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Obama email team reveals what worked – and didn’t – in election fundraising

first_imgM+R had a fascinating post* last week about political fundraising. It highlighted insights from the digital team who sent out fundraising emails for the Obama campaign. While political fundraising is its own animal, I do think many of these insights apply to all forms of fundraising. So whether you’re a political activist or a nonprofit fundraiser, or of the red or blue or purple persuasion, you will find this interesting.(The whole post is here. These are some highlights along with my commentary.)1. It’s hard to predict what will work – so testing matters. There were 18 very smart people on the email team alone, and they often predicted the wrong winners among versions of emails. And just when they figured out what worked, it stopped working. So they tested again. Keep testing!2. The best segmentation was based on what donors did – not how they voted or their demographics. Segmenting their message according to the ways people responded worked far better in yielding strong fundraising results than any other variable. What have people donated in the past? In response to which appeals? Segment accordingly.3. Length didn’t seem to matter a lot, until the end of the campaign, when shorter did better (reminds me of my advice to write very short appeals on December 31!). What did matter was the content and relevance of the message.4. For fundraising, setting a big goal for number of donations worked, but little, very local goals (we need six more donors in Washington, DC) did not. Those only worked for advocacy. Interesting. Something to test?And my favorite finding? The best appeals also had the highest unsubscribe rates. Like Mark Rovner always says, evoking passion means you get strong opinions on all sides. Bland is safe – and gets NO reaction.For more findings, check out the full post, “Surprises from Obama’s New Media Staff.”*Hat tip to Jono Smith of Event360 for sharing the post.last_img read more

Hiding in Plain Sight: The Importance of Respectful Maternity Care

first_img ShareEmailPrint To learn more, read: Share this: Posted on April 3, 2013March 13, 2017By: Kathleen McDonald, Senior Program Manager, Maternal Health Task Force, Women and Health InitiativeClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)The final plenary of the Global Maternal Health Conference 2013 (GMHC2013) in Arusha, Tanzania struck a nerve. The expert panel presented evidence of disrespect and abuse in maternity wards from all over the world. The audience was captivated and moved but not shocked. From Rwanda to the Netherlands, everyone had a story.Many had witnessed signs of undignified maternity care, yet it had not been named. It had been pushed aside as a cultural norm, or considered as an outcome of a constrained health system. Disrespect and abuse is practiced when laboring mothers are admonished or beaten in a moment of acute vulnerability for having too many children, for having children too soon, for having HIV, or for simply crying out in pain. It manifests itself structurally when an overburdened midwife tries desperately to accommodate an overflowing delivery room, when a mother is abandoned by skilled personnel to deliver on a bare labor ward floor, and when she is handcuffed to a bed when she cannot afford to pay hospital fees.Disrespect and abuse during childbirth is not a new phenomenon. Evidence of poor patient-provider interactions have been documented for decades in North America, Europe, Sub-Saharan Africa, South Asia, and Latin America. Maltreatment discourages women from delivering in health institutions, where life-saving treatment for complications in pregnancy and childbirth is available. Often referred to as the ‘moment of truth,’ the quality of the interaction between the healthcare provider and the patient is closely linked with women’s utilization of skilled birth attendance and, ultimately, maternal and newborn health outcomes. However, due to the already overstretched global health agenda, it is easy to overlook the importance of this critical relationship in maternal health programs and policies.The GMHC2013 afforded an opportunity for researchers, practitioners, and policymakers not only to share evidence, interventions, and advocacy for respectful maternity care, but also to challenge all those present to acknowledge this global problem that is hiding in plain sight. If advocates champion that maternal health is women’s health and share the imperative that women’s rights are human rights, then it is vital to support systems, infrastructure, and policies that ensure women’s rights extend to the delivery room.Over the next few weeks, the MHTF will host a series of guest blogs on respectful maternity care that will continue where we left off in Arusha. Posts will explore questions such as: What are programs and policies that are advocating for women’s dignity during childbirth?  Should respectful maternity care be considered a component of quality care?  What are the economic and human rights implications? How can communities become involved? How is disrespect and abuse present in rural and urban settings? In the private and public sectors?  In rich countries and poor countries?We invite you to share your story. Please submit your blog post to Sarah Blake sblake@maternalhealthtaskforce.orglast_img read more

Global Mom Relay Mobilizes Social Media for Maternal and Child Health

first_imgPosted on April 17, 2013March 13, 2017By: Sarah Blake, MHTF consultantClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)Between March 8, International Women’s Day, and Mothers’ Day on May 8, the Global Mom Relay, is using social media to connect and mobilize support for the  UN’s Every Woman Every Child campaign to improve maternal and child health.  The relay invites participants to contribute to organizations dedicated to promoting maternal, newborn and child health by either sharing blog posts hosted on the relay site via email, Twitter or Facebook, or by making a $5 donation to the day’s featured organization. Through tomorrow, the relay features MAMA, the Mobile Alliance for Maternal Action, and this week’s posts include a feature on Jill Sheffield, founder and President of Women Deliver, and by Every Mother Counts Founder Christy Turlington Burns.In today’s featured post, Fistula Foundation CEO Kate Grant writes:Not every woman is lucky enough to give birth in a modern delivery room, like I was. But no woman, anywhere, should have to suffer a life of misery and isolation simply for trying to bring a child into this world. Obstetric fistula has affected mothers since women began giving birth, and it will continue to happen until all women have access to high quality maternal care.The relay was developed by the UN Foundation, Johnson & Johnson, BabyCenter, The Huffington Post, and the Bill & Melinda Gates Foundation with thegoal of improving the lives of women and children around the globe.  For more, visit the Global Mom Relay website, or follow the discussion Twitter, Pinterest or watch the Global Mom Relay video.Share this: ShareEmailPrint To learn more, read:last_img read more

PMNCH Partners’ Forum Taking Place Today and Tomorrow in South Africa

first_img ShareEmailPrint To learn more, read: Posted on June 30, 2014November 4, 2016By: Katie Millar, Technical Writer, Women and Health Initiative, Harvard T.H. Chan School of Public HealthClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)Today and tomorrow up to 800 maternal, newborn, and child health leaders will gather in Johannesburg, South Africa at the 2014 World Health Organization’s (WHO) Partnership for Maternal, Newborn, and Child Health (PMNCH) Partners’ Forum. Given the current environment of determining the post-2015 agenda, this meeting is critical in gathering world leaders to emphasize the importance of protecting and ensuring the health of women and their children around the world.Since the contextual factors that impact maternal, newborn, and child health are diverse, representatives at the PMNCH Partners’ Forum include public and private sector representatives and experts in health, gender and development, nutrition and education. This diverse group of participants will allow conclusions of the forum to address how diverse sectors can all support supporting and ensuring maternal, newborn, and child health.The Partners’ Forum will also include the launch of four landmark reports:Every Newborn Action Plan provides a concrete plan and platform for improving neonatal health and preventing newborn deaths and stillbirths.Success Factors for Women’s and Children’s Health Report spotlights 10 countries that serve as models for making considerable progress improving maternal and child health, especially for high-need countries.Countdown to 2015 Report for 2014 is a report that assesses current coverage and equity of coverage of maternal and child health interventions and the financial, policy and health systems factors that determine if proven life-saving interventions are delivered to woman and children.State of the World’s Midwifery 2014 (Africa focused launch) highlights progress and challenges that 41 Sub-Saharan countries have seen since 2011 in delivering life-saving midwifery services.Tune into the discussion happening at PMNCH’s Partners’ Forum by going to the #PMNCHLive Hub, #PMNCHLive Daily Delivery sign-up, and #PMNCHLive on twitter.Are you attending the PMNCH Partners’ Forum? Would you like to share your experience or reaction to the discussions taking place? Please contact Katie Millar on how you can be a guest contributor to the MHTF Blog. Share this:last_img read more

End Strong

first_imgAs December 31st approaches, keep your fundraising momentum with these 8 tips:Don’t Make it Hard for Donors to Get to Your Donation PageWhen you ask a supporter for a donation, direct them exactly to your donation page. Don’t make them hunt for it. In a store setting, customers never have to climb a flight of stairs to checkout. It’s right there by the front door with lights illuminating all the cashiers’ stations. Think about this when you write an appeal or ask for a donation on social media. Put your donation page link in an obvious place and add a button that says DONATE NOW in all your email appeals.Do Make Your Online Donation Page Super SimpleToo many fields can discourage the donor from completing the gift, so keep the donation form as short as possible. Remove all the hurdles the donor might encounter to complete that donation, like requiring a login or requesting the donor use a specific browser or payment method. And make sure your donation page is mobile responsive. Let donors choose how and where they make their online donation and ensure each option is accessible and simple.Do Stick to the ThemeYour year-end campaign should focus on a story, a message, or a theme about how donors can impact your nonprofit’s work. Include those same visual cues and your campaign’s message on your donation page so that donors know that they’ve landed in the right place.Don’t Leave the Gift Amount Box BlankDonors need guidance on what’s expected—give them a starting point for making a decision about their gift. Create suggested donation amounts and tie each to a tangible impact if possible. Giving levels can help your donor visualize what their gift will do.Do Segment You Donor ListWhen sending your appeal, create more than one version and make sure the message makes sense to each group of donors who will receive the email. For example, if you had an event recently, you might want to send an email to those who attended or donated to the event with a note about how successful the event was before leading into your ask. Or, if you have volunteers or non-donors on your email list, you shouldn’t begin your appeal with “Thank you so much for your continuing support of our organization. Your donations have made a real difference in the lives of our clients…” the same thing goes for lapsed donors. Don’t confuse your audience by sending a one-size-fits-all donor appeal.Don’t Forget to Share Your Fundraising GoalAdd a thermometer on your donation page to drive urgency and create social proof. Network for Good recommends that our clients turn on their giving thermometer after they have received a few gifts because psychologically, donors don’t want to be “the first”. After those first few gifts are made, that thermometer provides social proof that your donors are coming together with others to help your organization achieve a common goal. We’ve also seen the donation page thermometer spark major donors to offer a matching gift or give that last big gift to make sure the nonprofit surpasses the goal before deadline. When you let your donors know that fundraising goal, and how close you are to getting to it, it helps build urgency and provides a sense of responsibility and then accomplishment when your goal is met.Do Make the Donor the HeroIn your appeal, clearly outline the donor’s impact. Instead of, “Our nonprofit makes sure children get the books they need” you should instead say “You can give a child the books they need to learn.” Avoid “Our nonprofit takes care of homeless veterans” but do say “You will provide a safe haven for homeless veterans.” Make your donor, or someone like them, part of the story. Causes often forget to involve the reader by not writing for them. If you zero in on the “our nonprofit is awesome” message, donors won’t be compelled to give. If your organization is so awesome, then it appears as though you don’t really need your donors’ support.Don’t Focus on the FinancesThis can be hard because many nonprofits want to make sure they fill the gap in their budget shortfall before the next year, but remember: your budget shortfall is not your donor’s problem to solve. They want to help solve the problem that your mission addresses. They want to help end homelessness, or make sure animals have a forever home.  Drive that point home to your donors because your mission is what matters the most to them.To get more off the ground by December 31, download our Last Minute Year-end Appeal Template.last_img read more

How to Inspire Donors Across Generations

first_imgThe changing of the guard is as old as time. It can be a bumpy road if you don’t plan for it. The older donor generations can feel pushed out of the very causes they helped launch. Meanwhile, the younger generations cry out for change and inclusion. How do you reach across the generations and bring everyone to the table?Compare the four primary generations of donors—Mature, Boomer, Gen X, Millennial—and you’ll see there’s more that unites us than divides us. Research scientist Jennifer Deal observed similarities in her book, Retiring the Generation Gap: How Employees Young and Old Can Find Common Ground. She found that all generations:Value family, integrity, honesty, trustworthiness.Want respect.Believe leaders must be trustworthy.Like to receive feedback.Don’t like change.Base loyalty on context, not age.Want to learn and better ourselves.In “How to Engage Multiple Generations of Donors,” we explore additional generational insights on giving activity, volunteer rates, tech use, and communication preferences. Incorporate these findings into your donor engagement to create lasting relationships.Generational Communication TipsYour donor’s preferred method of communication doesn’t always depend on their age. Gen X may prefer email and Boomers may prefer a phone call, but they both enjoy receiving a thank you card in the mail. Ask your donors how they prefer to be contacted, record that information in your donor management system, and use it to create a deeper level of engagement.Matures respect authority and respond to tradition and long-term commitment. Highlight your organization’s history and your position as a leader in your field.Boomers are dedicated, hard-working, goal-oriented individuals. They expect quality services and treatment. Put your nonprofit’s work—and your results—front and center. Inspire them with your story and your mission.Gen X donors risk being overlooked in favor of their Boomer and Millennial counterparts. Pay special attention to them today. As they enter the peak years of their careers, many Gen Xers are looking for proactive ways to support organizations they believe in.Millennials are drawn to transparency and access. As donors, they’re interested in more than just their name on a donor list. They want to contribute in different ways. Incorporate more targeted contact and engagement as part of cultivating this generation of donors. Bring them into your work on a deeper level.Never before has there been such a wide array of communication options. From the classic approach of direct mail to the modern invention of instant messaging, each generation has their preference. Use your donor data to create engagement that bridges the generation gap once and for all.Check out our infographic, Bridging The Donor Generation Gap, for more information on generational giving!last_img read more

International Day to End Obstetric Fistula: Ending Fistula Within a Generation

first_imgPosted on May 23, 2016July 11, 2017By: Kayla McGowan, Project Coordinator, Women and Health Initiative, Harvard T.H. Chan School of Public HealthClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)In honor of International Day to End Obstetric Fistula, May 23, we’ve compiled resources related to obstetric fistula, a serious and tragic health condition that impacts the lives of women and families around the world. While the global prevalence rate is not known, estimates suggest that obstetric fistula affects around 2 million women primarily in sub-Saharan Africa and South Asia. The devastating effects of fistula include incontinence of urine and/or feces, often accompanied by depression, social isolation, and poverty.Fortunately, the condition is usually treatable and preventable. The maternal health community can support this year’s theme of ending fistula within a generation by promoting universal access to high quality emergency obstetric care, treatment, and social support. Photo: “Africa Partnerships Hamlin Fistula 12” © 2009 Department of Foreign Affairs and Trade, used under a Creative Commons Attribution license 2.0Share this: Obstetric Fistula ResourcesDouble Burden of Tragedy: Stillbirth and Obstetric FistulaThis commentary, following The Lancet Stillbirth Series in 2011, draws attention to the highly prevalent link between obstetric fistula and stillbirth.  According to the meta-analysis of obstetric fistula studies published between 1990 and 2015, 90% of pregnancies in which the women develops obstetric fistula result in stillbirth.Good Practices on Ending Obstetric FistulaPublished in 2014, this UNFPA resource shares implementation strategies, progress, and lessons learned from program components and Campaign to End Fistula partner activities. Good Practices describes both challenges and innovations in addressing obstetric fistula.Maternal Health Thematic Fund 2014 ReportThis report examines the impact of UNFPA in ending fistula through the Campaign to End Fistula, one of the main projects of the Maternal Health Thematic Fund. Launched in 2008, the Maternal Health Thematic Fund manages programs in midwifery and emergency obstetric and newborn care that work to prevent and treat fistula. The 2014 report also identifies challenges in fistula prevention.New Research to Shorten Recovery Time For Fistula RepairThis MHTF blog post summarizes findings from Fistula Care Plus Project’s large multi-center randomized controlled trial published in the Lancet, which demonstrated that short duration catheterization is safe and effective following simple fistula repair surgery.Psychological Symptoms and Social Functioning Following Repair of Obstetric Fistula in a Low-Income SettingThis exploratory study identifies changes in psychological symptoms following fistula repair surgery, discharge, and reintegration home among women in rural Tanzania. The authors note the importance of equipping women with coping strategies should they experience residual fistula symptoms.Restoring Hope and Dignity: New Developments and Best Practices in Addressing Maternal MorbiditiesSupported by the MHTF, this Wilson Center event featured a panel presentation of the newest data and best practices from those who work most closely with maternal morbidities like obstetric fistula and pelvic organ prolapse. The speakers discussed root causes of maternal morbidities as well as new approaches and barriers to addressing the global burden of obstetric fistula.Selected Organizations Working to End FistulaCampaign to End FistulaFistula Care Plus Project at EngenderHealthFistula FoundationOperation FistulaDo you have any other resources on obstetric fistula that you’d like to recommend? If so, email us at mhtf@hsph.harvard.edu. We’d love to hear from you!Join the conversation on ending obstetric fistula within a generation using #FistulaDay.center_img ShareEmailPrint To learn more, read:last_img read more

Best Practices for Implementing the WHO Safe Childbirth Checklist: Engaging Staff and Stakeholders

first_imgFor more information on Safe Childbirth Checklist implementation, please email info@ariadnelabs.org.Download the Safe Childbirth Checklist and Implementation Guide in English, French or Spanish here.Share this: Posted on September 8, 2016September 26, 2016By: Kayla McGowan, Project Coordinator, Women and Health Initiative, Harvard T.H. Chan School of Public HealthClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)According to the World Health Organization (WHO), of the more than 130 million births occurring worldwide each year, approximately 303,000 end in maternal death, 2.6 million in stillbirth and 2.7 million in newborn death within 28 days of delivery. Most of these deaths take place in low-resource settings and are preventable with timely and appropriate interventions. However, providers do not always know, remember or have the supplies to implement these life-saving interventions, especially in emergency situations. Checklists remind health providers of necessary steps for routine deliveries as well as situations involving complications.The WHO Safe Childbirth Checklist (SCC), a set of evidence-based birth practices addressing major causes of maternal death, intrapartum-related stillbirths and neonatal deaths, is designed around four pause points during childbirth: on admission; just prior to delivery; within one hour of birth; and before discharge. The SCC identifies preventative practices, such as handwashing and antibiotic preparation, to avoid or manage complications like infection, hemorrhage and obstructed labor.Last month, scientists at Ariadne Labs, a collaboration between Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, hosted Implementing Checklists for Quality Improvement: Best Practices Along the Implementation Pathway – “Engage”, the second webinar in their interactive series dedicated to sharing lessons learned in implementing the SCC for quality improvement. Presenters explored how to ensure buy-in and identify relevant stakeholders, establish an implementation team and utilize best practices in checklist adaptation. Dr. Rosemary Ogu shared her team’s experience piloting a program using the Safe Childbirth Checklist in Port Harcourt, Nigeria.Engaging staff and stakeholdersAccording to the Ariadne team, effective implementation of the SCC relies on three core processes: engaging staff and stakeholders, formally launching the checklist and providing ongoing support for the team. The following steps are crucial to the ‘engage’ process:1. Determine program goals and gain buy-in.According to Dr. Joanna Paladino, Assistant Director of Implementation, Serious Illness Care Program at Ariadne Labs, teams who plan to implement the SCC should first consider their overarching goals: “What do you hope to accomplish with the program?” “How will the checklist improve quality of care?” “What impact will it have on staff?” Dr. Paladino encouraged teams to define a collaborative mission statement and set clear program goals.Another fundamental step in ensuring successful uptake of the SCC is to gain buy-in by building partnerships at the local, district, regional and national levels. Engaging leadership is also important as it shows the facility that implementing the checklist is a priority and helps ensure access to relevant resources. Moreover, according to Dr. Paladino, this step involves leveraging a collective effort:“Engaging and gaining buy-in is about changing hearts and minds. It’s bringing people into this effort so you that you do this as a team and everyone owns it and has a voice in the work.”Coordinating one-on-one conversations with team members is a highly effective way to gather feedback and convince team members of the SCC’s benefits.  When considering whom to involve in this step, the Ariadne team abides by its guiding principle, “Everyone who will be touched by the intervention should be engaged in this work.” Do not avoid the skeptics. Speaking with those who may not be enthusiastic about the SCC helps teams work through challenges and strengthen their implementation strategy.Dr. Ogu, an obstetrician gynecologist at the University of Port Harcourt Teaching Hospital in Nigeria, explained that her team knew poor quality of care was contributing to high maternal mortality rates at the hospital (in 2013, maternal mortality rates were 143 per 100,000 live births among registered patients and 7,857 per 100,000 live births among those who did not register for antenatal care). Thus, the team’s goal in using the checklist was to improve compliance with best practices among health care workers. Findings from focus group data show that as a result of piloting the SCC, midwives and doctors at the University of Port Harcourt Teaching Hospital in Nigeria felt better equipped to counsel patients, prepare for emergencies and remember all the steps necessary to provide high quality care.2. Create an implementation team and identify a champion.As Dr. William Berry, Ariadne Labs Chief Medical Officer and Director, Safe Surgery Program, emphasized, identifying a passionate champion is key to implementing the SCC in health facilities: “You need to find somebody who people look up to – it does not mean they need to be a boss or chief or supervisor … the person people go to for advice on the frontlines often makes a great champion, whether they hold a formal title or not.”Dr. Berry also emphasized the importance of forming a multidisciplinary team representative of the various roles that will be affected by the SCC, including physicians, nurses, birth attendants, pharmacists, lab technicians, administrators and coaches.3. Conduct a needs assessment.According to Dr. Paladino, this step is often skipped but is a critical element of successful implementation. Teams should ask themselves what they need to be ready to implement the SCC, including leadership support, resources and system capabilities. They should also reflect on prior quality improvement experiences and perform gap analyses to identify which supplies, human resources, referral systems and funding sources are available or missing.4. Adapt and own the WHO Safe Childbirth Checklist.Most importantly, teams should take the core framework presented in the SCC and customize it for their specific setting. It is essential for leaders to read the checklist thoroughly and discuss each item with their team. The SCC is a tool that should be compatible with the natural workflow of each facility. As Dr. Berry articulated“It’s not the WHO’s checklist – it’s the facility’s checklist … The workflow is built around the people and processes of those people. If you don’t respect those, the checklist will get put down.”—Watch the webinar and download the slides here.Missed the first webinar in the series?Read our summary post from the first webinar: Lessons Learned from Implementing the WHO Safe Childbirth Checklist.Watch the first webinar and download the slideshow.Join the BetterBirth Community.Learn more about the launch of the checklist and the Safe Childbirth Checklist Case Study in Namibia. ShareEmailPrint To learn more, read:last_img read more

How Social Factors Drive up Suicide Rates Among Pregnant Women

first_img ShareEmailPrint To learn more, read: Posted on February 21, 2017February 22, 2017By: Jason Bantjes, Senior Lecturer, Stellenbosch University; Nnachebe Michael Onah, Doctoral Candidate, University of Waterloo; Sally Field, Project Coordinator/Researcher, Perinatal Mental Health Project, University of Cape Town; Simone Honikman, Director/Senior Researcher, Perinatal Mental Health Project, University of Cape TownClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)Pregnant women in South Africa who live in poor communities are more likely to consider or attempt suicide than the general population. That’s a key finding from a recent study we undertook at Hanover Park.The research found 12% of pregnant women living in low-resource communities had thought of killing themselves during the previous month. In the same period, an additional 6% of pregnant women reported they had started to enact a suicide plan or attempted to end their lives. Rates of depression and anxiety were also found to be elevated among the pregnant women who took part in the study.These findings mirror research about high rates of suicidal ideation and behavior among pregnant women elsewhere in the world. A review of 17 studies in high- and low-income countries found the prevalence of suicidal ideation among pregnant and postpartum women ranged from 5% to 18%. Rates were higher among pregnant women living in low-income countries.Our study’s most-significant finding was that more than half of the pregnant women who were at risk of suicide did not have a diagnosable depressive or anxiety disorder. Their suicide risk was also associated with lower socioeconomic status, food insecurity, intimate partner violence and a lack of social support.This suggests suicidal ideation among pregnant women is about more than mental illness. Past studies suggest suicide and mental illness are strongly linked. Pregnant women who are depressed or have problems with anxiety are more likely to experience thoughts of death and engage in suicidal behavior compared with other pregnant women.But our research shows social and economic context may be a much more important contributor to suicide risk than previously thought.Pernicious impact of adversityThe findings show the pernicious impact of socioeconomic adversity, interpersonal violence and lack of social support on pregnant women’s wellbeing.We found pregnant women who are the victims of intimate partner violence are twice as likely to engage in suicidal behavior compared to other pregnant women. Those who experience food insecurity – either they go hungry regularly or they have considerable trouble feeding themselves and their families – are almost four times more likely to report suicidal behavior.Pregnant women who are not in a relationship are also more likely than other pregnant women to experience suicidal thoughts and attempt suicide. And we found suicide risk decreases as pregnant women experience more social support.These findings add to the growing body of evidence showing that sociocultural and economic factors are important risk factors for suicide. Suicidal ideation and behavior are not simply a symptom of mental illness. Suicide can be a reaction to living in a particular context or facing stressful circumstances.So, our research supports the idea that suicide risk should be assessed independently of – and in addition to – depression and anxiety among pregnant women.Broader focus neededThis is an important nuance. Suicide prevention initiatives have traditionally focused narrowly on identifying and treating psychiatric illness. Our findings suggest they should more broadly include interventions that tackle socioeconomic factors and adversity.Interventions that focus exclusively on psychiatric determinants of suicidal behavior are unlikely to be effective. This is especially true in low-resource settings. Contributing factors include a scarcity of mental health resources and factors that adversely affect people’s lives.More work still needs to be done to identify effective suicide prevention interventions for pregnant women living in adverse conditions. This requires more collaboration between different sectors. Policymakers also need to tackle social ills and find ways to increase the level of support for pregnant women and mothers of young babies.This post originally appeared on The Conversation.Share this:last_img read more

Diabetes in Pregnancy: A Neglected Cause of Maternal Mortality

first_img ShareEmailPrint To learn more, read: Posted on May 10, 2017January 2, 2018By: Katja Iversen, President and CEO, Women DeliverClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)In the lead up to the 70th World Health Assembly (22-31 May), president and CEO of Women Deliver, Katja Iversen, highlights a neglected health problem that must be addressed in order to reduce global rates of maternal mortality and fulfill Sustainable Development Goal targets: diabetes in pregnancy.Over the past two decades, improving maternal health has become an increasingly important focus of the global development agenda—and rightly so. Between 1990 and 2015, the maternal mortality rate has fallen by 44%, from approximately 546,000 to 303,000 deaths per year. That reduction is a testament to the sterling collective efforts of governments, institutional donors, health service providers and family planning agencies, as well as tireless campaigning by international, national and grassroots organizations.Yet despite these gains, some 830 women and girls still die from preventable causes related to pregnancy and childbirth every single day. These deaths are unacceptable. Clearly, the approach needs to change if there is any hope of meeting the Sustainable Development Goals target to reduce the global maternal mortality ratio from its current 216 deaths per 100,000 live births to less than 70 deaths per 100,000 live births by 2030.To achieve this ambitious target, the global health community must tackle previously neglected conditions that are associated with pregnancy complications, and which are thereby responsible for the unacceptably high numbers of maternal deaths each year. Diabetes in pregnancy is one such condition, affecting one out of every six pregnancies around the world.Diabetes in pregnancy includes women who have previously been diagnosed, as well as those who exhibit high blood glucose (blood sugar) levels and develop gestational diabetes mellitus (GDM) during their pregnancies. Left untreated, GDM can have devastating consequences for mother and baby alike. There are proven links, for example, between GDM and the risk factors that contribute to maternal mortality, like postpartum hemorrhage, obstructed labor and pre-eclampsia.Children born to mothers with untreated GDM face increased risk of neonatal death and long term disability. Furthermore, children born to mothers with GDM are four to eight times more likely to develop type 2 diabetes in later life, while daughters of affected mothers are more likely to be similarly affected during any future pregnancy of their own.Diabetes in pregnancy is on the rise globally, due to changes in lifestyle and dietary habits, and it currently affects some 14 million women every year. As with most problems related to pregnancy complications, diabetes in pregnancy is more prevalent in low- and middle-income countries, which account for 88% of cases worldwide. Yet the countries where diabetes in pregnancy is most prevalent are the least likely to offer routine screening and treatment.The public health challenge of diabetes in pregnancy is immense and pressing, and any concerted efforts to raise awareness and confront the problem are relatively recent. The XXI FIGO World Congress of Gynaecology and Obstetrics in Vancouver (2015) adopted new global guidelines on how to screen and manage GDM, and the World Diabetes Foundation hosted a panel on the subject at last year’s Women Deliver Conference in Copenhagen. Practical interventions are also underway. In 2011 the World Diabetes Foundation collaborated with others in Columbia to integrate GDM diagnosis and treatment into prenatal care for vulnerable women in the city of Barranquilla. Yet much still remains to be done.There is a strong need to build bridges between the diabetes and the maternal and newborn health communities to promote joint action around diabetes in pregnancy—particularly in the high burden countries of India, China, Indonesia, Pakistan, Bangladesh, Nigeria, Mexico and Brazil. Without this cooperation, the global development sector risks curtailing the great progress that has been made in improving maternal health over the past two decades. By including universal screening for diabetes as a standard of care for pregnant women, there is an opportunity to improve health, save lives and promote prevention efforts, like nutrition and physical activity, which will improve wellbeing for generations to come.Anyone interested in finding out more about the problem of diabetes in pregnancy can take part in Women Deliver’s Webinar Series. Watch part one here and register for part two at bit.ly/DIPwebinar2.This post originally appeared on the BMJ Opinion blog.Share this:last_img read more

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