分类： health

Ahead of Tuesday’s International Day of the Midwife, the Pan American Health Organization (PAHO) released a sobering assessment of midwifery systems across the Americas and Caribbean on Monday, highlighting widespread regulatory gaps that hold back life-saving maternal and reproductive care across the region.

According to the UN health agency’s analysis, only 60% of countries in the region have a national regulatory body that clearly outlines the full scope of practice for professional midwives, and just half have implemented formal systems for regular license renewal and ongoing quality assurance. PAHO officials emphasize that these systemic gaps prevent regional health systems from unlocking the full potential of midwifery personnel, leaving millions without access to consistent, high-quality, respectful maternity care.

At present, PAHO data collected through the National Health Workforce Accounts platform counts more than 78,000 active midwifery professionals across the Americas, translating to an average density of 3.5 midwives per 10,000 people. However, this regional average masks stark geographic inequities: subregions including Central America and many parts of the Caribbean report critically low midwife densities, ranging from just 0.1 to 13.5 per 10,000 people. PAHO notes these disparities highlight the urgent need to expand midwife training, improve equitable distribution of the workforce, and boost retention of professionals in underserved high-need areas.

Despite these challenges, there are signs of progress across the region. Three-quarters of countries in the Americas now formally recognize midwifery as a distinct profession separate from nursing, a key milestone that paves the way for specialized education, greater professional autonomy, and clear regulatory frameworks that allow midwives to practice to the full extent of their training. Currently, 160 accredited professional midwifery training programs operate across the region, many of which have integrated modern digital learning tools, interprofessional education opportunities, and diverse clinical training settings to better prepare graduates. On average, 88% of these program graduates meet all core midwifery competency requirements, equipping them to deliver comprehensive care spanning sexual and reproductive health, pregnancy, childbirth, and postnatal care.

PAHO is currently collaborating closely with member states to strengthen midwifery systems and the broader regional health workforce. The agency supports data-driven national workforce planning, the development and modernization of midwifery education and training curricula, and the advancement of clear regulation and formal professional recognition. It also prioritizes the integration of midwives into interprofessional health care teams, and promotes the adoption of evidence-based clinical guidelines to raise care standards, including the expansion of respectful person-centered maternity care.

Benjamín Puertas, Unit Chief of Human Resources for Health at PAHO, emphasized that strengthening the midwifery workforce is a core strategic priority for the entire region. “Midwives are essential to expanding access to care, particularly in rural and underserved areas, and to ensuring continuity of high-quality services for women and newborns,” Puertas stated.

PAHO officials stress that when midwifery personnel are adequately trained, fully supported, and properly integrated into national health systems, they can deliver up to 90% of all essential sexual, reproductive, maternal, newborn, and adolescent health interventions. Beyond improving pregnancy and birth safety, well-integrated midwifery also boosts broader public health outcomes including sexual health, adolescent health, disease prevention, and community-wide health promotion. Rooted in respectful, culturally congruent care that centers the unique social and community contexts of patients, midwifery also helps build long-term community trust in health services and advances broader health equity across populations. To unlock these benefits, PAHO is urging all regional governments to prioritize investment in midwifery as a foundational pillar of building resilient, equitable, people-centered national health systems.

Nearly seven months after Hurricane Melissa slammed into western Jamaica, destroying critical community healthcare infrastructure, the island nation is on the cusp of fully restoring primary care access for rural residents, with top health officials calling on locals to re-engage with local clinics to manage chronic conditions and reduce strain on overloaded hospitals.

Jamaica’s Minister of Health and Wellness Dr Christopher Tufton made the announcement during an April 30 press briefing, held immediately after he completed an inspection tour of the Black River Hospital and Health Centre in the parish of St Elizabeth, one of the regions hardest hit by last October’s storm. Of the 23 public health centres operating across St Elizabeth before the hurricane, 10 suffered severe structural damage that forced temporary closures and pushed thousands of patients to seek care at already crowded regional hospitals.

As of late April, all but one of the damaged clinics have completed repairs and resumed full operations, Tufton confirmed. The lone outlier, the Black River Health Centre, is currently undergoing final reconstruction work, with care currently being delivered out of a temporary container-based facility set up on the clinic’s original compound. Tufton projected that the full restoration will be finished by late May or early June, bringing all 23 St Elizabeth health centres back online to serve local communities.

The nationwide push to reopen storm-damaged primary care facilities is a core component of Jamaica’s broader public health strategy, which aims to center primary and preventive care rather than rely on overstretched hospital services. By encouraging patients to return to community clinics for routine chronic disease management, preventive health screenings, and prescription refills, officials hope to decongest acute care hospitals, extend essential services to underserved rural populations, and reduce the rate of preventable hospitalizations that strain both the public health system and household finances.

Currently, only around 80% of former primary care patients have resumed regular visits to their local clinics, a gap Tufton attributes to lingering disruption from the hurricane. Recognizing the trauma that storm-affected communities have endured, the ministry has launched a targeted community outreach effort, with community health aides and primary care teams going door-to-door to encourage residents of all ages to return to routine care.

“ We understand the trauma that they have been through, but we don’t want them to neglect their chronic illnesses, their screening opportunities, and their access to drugs, ” Tufton said, noting that consistent primary care is the foundation of long-term public health, national economic resilience, and protection for Jamaica’s most vulnerable populations.

The initiative also incorporates a data-driven framework to track progress: officials will monitor key metrics including patient re-engagement rates, completion of preventive screenings, and adherence to ongoing treatment plans to refine outreach efforts and address gaps in access.

Once full restoration is complete, the Black River Hospital – which was also heavily damaged by the storm – will operate close to 150 beds, a capacity that reflects the growing demand for expanded healthcare services across western Jamaica.

Every May, communities around the world observe Mental Health Awareness Month, an annual initiative designed to break down long-held stigma around psychological distress, expand public understanding of emotional wellbeing, and motivate people of all backgrounds to prioritize their mental health. This year, clinical experts are turning focused attention to the distinct, overlapping pressures that disproportionately impact women’s mental health – pressures forged by biological shifts, deeply ingrained social expectations, and the unbalanced distribution of domestic and emotional labor across most households.

Angela Dacres, a licensed mental health counselor, explains that the challenges women face often cut across every domain of daily life, intersecting in complex ways that make consistent emotional wellbeing harder to maintain. For this reason, she argues, intentional awareness and targeted action during Mental Health Awareness Month are especially critical for women navigating these overlapping stressors.

Unlike many other demographic groups, women’s mental health is tightly intertwined with lifelong hormonal and physical changes that can trigger dramatic shifts in emotional state. From the premenstrual mood fluctuations many face each cycle to the dramatic biological upheaval of pregnancy, postpartum recovery, and menopause, these physiological shifts create consistent emotional vulnerability that is still widely overlooked by both the public and many healthcare providers. Conditions like postpartum depression, for example, are a widespread and serious public health issue, yet they remain widely misunderstood, downplayed, or misdiagnosed, leaving millions of women without the support they need.

Compounding these biological challenges are unforgiving social norms that demand women maintain high levels of productivity even when they are struggling with physical fatigue, chronic pain, or intense emotional strain. This constant pressure to perform often leads to burnout before many women even recognize they are experiencing distress. Systemic and cultural barriers only make this worse: limited access to affordable mental healthcare, persistent cultural stigma around seeking help for psychological issues, and a widespread lack of structural support leave many women unable to reach out for care even when they recognize they need it.

One of the most underrecognized contributors to poor mental health among women is the unequal distribution of invisible emotional labor within family units. In the vast majority of households, women still serve as the primary caregivers for children, elderly relatives, and partners, taking on not just physical household tasks but also the full responsibility for managing every family member’s emotional needs. This uncompensated, unseen work – from remembering every family member’s schedule and medical appointments to mediating conflicts between relatives to maintaining the emotional stability of the home – is consistently draining and rarely acknowledged by other household members or society at large. Over time, the constant weight of this responsibility, paired with little to no time left for personal rest or self-care, often leads to chronic stress, clinical anxiety, and a persistent feeling of being overwhelmed.

Romantic and personal partnerships add another layer of emotional pressure for many women. Social norms often push women into unequal dynamics that require them to take on most of the work of relationship communication, manage a partner’s emotional needs, and balance the expectation of independence with the pressure to prioritize a partner’s goals over their own. This widespread social pressure to put others’ needs before their own leads many women to suppress their own emotions and leave their core emotional needs unmet for years. In more extreme cases, when relationships are marked by conflict or a total lack of mutual support, this persistent imbalance can cause long-term damage to both mental health and self-esteem.

For women who are parents, the pressure is amplified even further by the pervasive cultural myth of the “perfect mother” that is constantly reinforced through social media and popular culture. Women are bombarded with unrealistic standards for what it means to be a “good mom,” leading to widespread feelings of guilt, crippling self-doubt, and constant unhealthy comparisons to other women. Juggling the demands of parenting with paid work, personal career goals, and maintaining a romantic partnership often feels unmanageable, and without adequate structural or familial support, many mothers end up experiencing chronic emotional exhaustion and social isolation.

Despite the scope of these challenges, Dacres emphasizes that Mental Health Awareness Month offers a critical, accessible opportunity for women to pause, reflect on their current state, reset their routines, and take intentional action to improve their long-term wellbeing. Meaningful action does not require dramatic overhauls of daily life, she notes: simple, consistent steps can make a profound difference over time. These steps include setting clear boundaries to protect personal time and energy, reaching out for licensed professional support when distress persists, and building intentional support networks with friends, family members, or local community groups who can step in during difficult times.

Dacres adds that this month is also an ideal time for women to prioritize realistic, guilt-free self-care that fits their individual schedules and needs. Whether that means prioritizing extra rest, adding regular low-impact movement to a routine, keeping a mood journal to process emotions, or simply taking small daily breaks without feeling guilty for putting their needs first, every small action counts. Educating oneself on common signs of chronic stress and burnout can also help women catch distress early before it develops into more serious mental health conditions.

Ultimately, Dacres explains, the goal of engaging with Mental Health Awareness Month as a woman is not to make dramatic, unsustainable changes to one’s life. It is to build consistent, small habits that support long-term emotional wellbeing. By openly acknowledging the unique challenges women face and taking intentional steps to address them, women can turn this annual awareness month into an opportunity to not just cope with daily stress, but to build lasting emotional resilience and create a healthier, more sustainable balance across all areas of their lives.

BLACK RIVER, St Elizabeth – Nearly seven months after Category 5 Hurricane Melissa devastated key public infrastructure across Jamaica, the large-scale recovery effort at Black River Hospital is moving ahead at a faster-than-expected pace, with construction teams focused on delivering a more storm-resilient facility to reverse widespread disruptions to regional healthcare services.

During an on-site inspection tour Thursday alongside senior leadership from the Southern Regional Health Authority (SRHA), Health and Wellness Minister Dr. Christopher Tufton shared updated details on the rebuild, confirming that core medical services are on track to be restored within the next two months. While a long-term national ecological study is being conducted to assess the flood and storm vulnerability of all public health facilities across the country – a process that could lead to additional major structural upgrades in a final resilience phase – the government’s immediate priority remains restarting full service delivery as quickly as possible.

“Right now our biggest challenge is getting the entire system back up and running so we can meet the healthcare needs of the community, and so far, the progress has exceeded expectations. The project team has done exceptional work moving this forward,” Tufton told reporters during the tour.

Construction crews are currently working to wrap up upgrades to key facilities on schedule. The hospital’s male and female inpatient wards, rebuilt with reinforced structural materials to withstand future extreme weather events, are expected to open to patients by the end of June. Two operating theatres, which also received full overhauls, are on track to be commissioned and put into service in just two weeks.

Tufton explained that the rebuilt facility incorporates far more robust engineering than the original structure. “Construction is well advanced: we are preparing to install reinforced metal roofing and a reinforced concrete slab designed to withstand hurricane-force winds and flooding, so this will be a much stronger, safer facility for both patients and staff,” he said. “Inside the two operating theatres, surgical lighting is already being installed and final finishing work is underway. That means we will once again be able to perform routine and emergency surgeries right here at Black River Hospital, in a fully updated facility.”

Melissa made landfall in Jamaica on October 28, 2025, leaving a trail of destruction across the island. Black River Hospital was one of the hardest-hit major government facilities, forcing the facility to suspend most core services and divert patients to nearby hospitals for months.

In addition to the main hospital reconstruction, the project team has already completed renovations to on-site staff quarters. Tufton noted that part of the newly restored staff housing will be repurposed temporarily to expand outpatient services, while the remaining space will be used for staff accommodation. When the full hospital rebuild is complete in 6 to 8 weeks, the facility will have nearly 150 inpatient beds available, a capacity upgrade that will significantly ease the overcrowding and patient backlogs that have plagued neighboring facilities since the storm.

“This restoration will take huge pressure off Mandeville Regional Hospital, Percy Junor Hospital in Manchester, and Savanna-la-Mar Public General Hospital in Westmoreland, all of which have absorbed thousands of extra patients from St Elizabeth since Hurricane Melissa hit,” Tufton explained.

The recovery effort extends beyond the main hospital to community care across the parish. Of the 23 public health centers serving St Elizabeth, 10 suffered severe damage during the storm. Only the Black River Health Centre remains out of its original building, but Tufton confirmed reconstruction is on schedule to wrap up in one month, allowing services to move back to the permanent facility. Currently, the health center is operating out of a temporary container-based facility on the original compound, and the operation has been running smoothly.

Tufton projected that all 23 health centers across the parish will be fully operational by the end of May or early June. Currently, around 80 percent of primary care patients have returned to their local community health centers, but the ministry is launching an outreach effort to encourage more residents to resume routine care, after many avoided seeking services in the wake of the storm.

“We understand the trauma that the people of this parish have been through, but we cannot let that lead to people neglecting their ongoing health needs,” Tufton said. “We don’t want people putting off chronic disease management, life-saving screenings, or access to their prescription medications. That’s why I’ve challenged the local health team to conduct targeted community outreach, to encourage mothers, children, and elderly residents to return to their local health centers for the care they need.”

An outbreak of severe acute respiratory illness has shaken a polar cruise ship traveling through the Atlantic Ocean, leaving at least two people confirmed dead and one patient in intensive care in Johannesburg, South Africa’s health ministry confirmed to Agence France-Presse on Sunday.

The incident unfolded aboard the MV Hondius, a polar exploration vessel operated by Dutch tour firm Oceanwide Expeditions, which was carrying out a voyage from Ushuaia, Argentina, bound for Cape Verde. The ship, which holds capacity for roughly 170 passengers and 70 crew members, was positioned just off Praia, Cape Verde’s capital, as of Sunday, according to multiple online vessel tracking platforms.

South African health department spokesperson Foster Mohale confirmed that one patient evacuated to Johannesburg for treatment has tested positive for hantavirus, a group of pathogens most commonly spread to humans via rodent populations. The virus spreads through direct contact with infected rodents’ urine, fecal matter or saliva, through bites, or via inhalation of dust contaminated with viral particles, guidance from the U.S. Centers for Disease Control and Prevention notes. Different strains of hantavirus circulate across different global regions, and they can trigger a range of severe symptoms including life-threatening hemorrhagic fever.

According to Mohale, the first fatality was a 70-year-old passenger who first developed symptoms and died while the vessel was still at sea. His remains are currently held on Saint Helena, a British overseas territory in the South Atlantic that was one of the ship’s scheduled stops. The passenger’s 69-year-old spouse was also infected and evacuated to South Africa for urgent care, and she later died in a Johannesburg hospital. Mohale added that official confirmation of the victims’ nationalities was still pending as of Sunday, though an anonymous source close to the investigation told AFP the two deceased are a Dutch couple, bringing the provisional death toll to three.

A third infected passenger, a 69-year-old British national, was also evacuated to Johannesburg and remains in intensive care as public health teams continue to monitor his condition. Discussions are ongoing between international health authorities about whether two additional sick passengers should be admitted to hospitals in Cape Verde for isolation, the anonymous source said. After the ship completes its stop in Cape Verde, it is scheduled to continue its voyage to the Spanish Canary Islands.

The World Health Organization confirmed Sunday that it is aware of the outbreak, and that a coordinated international public health investigation and response is already underway. “We will share more information as it becomes available,” the organization said from its Geneva headquarters. AFP reached out to Oceanwide Expeditions, the ship’s operator, for comment on the outbreak as of Sunday, but had not received a response by the time of reporting.