Howard L Sobel

Howard L Sobel
World Health Organization WHO | who · Regional Office for the Western Pacific

MD, MPH, PHD

About

59
Publications
34,605
Reads
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875
Citations
Introduction
Howard L Sobel currently works at the Regional Office for the Western Pacific, World Health Organization WHO as Regional Coordinator for Reproductive, Maternal, Newborn, Child Health, quality & safety of health service delivery, IPC & safe affordable surgery. He does implementation and operational research in health systems in Low and Middle Income Countries toward improving quality.
Additional affiliations
June 2012 - present
World Health Organization WHO
Position
  • Manager
Description
  • Reproductive, Maternal, Newborn, Child, Adolescent Health Health Service and Facility Quality and Safety Infection Prevention and Control (IMST and programmatic) Safe and Affordable Surgery
Education
June 1998 - June 2000
Johns Hopkins Bloomberg School of Public Health
Field of study
  • Preventive Medicine

Publications

Publications (59)
Article
Full-text available
The WHO recommends kangaroo mother care (KMC) for stable preterm and low birthweight babies because it has been demonstrated to reduce mortality by up to half compared with conventional incubator-based care. Uptake of KMC in low/middle-income countries has been limited, despite its suitability for low-resource environments. This paper reviews facto...
Article
Full-text available
Background: To improve maternal and neonatal outcomes, Vietnam implemented early essential newborn care (EENC) using clinical coaching and quality improvement self-assessments in hospitals to introduce policy, practice and environmental changes. Da Nang Hospital for Women and Children began EENC with caesarean section births to inform development...
Book
Full-text available
Provision of safe and affordable surgical care is essential to achieving universal health coverage and the health-related Sustainable Development Goals. Universal provision of an essential surgical service package could prevent around 6–7% of all avertable deaths in low- and middle-income countries, where an additional 143 million surgical procedur...
Article
Full-text available
We describe the first infant born to a woman with COVID‐19 in Vietnam, by Caesarean section at 36 weeks and five days of gestation. The mother and baby remained together during their hospital stay and prolonged skin‐to‐skin contact and early and exclusive breastfeeding were achieved. This was in line with the World Health Organization’s Early Essen...
Article
The WHO Safe Childbirth Checklist (the SCC) is a clinical tool developed to help health workers follow evidence-based maternal and perinatal care practices at childbirth. Newborn delivery care practices at facilities in 7 countries in East Asia and the Pacific were compared to practices checked by the SCC. The analysis found that the SCC does not i...
Article
Full-text available
Objective: To explore the association between early essential newborn care (EENC) policy, practice and environmental interventions and breastfeeding outcomes. Design: Cross-sectional observational study. Setting: 150 national, provincial and district hospitals implementing EENC in eight countries in East Asia and the Pacific. Participants: 1383...
Article
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Background In the World Health Organization Western Pacific Region (WHO WPRO), most adolescents enroll in secondary school. Safe, healthy and nurturing school environments are critical for adolescent health and development. Yet, there were no systematic reviews found on the efficacy of school-based interventions among adolescents living in low and...
Article
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Background: Newborn mortality in Oceania declined slower than other regions in the past 25 years. The World Health Organization (WHO) introduced the Early Essential Newborn Care program (EENC) in 2015 in Solomon Islands, a Small Island Developing State, to address high newborn mortality. We explored knowledge and skills retention among healthcare...
Article
Background Water, sanitation and hygiene (WASH) services are critical to providing quality maternal and neonatal care in health facilities. This study aimed to investigate availability of WASH policies, standards, and services for childbirth and newborn care in hospitals in East Asia and the Pacific. Methods Descriptive analysis of survey data and...
Article
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Objectives: To explore the reasons for discontinuation of the last contraceptive method used in women with a current unintended pregnancy. Study design: We conducted a retrospective analysis using contraceptive calendar data from Demographic and Health Surveys from 36 low- and middle-income countries from 2005 through 2014. The prevalence of con...
Article
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Background: In the Philippines, one in four pregnancies are unintended and 610 000 unsafe abortions are performed each year. This study explored the association between missed opportunities to provide family planning counseling, quality of counseling and its impact on utilization of effective contraception in the Philippines. Methods: One-hundre...
Article
Full-text available
Emergency obstetric and newborn care (EmONC) can be life-saving in managing well-known complications during childbirth. However, suboptimal availability, accessibility, quality and utilisation of EmONC services hampered meeting Millennium Development Goal target 5A. Evaluation and modelling tools of health system performance and future potential ca...
Article
Full-text available
Background: To accelerate reductions in neonatal mortality, Viet Nam rolled out early essential newborn care (EENC) using clinical coaching, quality improvement assessments in hospitals, and updated protocols. Da Nang Hospital for Women and Children, a tertiary referral hospital in central Viet Nam, compared outcomes preand post-EENC introduction....
Article
Full-text available
Objectives: As a part of the process of implementing Early Essential Newborn Care (EENC) in China, which are evidence-based interventions recommended by the World Health Organization (WHO), we sought to understand whether current hospital policies are consistent with WHO-recommended standards and what factors influence their use. Data from the stu...
Article
Objective: To determine whether intrapartum and newborn care practices improved in 11 large hospitals between 2008 and 2015. Design: Secondary data analysis of observational assessments conducted in 11 hospitals in 2008 and 2015. Setting: Eleven large government hospitals from five regions in the Philippines. Participants: One hundred and se...
Book
Full-text available
Early Essential Newborn Care (EENC) Module 1 is the first in a series of five modules which support planning, implementation, improvement and monitoring and evaluation of EENC. Module 1 is used at the national and subnational levels to collect data for the development of annual implementation plans and five-year national action plans. http://iris...
Book
Full-text available
This module aims to provide the EENC hospital team with a practical approach to assess and improve the quality of routine childbirth and newborn care. The team will use data from observations, interviews and reviews of charts, policies and hospital registers to complete checklists, identify priorities and develop plans
Book
Full-text available
Stand-alone trainings rarely change health worker practices. Clinical coaching is an on-the-job approach. The interactive coaching methodology explores normal practices, the evidence around beneficial and harmful practices and how to improve practices. Staff and facilitators alike found the methodology more effective than usual training methodologi...
Book
Full-text available
This Guide aims to provide health professionals with a user-friendly, evidence-based protocol to essential newborn care – focusing on the first hours and days of life. The target users are skilled birth attendants including midwives, nurses and doctors, as well as others involved in caring for newborns. This pocket book provides a step-by-step guid...
Book
Full-text available
In its mandate to provide normative guidance to Member States, WHO has issued various evidence-based guidelines and recommendations on maternal health care. This report shows the dissemination and implementation status of these guidelines and recommendations in eight Member States that account for 96% of maternal deaths and 97% of neonatal deaths i...
Book
Full-text available
Background Among the Member States of the World Health Organization (WHO) Western Pacific Region, Cambodia has one of the lowest modern methods contraceptive prevalence rates (CPRs) at 38.8% among married women. Thirty per cent of married women not desiring pregnancy either do not use a family planning method or use a traditional method, placing th...
Book
Full-text available
Newborn deaths account for half of deaths of children under 5 years. Member States developed the Action Plan for Healthy Newborn Infants in the Western Pacific Region (2014–2020) to support scaling up EENC interventions. Eight priority countries with the highest burden of neonatal mortality (Cambodia, China, the Lao People's Democratic Republic, Mo...
Book
Full-text available
Among the Member States of the World Health Organization (WHO) Western Pacific Region, Papua New Guinea has one of the lowest contraceptive prevalence rates at 32.4%, among married women. Addressing the unmet need for family planning is critical to reach the United Nations Sustainable Development Goals (SDGs). Fewer unwanted pregnancies reduce mate...
Poster
Full-text available
Abortion infographics of priority countries in the Western Pacific Region: http://iris.wpro.who.int/handle/10665.1/13974 Select regional or country infographics from Cambodia, China, Lao People’s Democratic Republic, Papua New Guinea, Philippines ,Solomon Islands, Viet Nam
Article
Full-text available
Background: Around the world, the incidence of multiple pregnancies reaches its peak in the Central African countries and often represents an increased risk of death for women and children because of higher rates of obstetrical complications and poor management skills in those countries. We sought to assess the association between twins and early...
Article
Every year, an estimated 180 000 babies in the Western Pacific Region are infected by hepatitis B, 13 000 by syphilis and 1400 by HIV through mother-to-child transmission.1 These infections can be largely prevented by antenatal screening, treatment and timely vaccination for newborns. Despite challenges in controlling each disease, major achievemen...
Article
Objective: To determine the prevalence of eclampsia symptoms and to explore associations between eclampsia and early neonatal mortality. Methods: The present secondary analysis included Demographic and Health Surveys data from 2005 to 2012; details of signs related to severe obstetric adverse events of singleton deliveries during interviewees' m...
Article
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Aim: To review literature on identifying the risk factors associated with early sexual coerced debut with the aim to facilitate the health care workers' planning of relevant health services to improve intervention strategies for delaying of early coerced sexual debut or forced sexual debut (CSD/FSD) in the communities. Background: Identifying th...
Article
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Background Around 1.5 million annual neonatal deaths occur in the first week of life, and infections represent one of the major causes in developing countries. Neonatal sepsis is often strictly connected to infection of the maternal genital tract during labour. Methods The association between signs suggestive of puerperal infection and early neona...
Article
Objectives: To determine the relation between place and skilled birth attendance at birth and early neonatal mortality. Design: Retrospective analysis using data from Demographic and Health Surveys on obstetric complications. Setting: Nine low and middle income countries between 2006 and 2013. Population: 71 758 women aged 15-49 years. Meth...
Technical Report
Full-text available
Second Biennial Report Report (2016-2017): Action Plan for Healthy Newborns in the Western Pacific Region Eight priority countries with the highest burden of newborn deaths (Cambodia, China, the Lao People's Democratic Republic, Mongolia, Papua New Guinea, the Philippines, Solomon Islands and Viet Nam) met in August 2017 to review progress in impl...
Thesis
Full-text available
EXECUTIVE SUMMARY The Philippines is one of 42 countries accounting for 90% of global deaths of children under five years of age. Annually an estimated 82 000 Philippine children die before reaching five years of age, most in infancy. Simple interventions such as breastfeeding and immunization can prevent a large portion of these deaths. These have...
Article
Full-text available
The last decade of the MDG era witnessed substantial focus on reaching the bottom economic quintiles in low and middle income countries. However, the inordinate focus on reducing financial risk burden and increasing coverage without sufficient focus on expanding quality of services may account for slow progress of the MDGs in many countries. Human...
Article
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Background: An estimated two-thirds of the world's 2.7 million newborn deaths could be prevented with quality care at birth and during the postnatal period. Basic Newborn Care (BNC) is part of the solution and includes hygienic birth and newborn care practices including cord care, thermal care, and early and exclusive breastfeeding. Timely provisi...
Article
Full-text available
What is the contribution of the underuse of modern methods (MM) of contraception to the annual undesired pregnancies in 35 low- and middle-income countries? Fifteen million out of 16.7 million undesired pregnancies occurring annually in 35 countries could have been prevented with the optimal use of MM of contraception. Every year, 87 million women...
Article
Full-text available
Optimal breastfeeding saves lives. However, suboptimal breastfeeding is prevalent, primarily resulting from inappropriate promotion of infant formula and challenges of working mothers to continue breastfeeding. The article aims to determine the extent to which World Health Organization (WHO) policies protect, promote, and support breastfeeding wome...
Article
In the World Health Organization Western Pacific Region, the high rates of births attended by skilled health personnel (SHP) do not equal access to quality maternal or newborn care. 'A healthy start for every newborn' for 23 million annual births in the region means that SHP and newborn care providers give quality intrapartum, postpartum and newbor...
Article
To determine the accuracy of reported maternal deaths for 2008 in a province in the Philippines. A reproductive-age mortality survey (RAMOS) was conducted to identify deaths of women aged 15-49years from Bukidnon, Philippines, in 2008. Sources included various health and community reporting units. Verbal autopsies were carried out to ascertain mate...
Article
Timely administration of hepatitis B vaccine beginning at birth prevents up to 95 per cent of perinatally acquired hepatitis B virus infections in infants of infected mothers. The Philippines changed its national HepB schedule in 2007 to include a dose at birth. We evaluated vaccination schedule change by reviewing infant records at selected health...
Article
Full-text available
Infant formula usage places children at risk for illness and death. Studies in the United States demonstrated high economic burden, health care costs, and absenteeism of caregivers associated with formula usage. Despite high formula usage in developing countries, no economic studies were found. This study examines the financial burden of purchasing...
Article
Infant mortality and morbidity risk is linked to formula usage. The proportion of Filipino infant formula users rose 6% between 2003 and 2008. It is hypothesized this rise resulted from aggressive formula industry marketing. We conducted a household survey between April and December 2006 and focus groups in April-May 2007 in The Philippines to exam...
Article
Full-text available
A deadly nosocomial outbreak in a Philippine hospital drew nationwide attention to neonatal sepsis. Together with specific infection control measures, interventions that protect newborns against infection-related mortality include drying, skin-to-skin contact, delayed cord clamping, breastfeeding initiation and delayed bathing. This evaluation char...
Article
An estimated seven million Filipinos (10-12% of the population) are chronically infected with hepatitis B virus (HBV). Achieving high birth dose coverage with hepatitis B vaccine is critical for achieving the World Health Organization's Western Pacific Regional goal of reducing the prevalence of chronic HBV among children 5 years of age to <2% by 2...
Article
To elucidate factors that influence Philippine women to deliver at home and not be attended by a healthcare professional. Analysis of hospital data that were collected through Global Positioning System technology uploaded into the WHO HealthMapper and data on 7380 women from the Philippines Demographic and Health Survey, 2003. Most of the home deli...
Article
Full-text available
This case control study evaluates the association between hospitalization due to infection and feeding practices among infants aged >or= 3 days to < 6 months. Mothers of 191 cases hospitalized for infections and 208 healthy controls were interviewed using a standardized questionnaire documenting infant-feeding history. Results given in odds ratio a...
Article
Full-text available
The Philippines is among 42 countries accounting for 90% of under 5-year-old deaths. Only 16% of 4 to 5 month old Filipinos exclusively breastfeed. In 2006, almost $100 million was spent advertising formula in the Philippines. To counter widespread misinformation and improve breastfeeding a peer counseling intervention was developed to target mothe...
Article
Full-text available
Prior to the 2004 Philippines Measles Follow up Elimination Campaign, measles caused an estimated 6000 deaths among Filipino children. After the campaign, cases and deaths decreased by 96.4% and 99.2%, respectively. The Nationwide Rapid Coverage Assessments, with an extensive system of feedback, was the prime factor in reaching the under-immunized...
Article
Full-text available
Because the severe acute respiratory syndrome (SARS) outbreak in Taiwan in 2003 was worsened by hospital infections, we analyzed 229 questionnaires (84.8% of 270 sent) completed by surveyed healthcare workers who cared for patients with SARS in 3 types of hospitals, to identify surveillance problems. Atypical clinical presentation was the most ofte...
Article
The examination of natural materials at the microscopic and microchemical level from a materials science perspective can occasionally suggest advances in modern materials engineering. The present paper reports on such a case: an analytical study of the detailed structure and composition of sea urchin teeth.
Article
The widespread use of any antimicrobial agent, including antiretroviral agents, has the potential to select drug-resistant populations of microorganisms. HIV drug-resistant strains have been recognized as a serious threat to the efficacy of current antiretroviral treatments and could jeopardize efforts to increase access to treatment in countries m...
Article
Tobacco use continues to occur in epidemic proportions and with it, significant morbidity and mortality. One third of smokers will die prematurely of a smoking-related disease. In fact, of the five major causes of death in the United States, tobacco use is implicated in four: MI, lung cancer, strokes, and chronic obstructive lung disease. Tobacco u...
Article
The examination of natural materials at the microscopic and microchemical level from a materials science perspective can occasionally suggest advances in modern materials engineering. The present paper reports on such a case: an analytical study of the detailed structure and composition of sea urchin teeth.
Article
Typescript. Department of Materials Science and Engineering. Thesis (M.S.)--Case Western Reserve University, 1991.
Article
A computer code was developed to calculate final ion implantation profiles considering the effects of radiation induced transport and precipitation. The formalism accounts for the possibility of second phase precipitation occurring during the implantation process. These processes are modeled simultaneously with the implantation and radiation induce...

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