Transition to Skilled Birth Attendance: Is There a Future Role for Trained Traditional Birth Attendants?

A brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that emphasizes transition to skilled birth attendance are provided. Evidence of the effectiveness of TBA training, based on 60 studies and standard meta-analytic procedures, includes moderate-to-large improvements in behaviours of TBAs relating to selected intrapartum and postnatal care practices, small significant increases in women's use of antenatal care and emergency obstetric care, and small significant decreases in perinatal mortality and neonatal mortality due to birth asphyxia and pneumonia. Such findings are consistent with the historical focus of TBA training on extending the reach of primary healthcare and a few programmes that have included home-based management of complications of births and the newborns, such as birth asphyxia and pneumonia. Evidence suggests that, in settings characterized by high mortality and weak health systems, trained TBAs can contribute to the Millennium Development Goal 4—a two-thirds reduction in the rate of mortality of children aged less than 14 years by 2015—through participation in key evidence-based interventions

Child Support Payment and Child Visitation: Perspectives from Nonresident Fathers and Resident Mothers

The purpose of this qualitative study was to examine the child support and visitation perspectives of nonresidential fathers and custodial mothers. The focus of the study was to present definitions of child support from both noncustodial fathers and custodial mothers, the barriers they experience that prevent child support and visitation, and suggestions the parents have for improvements in the child support system. The data suggest that although nonresidential fathers and custodial mothers have similar definitions of what characteristicsd efine child support, they have vastly different views of what barriers prevent child support and visitation. Interparental hostility appeared to shape their perspectives about child support and visitation. Recommendations targeting the negative perceptions parents have of one another are presented

Transition to Skilled Birth Attendance: Is There a Future Role for Trained Traditional Birth Attendants?

A brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that empha\uadsizes transition to skilled birth attendance are provided. Evidence of the effectiveness of TBA training, based on 60 studies and standard meta-analytic procedures, includes moderate-to-large improvements in behaviours of TBAs relating to selected intrapartum and postnatal care practices, small significant increases in women\u2019s use of antenatal care and emergency obstetric care, and small significant decreas\uades in perinatal mortality and neonatal mortality due to birth asphyxia and pneumonia. Such findings are consistent with the historical focus of TBA training on extending the reach of primary healthcare and a few programmes that have included home-based management of complications of births and the new\uadborns, such as birth asphyxia and pneumonia. Evidence suggests that, in settings characterized by high mortality and weak health systems, trained TBAs can contribute to the Millennium Development Goal 4\u2014a two-thirds reduction in the rate of mortality of children aged less than 14 years by 2015\u2014through participation in key evidence-based interventions

Person-to-Person Interventions Targeted to Parents and Other Caregivers to Improve Adolescent Health A Community Guide Systematic Review

Context: Adolescence marks a time when many young people engage in risky behaviors with potential implications for long-term health. Interventions focused on adolescents ’ parents and other caregivers have the potential to affect adolescents across a variety of risk and health-outcome areas. Evidence acquisition: Community Guide methods were used to evaluate the effectiveness of caregiver-targeted interventions in addressing adolescent risk and protective behaviors and health outcomes. Sixteen studies published during the search period (1966–2007) met review requirements and were included in this review. Evidence synthesis: Effectiveness was assessed based on changes in whether or not adolescents engaged in specifıed risk and protective behaviors; frequency of risk and protective behaviors, and health outcomes, also informed the results. Results from qualifying studies provided suffıcient evidence that interventions delivered person-to-person (i.e., through some form of direct contact rather than through other forms of contact such as Internet or paper) and designed to modify parenting skills by targeting parents and other caregivers are effective in improving adolescent health. Conclusions: Interventions delivered to parents and other caregivers affect a cross-cutting array o