disruptions to education, economic uncertainty, loss or lack of employment opportunities, impacts on physical and mental health, and trauma from domestic violence. For example, mental anxiety brought on by COVID-19 has been identified in nearly 90 per cent of young people; more than 1 billion students in almost every country have been impacted by school closures; and 1 in 6 young people worldwide have lost their jobs during the pandemic.
At the same time, young people are also driving change and implementing solutions in response to COVID-19 by taking action through community-based interventions and voluntary service, such as acting as first responders and delivering food and supplies to those in need. The Global Youth Mobilization will draw attention to the urgent need for solutions to support young people, and to highlight the critical leadership role young people are playing in their communities to counter the effects of the pandemic.
“We are proud to team up with the WHO to provide opportunities and funding to help millions of young people across the globe to respond to local challenges related to COVID-19 in their communities,” said the leadership of the Big 6 in a joint statement. “The mobilization will provide direct financial and programmatic support to youth organizations at the national and international level. We believe that young people have the solutions to solve their own problems, and by providing a global youth platform, combined with national activation for youth projects, we can unleash the skills, enthusiasm and desire for young people to be a force for good in their communities.”
Supported by the COVID-19 Solidarity Response Fund for WHO and powered by the United Nations Foundation, the Global Youth Mobilization features a strategic partnership with the WHO and its newly launched Youth Council. It will involve other United Nations agencies, as well as a number of high-profile global partners, brands, and advocates, from FIFA to YOUNGA by BridgingTheGap Ventures, and the creation of a youth council of social media influencers, including the Influential platform. The initiative, developed in consultation with young people from across the globe, will be youth-led, community-driven, evidence-based, and inclusive of diverse communities rooted in meaningful youth participation and engagement.
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About the Big 6 Youth Organizations
Formed in 1996, the Big 6 Youth Organizations are an alliance of leading international youth-serving organizations. The ‘Big 6’ comprises the five largest youth movements in the world: Young Men’s Christian Association (YMCA), World Young Women’s Christian Association (YWCA), World Organization of the Scout Movement (WOSM), World Association of Girl Guides and Girl Scouts (WAGGGS), International Federation of Red Cross and Red Crescent Societies (IFRC) and a leading programme for youth development, The Duke of Edinburgh’s International Award (The Award). Together, the Big 6 actively involve in excess of 250 million young people, contributing to the empowerment of more than 1 billion young people during the last century. For more information visit www.bigsix.org
In response to the unique challenges facing young people today, and to coincide with the launch of the Global Youth Mobilization, the Big 6 have also published a new policy paper: ‘Young People Championing Post-Pandemic Futures’. The paper is a joint call to action on behalf of 250 million children and young people that make up the Big 6 Youth Organizations and includes recommendations concerning education, employment, mental health and digital inclusion. Read the full report and calls to action at bigsix.org.
About the World Health Organization
The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 149 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube, and Twitch.
About the United Nations Foundation
The United Nations Foundation brings together ideas, people, and resources to help the United Nations drive global progress and tackle urgent problems. Our hallmark is to collaborate for lasting change and innovate to address humanity’s greatest challenges. Learn more at www.unfoundation.org
About the COVID-19 Solidarity Response Fund
To support the World Health Organization (WHO) and partners in their global response to COVID-19, the United Nations Foundation helped launch the COVID-19 Solidarity Response Fund, which has raised more than $238 million for lifesaving work around the world to prevent, detect, and respond to COVID-19. Learn more about the COVID-19 Solidarity Response Fund for WHO, powered by the United Nations Foundation at www.covid19responsefund.org.
New WHO tool to help countries advance towards universal health coverage
One of WHO’s 3 strategic goals is to ensure that an additional 1 billion people in the world are protected by universal health coverage (UHC) by 2023 – able to access the services they need to keep healthy, without falling into poverty as a result.
A key step in making this a reality is for countries to be able to work out what services their people need and how to provide them.
WHO’s new UHC Compendium, the product of a wide-ranging multi-year collaboration across WHO programmes and partners, is designed to help them do just this.
Basically a toolbox for countries to build packages of essential services, the Compendium offers national health authorities and decision-makers a database of over 3500 health actions across all health areas from which they can choose when planning and budgeting their health programmes.
The Compendium brings together evidence, guidance, resource inputs and cost analysis into one go-to platform. In addition, it gives tips and options for choosing among the most cost-effective actions to develop a comprehensive package suited to national context.
The database provides a global reference point for how to organize and present information on health interventions for UHC across the full life course and for all diseases, and includes a diverse set of actions spanning prevention, rehabilitation, and treatment, as well as inter-sectoral interventions.
Version 1.0 of the Compendium focuses on clinical health services that can be grouped dynamically into categories such as health programmes, life-course stage, and sustainable development goals.
For example, the Expanded Program for Immunization (EPI) can filter health actions related to immunization to see the relevant health actions in a table.
So country users can refer to the UHC Compendium as a one-stop shop to inform decisions around which services to consider for provision within their system. In forthcoming versions, users will be able to view resource needs, costs and other information to guide their prioritization process.
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*A public webinar will be held on Monday, 14 December, at 13:00, to explain and illustrate how and why all countries can benefit from this new, vital tool to achieve universal health coverage.
To register in advance for this webinar:
https://who.zoom.us/webinar/register/WN__XV99Hl8SgWu_MQQrJFGMA