Background Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management.Methods We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups.

Objective This cross‐sectional study aimed to evaluate the prevalence and factors potentially associated with the development of actinic cheilitis (AC) in Brazilian rural workers. Subjects and methods A professional performed all physical examinations and evaluations using semi‐structured questionnaires in 240 rural workers. Results Eighty‐three participants were diagnosed with AC (34.6%). It was more prevalent among workers older than 45 years (3.29–10.96 95% IC; OR = 3.30; p = .0018), Caucasians (phototypes I and II) (4.78–16.12 95% IC; OR = 10.81; p < .0001), illiterate individuals (2.16–21.59 95% IC; OR = 10.43; p = .0037), those with 6 or fewer years of formal schooling (2.03–7.89 95% IC; OR = 4.63; p = .0013), those regularly using pesticides (1.58–6.64 95% IC; OR = 2.79; p = .0260) and those who used the private health service in their last appointment (1.17–3.54 95% IC; OR = 2.72; p = .0083). Conclusion There was a substantial prevalence of AC among rural workers with advanced age, white skin, and illiteracy, those with lower levels of education, those who regularly use pesticides, and those who utilised private health services in their last appointment. Thus, healthcare strategies that include rural workers are required for the control and prevention of AC in both public and private health services.

BackgroundIn Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care.MethodsThis study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans.ResultsThe most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts.ConclusionFormative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

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Summarybackground Despite a broadening consensus about the effectiveness of intermittent preventive treatment (IPTp) in preventing the adverse outcomes of malaria during pregnancy, policy change to IPTp was initially limited to East Africa. In West Africa, where the policy change process for the prevention of malaria during pregnancy started much later, IPTp has been taken up swiftly.objective To describe the factors that contributed to the rapid adoption of policies to prevent malaria during pregnancy in West Africa.results and conclusion Several factors appear to have accelerated the process: (1) recognition of the extent of the problem of malaria during pregnancy and its adverse consequences; (2) a clear, evidencebased program strategy strongly articulated by an important multilateral organization (World Health Organization); (3) subregionally generated evidence to support the proposed strategy; (4) a subregional forum for dissemination of data and discussion regarding the proposed policy changes; (5) widespread availability of the proposed intervention drug (sulfadoxine-pyrimethamine); (6) technical support from reputable and respected institutions in drafting new policies and planning for implementation; (7) donor support for pilot experiences in integrating proposed policy change into a package of preventive services; and (8) financial support for scaling up the proposed interventions.