A clinical photograph depicting an antenatal care (ANC) visit in a global health setting, illustrating the administration of Intermittent Preventive Treatment of malaria in pregnancy (IPTp). The image shows a pregnant woman in the third trimester seated on a bench, holding oral medication (pills) in one hand and a blue cup of water in the other, demonstrating Directly Observed Therapy (DOT). Across from her, a healthcare provider in a professional white nurse's uniform with a red cross emblem and nursing cap provides clinical guidance. The setting includes essential clinic supplies, such as a water dispenser and medical documentation on a yellow notepad. This visual serves as an educational example of maternal health interventions, specifically the prevention of Malaria in Pregnancy (MiP) through health system scaling and standardized diagnostic/treatment protocols in resource-limited environments.

This infographic and comparison chart illustrates the impact of health system shocks on public health service delivery in Western Kenya from March 2019 to March 2021. The figure is divided into three panels. Panel A is a bar graph showing monthly COVID-19 cases, revealing a substantial increase between August and December 2020. Panel B uses box-and-whisker plots to display monthly Antenatal Care (ANC) first visits, showing relative stability until a sharp decline in December 2020. Panel C utilizes box-and-whisker plots to track monthly distributions of Long-Lasting Insecticidal Nets (LLINs) to pregnant women and children. Key visual indicators include a red vertical dashed line (March 2020) representing the initiation of COVID-19 mitigation protocols and a blue vertical dashed line (December 2020) marking a national health worker strike. The data demonstrates how external shocks, particularly the strike, caused significant disruptions in routine service provision, such as malaria prevention (LLIN distribution) and maternal health access (ANC visits), followed by recovery periods.

Summary : This photograph shows a pregnant woman seated in a waiting area, likely a clinic or healthcare facility, with other women in the background, illustrating the context of antenatal care in Jamaica. photo: Scene Overview : • Main subject is a visibly pregnant woman sitting on a wooden bench, wearing a blue button-up dress. • The setting appears to be a clinic or healthcare waiting room, with several other women seated on benches in the background. • The perspective is at eye level, focusing on the woman in the foreground. • Lighting is natural or fluorescent, typical of indoor public health facilities. • The colour palette includes neutral tones, with the blue dress of the main subject standing out. Technical Details : • No scale bar or magnification is present. • No visible on-image text or user interface elements. • The image is credited to WHO / Aphaluck Bhatiasevi. Spatial Relationships : • The pregnant woman occupies the foreground, positioned centrally and slightly to the right. • Other women are seated behind her, some facing forward, others turned to the side, indicating a communal waiting area. • The benches are arranged in rows, suggesting an orderly seating arrangement. Analysis : • The image visually communicates the experience of antenatal care in Jamaica, highlighting the communal aspect of healthcare access for pregnant women. • The focus on the pregnant woman in the foreground draws attention to maternal health as a central theme. • The presence of multiple women in the background suggests a shared healthcare environment, possibly indicating demand for antenatal services.

This clinical photograph depicts a public health immunization outreach scene in a rural setting in Vietnam. A seated pregnant woman is receiving an intramuscular vaccination, such as the influenza vaccine, administered by a health professional. The healthcare worker, dressed in a white clinical uniform with a visible identification tag, is performing the injection into the patient's deltoid muscle using a standard syringe and needle. The surrounding environment illustrates a community-based grassroots health system, featuring other residents waiting for care and an outdoor village backdrop. The image serves as an educational example of maternal immunization programs, primary healthcare delivery in resource-limited or mountainous regions, and the role of village health workers in promoting public health and preventive medicine during pregnancy.

This clinical photograph captures a pediatric vaccination procedure in a global health setting. A healthcare provider is shown administering an intramuscular or subcutaneous injection into the deltoid region of an infant's upper left arm. The equipment visible is a small-gauge syringe with a fine-bore needle, consistent with standard immunization protocols. The infant is cradled securely by a caregiver, who is observing the procedure. This visual illustrates key concepts in public health, including routine childhood immunization programs, primary care delivery in developing regions, and efforts to reduce under-five mortality. The focus of the image is on the precision of the injection technique and the delivery of preventative medicine. Relevant medical themes include maternal and child health (MCH), immunology, and community-based healthcare interventions.

<table><thead><tr><th>Vaccines and other Immunizing Agents</th><th>Contraindicated or Not Recommended¹</th><th>Precautions²</th></tr></thead><tbody><tr><td>Dengue (DEN4CYD)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³<br>• Severe immunodeficiency (eg, hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised)<br>• Lack of laboratory confirmation of a previous dengue infection</td><td>• Pregnancy<br>• HIV infection without evidence of severe immunosuppression<br>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Diphtheria, tetanus, pertussis (DTaP)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³<br>• Encephalopathy (eg, coma, decreased level of consciousness, prolonged seizures) not attributable to another identifiable cause within 7 days of administration of previous dose of DTP or DTaP</td><td>• Guillain-Barré syndrome within 6 weeks after previous dose of tetanus toxoid-containing vaccine<br>• History of Arthus-type hypersensitivity reactions after a previous dose of diphtheria toxoid-containing or tetanus toxoid-containing vaccine; defer vaccination until at least 10 years have elapsed since the last tetanus toxoid-containing vaccine<br>• For DTaP only: Progressive neurologic disorder, including infantile spasms, uncontrolled epilepsy, progressive encephalopathy; defer DTaP until neurologic status clarified and stabilized<br>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Haemophilus influenzae type b (Hib)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³<br>• Younger than age 6 weeks</td><td>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Hepatitis A (HepA)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³ including neomycin</td><td>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Hepatitis B (HepB)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³ including yeast</td><td>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Hepatitis A-Hepatitis B vaccine (HepA-HepB) [Twinrix]</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³ including neomycin and yeast</td><td>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Human papillomavirus (HPV)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³<br>• Pregnancy: HPV vaccination not recommended.</td><td>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Measles, mumps, and rubella (MMR)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³<br>• Severe immunodeficiency (eg, hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy or patients with HIV infection who are severely immunocompromised)<br>• Pregnancy<br>• Family history of altered immunocompetence, unless verified clinically or by laboratory testing as immunocompetent<br>• For MMRV only: HIV infection of any severity</td><td>• Recent (≤11 months) receipt of antibody-containing blood product (specific interval depends on product)<br>• History of thrombocytopenia or thrombocytopenic purpura<br>• Need for tuberculin skin testing or interferon-gamma release assay (IGRA) testing<br>• Moderate or severe acute illness with or without fever<br>• For MMRV only: Personal or family (ie, sibling or parent) history of seizures of any etiology<br>• If using MMRV, see Varicella/MMRV for additional precautions</td></tr><tr><td>Meningococcal ACWY (MenACWY)<br>MenACWY-CRM [Menveo]<br>MenACWY-TT [MenQuadfi]</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³<br>• For MenACWY-CRM only: severe allergic reaction to any diphtheria toxoid—or CRM197—containing vaccine<br>• For MenACWY-TT only: severe allergic reaction to a tetanus toxoid-containing vaccine</td><td>• For MenACWY-CRM only: Preterm birth if younger than age 9 months<br>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Meningococcal B (MenB)<br>MenB-4C [Bexsero]<br>MenB-FHbp [Trumenba]</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³</td><td>• Pregnancy<br>• For MenB-4C only: Latex sensitivity<br>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Meningococcal ABCWY<br>(MenACWY-TT/MenB-FHbp) [Penbraya]<br>(MenACWY-TT/MenB-4C) [Penmenvy]</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³<br>• Severe allergic reaction to a tetanus toxoid-containing vaccine</td><td>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Mpox [JYNNEOS]</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³</td><td>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Pneumococcal conjugate (PCV)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³<br>• Severe allergic reaction (eg, anaphylaxis) to any diphtheria toxoid-containing vaccine or its component⁴</td><td>• Moderate or severe acute illness with or without fever</td></tr><tr><td>Pneumococcal polysaccharide (PPSV23)</td><td>• Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component³</td><td>• Moderate or severe acute illness with or without fever</td></tr></tbody></table>