Averting mortality from PPH in Africa: moving from research to practice/la prevention de la mortalite due a l'HPP en Afrique: avancee de la recherche a la pratique.The conference on preventing postpartum postpartum /post·par·tum/ (post-pahr´tum) occurring after childbirth, with reference to the mother. post·par·tum adj. Of or occurring in the period shortly after childbirth. haemorrhage (PPH) was held 4-7 April 2006 in Entebbe, Uganda. It was organised by ACCESS/JHPIEGO (international organisation Noun 1. international organisation - an international alliance involving many different countries global organization, international organization, world organisation, world organization working to combat maternal and neonatal mortality Noun 1. neonatal mortality - the death rate during the first 28 days of life neonatal mortality rate death rate, deathrate, fatality rate, mortality rate, mortality - the ratio of deaths in an area to the population of that area; expressed per 1000 per year , including that at community level) in collaboration with POPPHI (Prevention of Postpartum Haemorrhage Initiative). Twenty-one countries took part in the conference: Ghana, Kenya, Mali, Nigeria, Rwanda, South Africa South Africa, Afrikaans Suid-Afrika, officially Republic of South Africa, republic (2005 est. pop. 44,344,000), 471,442 sq mi (1,221,037 sq km), S Africa. , Tanzania, Uganda, Ethiopia, Mauritania, Guinea-Bissau, Burkina Faso Burkina Faso (burkē`nə fä`sō), republic (2005 est. pop. 13,925,000), 105,869 sq mi (274,200 sq km), W Africa. It borders on Mali in the west and north, on Niger in the northeast, on Benin in the southeast, and on Togo, Ghana, and , Senegal, Haiti, Madagascar, the Democratic Republic of the Congo, Cameroon, Angola, Malawi, Benin and Mozambique. The number of participants per country varied from two to ten persons. Mali had eight participants. Objectives * to prevent PPH during childbirth where skilled attendants are present, i.e. to promote active management of the third stage of labour (AMTSL) * to prevent PPH during home births where no skilled providers are present * to improve the treatment of PPH. Methodology * Presentations followed by discussion and comments * Skills laboratories * PPH marketplace * Presentation of posters from different countries * Group work followed by plenary session Plenary session is a term often used in s to define the part of the conference when all members of all parties are in attendance. These sessions may contain a broad range of content from Keynotes to Panel Discussions and are not necessarily related to a specific style of delivery. * Development of country/action plans * Panel on the presentation of the policies and prospects of the various partners for preventing PPH. Organisation of sessions The opening ceremony was chaired by the Minister of Health, representing the Vice President of Uganda This is a list of vice presidents of Uganda. It may be incomplete.
During the three days of the conference, the presentations covered: * The prevention of PPH where skilled providers are present * The prevention of PPH where no skilled providers are present * The epidemiology of PPH in Africa * Active management of the third stage of labour * A survey of uterotonic drugs * The joint declaration by FIGO/ICM on the prevention of PPH * The treatment of PPH * Support for programmes to prevent maternal mortality due to PPH. Group work focused on: * Innovations in the treatment of PPH: promoting and extending AMTSL * Promotion of community level interventions to prevent PPH * The management of uterotonic drugs * Approval of the use of misoprostol for preventing and treating postpartum haemorrhages * Social mobilisation: how to involve the parties concerned and increase dialogue in order to prevent PPH * Analysis of AMTSL training needs * Training and supervision for facilitating interventions at community level * Training and supervision for facilitating AMTSL. The skills laboratories dealt with * AMTSL demonstration technique on an anatomical model * Basic procedures for treating postpartum haemorrhage: demonstration of bimanual bimanual /bi·man·u·al/ (bi-man´u-al) with both hands; performed by both hands. bi·man·u·al adj. Using or requiring the use of both hands. bimanual with both hands. and aortic aortic pertaining to or emanating from the aorta. See also aortic arch. aortic aneurysm occurs most often in dogs, where it is caused by Spirocerca lupi larvae, turkeys and primates, causing dyspnea, cyanosis and coughing. compression * Artificial delivery of the placenta placenta (pləsĕn`tə) or afterbirth, organ that develops in the uterus during pregnancy. It is a unique characteristic of the higher (or placental) mammals. In humans it is a thick mass, about 7 in. and suturing su·ture n. 1. a. The process of joining two surfaces or edges together along a line by or as if by sewing. b. The material, such as thread, gut, or wire, that is used in this procedure. c. * Demonstration of a cloth with pocket for measuring blood loss * Demonstration of the use of anti-shock clothing * Demonstration of the use of the B-Lynch procedure and hydrostatic hy·dro·stat·ic or hy·dro·stat·i·cal adj. Of or relating to fluids at rest or under pressure. hydrostatic pertaining to a liquid in a state of equilibrium or the pressure exerted by a stationary fluid. tamponade tamponade /tam·pon·ade/ (tam?po-nad´) 1. surgical use of a tampon. 2. pathologic compression of a part. using condoms. Development & presentation of country action plans Every country presented a three-year action plan. The 15 partners presented their countries' policies and prospects for supporting activity to prevent PPH within the framework of reducing maternal and neonatal mortality. The closing ceremony was chaired by JHPIEGO JHPIEGO Johns Hopkins Program for International Education in Gynecology and Obstetrics Medical Director, Dr. Harshad Sanghvi, who reported on the situation throughout the world as regards the impact of PPH on maternal mortality and the means of preventing it. Conclusion This conference gave us a better understanding of the various innovative strategies for preventing and treating PPH. It also allowed us to assess how Mali is placed in PPH issues compared to other countries: Mali already implements the techniques and integrates them in its policies, norms and protocols, unlike other countries. It was, however, important to allow each country not just to present its posters but also its experience in the field of PPH, which will enrich debate further. Rapport de mission par Madame Dicko Fatoumata Maiga, Presidente de l'Association de Sages-Femes du Mali L'an 2006 du 04 au 07 avril s'est tenue a Entebbe en Ouganda la conference sur la prevention des hemorragies du post partum post partum /post par·tum/ (post pahr´tum) [L.] after parturition. (HPP HPP hyperkalemic periodic paralysis. ). Cette conference a ete organisee par ACCESS/JHPIEGO (organisation internationale qui oeuvre pour la lutte contre la mortalite maternelle neonatale incluant l'aspect communautaire) en collaboration avec POPPHI (initiative pour la prevention de l'HPP). Ont pris part a cette conference 21 pays: Ghana, Kenya, Mali, Nigeria, Rwanda, Afrique du Sud, Tanzanie, l'Ouganda, l'Ethiopie, la Mauritanie, la Guinee Biseau, le Burkina-Faso, le Senegal, Haiti, Madagascar, RDC RDC Republique Democratique du Congo (French) RDC Rez de Chaussee (French: Ground Floor) RDC Red Deer College RDC Remote Desktop Connection (Microsoft) RDC Rowan Companies, Inc , Cameroun, Angola, Malawi, le Benin et le Mozambique. Le nombre de participants par pays varie de deux a dix personnes. Le Mali avait huit participants. Objectifs * Prevenir l'HPP lors de l'accouchement en presence de prestataires competents, promouvoir la gestion active du troisieme periode de l'accouchement (GATPA) * Prevenir l'HPP lors de la naissance au foyer sans prestataires competents * Ameliorer le traitement de l'HPP. Methodologie * Exposes suivis de discussions et de commentaires; * Les laboratoires de competences * Place de marche HPP * Presentation de posters des differents pays; * Travaux de groupe suivis de pleniere * Elaboration des plans d'action/pays * Panel sur la presentation des actions et perspectives des differents partenaires pour la prevention de l'HPP. Deroulement des sessions La ceremonie d'ouverture a ete presidee par le Ministre de la sante representant le vice president Ougandais. La ceremonie d'ouverture a ete accompagnee d'un diner diner, restaurant resembling the railroad dining car that is its source. In the mid-19th cent., the first dining cars that appeared on trains were nothing more than an empty car with a fastened-down table. George M. . L'equipe du Mali pour des difficultes rencontrees lors du transport n'a pas pu assister a la ceremonie d'ouverture. La conference proprement dite a debute le 5 avril par la presentation des objectifs, l'agenda et les resultats attendus, Pendant pendant or pendent In architecture, a sculpted ornament suspended from a vault or ceiling, especially an elongated boss (carved keystone) at the junction of the intersecting ribs of the fan vaulting associated with the English Perpendicular style. les trois jours de la conference les presentations ont porte sur: * La prevention de l'HPP la ou il y a des prestataires competents * La prevention de l'HPP la ou il n'y a pas des prestataires competents * L'epidemiologie de l'HPP en Afrique * La prise en charge active du troisieme stade du travail TRAVAIL. The act of child-bearing. 2. A woman is said to be in her travail from the time the pains of child-bearing commence until her delivery. 5 Pick. 63; 6 Greenl. R. 460. 3. * L'apercu des medicaments uterotoniques * La declaration conjointe FIGO/ICM sur la prevention de l'HPP * Le traitement de l'HPP * Soutien des programmes pour prevenir la mortalite maternelle due a l'HPP. Les travaux de groupe etaient centrees sur: * Les innovations dans le traitement de HPP; la promotion de la GATPA et son extension * La promotion des interventions communautaires pour prevenir l'HPP * La gestion des medicaments uterotoniques * L'autorisation de l'utilisation du misoprostol pour la prevention et le traitement des hemorragies du post partum * La mobilisation sociale: comment impliquer les parties pre-nantes et augmenter le dialogue pour la prevention de l'HPP * Analyse des besoins de formation sur la GATPA * Formation et supervision facilitante pour les interventions communautaires * Formation et supervision facilitante pour la GATPA. Les laboratoires de competences ont concerne: * La technique de demonstration de la GATPA sur le modele anatomique * Les procedures de bases pour le traitement de l'HPP: demonstration de la compression bimanuelle et aortique * Delivrance artificielle du placenta et suture suture /su·ture/ (soo´cher) 1. sutura. 2. a stitch or series of stitches made to secure apposition of the edges of a surgical or traumatic wound. 3. to apply such stitches. 4. * Demonstration du drap avec poche pour mesurer la perte sanguine sanguine /san·guine/ (sang´gwin) 1. plethoric. 2. ardent or hopeful. san·guine adj. 1. Of a healthy, reddish color; ruddy. 2. * Demonstration de l'utilisation des vetements anti-choc * La demonstration de l'utilisation de la procedure B-Lynch et la tamponnade intra-uterine hydrostatique avec des preservatifs. Elaboration et presentation des plans d'action pays Chaque pays a presente un plan d'action qui s'etend sur 3 ans. Les 15 partenaires ont presente les actions qu'ils menent dans les pays et les perspectives pour supporter les activites de la prevention des hemorragies du post partum dans le cadre de la reduction de la mortalite maternelle et neonatale. La ceremonie de cloture The procedure by which debate is formally ended in a meeting or legislature so that a vote may be taken. Cloture is a means of terminating a filibuster, which is a prolonged speech on the floor of the Senate designed to forestall legislative action. a ete presidee par Dr Harshad Sanghvi, Directeur Medical JHPIEGO, qui a fait un rapport de la situation mondiale sur l'impact de l'HPP sur la mortalite maternelle et les moyens pour la prevenir. Conclusion Cette conference nous a permis de mieux comprendre la technique de prise en charge des differentes strategies novatrices de prevention et de traitement de l'HPP. La conference a permis aussi de situer l'etat d'avancement du Mali en matiere de HPP par rapport aux autres pays participants: le Mali execute deja la technique et la integrer dans les PNP contrairement a d'autres pays. Il etait cependant important de permettre a chaque pays en plus des posters de presenter son experience dans le domaine des HPP ce qui allait mieux enrichir les debats. |
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