BackgroundAround 303,000 maternal deaths occur every year; most of these are preventable (World Health Organization), ICD-10: International classification of diseases and related health problems, 10th revision. Volume 2: Instruction manual, 2010). Ninety-nine percent of these maternal deaths occur in developing countries. PPH contributed 35 % (35%) of total maternal. Several interventions being done to reduce the number of maternal deaths. It has been noted that a simple low cost intervention of providing misoprostol timely could prevent these deaths.ObjectivesThe objectives of this systematic review was to identify barriers/gaps in the implementation of misoprostol use for prevention of postpartum hemorrhage and management of Post-abortion care services in developing countries.MethodsThis study was a systematic review of published qualitative and quantitative literature on misoprostol in developing countries. Documents included were local and international peer reviewed articles and program reports on misoprostol implementation. PubMed, Google Scholars and Science direct databases were used along with Grey literature and manual search using terms “implementation gaps”, “misoprostol use”, “postpartum hemorrhage”, “post-abortion care” and “developing countries”.ResultsGaps or barriers in misoprostol use identified through systematic review can be categorized into six broader thematic areas including: inconsistency in supplies and its distribution; inadequate staffing; lack of knowledge of providers and end users, absence of the registration of drug and fear and apprehensions related to its use at provider and policy level.ConclusionIt is concluded that barriers and gaps can be addressed through providing enabling environment through supportive policies, designing a formal plan for supplies, task shifting strategies and use of guidelines and protocols for successful implementation.Electronic supplementary materialThe online version of this article (10.1186/s12978-017-0383-5) contains supplementary material, which is available to authorized users.

Each year around 529,000 women die worldwide due to harmful consequences of childbirth in developing countries. Thus, this study aimed to explore barriers and facilitators that influence the provision of quality care during labor at maternity centers of Karachi, Pakistan. The qualitative exploratory study design was used to explore such factors from public and private maternity health facilities of Karachi, Pakistan. In-depth interviews were conducted through purposive sampling by using validated semi-structured interview guide. Data was analyzed using content analysis manually. Among major barriers; unhygenic environment, lack of basic equipment, supplies and medicine, unprofessional attitude of staff, physical infrastructre and  shotrage of staff were explored. Among facilitators; Caring and supportive attitude of healthcare personnel during labor were identified. Continuous...

The 18 th Constitutional Amendment was passed in April 2010 by ruling party of that time Pakistan people's party in support of the opposition party with the aim of providing more autonomy to the provincial governments. Abolishing 17 ministries at federal level and transferring the responsibilities to provinces. It has provided new prospect to provincial governments to review and revise administrative, personnel, management and financial resources to narrow down the wide existing gaps and plan for additional responsibilities. This analysis was entirely based on secondary data. Secondary data were selected randomly without using any specific search strategy, however the focused was post devolution trend analysis of health sector budget allocation. Several government documents/reports were a part of this analysis. Nominal values were used in all these analyses using descriptive approach for analysing the trend. The review article emphasized more on Sindh province. It is evident from the statistics that there has been no change in health indicators over the year's despite of 5-6 fold increase in budget allocation to health sector. Provincial government need to prioritize budget allocation within sector from non-developmental to developmental, also a shift from curative to preventive programs. In addition, government need to provide some sort of financial cushions like insurance, health vouchers to reduce the out of pocket expenditure.

Background Early years of life are crucial for growth and development; any adverse events (such as nutrition deficiencies) during this period significantly influence children’s life-course developmental trajectories to maturity. In 1995, the World Health Organization launched its Global School Health Initiative with the aim of expanding the Health Promoting School (HPS) approach globally. Therefore the primary objective of this study is to assess the preschool preparedness intervention package in adoption of Nutrition Friendly School Initiative. Methodology: An exploratory sequential mixed method study design was carried out in three campuses of Aga Khan School (Mirpur Sakro, Junior Campus Vur, community-based school Sujawal) in the Sindh province of Pakistan. Study participants (children & parents) were selected using purposive sampling. Data collection includes in-depth interviews with the school community, pre & post assessment of knowledge of parents, baseline and end-line nutrition status of preschool children of age 24-59 months and beyond, and baseline & end line assessment of Preschool preparedness using checklist Results/outcomes: The qualitative findings has informed additional measures (setting up nutrition theme corner, including parenting package in manual, aligning school nutrition policy with school handbook, launch of special campaign for engagement and awareness purpose with parents) that were adapted within the intervention package. Preschool preparedness also improved from 10 points to 22 points out of 26 indicators (with some indicators labeled at not applicable). The knowledge of parents on nutrition and health promoting manual has been enhanced with mean improvement of 7.17 points (out of 25 points). Also the mean increase in MUAC, height and weight of preschool children are 0.27cm, 0.6cm and 0.26kg respectively. Discussion and conclusion: This initiative has improved preschools preparedness in creating an enabling environment in addressing health and nutritional problems within and beyond the classroom. Program implementers should not ignore this nexus of health, nutrition, and early child development by utilizing school platforms to improve the nutrition status and prevent all forms of malnutrition. Policy takeaway include initiating a school accreditation program to certify schools as Nutrition friendly and utilized the developed school nutrition policy developed to feed the development of National Nutrition Friendly school policy

Abstract Background:In year 2019 approximately 47.0 million children under five were wasted of which 32.3 million were moderately & remaining 14.3 million were severely wasted. Acute malnutrition has been estimated to be responsible for almost 12.6% of under five deaths globally. If remained untreated moderate Acute malnutrition (MAM) is likely to progress to Severe Acute Malnutrition (SAM). Both prevention and treatment of MAM are, therefore, likely to improve under-five survival globally. Therefore, this review aimed in determining the effectiveness of different approaches used for the management of MAM in Children 6-59 months of age in comparison with WHO Protocol for the management of MAM.Methods:Systematic review of Quantitative literature on Management of MAM in children 6-59 months using two electronic data bases (PubMed and Cochrane Library) and search engine (google scholars). Use of Grey literature, manual search and cross referencing were also performed. PRISMA checklist was used as a guide to this review. Total 14 studies out of XXXX were available for full text review based on eligibility criteria. Data extraction sheet was designed to extract relevant information. Overall Quality appraisal of included studies will be undertaken using Joanna Briggs Institute (JBI) checklist for RCTs and New castle checklist for other studies. Data Synthesis will be done using Review Manager software version 5.3.Discussion: Acute malnutrition is a continuum condition, but severe and moderate forms are treated separately This review findings would expect to explore the effective interventions and approaches undertaken for the management of MAM; in order to support and advocate for uniform, effective, simpler and sustainable approach for its management and to ensure that all MAM children should have access to treatment and hence not been neglected or awaited till the situation deteriorated to SAM. Systematic Review registration: PROSPERO, CRD42020161404