Maryland Infant Mortality Epidemiology Work Group Findings from Data Analysis and Overall Recommendations

The Infant Mortality Epidemiology Workgroup was charged to examine the risk factors associated with infant mortality in Maryland and to identify interventions that were most likely to enhance the state’s ability to achieve the goal of 10% reduction in infant mortality and to reduce the health disparities gap in infant mortality rates. The Workgroup examined linked birth and infant death data from the Maryland Vital Statistics Administration, and data from the Maryland Pregnancy Risk Assessment Monitoring System

Knowledge and willingness of prenatal women in Enugu Southeastern Nigeria to use in labour non-pharmacological pain reliefs

Background: Nigerian parturients desire, but experience unsatisfactory pain relief as labour analgesia is underutilised and unpopular among skilled-birth attendants. Objectives: To assess pregnant women\u2019s knowledge and willingness to use non-pharmacological labour pain reliefs. Methods: Using a descriptive cross-sectional design, a pre-tested, structured questionnaire was interviewer administered to a convenient sample of 245 prenatal women at a specialist maternity hospital in Enugu. Results: Majority (68.6%) of the women knew, but 31.4% were unaware that non-pharmacological labour pain reliefs exist in the study facility. Only 34.7% were able to identify at least four such methods, 21.2% could elicit two (each) advantages and disadvantages, and 0% to 28.3% had perceived self-efficacy of how to use each method. The leading four methods identified were breathing exercises (51.8%), massage (36.7), position changes (32.2%), and relaxation techniques (26.5%). Majority (59.6%) of the women expressed willingness to use non-pharmacological pain strategies in future labour, which is associated with increased knowledge of the methods, and parity (p<0.001). Conclusion: Pregnant women had limited knowledge of, but majority expressed willingness to use in labour non-pharmacological pain reliefs. Nurses/midwives should give adequate childbirth information and preparation on labour pain reliefs to antenatal women to inform their choices and effective use during labour. Key words: Knowledge; desire to us; non-pharmacological; labour pain reliefs; prenatal women

Global Learning for Health Equity: A Literature Review

BACKGROUND: In high income countries struggling with escalating health care costs and persistent lack of equity, there is growing interest in searching for innovative solutions developed outside national borders, particularly in low- and middle-income countries (LMICs). Engaging with global ideas to apply them to local health equity challenges is becoming increasingly recognized as an approach to shift the health equity landscape in the United States (US) in a significant way. No single name or set of practices yet defines the process of identifying LMIC interventions for adaptation; implementing interventions in high-income countries (HIC) settings; or evaluating the implementation of such projects. OBJECTIVES: This paper presents a review of the literature describing the practice of adapting global ideas for use in the US, particularly in the area of health equity. Specifically, the authors sought to examine; (i) the literature that advocates for, or describes, adaption of health-related innovations from LMICs to HICs, both generally and for health equity specifically, and (ii) implementation practices, strategies, and evidence-based outcomes in this field, generally and in the area of health equity specifically. The authors also propose terminology and a definition to describe the practice. METHODS: The literature search included two main concepts: global learning and health equity (using these and related terms). The search consisted of text-words and database-specific terminology (e.g., MeSH, Emtree) using PubMed, Embase (Elsevier), CINAHL (Ebsco), and Scopus in March 2021. The authors also contacted relevant experts to identify grey literature. Identified sources were categorized according to theme to facilitate analysis. In addition, five key interviews with experts engaged with global ideas to promote health equity in the United States were conducted to develop additional data. RESULTS: The literature review yielded over ninety (n = 92) sources relating to the adaptation of global ideas from low resource to higher resource settings to promote health equity (and related concepts). Identified sources range from those providing general commentaries about the value of seeking health-related innovations outside the US border to sources describing global projects implemented in the US, most without implementation or outcome measures. Other identified sources provide frameworks or guidance to help identify and/or implement global ideas in the US, and some describe the role of the World Health Organization and other international consortia in promoting a global approach to solving domestic health equity and related challenges. CONCLUSIONS: The literature review demonstrates that there are resources and commentary describing potential benefits of identifying and adapting novel global ideas to address health equity in the US, but there is a dearth of implementation and evaluation data. Terminology is required to define and frame the field. Additional research, particularly in the area of implementation science and evidence-based frameworks to support the practice of what we define as \u27global learning\u27 for health equity, is necessary to advance the practice

Global learning: A post-COVID-19 approach to advance health equity

ABSTRACTThe COVID-19 pandemic has accelerated acceptance of learning from other countries, especially for high-income countries to learn from low- and middle-income countries, a practice known as global learning. COVID-19’s rapid disease transmission underscored how connected the globe is as well as revealed stark health inequities which facilitated looking outside of one’s borders for solutions. The Global Learning for Health Equity (GL4HE) Network, supported by Robert Wood Johnson Foundation, held a 3-part webinar series in December 2021 to understand the current state of global learning and explore how global learning can advance health equity in the post-COVID-19 era. This paper reflects on these cutting-edge discussions about the current state of global learning, drawing upon the highlights, perspectives, and conclusions that emerged from these webinars. The paper also comments on best practices for global learning, including adapting for context, addressing biases, funding considerations, ensuring bidirectional partnerships, community engagement, and adopting a multidisciplinary approach

Building the institutional capacity for sustainable global health nursing partnerships: a case study

Background: Globally, nursing is the largest health profession. Nurses provide crucially important health services in both acute and primary health-care settings around the world. Building the capacity of nurses to address global health challenges—particularly in resource-constrained settings—is a key element of health systems strengthening. North–South global partnerships between sister schools of nursing can contribute to building the capacity of nurses on both sides of the partnership. We developed a strategy to build institutional capacity for global health at the University of Maryland School of Nursing (UMSON) and aimed to identify key elements of success. Methods: We used a case study approach to identify and analyse the key elements in the successful implementation of UMSON's 6-year global health strategic plan to build institutional capacity for programmatic partnerships with nursing schools in Nigeria, Liberia, Rwanda, and Haiti, and faculty and student exchange programmes with schools of nursing in Africa, Asia, and the Middle East. Findings: Four crucial elements were identified in successful programme implementation: (1) strong advocacy for global health by student and faculty organisations within UMSON and the University of Maryland Baltimore; (2) integration of global health into the School of Nursing's overall strategic plan; (3) establishment of the Office of Global Health to provide core institutional agency to leverage resources; and (4) development of strong partnerships with nursing schools in Africa, the Caribbean, Asia, and the Middle East, which includes faculty and student exchange programmes and long-term programmatic collaborations that focus on nursing capacity development. Interpretation: The implementation of UMSON's strategic plan for global health has provided a sustainable institutional framework that supports the development of partnerships with other schools of nursing in several countries worldwide. These partnerships have provided mutually beneficial educational experiences for nursing students and faculty from both UMSON and our sister schools of nursing. These partnerships have also contributed to continuing changes in nursing education and practice at home and abroad. Funding: None