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New York Times Series Examines Maternal Mortality In Tanzania
The New York Times on Sunday examined maternal mortality in Tanzania, in the opening of a three-part series on maternal mortality in Africa. According to the Tanzanian Ministry of Health, the country has a maternal death rate of 578 per 100,000 births, though the World Health Organization puts the count at 950 maternal deaths per 100,000 births. Roughly 13,000 Tanzanian women die of pregnancy- or childbirth-related causes annually, giving it "neither the best nor the worst record in Africa," the Times reports. Tanzania is one of the world"s poorest countries and faces shortages in several areas -- including health workers, drugs, equipment and infrastructure -- that contribute to maternal mortality.The Times profiled obstetrical care at a rural hospital in Berega, Tanzania, that typifies efforts to reduce maternal mortality in Africa. Facing a shortage of doctors and nurses, the hospital has been training "assistant medical officers" to perform caesarean sections and other procedures. Meanwhile, the government also is attempting to train more assistants and midwives, build more clinics and nursing schools, offer housing to attract health workers to rural areas and provide places for pregnant women to stay closer to hospitals.According to the Times, many women who die in childbirth are young and healthy, and most maternal deaths are preventable with basic obstetrical care. The five leading causes of maternal death are bleeding, infection, high blood pressure, prolonged labor and complications resulting from abortions, the Times reports. In discussing maternal mortality, experts often refer to what are known as "the three delays": a woman"s delay in going to the hospital, the time spent traveling there and the hospital"s delay in starting treatment upon the woman"s arrival. Although only around 15% of births have dangerous complications, the problems are almost impossible to predict, and seemingly normal labors can quickly progress into serious emergencies. Worldwide, more than 536,000 women die annually from pregnancy or childbirth, according to WHO (Grady, New York Times, 5/24).
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'Homework Assignment' Could Mean Success, Failure For Health Reform Legislation

How well health care industry groups follow through on their "homework assignment" from President Obama to submit specific plans by early June on how they intend to reduce health care spending growth by $2 trillion over the next decade could determine whether current attempts to develop health care overhaul legislation are successful, the AP/Contra Costa Times reports (Alonso-Zaldivar, AP/Contra Costa Times, 5/25).In a letter that was sent to Obama on May 10, a coalition of health care industry groups wrote, "We will do our part to achieve your administration"s goal of decreasing by 1.5 percentage points the annual health care spending growth rate. ... This represents more than a 20% reduction in the projected rate of growth." The letter -- which was signed by the American Medical Association, the American Hospital Association, Pharmaceutical Research and Manufacturers of America, the Advanced Medical Technology Association, America"s Health Insurance Plans and the Service Employees International Union -- did not elaborate on what specific measures the groups would take to achieve such reductions. The Obama administration requested specifics on the coalition"s cost-cutting plans by June 1 (Kaiser Daily Health Policy Report, 5/18).Each group has been looking into its own ways it can reduce spending growth, the AP/Contra Costa Times reports. Insurers currently are examining strategies to cut the administrative costs of filing claims. AMA President-elect James Rohack said his organization will look at how to implement comparative effectiveness research and ways to prevent harmful and costly drug interactions, which he said "can save money ... by preventing unnecessary readmissions to hospitals," adding, "The most costly site where patients get care is the hospital." In addition, hospitals have begun looking into how to reduce readmissions.If the industry groups are able to convince lawmakers that their plans can significantly reduce spending growth, Obama "could be well on his way to closing a deal with Congress" on universal health coverage, the AP/Contra Costa Times reports. However, if the plans are rejected, the groups risk their reputations and Obama could be "seen as naive for entertaining such promises," according to the AP/Contra Costa Times. Some experts have said that the groups" pledge to cut health care spending is possible "in theory." According to the AP/Contra Costa Times, the challenge will be to persuade medical providers "to change years of ingrained habits that lead to much of the wasteful spending" in the health care system (AP/Contra Costa Times, 5/25). AHIP"s Ignagni Profiled The AP/Washington Times on Tuesday profiled AHIP President and CEO Karen Ignagni, who was a "key architect" of the industry"s pledge to reduce health care spending. According to the AP/Washington Times, "with the prospect of a congressional health care overhaul looming, ... Ignagni"s role is more important than ever." The AP/Washington Times reports that there are several questions surrounding Ignagni"s involvement in the debate over health care reform, including, "What will Ms. Ignagni do if Congress produces a bill she doesn"t like? Will her group try to kill it, resurrecting "Harry and Louise"-style attack ads that proved so devastating during the Clinton years?" Ignagni has declined to say how the group would respond in the event of such a bill, but said in a recent interview, "The people who are working on this issue, even in areas where we have differences, are very thoughtful, have the right objectives, and we have a long history of working with them," adding, "So we"re going to give them the courtesy of thoughtfully responding to what they propose" (Werner, AP/Washington Times, 5/26). Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.


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