scholarly journals Professionally responsible advocacy for women and children first during the COVID-19 pandemic: guidance from World Association of Perinatal Medicine and International Academy of Perinatal Medicine

2020 ◽  
Vol 48 (9) ◽  
pp. 867-873
Author(s):  
Frank A. Chervenak ◽  
Laurence B. McCullough ◽  
Amos Grünebaum ◽  
Eran Bornstein ◽  
Cihat Sen ◽  
...  
Keyword(s):  
New York ◽  
Low Income ◽  
Ethical Framework ◽  
Low Income Countries ◽  
Ethical Challenges ◽  
Perinatal Medicine ◽  
World Association ◽  
Women And Children ◽  
Children First ◽  
International Academy

AbstractThe goal of perinatal medicine is to provide professionally responsible clinical management of the conditions and diagnoses of pregnant, fetal, and neonatal patients. The New York Declaration of the International Academy of Perinatal Medicine, “Women and children First – or Last?” was directed toward the ethical challenges of perinatal medicine in middle-income and low-income countries. The global COVID-19 pandemic presents common ethical challenges in all countries, independent of their national wealth. In this paper the World Association of Perinatal Medicine provides ethics-based guidance for professionally responsible advocacy for women and children first during the COVID-19 pandemic. We first present an ethical framework that explains ethical reasoning, clinically relevant ethical principles and professional virtues, and decision making with pregnant patients and parents. We then apply this ethical framework to evidence-based treatment and its improvement, planned home birth, ring-fencing obstetric services, attendance of spouse or partner at birth, and the responsible management of organizational resources. Perinatal physicians should focus on the mission of perinatal medicine to put women and children first and frame-shifting when necessary to put the lives and health of the population of patients served by a hospital first.

scholarly journals Multivalue ethical framework for fair global allocation of a COVID-19 vaccine

2020 ◽  
Vol 46 (8) ◽  
pp. 499-501 ◽  
Author(s):  
Yangzi Liu ◽  
Sanjana Salwi ◽  
Brian C Drolet
Keyword(s):  
Low Income ◽  
Vaccine Development ◽  
Ethical Framework ◽  
Low Income Countries ◽  
Ethical Considerations ◽  
Allocation Model ◽  
Public And Private ◽  
Successful Vaccine ◽  
Global Access ◽  
Pandemic Vaccine

The urgent drive for vaccine development in the midst of the current COVID-19 pandemic has prompted public and private organisations to invest heavily in research and development of a COVID-19 vaccine. Organisations globally have affirmed the commitment of fair global access, but the means by which a successful vaccine can be mass produced and equitably distributed remains notably unanswered. Barriers for low-income countries include the inability to afford vaccines as well as inadequate resources to vaccinate, barriers that are exacerbated during a pandemic. Fair distribution of a pandemic vaccine is unlikely without a solid ethical framework for allocation. This piece analyses four allocation paradigms: ability to develop or purchase; reciprocity; ability to implement; and distributive justice, and synthesises their ethical considerations to develop an allocation model to fit the COVID-19 pandemic.

scholarly journals Joining psychiatric care and faith healing in a prayer camp in Ghana: randomised trial

2018 ◽  
Vol 212 (1) ◽  
pp. 34-41 ◽  
Author(s):  
A. Ofori-Atta ◽  
J. Attafuah ◽  
H. Jack ◽  
F. Baning ◽  
R. Rosenheck ◽  
...  
Keyword(s):  
Low Income ◽  
Psychiatric Care ◽  
Rating Scale ◽  
Randomised Trial ◽  
Faith Healing ◽  
Low Income Countries ◽  
Ethical Challenges ◽  
Significant Difference ◽  
Short Run ◽  
Psychiatric Rating Scale

BackgroundCare of people with serious mental illness in prayer camps in low-income countries generates human rights concerns and ethical challenges for outcome researchers.AimsTo ethically evaluate joining traditional faith healing with psychiatric care including medications (Clinical trials.gov identifier NCT02593734).MethodResidents of a Ghana prayer camp were randomly assigned to receive either indicated medication for schizophrenia or mood disorders along with usual prayer camp activities (prayers, chain restraints and fasting) (n= 71); or the prayer camp activities alone (n= 68). Masked psychologists assessed Brief Psychiatric Rating Scale (BPRS) outcomes at 2, 4 and 6 weeks. Researchers discouraged use of chaining, but chaining decisions remained under the control of prayer camp staff.ResultsTotal BPRS symptoms were significantly lower in the experimental group (P= 0.003, effect size –0.48). There was no significant difference in days in chains.ConclusionsJoining psychiatric and prayer camp care brought symptom benefits but, in the short-run, did not significantly reduce days spent in chains.Declaration of interestNone.

Solid Waste Management Policies in Kenya: The Silence on the Plight of Women and Children

2020 ◽  
Vol 46 (1) ◽  
pp. 87-96
Author(s):  
Dickson A. Amugsi ◽  
Jane N. Mwangi ◽  
Tilahun Nigatu Haregu ◽  
Isabella Aboderin ◽  
Kanyiva Muindi ◽  
...  
Keyword(s):  
Waste Management ◽  
Solid Waste ◽  
Low Income ◽  
Solid Waste Management ◽  
Low Income Countries ◽  
Analytical Review ◽  
Vision 2030 ◽  
Preceding Discussion ◽  
Women And Children ◽  
Implementation Gaps

Building on available evidence that there are differences of exposure to solid waste among men, women and children, it follows that effective solid waste management (SWM) policies need to recognise such variations, as a prelude to rolling out programmes to address associated socio-economic and health risks. However, this logical scenario does not seem to be the case in many middle- and low-income countries. In this paper, we use analytical review methodology to examine integrated environmental management and sector specific policies in Nairobi and Mombasa, Kenya's two biggest cities, to highlight the extent to which existing policies cover the differential challenges of exposure to solid waste and associated health challenges for women and children. We found that apart from one municipal policy and the Kenya Vision 2030 documents respectively, which underscore the importance of including women and young people in waste management, 16 other policy documents reviewed are generally silent on women and children issues. Beyond the limited focus on women- and children-specific challenges, the general lag in policy implementation and enforcement of regulations will still hinder the emergence of an effective SWM system out of the best policy frameworks . The preceding discussion underscores both policy and implementation gaps, which need to be filled, if policies will potentially engender SWM practices that will be relevant and effective in protecting the health of the most vulnerable in urban Africa.

scholarly journals Pilot Study on the Impact of Biogas as a Fuel Source on Respiratory Health of Women on Rural Kenyan Smallholder Dairy Farms

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Carolyn Dohoo ◽  
Judith Read Guernsey ◽  
Kimberley Critchley ◽  
John VanLeeuwen
Keyword(s):  
Low Income ◽  
Respiratory Health ◽  
Low Income Countries ◽  
Respiratory Morbidity ◽  
Indoor Environments ◽  
Difficulty Breathing ◽  
Referent Group ◽  
Women And Children ◽  
The Impact

Biomass burning in indoor environments has been highlighted as a major cause of respiratory morbidity for women and children in low-income countries. Inexpensive technological innovations which reduce such exposures are needed. This study evaluated the impact of low tech compost digesters, which generate biogas for cooking, versus traditional fuel sources on the respiratory health of nonsmoking Kenyan farmwomen. Women from 31 farms with biogas digesters were compared to age-matched women from 31 biomass-reliant farms, in June 2010. Only 43% of the biogas group reported any breathing problems, compared to 71% in the referent group (P=0.03). Referent women self-reported higher rates of shortness of breath (52% versus 30%), difficulty breathing (42% versus 23%), and chest pain while breathing (35% versus 17%) during the last 6 months (P=0.09to 0.12) compared to biogas women. Biogas women demonstrated slightly better spirometry results but differences were not statistically significant, likely due to limited latency between biogas digester installation and spirometry testing. Most biogas women reported improved personal respiratory health (87%) and improved children’s health (72%) since biogas digester installation. These findings suggest that using biogas in cookhouses improves respiratory symptoms but long-term impacts on lung function are unclear.

scholarly journals Program Life for Africa

2011 ◽  
Vol 5 (4) ◽  
pp. 421-426
Author(s):  
José M Carrera ◽  
Vicenc Cararach ◽  
Manuel R Carrapato ◽  
Francesc Castella
Keyword(s):  
Infant Health ◽  
International School ◽  
African Union ◽  
Perinatal Medicine ◽  
World Association ◽  
Maternal And Infant Health ◽  
Reference Hospital ◽  
Exploratory Mission ◽  
International Academy ◽  
And Training

ABSTRACT Life for Africa is an international cooperation program that was developed by Matres Mundi International. It aims to improve the critical situation of maternal and infant health in Africa by improving the number and training of health professionals, particularly in the area of the maternal and infant health. The program, which is sponsored by the majority of the international societies of perinatal medicine (the International Academy of Perinatal Medicine, the World Association of Perinatal Medicine, etc.), consists of the creation of an International School of Perinatal Medicine for Africa and a Reference Hospital for Mothers and Children in Addis Abeba, capital of the African Union. This paper will discuss the reasons in favor of this project and will describe the details and the current situation. It will also provide information about the ‘exploratory mission’ that several members of Matres Mundi and the international societies made to Addis Abeba.

Women and children first–or last? The New York Declaration

2009 ◽  
Vol 201 (4) ◽  
pp. 335 ◽  
Author(s):  
Frank A. Chervenak ◽  
Laurence B. McCullough
Keyword(s):  
New York ◽  
Women And Children ◽  
Children First
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