WHO’s recommendations on antenatal care

Pregnancy can be a precarious time in a woman’s life. By ensuring high-quality and people-centred health services for mothers-to-be, health systems make a valuable investment, with benefits that go well beyond pregnancy. Pregnancy offers an opportunity for health-care providers to work across sectors to address many aspects of health, leading to a reduction in disease and death and improvements to well-being. The information given to pregnant women is passed from mothers to their children and wider families, from generation to generation, and is a prime example of the life-course approach, as health behaviour at this critical time in life influences health behaviour and affects health later in life.

Prenatal classes in Georgia are turning pregnancy into a life-course opportunity for health.

Tinatin Gagua, head of an antenatal care clinic in Tbilisi, Georgia stated:

“When we started our training in 2011, antenatal care was a brand new concept in Georgia. Doctors were not used to spending time informing pregnant women about their pregnancies and their babies’ health. We were trained to give classes to groups of pregnant women. Being in a group made a great difference because it helped women to ask questions and socialize with their peers.”

More information about the WHO’s recommendations on antenatal care on the who.int website.

Breast implants

The European Commission and its Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) has published two Scientific Advices related to breast implants and health. They are on 1) new scientific information on the safety of PIP breast implants and 2) the possible association between breast implants and anaplastic large cell lymphoma (ALCL).

The first piece of advice concerns whether there is sufficient new scientific information on the safety of PIP breast implants to warrant an update of the 2014 SCENIHR Opinion and based on the scientific information it has gathered and evaluated, the SCHEER concludes that this is not the case at present.

The second piece of advice is on the state of scientific knowledge on a possible association between breast implants and anaplastic large cell lymphoma (ALCL). The SCHEER concluded that, at present, there is insufficient scientific information available to establish a methodologically robust risk assessment on the potential association of breast implants with the development of ALCL.

To download the full advice on the safety of PIP breast implants from the ec.europa.eu website

To download the full advice on the association between breast implants and ALCL from the ec.europa.eu website

Women’s health and well-being in Europe

The latest session of the WHO Regional Committee for Europe has considered the Strategy on women’s health and well-being in the WHO European Region and produced a report “Women’s health and well-being in Europe: beyond the mortality advantage”.

To provide background to the Strategy, the new report:

  • presents a snapshot of women’s health in the Region;
  • discusses the social, economic and environmental factors that determine women’s health and well-being;
  • focuses on the impact of gender-based discrimination and gender stereotypes;
  • considers how people-centred health systems could respond to women’s needs; and
  • outlines important perspectives for the international and national frameworks that govern women’s health and well-being in Europe.

Download the full report on Women’s health and wellbeing in Europe from the euro.who.int website

Breast cancer care

Breast cancer is the most common cancer in Europe.
It is the most deadly cancer in women: one out of every six women with cancer will die from breast cancer.
In addition, incidence and mortality rates for breast cancer vary widely between countries: although a higher mortality rate in some countries may be due to a higher incidence rate, in others it is due to a lower rate of survival. This reflects major inequalities, including diverse quality of care.
The European Commission Initiative on Breast Cancer is a person-centred, sustainable initiative aimed at improving and harmonising breast cancer care across Europe. It will include training templates and a platform of guidelines.
To download the leaflet on the Initiative on Breast Cancer from the ecibc.jrc.ec.europa.eu website

Perinatal mental health

Perinatal mental illnesses affect at least 10% of new mothers and can have a devastating impact on them and their families. When mothers suffer from illnesses such as anxiety, depression and postnatal psychotic disorders it increases the likelihood of their children experiencing behavioural, social or learning difficulties and failing to fulfil their potential.

This project (PATH) is applying for funding from the Interreg 2Seas programme and will devise and pilot a range of services within local areas to ensure that women who are at risk of, or suffering from, perinatal mental illnesses are given appropriate support at the earliest opportunity. These services will support new mothers in their return to work and will have a clear cost benefit to them, their families and to health systems. Perinatal mental illnesses in the UK are estimated to cost society around £8.1 billion for each one-year cohort of births, with 72% of this cost relating to adverse, long-term  impacts on the child.

We have only just started looking for partners but already have interested organisations in the UK including KMPT, Plymouth MIND and the Institute of Health Visitors as well as Odisee and Karel de Grote University in Belgium.

Maternal nutrition linked to children’s risk of NCDs and obesity

The nutritional well-being of pregnant women affects not only their fetuses’ development but also children’s long-term risk of developing non-communicable diseases (NCDs) or obesity, according to a new report from WHO/Europe “Good maternal nutrition. The best start in life”.

While the importance of good nutrition in the early development of children has been recognized for decades, the report offers a systematized review of the most recent evidence on maternal nutrition and obesity and NCD prevention. The findings confirm that a mother’s nutritional status – including overweight and obesity, excessive gestational weight gain and gestational diabetes – affects not only her child’s health as an infant but also the child’s risk of obesity and related chronic diseases as an adult. In short, maternal nutrition can truly have an intergenerational impact.

The findings of this report further emphasize the need to implement strategies to optimize the nutrition of reproductive-age women. The evidence suggests that such interventions are among the most effective and sustainable means of achieving positive effects on health and reducing health inequalities across the next generation.

For more information about the impact of maternal nutrition on children on the euro.who.int website

 

European strategy for women’s health

Just over half of the 900 million people living in the WHO European Region (463 million) are women and they are living longer than men. Their life expectancy is also increasing but these extra years (women’s “mortality advantage”) are not necessarily healthy years: on average, women spend 10 years in ill health.

The main causes of ill health and death among women differ across life stages and countries. Physical health conditions dominate in early life; depressive and anxiety disorders develop among young women moving into adult life; and lower back pain, ischaemic heart disease and cancers are more prevalent in older age.

Health inequities among women both within and between countries in the Region are large and unjustifiable. Equal access to health services has not been achieved for women living in rural areas, those from minority groups or those who are migrants, refugees or asylum seekers.

WHO/Europe is drawing on the evidence and experience of key experts in women’s health from national and local governments, academia, United Nations agencies, civil society and other partners to develop a European strategy for women’s health.

This strategy will focus on the determinants of women’s health, without necessarily comparing women with men. The aim is to inspire governments and stakeholders to work towards improving women’s and girls’ health and well-being beyond issues of reproductive, maternal and child health. The strategy will encourage taking action to reduce health inequities for women by, for example, eliminating discriminatory values, norms and practices; tackling the impact of gender and social, economic, cultural and environmental determinants; and improving health system responses to women’s health and well-being.

To read Beyond the mortality advantage:investigating women’s health in Europe on the who.int website

 

Safety of surgical meshes

The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) has published its final Opinion on the safety of surgical meshes used in urogynaecological surgery.

A key conclusion is that in assessing the risk associated with mesh application, it is important to consider the overall surface area of material used, the product design and the properties of the material used. In addition, the available evidence suggests a higher morbidity in treating female pelvic organ prolapse (POP) than Stress Urinary Incontinence (SUI), as the former uses a much larger amount of mesh.

SCENIHR’s recommendations include:

  • Material properties, product design, overall mesh size, route of implantation, patient characteristics, associated procedures (e.g. hysterectomy) and surgeon’s experience should be considered when choosing appropriate therapy.
  • The implantation of any mesh for the treatment of POP via the vaginal route should be only considered in complex cases in particular after failed primary repair surgery.
  • For all procedures, the amount of mesh should be limited where possible.
  • A certification system for surgeons should be introduced based on existing international guidelines and established in cooperation with the relevant European Surgical Associations.

To read the full opinion on the ec.europa.eu website

Zika virus in Europe

The WHO has declared the Zika virus outbreak a “Public Health Emergency of International Concern”.

The European Commission has created a central web page with information on the Zika outbreak and how it is being managed in the EU. It will be regularly updated in line with the latest developments.

To see more about the Zika virus in Europe on the ec.europa.eu website.