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Brighton, United Kingdom, University of Sussex, Institute of Development Studies [IDS], 2011 Sep.  p. (IDS Practice Paper in Brief 7; ILT Brief 7)This paper draws on a study conducted on capturing innovation and lessons from across a ‘multi-sited’ organisation. The lessons in question were about effective social protection programmes, however the paper focuses on the general principles of learning in an international organisation spread across many countries. The study was undertaken in collaboration with UNICEF and Irish Aid. The implementing team developed an action research programme exploring how to capture, share and use findings and lessons, in an organisation like UNICEF. The paper describes the processes and limitations of studies like this in building an institutional learning environment.
Geneva, Switzerland, World Health Organization [WHO], 2007. 37 p.One fifth of the world's population - a total of 1.2 billion people - are adolescents, and 85% of them are in the developing world. Adolescence is a time of unprecedented promise - and peril. During the second decade of life, young people can encounter a rapidly widening world of opportunities, as they gradually take on adult characteristics in size, sexual characteristics, thinking skills, identity and economic and social roles. Too often, however, the widening world also exposes adolescents to serious risks before they have adequate information, skills and experience to avoid or counteract them. Their level of maturity and social status is no match for some challenges, unless they are provided with support, information and access to resources. Without help, the consequences of health risk behaviours in adolescence can be life-threatening and life-long. Nearly two thirds of premature deaths and one third of the total disease burden in adults can be associated with conditions or behaviours that begin in youth. 1 To protect and preserve our subsequent generations, no better investment can be made in the developing world than to foster promotion of adolescent development and prevention of health risk behaviours among adolescents. (excerpt)
Lancet. 2007 Sep 22; 370(9592):1007.This week, The Lancet publishes two papers of critical interest to child survival. Unfortunately, both have stirred concerns about misuse of data by UN agencies. Here, we review the allegations and try to draw lessons about the place of independent scientific inquiry in the arena of global health policymaking. Greg Fegan and colleagues report the success of an expanded insecticide-treated bednet programme in Kenya. The full paper reveals the strengths and limitations of the study, and provides important estimates of uncertainty. No such statistical caution was expressed in the WHO statement about these data, released on Aug 16. Indeed, WHO claimed that this finding "ends the debate about how to deliver long-lasting insecticidal nets". Yet communications between the Kenyan research team and WHO suggest an ill-considered rush by WHO against the advice of wiser scientific minds. (excerpt)
ICRW Information Bulletin. 2002 Feb;  p..The International Center for Research on Women (ICRW) and the United Nation's Children's Fund (UNICEF) are developing and implementing gender-sensitive strategies to reduce the vulnerability of young women to HIV/AIDS. (excerpt)
Geneva, Switzerland, WHO, Global Programme on AIDS, Division of Research and Intervention Development, 1994 Dec 4. 6 p.The World Health Organization Global Program on AIDS' (GPA) Social and Behavioral Studies and Support Unit (SSB) is responsible for commissioning, conducting, facilitating, and supporting research on the social and behavioral aspects of HIV and AIDS. The GPA Steering Committee on Social and Behavioral Research has identified the following priorities for social and behavioral research: the nature of sexual negotiation between men and women, and the potential impact of the female condom on gender relationships; contextual factors which affect risk-related sexual behavior, especially among young people in developing countries; studies of household and community responses to HIV and AIDS, with an emphasis upon coping in developing countries; studies of the determinants of HIV and AIDS-related discrimination and stigmatization; and social and behavioral research linked to HIV vaccine trials.
The use of economic and financial studies for the Expanded Programme on Immunization: third international meeting proceedings, June 13 - 15, 1990, Paris, France.
Paris, France, Centre International de l'Enfance, 1990. , 22 p.With the financial support of the US Agency for International Development (USAID) and the Centre International de l'Enfance (CIE), 23 meeting participants considered the extent to which financial studies of the Expanded Program on Immunization (EPI) have been used, factors contributing to their use or nonuse, types of information which could come out of financial studies which are most important for EPI managers, and recommendations which should be made about developing and using such studies in the future. Participants included 7 nationals involved in EPI management from Benin, Burkina Faso, Guinea, Haiti, Philippines, Sudan, and Turkey, as well as representatives from CIE, the Resources for Child Health (REACH) project, the world Health Organization (WHO), the Pan American Health Organization, the Association pour la Promotion de la Medecine Preventive, l'Organisation de Coordination et de Cooperation pour la Lutte contre les Grandes Endemies, and INSERM. Participants were introduced and presentations made on experiences with cost and cost-effectiveness studies from the perspectives of national EPI management and technical assistance/donor agencies. Participants were then divided into 2 working groups, 1 French-speaking and 1 mixed language, to consider questions about economic and financial studies, and the relevance of these studies to EPI management. Conclusions were reported in plenary sessions. The meeting closed with remarks from James Cheyne of WHO, a summary and commentary from Walter Batchelor of REACH, group recommendations for the future of EPI studies, and a summary by Dr. Pierre Claquin of REACH on participants' evaluation of the meeting and suggestions for the next meeting. Dr. Lucien Houllemare of CIE closed by stating that EPI financial management issues are broader than EPI and pertain to more general program development problems.
Clinical management of acute diarrhoea: report of a Scientific Working Group, New Delhi, October 30-November 2, 1978.
[Unpublished] 1979. 21 p.This is a discussion of the clinical management of acute diarrhea, which was covered by a Scientific Working Group at the Southeast Asian Regional meeting of WHO in 1978. Current knowledge on the use of oral rehydration therapy for diarrhea was reviewed at the meeting. The mixture, which works for all age groups and for diarrhea of any etiology, is aimed at restoring normal fluid and electrolyte balances. The chemical means whereby these balances are restored are discussed in detail. There is evidence that the therapy reduces mortality caused by diarrhea to nearly zero and reduces the cost of hospitalization and intravenous therapy. Its great advantage is that it can be administered at home early in the course of the disease. Use of the oral rehydration technique with the complete and the incomplete formulae and by home reconstitution are discussed. Supply has not always kept pace with demand. Other aspects of the clinical management of diarrhea, e.g., with drugs, diet, or intravenous fluids, are covered. Recommendations for future research both on the clinical and the program sides of the issue are proposed. The UNICEF activities connected with national oral rehydration programs are listed.
N.Y., United Nations, 1971. 69 pThe mission has concluded that it is highly desirable to establish a new facility within the United Nations system, which, for the purpose of the present report, is designated as "World Population Institute". The extent of our investigations was necessarily limited by the need to submit a report within three months. Within this period it was essential to discover what was being thought and done on the subject of population by the United Nations and the specialized agencies most concerned; by a cross-section of Governments with varying interests and experiences; by academic institutions, foundations and international non-governmental organizations associated with those Governments and with the United Nations agencies in studies and action. Clearly, we could not visit all the countries we would have liked to contact, nor could we carry out a comprehensive inventory of all national and multinational training and research facilities. Nevertheless, the mission feels that its sample was indicative of the entire range of attitudes and stages of programmes designed to illuminate population questions, formulate policies or carry out actions designed to influence fertility. Moreover, all the members of the mission have had previous wide experience in the international field; and we believe that, thanks to the excellent arrangements made for us in the countries visited and the warm assistance everywhere given to us, we have in fact had sufficient exposure to relevant views and facts to enable us to discharge our tasks. (excerpt)
[Plan of the investigation and production of mass media programs, for family planning] Proyecto de investigacion y produccion de programas de comunicacion de investigacion y produccion de programas of comunicacion colectiva en planificacion familiar.
Research proposal of ADS submitted to U.N. Fund for Population Activities, April 1972. 26 p.Add to my documents.
Proposals for a population programme of action for Africa following from the recommendations of the 1974 World Population Conference.
n.p., U.N. Economic and Social Council, March 1975. 18 pAdd to my documents.
Geneva, Switzerland, WHO, 1965. 19 p. (WHO Technical Report Series No. 304)This WHO technical report focuses on the 1) psychosomatic factors in human reproduction; 2) hypothalamo-hypophyseal system; 3) mechanism of sexual rhythm; 4) nervous influences on the hypothalamus; 5) hormonal influences on the hypothalamus; 6) neuroendocrine aspects of sexual behavior; and 7) effects of drugs on reproduction. After summarizing current research status on the above-mentioned topics, the following research needs are suggested: 1) assays of individual human endogenous gonadotropins, suitable for clinical application; 2) autoradiography, fluorescent-antibody, spectrophometric interference and histochemical and biochemical techniques for studying cells that supply axons to the primary capillary plexus of the hypophyseal portal system and for studying effects of different hormonal status on hypothalmic structure and function; 3) computer techniques for evaluating electrophysiological data; 4) improved lesioning techniques; 5) comparative studies of reproductive activity patterns, exteroceptive factors, neuroendocrine factors in sexual and related social behavior, and long-term or delayed effects of drugs administered during gestation on subsequent sexual development; 6) studies of synaptic connections of hypothalamic neurones; 7) studies of endogenous gonadal and gonadotropin production in prepuberal animals; 8) functional significance of regional distribution of hypophyseal portal system; 9) mechanisms involved in selective uptake of labeled hormones; 10) hypothalamic lesions in species with spontaneous ovulation and active luteal function; 11) direct effect of gonadal hormones on single hypothalamic neurones studied with combination of microinjection and unit recording devices; 12) studies of the possibility of a direct feedback of gonadotropic hormones on the hypothalamus; 13) studies of the receptor mechanisms involved in neuroendocrine reflexes; 14) wider exploration of brain structures, with regard to feedback action of gonadal hormones; 15) studies of pineal function; 16) further investigation of a possible role of the peripheral autonomic pathways in reproductive processes; and 17) research on the application of tissue culture techniques for studying problems of the origin and metabolic effects of neurohormonal mediators and the biochemcial and morphological changes induced by sex hormones.
London, FPA, 1972. 48 p.Currently, public authorities pay for almost 2/3 of the family planning consultations conducted by the Family Planning Association, and this is the most significant development since the publication of the last Family Planning Association Report. Additionally, more local health authorities are operating direct clinic and domiciliary services. The Family Planning Association handed over the management of 39 clinics to public authorities in the 1971-1972 year. However, despite this progress, family planning service provision by public authorities throughout England continues to be uneven in quality and extent. Spending by local health authorities for each woman at risk varies from 1 penny per woman at risk in Burnley (excluding the city of London) to 179 pence at Islington. In addition to the problem of inconsistency in spending, there appears to be no immediate prospect of a comprehensive family planning service - one that is available to all, is free of charge, and is backed by an adequate education campaign. Although government help for the extension of domiciliary family planning service is impressive, it should not obscure the false economies in spending on other contraceptive delivery services such as general practitioners, specialist clinics, and specialized advisory centers. Until the government announces the details of its plans for family planning services within the National Health Service beginning April 1974, the Family Planning Association's own detailed planning cannot be exact. The Association's basic policy continues to be to turn over the responsibility for the management of clinic and domiciliary contraceptive services as quickly and as smoothly as possible to the public authorities. Already there is concern that some clinic services managed by public authorities may become less attractive, particularly to young people, and that differences in the quality of service will increase under local public management as well as that backup services will be neglected. Also existing is the realization that the public authorities do not do enough to attract people to the use of contraception.
Paper presented at the Nineteenth Session of the UNICEF/WHO Joint Committee on Health Policy, Geneva, February 1-2, 1972. 40 pFamily planning is an integral part of the health care of the family and has a striking impact of the health of the mother and children. Many aspects of family planning care require the personnel, skills, techniques, and facilities of health services and is thus of concern to UNICEF and WHO. Once individual governments have determined basic matters of family planning policy and methods, UNICEF and WHO can respond to requests for assistance on a wide range of activities, with the primary goal being the promotion of health care of the family. Emphasis will be placed on achieving this by strengthening the basic health services that already have a solid foundation in the community. The past experience of UNICEF and WHO should provide valuable guidance for assistance to the health aspects of family planning, particularly as they relate to the planning and evaluation of programs; organization and administration; public education; the education and training of all medical personnel; and the coordination of family health activities both inside and outside the health sector. The review recommends that UNICEF and WHO first regard the capacity of the host country to absorb aid and maintain projects, and that specific family planning activities, such as the provision of supplies, equipment, and transport, be introduced only when the infrastructure is actually being expanded. Capital investment should be viewed in relation to the government's ability to meet budgetary and staff requirements the new facilities demand.
[First reflection workshop of the research network "Gender, Reproductive Health and Population Policies (GRHPP), Maghreb region, Amsterdam, July 3-7, 1995. General report] Premier atelier de reflexion du reseau de recherche "Gender, Reproductive Health and Population Policies" (GRHPP), region Maghreb, Amsterdam, du 3 au 7 juillet 1995. Rapport general.
Amsterdam, Netherlands, University of Amsterdam, Faculty of Political and Social-Cultural Sciences, Medical Anthropology Unit, 1996. 12 p.This paper reports upon the first workshop of the research network on gender, reproductive health, and population policies in the Maghreb, held in Amsterdam during July 3-7, 1995. The report is comprised of papers by various authors on gender, reproductive health, and population policies in the Maghreb; population policies in Morocco; population policies in Tunisia; population-related debates, including the new concepts introduced by the International Conference on Population and Development; the Rutgers Foundation’s activities with regard to reproduction and sexuality in Holland; the evolution from family planning to an integrated reproductive health approach; discourse on Norplant’s effectiveness; the research network on gender, reproductive health, and population policies in Latin America; identifying relevant research themes in the Maghreb; Internet-based research; a research project; and the decision to submit a project of concerted efforts designed to identify and strengthen research capacity in the countries of the Maghreb. The workshop’s activities are noted in the annex.
Gender, sexuality and reproductive health in Thailand. Development of a Research Agenda towards a Gender Sensitive Reproductive Health Program (phase I: compilation study). Final report.
Nakhon Pathom, Thailand, Mahidol University, Institute for Population and Social Research [IPSR], 1999 Apr. x, 103 p. (IPSR Publication No. 232; THA/98/P01)The relevance of issues of gender and sexuality in relation to reproductive health in Thailand is discussed here. The topics of this monograph were categorized according to a list formulated by WHO. These categories are family planning, maternal/child health and safe motherhood, infertility, and abortion/complications of abortions. The document also provides information on sexually transmitted diseases/reproductive tract infections, sex education, reproductive tract malignancy, adolescent health, menopause, and the elderly. These categories fall naturally under three headings: family planning, maternal/child health, and the consequences of unwanted pregnancies. In the latter stage of the project, consultative meetings were held in Bangkok, Hat Yai, Khon Kaen and Chiang Mai to obtain valuable views from other experts. The results were discussed at a seminar held in Bangkok on November 21-22, 1998. This seminar saw the adoption of a life cycle perspective in which men and women act out their gender roles--including those associated with sexuality--during adolescence and the subsequent stages of their adult lives. Because reproductive health is a coherent entity, policy and programs for all aspects of reproductive health should be integrated. This project concludes that research, advocacy and training concerning the gender-related aspects of interactions between providers and clients in the delivery of reproductive health services is needed. Also, a comprehensive information, education and communication program is called for so that services can be extended to include men in supportive roles wherever possible.
Programming for adolescent health and development. Report of A WHO / UNFPA / UNICEF Study Group on Programming for Adolescent Health.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES.. 1999; (886):i-vi, 1-260.This is a technical report compiled by the WHO/UNFPA/UNICEF Study Group on Programming for Adolescent Health. The cooperation exemplified by the convening of the Joint Study Group is vital to the achievement of the goal of ensuring that adolescents are able to acquire the information, build the skills, obtain the health services and live in the supportive environment they need for their health and development. The purpose of the Study Group was to provide the technical rationale and basis for the action required for the health and development of adolescents. In this technical series, the WHO, UNFPA, and UNICEF both formulated an overall policy on adolescent health and development and created a programmatic approach at the level of the individual country in order to maximize the policy s coverage and impact. In addition, the Study Group reviewed current experiences--especially in developing countries--as well as the scientific evidence concerning the effectiveness of major interventions in adolescent health. Lastly, the Study Group recommended a common agenda of actions to accelerate and strengthen programming for adolescent health; this included strategies for securing the global and regional support needed for country-level programming.
[Unpublished] 1991. Presented at the 1st International Course on Planning and Managing STD Control Activities in Developing Countries, Antwerp, Belgium, September 9-21, 1991.  p.Comprised of an interdisciplinary group of scientists from both developed and developing countries, a sexually transmitted diseases (STDs) research working group met April 22-24, 1991, in Geneva to develop recommendations for the WHO/STD program on global STD research needs and priorities. The group took direction from a September 1989 meeting of a WHO consultative group to the WHO STD program, and a meeting of the research sub-committee of the WHO AIDS/STD Task Force held in July 1990, to consider global strategies of coordination for AIDS and STD control programs. Recommendations for the WHO/STD program on global STD research needs and priorities would stress the needs of developing countries in the areas of cost-effective prevention, case detection and management, surveillance, and program evaluation. The relevancy of potential projects to practical, operational issues was stressed throughout the meeting, and the unique global role played by the WHO STD program in encouraging and coordinating STD research and control efforts, as well as in working with donor agencies, were central themes of the meeting. The working group determined that it should prioritize research needs based upon selected factors, and consider how potential plans addressing such needs could be accomplished and funded. Program support, case management, behavior, epidemiology, and interventions were identified as broad areas of research need.
Sexually transmitted diseases research needs: report of a WHO consultative group, Copenhagen, 13-14 September 1989.
[Unpublished] 1991. Presented at the 1st International Course on Planning and Managing STD Control Activities in Developing Countries, Antwerp, Belgium, September 9-21, 1991. 31 p.In response to the growing needs for research into sexually transmitted diseases (STDs), the STD Program of the World Health Organization (WHO) in September 1989 convened a small interdisciplinary consultative group of scientists from both developing and more developed countries to review STD research priorities. The consultation was organized based upon the belief that a joint consideration of global STD research priorities and local research capabilities would increase overall research capacity by coordinating the efforts of scientists from around the world to get the job done. Participants considered the areas of biomedical research, clinical and epidemiological research, behavioral research, and operations research. However, research needs directly related to HIV were not considered except where they interfaced with research on other STDs. The above areas of research, as well as the expansion of interregional and interdisciplinary collaborations, the strengthening of research institutions, developing and strengthening research training, and facilitating technology transfer and the use of marketing systems are discussed.
Addressing the demographic imperative through health, empowerment, and rights: ICPD implementation in Bangladesh.
HEALTH TRANSITION REVIEW. 1997; 7 Suppl 4:33-6.It has been debated since the 1994 International Conference on Population and Development (ICPD) whether the ICPD program of action constitutes population policy. Opponents of the ICPD reproductive health approach argue that vertical family planning programs will be more cost-effective, while proponents counter that the reproductive health approach will be more cost-effective in meeting demographic goals. The program of action calls for social investments to be made by development agencies and budgets, not from family planning budgets. The roles of population professionals and agencies in the program are to conduct relevant research and advocate for broader policy change. The case of Bangladesh is examined. The following issues need to be researched in both Bangladesh and worldwide in order to support the implementation of the ICPD program of action: the situation of young people, the significance of sex and gender in reproductive and health-seeking behavior, the decision-making environment, and applied demographic research into the costs and benefits of reproductive health services. Professionals working in the field of population need to get involved in assessing and promoting changes in broader national development policies.
AFRICA HEALTH. 1997 Nov; 20(1):21-2.Directly observed treatment short course (DOTS) is the World Health Organization's (WHO) recommended strategy for eradicating tuberculosis (TB). Although DOTS involves 5 key elements, watching TB patients swallow their drugs is the core of the approach. WHO insists that patients, especially if smear positive, must have every dose observed, even those on ambulatory treatment. People should come to health facilities to have their treatment observed. Where that is not possible, a community health worker or community leader should observe. The WHO DOTS strategy is not easy to implement, but evidence suggests that it is a feasible, necessary, and effective strategy for controlling TB. It is, however, possible that good quality TB care including health education, microscopy, drugs, and follow-up can be made effective without direct observation. Operational research is needed to determine whether such observation is necessary. Every country needs to evaluate DOTS within its own context.
PROGRESS IN HUMAN REPRODUCTION RESEARCH. 1997; (41):1.20% of the world's population is aged 10-19 years. Annually, almost 15 million young women under age 20 become mothers. However, surveys in developing countries show that 20-60% of the pregnancies and births to women under age 20 are mistimed or unwanted. While later marriage age in many places has provoked a decline in birth rates among young women, levels of sexual relations before marriage are increasing. Such sexual behavior opens sexually active young women to the risks of unwanted pregnancies, unsafe abortion, and sexually transmitted diseases (STDs). Millions of young people become infected with STDs annually. Among all age groups in the US, young women aged 15-19 have the highest incidence of gonorrhea among females and young men aged 15-19 have the second highest incidence among males. At least half of all people infected with HIV are under age 25. The UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction (HRP) completed 9 studies in 1996 on adolescent reproductive health. 14 studies were completed before 1996, and 18 are still underway.
In: Proceedings of the Beijing International Symposium on Fertility Regulation, Fertility Regulation: Present and Future, May 21-25, 1995, Beijing, China, edited by Li Weixiong, Rose Maria Li, Hao-Chia Chen, Do Won Hahn. Bethesda, Maryland, National Institutes of Health [NIH], National Institute of Child Health and Human Development [NICHD], 1995. 1-18 - 1-25.The World Health Organization Special Program of Research in Human Reproduction's primary research goal is concerned with empowering women, that is increasing informed choices in reproductive health for women. Reproductive health is not just the absence of disease or disorders of the reproductive process, but rather a condition in which the reproductive process is accomplished in a state of complete physical, mental, and social well-being. That definition implies that people have the ability to reproduce, that women can go through pregnancy and child birth safely, and that infants survive and grow up healthy. It further goes that people are able to regulate their fertility without risk to their health and that they are safe in having sex. Research is key to providing individuals with the highest possible level of reproductive health, providing the knowledge needed to guide the development of acceptable contraceptive methods which are respectful of local traditions, beliefs, and cultural values, and effective in preventing both unwanted pregnancies and the spread of sexually transmitted diseases and HIV infection.
International Family Planning Perspectives. 1997 Jun; 23(2):86-9.Since the 1994 International Conference on Population and Development (ICPD), researchers have debated the potential gains and losses which may result from the changes which underlay the Cairo Plan of Action. Population policy was redefined at the ICPD through a greater emphasis upon reproductive health and empowering women at the expense of traditional macro-level demographic rationale linking population and development. Policy emphasizing basic individual human rights with a focus upon health, especially for the least empowered, can help lead to the achievement of national demographic objectives in Burkina Faso, Chad, Mali, Mauritania, Niger, and Senegal. Policy and research agenda, demographics of the Sahel, and a new approach to reducing population growth rates in the region are discussed. High-quality reproductive health services need to be delivered and a better understanding of the determinants of reproductive health behavior attained.
POPULATION - FAMILY PLANNING NEWS. 1996 Jan-Jun; (2):8.A project funded by the United Nations Population Fund (UNFPA) and entitled "Improving Quality of Care in Family Planning and Reproductive Health Programmes," identified modest cost approaches to improving quality of care (QOC). After official clearances were received in April, a rapid assessment study began in May / June at the Shamirpet primary health center in Andhra Pradesh, India; in the Eheliyagoda and Kuruwita divisions in Ratnapura, Sri Lanka; and in the Duytien district in Namha province, Viet Nam. ICOMP collaborated with two government agencies, the Family Health Bureau (FHB) in Sri Lanka and the Center for Population Studies and Information (CPSI) in Viet Nam; the collaborating agency in India was the Administrative Staff College of India (ASCI). The study covered prenatal care, immunizations, reproductive health, and family planning. Assessment tools, developed and provided by ICOMP, included guidelines for interviews and group discussions involving contraceptive users and nonusers, men, various kinds of providers and managers, and checklists for observation of services and facilities. A five-day workshop was organized in Kuala Lumpur in July for the three country teams. Based on the results of the rapid assessment study, an action plan was developed by each team, and the baseline research tools were discussed and modified. The Indian team began interventions in October 1995; the Sri Lankan and Vietnamese teams concentrated on completing the action plans and planning for the various interventions during the last quarter.
The World Health Organization's future research agenda and efforts to incorporate women's perspectives.
In: Issues in essential obstetric care. Report of a technical meeting of the Inter-Agency Group for Safe Motherhood, May 31 - June 2, 1995, edited by Diana M. Measham with Virginia D. Kallianes. New York, New York, Population Council, 1996 Mar. 62-4. (Partnership for Safe Motherhood)The World Health Organization's (WHO) Steering Committee on Research in Safe Motherhood recently met in Geneva. Highlights and main recommendations of the committee are presented. The committee set a course for WHO to follow under its continuing technical guidance. In setting that course, the committee considered the lessons learned from research supported by WHO and other agencies/organizations, as well as the strategy developed by WHO to help countries achieve safe motherhood. It also recognized that incorporating women's perspectives is essential to the research process. Much progress has been made in improving the understanding of the problem of maternal mortality, but much more remains to be accomplished. It has proved difficult to conduct health services research under prevailing conditions in many countries. Constraints from WHO's perspective were also significant. The Steering Committee recommended that research focus upon efforts to maximize or improve the impact of various components of the Mother-Baby Package.