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Reproductive Health Matters. 2011 Nov; 19(38):197-207.In March 2009, UN member states met at the 53rd Commission on the Status of Women (CSW) to discuss the priority theme of "the equal sharing of responsibilities between women and men, including caregiving in the context of HIV/AIDS". This meeting focused the international community's attention on care issues and generated Agreed Conclusions that aimed to lay out a roadmap for care policy. I examine how the frame of "care" - a contested concept that has long divided feminist researchers and activists - operated in this site. Research involved a review of documentation related to the meeting and interviews with 18 participants. Using this research I argue that the frame of care united a range of groups, including conservative faith-based actors who have mobilized within the UN to roll back sexual and reproductive rights. This policy alliance led to important advances in the Agreed Conclusions, including strong arguments about the global significance of care, especially in relation to HIV; the need for a strong state role; and the value of caregivers' participation in policy debates. However, the care frame also constrained debate at the CSW, particularly about disability rights and variations in family formation. Those seeking to reassert sexual and reproductive rights are grappling with such limitations in a range of ways, and attention to their efforts and concerns can help us better understand the potentials and dangers for feminist intervention within global policy spaces. Copyright (c) 2010 UNRISD. Published by Elsevier Ltd. All rights reserved.
Gonorrhoea surveillance, laboratory diagnosis and antimicrobial susceptibility testing of Neisseria gonorrhoeae in 11 countries of the eastern part of the WHO European region.
APMIS Acta Pathologica Microbiologica Et Immunologica Scandinavica. 2011 Sep; 119(9):643-649.Quality-assured worldwide surveillance of antimicrobial resistance (AMR) in Neisseria gonorrhoeae is crucial for public health purposes. In the countries of the eastern part of the WHO European region the knowledge regarding gonococcal AMR is limited, and antimicrobials of many different types, sources and quality are used for gonorrhoea treatment. This study surveyed gonorrhoea incidence, laboratory diagnosis and gonococcal AMR testing in 11 independent countries of the former Soviet Union. The national gonorrhoea incidences remain mainly high. In general, gonococcal culture and AMR testing were rarely performed, poorly standardized and rarely quality assured. To establish a gonococcal AMR surveillance programme in Eastern Europe, i.e. the geographical area of the former Soviet Union, several actions have recently been undertaken by the Eastern European Sexual and Reproductive Health (EE SRH) Network and the WHO. The information provided herein will be useful in this respect.
Bulletin of the World Health Organization. 2011 Jun 1; 89(6):442-50.OBJECTIVE: To appraise the process of development and clinical content of national human immunodeficiency virus (HIV) clinical practice guidelines of countries in the eastern Mediterranean and to formulate recommendations for future guideline development and adaptation. METHODS: Twenty-three countries in the World Health Organization (WHO) Eastern Mediterranean and United Nations Children's Fund Middle East and North Africa regions were invited to submit national HIV clinical practice guidelines for review. The guideline development methodology was assessed using an adaptation of the Appraisal of Guidelines Research and Evaluation (AGREE) instrument and guideline content, using a checklist to evaluate concordance with WHO 2006 generic guidelines. FINDINGS: Twelve countries submitted 20 guidelines developed between 2004 and 2009. Median scores were poor (i.e. < 0.6) for the methodological quality domains of rigour of development, stakeholder involvement and applicability and flexibility. Scores were better for the domains of scope and purpose (median: 0.82, interquartile range, IQR: 0.58-0.89) and clarity and presentation (median: 0.67, IQR: 0.50-0.78). Concerning guideline content, recommended first-line treatment and eligibility criteria for antiretroviral therapy (ART) in adults were in line with WHO recommendations in most guidelines. However, recommendations on antiretroviral prophylaxis for the prevention of vertical HIV transmission, diagnosis and treatment of HIV infection in infants, monitoring patients on ART, treatment failure and co-morbidities were often lacking. CONCLUSION: The large majority of national HIV clinical practice guidelines had methodological weaknesses and content inaccuracies. Countries require assistance with the adaptation process to ensure that guidelines are valid and up to date and accurately reflect WHO global clinical care recommendations for patients with HIV.
Journal of Family Planning and Reproductive Health Care. 2011 Jul; 37(3):128-31.This commentary focuses on guidance around 'missed pill' rules. It discusses the simplification of these rules taken on by the UK's Medicines and Healthcare products Regulatory Agency (MHRA) in 2010 with the aim to produce standardized guidance on the starting of combined hormonal contraceptives and on 'missed pills.'