Integrating international policy standards in the implementation of postnatal care: a rapid review

INTRODUCTION

International legal and political documents can assist policy-makers and programme managers in countries to create an enabling environment to promote maternal and newborn health. This review aimed to map and summarise international legal and political documents relevant to the implementation of the WHO recommendations on maternal and newborn care for a positive postnatal experience.

METHODS

Rapid review of relevant international legal and political documents, including legal and political commitments (declarations, resolutions and treaties) and interpretations (general comments, recommendations from United Nations human rights treaty bodies, joint United Nations statements). Documents were mapped to the domains presented in the WHO postnatal care (PNC) recommendations; relating to maternal care, newborn care, and health systems and health promotion interventions, and by type of human right implied and/or stated in the documents.

RESULTS

Twenty-nine documents describing international legal and political commitments and interpretations were mapped, out of 45 documents captured. These 29 documents, published or entered into force between 1944 and 2020, contained content relevant to most of the domains of the PNC recommendations, most prominently the domains of breastfeeding and health systems interventions and service delivery arrangements. The most frequently mapped human rights were the right to health and the right to social security.

CONCLUSION

Existing international legal and political documents can inform and encourage policy and programme development at the country level, to create an enabling environment during the postnatal period and thereby support the provision and uptake of PNC and improve health outcomes for women, newborns, children and families. Governments and civil society organisations should be aware of these documents to support efforts to protect and promote maternal and newborn health.

Effect of heat load and dietary protein on oxygen pulse and energy cost for locomotion in heifers

The objectives of the present study were to evaluate the effect of heat load, bodyweight and dietary protein on oxygen pulse of heifers, to obtain the energy cost of walking on flat and sloping terrain, and to compare the energy cost of heifers during continuous walking and intermittent walking. In Experiment 1, the correlations of oxygen consumption, heart rate and oxygen pulse (O2P) with bodyweight, black globe temperature and temperature and humidity index were examined. Moreover, the effect of dietary protein on O2P was evaluated. The temperature and humidity index and black globe temperature had a low positive correlation with O2P and oxygen consumption, and a low negative correlation with heart rate. However, weight had no correlation with O2P. There was a linear increase in O2P with a very low adjustment with an increasing dietary crude protein concentration. In Experiment 2, the energy cost of heifers walking continuously at a constant speed in a terrain with 0%, 6% and 12% gradient was measured. The energy expenditure was similar among the terrain gradients. The heifers walking had a 16.6% higher energy expenditure than when they were standing. In Experiment 3, a comparison of the energy cost was made among heifers standing, continuously walking and intermittently walking at a constant speed on flat ground. The energy cost for walking was similar between continuous and intermittent walking. The heat load, bodyweight and dietary protein concentration had a low effect on O2P in dairy heifers. Therefore, measurements over a short time (5–15 min) are a reliable estimator of O2P through the day. Both intermittent and continuous walking can be used to evaluate energy expenditure.

New World Health Organization guidance helps protect breastfeeding as a human right

Written by the WHO/UNICEF NetCode author group, the comment focuses on the need to protect families from promotion of breast‐milk substitutes and highlights new WHO Guidance on Ending Inappropriate Promotion of Foods for Infants and Young Children. The World Health Assembly welcomed this Guidance in 2016 and has called on all countries to adopt and implement the Guidance recommendations. NetCode, the Network for Global Monitoring and Support for Implementation of the International Code of Marketing of Breast‐milk Substitutes and Subsequent Relevant World Health Assembly Resolutions, is led by the World Health Organization and the United Nations Children's Fund. NetCode members include the International Baby Food Action Network, World Alliance for Breastfeeding Action, Helen Keller International, Save the Children, and the WHO Collaborating Center at Metropol University. The comment frames the issue as a human rights issue for women and children, as articulated by a statement from the United Nations Office of the High Commissioner for Human Rights.

Using human rights for sexual and reproductive health: improving legal and regulatory frameworks

This paper describes the development of a tool that uses human rights concepts and methods to improve relevant laws, regulations and policies related to sexual and reproductive health. This tool aims to improve awareness and understanding of States' human rights obligations. It includes a method for systematically examining the status of vulnerable groups, involving non-health sectors, fostering a genuine process of civil society participation and developing recommendations to address regulatory and policy barriers to sexual and reproductive health with a clear assignment of responsibility. Strong leadership from the ministry of health, with support from the World Health Organization or other international partners, and the serious engagement of all involved in this process can strengthen the links between human rights and sexual and reproductive health, and contribute to national achievement of the highest attainable standard of health.