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The importance of sexual and reproductive health and rights to prevent HIV in adolescent girls and young women in eastern and southern Africa.
Geneva Switzerland, World Health Organization [WHO], 2017. 24 p. (Evidence Brief; WHO/RHR/17.05)Over the last several years, countries in the eastern and southern Africa (ESA) region have made significant and commendable progress in preventing mother-to-child transmission (PMTCT) of HIV and in scaling up HIV treatment efforts. However, despite these gains, there have been no significant reductions in new HIV infections and the region continues to be the hardest hit by the epidemic, highlighting the need to place stronger emphasis on HIV prevention. The risk of HIV infection among adolescent girls and young women (AGYW) in the ESA region is of particular concern. The 2016 UNAIDS World AIDS Day report, Get on the Fast-Track – The life-cycle approach to HIV, stated that efforts to reduce new HIV infections among young people and adults have stalled, threatening to undermine progress towards ending AIDS as a global public health threat by 2030.
Adolescent girls in disaster and conflict. Interventions for improving access to sexual and reproductive health services.
New York, New York, UNFPA, 2016. 92 p.Safe spaces, mobile medical teams and youth engagement are effective ways to reach displaced, uprooted, crisis-affected girls at a critical time in their young lives. Adolescent Girls in Disaster & Conflict: Interventions for Improving Access to Sexual and Reproductive Health Services is a collection of UNFPA-supported humanitarian interventions for reaching adolescents when crisis heightens vulnerability to gender-based violence, unwanted pregnancy, HIV infection, early and forced marriage and other risks.
Lancet. 2016 Nov 26; 388(10060):2579.Add to my documents.
Improving health, social welfare, and human development through women's empowerment in developing countries: The 2016 Girl Up Leadership Summit, Washington, DC, USA.
International Journal of MCH and AIDS. 2016; 5(2):87-91.The United Nations Foundation’s Girl Up campaign, an initiative dedicated to promoting the health, education, and leadership of adolescent girls in developing communities around the world, hosted its annual Girl Up Leadership Summit in Washington, DC from July 11-13 and welcomed more than 275 girl empowerment and women empowerment proponents to take part in leadership training, listen to and learn from influential figures like United Nations Deputy High Commissioner for Human Rights Kate Gilmore and Treasurer of the United States Rosie Rios, and engage in an official lobby day in the nation’s capital. Topics ranged from the issue of child marriage and sexual and reproductive health rights to intersectional feminism and the importance of the next generation of global girl advocates. The purpose and, later on, achievement of the conference was the development of such leaders and Girl Up representatives. Summit attendee and Girl Up Campus Leader Janel Mendoza shares her experience as a longstanding Girl Up supporter and reflects on the preeminent conversations held during and following the summit.
Washington, D.C., World Bank, 2015. 32 p.The adolescent girl’s initiative (AGI) was motivated by the idea that vocational training and youth employment programs tailored to the needs of girls and young women can improve the economic empowerment and agency. By putting that idea into practice in a number of ways, the AGI pilots are making it possible to learn about the demand for such programs and whether in their current form they are a feasible and (in some cases) cost-effective means of meeting their objectives. Adolescent females in lower-income countries face a difficult environment in their path toward economic empowerment, a critical dimension of adulthood. Females, especially from low-income countries, want to participate in programs to support their economic empowerment. Effective programs shared certain features that made it possible for them to reach adolescent girls and young women and successfully assess and impart the skills that they needed.
New York, Evaluation Office, United Nations Population Fund [UNFPA], 2016 Apr. 214 p.The purpose of the evaluation was to assess the performance of UNFPA in the field of family planning during the period covered by the Strategic Plan 2008-2013 and to provide learning to inform the implementation of the current UNFPA Family Planning Strategy Choices not chance (2012-2020). The evaluation provided an overall independent assessment of UNFPA interventions in the area of family planning and identified key lessons learned for the current and future strategies. The particular emphasis of this evaluation was on learning with a view to informing the implementation of the UNFPA family planning strategy Choices not chance 2012-2020, as well as other related interventions and programmes, such as the Global Programme to Enhance Reproductive Health Commodity Security (GPRHCS- 2013-2020). The evaluation constituted an important contribution to the mid-term review of UNFPA strategic plan 2014-2017. The evaluation features five country case study reports: Bolivia, Burkina Faso, Cambodia, Ethiopia, and Zimbabwe.
Feasibility and validity of using WHO adolescent job aid algorithms by health workers for reproductive morbidities among adolescent girls in rural North India.
BMC Health Services Research. 2015 Sep 21; 15(1):400.Background: High prevalence of reproductive morbidities is seen among adolescents in India. Health workers play an important role in providing health services in the community, including the adolescent reproductive health services. A study was done to assess the feasibility of training female health workers (FHWs) in the classification and management of selected adolescent girls' reproductive health problems according to modified WHO algorithms. Methods: The study was conducted between Jan-Sept 2011 in Northern India. Thirteen FHWs were trained regarding adolescent girls' reproductive health as per WHO Adolescent Job-Aid booklet. A pre and post-test assessment of the knowledge of the FHWs was carried out. All FHWs were given five modified WHO algorithms to classify and manage common reproductive morbidities among adolescent girls. All the FHWs applied the algorithms on at least ten adolescent girls at their respective sub-centres. Simultaneously, a medical doctor independently applied the same algorithms in all girls. Classification of the condition was followed by relevant management and advice provided in the algorithm. Focus group discussion with the FHWs was carried out to receive their feedback. Results: After training the median score of the FHWs increased from 19.2 to 25.2 (p - 0.0071). Out of 144 girls examined by the FHWs 108 were classified as true positives and 30 as true negatives and agreement as measured by kappa was 0.7 (0.5-0.9). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 94.3 % (88.2-97.4), 78.9 % (63.6-88.9), 92.5 % (86.0-96.2), and 83.3 % (68.1-92.1) respectively. Discussion: A consistent and significant difference between pre and post training knowledge scores of the FHWs were observed and hence it was possible to use the modified Job Aid algorithms with ease. Limitation of this study was the munber of FHWs trained was small. Issues such as time management during routine work, timing of training, overhead cost of training etc were not taken into account. Conclusions: Training was successful in increasing the knowledge of the FHWs about adolescent girls' reproductive health issues. The FHWs were able to satisfactorily classify the common adolescent girls' problems using the modified WHO algorithms.
Turning gender and HIV commitments into action for results: an update on United Nations interagency activities on women, girls, gender equality and HIV.
[Geneva, Switzerland], UNAIDS, 2009 Dec. 4 p.In September 2000, 189 UN Member States committed to achieving the Millennium Development Goals (MDGs) by 2015. Among these goals is a commitment to promoting gender equality and empowering women and combating HIV, malaria, and other diseases. Today, almost 10 years on, addressing gender inequality and AIDS remains the most significant challenge to achieving the MDGs, as well as broader health, human rights, and development goals. This update highlights key 2009 interagency initiatives, all of which operate at the intersection of gender equality, women's empowerment, and HIV.
Washington, D.C., ICRW, 2010. 43 p.Girls receive a disproportionally small share of the total development dollars invested globally each year, but the field is primed for even greater action and investment. Before charting the way forward, it is important to understand more about current efforts underway on behalf of girls. ICRW designed a mapping exercise to identify the scope and range of work on issues related to girls being undertaken by key development actors. The exercise also helped analyze the core directions, opportunities, and gaps inherent across the efforts of multiple stakeholders. This report presents the key findings from this exercise, describing what we have learned about the donors and organizations engaged in working with girls, the policy and program efforts underway, and current and future directions for the field.
Meeting summary: Protecting and Empowering Adolescent Girls: Evidence for the Global Health Initiative. Sponsored by the Interagency Youth Working Group (IYWG), Thursday, June 3, 2010.
[Washington, D.C.], Interagency Youth Working Group, 2010.  p.The third annual meeting of the Interagency Youth Working Group (IYWG) highlighted examples of innovative programs that address girls’ vulnerability to HIV and reproductive health (RH) risks in more than 15 countries. These programs have used a variety of approaches, including school-based interventions, advocacy, empowerment, targeting of especially vulnerable girls, physical activity, and male involvement. One of the main purposes of the meeting was to formulate recommendations on women- and girl-centered approaches within the U.S. Government’s Global Health Initiative. (Excerpt)
Improving maternal health to achieve the Millennium Development Goals in the Eastern Mediterranean Region: a youth lens.
Eastern Mediterranean Health Journal. 2008; 14 Suppl:S97-106.The fifth Millennium Development Goal (MDG) aims to improve maternal health. The 2 targets set for this goal are to "reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio" and "achieve, by 2015, universal access to reproductive health". Six indicators have been selected to help track progress towards these targets: maternal mortality ratio; proportion of births attended by skilled health personnel; contraceptive prevalence rate; adolescent birth rate; antenatal care coverage (at least 1 visit and at least 4 visits); and unmet need for family planning. This paper briefly outlines the general situation in relation to maternal health in the Eastern Mediterranean Region of the World Health Organization (WHO) and goes on to focus on the perspective of adolescent pregnancy and reproductive health.
African Journal of Reproductive Health. 2008 Apr; 12(1):7-11.Add to my documents.
Geneva, Switzerland, World Health Organization [WHO], 2007.  p. (WHO Discussion Papers on Adolescence; Issues in Adolescent Health and Development)The World Health Organization (WHO) has been contributing to meeting the Millennium Development Goals (MDGs) by according priority attention to issues pertaining to the management of adolescent pregnancy. Three of the aims of the MDGs - empowerment of women, promotion of maternal health, and reduction of child mortality - embody WHO's key priorities and its policy framework for poverty reduction. The UN Special Session on Children has focused on some of the key issues affecting adolescents' rights, including early marriage, access to sexual and reproductive health services, and care for pregnant adolescents. This review of the literature was conducted to identify (1) the major factors affecting the pregnancy outcome among adolescents, related to their physical immaturity and inappropriate or inadequate healthcare-seeking behaviour, and (2) the socioeconomic and political barriers that influence their access to health-care services and information. The review also presents programmatic evidence of feasible measures that can be taken at the household, community and national levels to improve pregnancy outcomes among adolescents. (excerpt)
New York, New York, United Nations Population Fund [UNFPA], 2007.  p.The influence behind faith-based organizations is not difficult to discern. In many developing countries, FBOs not only provide spiritual guidance to their followers; they are often the primary providers for a variety of local health and social services. Situated within communities and building on relationships of trust, these organizations have the ability to influence the attitudes and behaviours of their fellow community members. Moreover, they are in close and regular contact with all age groups in society and their word is respected. In fact, in some traditional communities, religious leaders are often more influential than local government officials or secular community leaders. Many of the case studies researched for the UNFPA publication Culture Matters showed that the involvement of faith-based organizations in UNFPA-supported projects enhanced negotiations with governments and civil society on culturally sensitive issues. Gradually, these experiences are being shared across countries andacross regions, which has facilitated interfaith dialogue on the most effective approaches to prevent the spread of HIV. Such dialogue has also helped convince various faith-based organizations that joining together as a united front is the most effective way to fight the spread of HIV and lessen the impact of AIDS. This manual is a capacity-building tool to help policy makers and programmers identify, design and follow up on HIV prevention programmes undertaken by FBOs. The manual can also be used by development practitioners partnering with FBOs to increase their understanding of the role of FBOs in HIV prevention, and to design plans for partnering with FBOs to halt the spread of the virus. (excerpt)
Washington, D.C., World Bank, Gender and Development Group, 2004 Nov.  p.This Operational Guide provides specific guidance to national HIV/AIDS program management teams, public-sector ministries, private sector entities, and non-governmental and community-based organizations (NGOs/CBOs) implementing World Bank-financed HIV/AIDS programs and projects, as well as the World Bank's operational staff who design these programs and projects. It provides concrete examples of the integration of gender concerns into all stages of project preparation, implementation, monitoring and evaluation (M&E). The immediate objective is to provide the tools needed to identify and analyze gender-specific issues and concerns in HIV/AIDS programs and make appropriate provisions in HIV/AIDS operations to address these concerns. The ultimate goal of this Operational Guide is to enhance the effectiveness of HIV/AIDS interventions by ensuring that the gender inequalities that underlie the epidemic are addressed. (excerpt)
The gender dimensions of HIV / AIDS: challenges for South Africa. Extracts from a regional scan and South Asian Regional Consultation.
New Delhi, India, Joint United Nations Programme on HIV / AIDS [UNAIDS], South Asia Inter-Country Team, 2004 Aug. 39 p. (UNAIDS/04.47E)The regional consultation brought together key Government representatives from seven countries of the region, across the HIV/AIDS sector, women's machinery, representative of the South Asian Association for Regional Cooperation (SAARC) Secretariat, and UN agencies working at regional levels, bilateral agencies and UNIFEM's partner organizations working on a range of development issues - such as mental health, violence against women, anti-trafficking, home-based work and economic rights, gender and sexuality, media advocacy - and networks of women living with HIV/AIDS. It provided a platform for learning and cross-regional sharing and identification of gaps and opportunities, and enabled the development of a regional strategy to work cohesively towards tackling the gender dimensions of HIV/AIDS. The consultation also provided strategic direction for UNIFEM to advance its work in the region. (excerpt)
Facing the future together: Report of the Secretary General's Task Force on Women, Girls and HIV / AIDS in Southern Africa. Advocacy version.
Johannesburg, South Africa, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2004 Jul. 26 p. (UNAIDS/04.33E)Southern Africa is the epicenter of the global HIV/AIDS pandemic. After growing steadily for two decades, the prevalence rates appear at last to have stabilised - but at shockingly high levels of prevalence. By 2002, more than 20 percent of pregnant women tested were HIV-positive, with several countries in the sub-region reporting a rate of infection in antenatal care clinics of more than 25 percent. Sub-Saharan Africa is also the only region in the world in which HIV infection rates are higher among women than men. For every ten men with the HIV virus, thirteen women are infected. The impact on young women and girls aged 15-24 - those who have only recently become sexually active - is even more dramatic. They are two and a half times more likely to be infected than males in the same age group. The gap is larger still in Southern Africa, where in Zambia and Zimbabwe girls and young women make up close to a staggering eighty percent of all young people aged 15-24 who are living with HIV/AIDS. What are the reasons for this enormous disparity? Why are women and young girls bearing the brunt of the pandemic in Southern Africa? The answers lie in poverty, violence and gender inequality. (excerpt)
Washington, D.C., World Bank, 2004 Nov. 132 p.It is estimated that 98 percent of Somali women and girls have undergone some form of genital mutilation. About 90 percent have been subjected to the most drastic form. Since the 1991 collapse of its central government, Somalia has lacked established institutions, infrastructure, human resources and a secure environment suitable for development programs. Despite a harsh and uncertain environment, a vibrant civil society has been born in Somalia. Hundreds of NGOs, including women and youth groups, are actively involved in assisting victims of war, displaced persons, ethnic minorities, orphans, returned refugees, drought-stricken nomads and rural communities. These civil society groups receive significant humanitarian and development assistance from U.N. agencies and 40 international NGOs operating in Somalia. The Somalia Aid Coordination Body (SACB) was established to coordinate and facilitate information sharing among donor agencies, mostly based in Nairobi, Kenya. FGM/FGC eradication programs andactivities are coordinated through the SACB FGM/FGC Task Force, which meets every month. This assessment is aimed at guiding the World Bank, UNFPA and their partners in current and future anti-FGM/FGC initiatives. Programmatic and policy issues which emerged during the assessment are reflected in the relevant sections of the report. (excerpt)
Geneva, Switzerland, WHO, 2006. 35 p.Marriage is widely regarded as a place of safety to shelter from the risks of adolescence. In many parts of the developing world, parents and policy makers see marriage as a walled garden where cultural and family values protect young girls from defilement and stigma. Particularly in poorer and rural areas, there is pressure on parents to marry off their daughters while they are very young before they become an economic liability. Millions of girls reluctantly enter into marriage while they are still children, just sexually mature but unready in every other way for this profound change in their lives. Typically, an adolescent bride knows little of her new husband or new life, has little control over her destiny and is unaware of the health risks that she faces. When an adolescent girl starts a sexual relationship with a man 10 years older than she is, he may be sexually experienced. If he is infected with a sexually transmitted infection (STI) or with HIV, a marriage certificate offers no protection. In the context of the AIDS pandemic, it is a chilling fact that the majority of unprotected sex between an un-infected adolescent girl and an infected older man takes place within marriage with the blessing of parents and community. Neither AIDS nor STIs respect marriage as a place of safety. (excerpt)
Lancet. 2007 Mar 31; 369(9567):1069-1070.During the past 2 years, substantial progress has been made in changing attitudes towards female genital mutilation in countries such as Guinea, Egypt, Tanzania, Kenya, and Senegal. But the practice remains widespread across Africa. Wairagala Wakabi reports. In Guinea, where 97% of all women undergo female genital mutilation, about 150 communities made a declaration to collectively abandon the practice at the beginning of this year. Attitudes towards the harmful procedure are also changing in other countries in Africa such as Egypt, Tanzania, Kenya, and Senegal. But despite this growing momentum against the practice, it is still prevalent in these countries and it remains widespread in at least 28 countries on the continent. Poor education and low levels of income among women in African countries, coupled with inadequate governmental support in efforts to eradicate the practice, mean it will take longer to stamp out. Human rights activists place much of the blame for slow progress at the door of governments. "The struggle to have communities in Africa abandon female genital mutilation is taking too long because it's only civil society who have taken it seriously. Governments are yet to take up the matter to the expected level", says Faiza Mohamed, Africa regional director of women rights group Equality Now, which works with 23 organisations in 16 African countries. (excerpt)
Forced Migration Review. 2007 Jan; (27):42-43.The following is extracted by the FMR editors from a recent UNFPA/UNICEF report on The Effects of Conflict on Health and Well-Being of Women and Girls in Darfur: Conversations with the Community. How do the women and girls of Darfur assess the risks they face? UNFPA and UNICEF interviewed conflict-affected women and their male household members in order to better understand priority actions needed to improve women and girls' health and well-being. The counter-insurgency strategy employed by the Government of Sudan and the Janjaweed militia appears to have been one of asset stripping and population displacement. Indiscriminate attacks on villages have not only killed and injured civilians but also destroyed or looted housing, infrastructure, community services, wells and irrigation systems, fruit trees and other property such as cattle. The result has been the large-scale movement of a highly vulnerable, traumatised population of 2.75 million people, rendered almost completely dependent on humanitarian aid for survival. (excerpt)
Forced Migration Review. 2007 Jan; (27):5-6.Throughout history, violence against women has been accepted as an inevitable if unfortunate feature of conflict. This is now changing. While such violence continues to be inflicted on a massive scale, it is now recognised as a threat to development, peace and security; a violation of human rights; and a crime under international law. The challenge confronting the international community is whether all parties can make the prevention, treatment and prosecution of sexual violence a priority. Our current inability to protect women and girls in conflict and postconflict settings represents a human rights failure of massive proportions. Some 40,000 cases of war-related rape were reported during the war in Bosnia and Herzegovina. Between 23,000 and 45,000 Kosovar Albanian women were reportedly raped in 1998 to 1999 at the height of the conflict with Serbia. In Rwanda, 39% of women surveyed reported being raped during the genocide and, in one study, two in three women who were raped were HIV-positive. In Burundi, 19% of a sample of women reported being raped. Unfortunately, these cases are not the exception. Similar horrific data are reported wherever there is conflict. And behind each statistic is a human being - a woman who needs support to heal and reintegrate into her family and community. Yet all too often survivors are subjected to discrimination and stigma, which only compound the suffering they have already endured. (excerpt)
Forced Migration Review. 2007 Jan; (27):13-14.UNSCR 1325 provides a useful framework from which to develop and improve policy and programming on gender, peace, security and development issues. Most importantly, UNSCR 1325 provides a platform for civil society to demand accountability from their governments and to raise public and political awareness on the issue of sexual violence in conflict and beyond. UNSCR 1325 is an 18-point document focusing on four inter-related thematic areas: participation of women at all decision-making levels and in peace processes; inclusion of gender training in peacekeeping operations; protection of the rights of girls and women; gender mainstreaming in the UN's reporting and implementation systems. Within each of these thematic areas, UNSCR 1325 encourages action by UN agencies, the Security Council, the Secretary General, governments and all parties to armed conflict. Importantly, a Security Council resolution brings international attention to a particular issue and also provides a political framework that recommends action to be taken by governments and international institutions. (excerpt)
Paris, France, UNESCO, 2005. 80 p.This publication focuses on the key issues to address and strategies to put in place in order to meet international targets and national goals for universalizing girls' access to, retention in and completion of quality education. The right of all children to education that is free from discrimination and of a sufficient quality to enable their full participation in society has been a goal emphasized through all major modern universal rights treaties, and development discourses. In particular, the Convention against Discrimination in Education, 1960, and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), 1979, have defined discrimination in many spheres, including education, as a violation of universal rights. The Convention on the Rights of the Child, 1989, has made the promotion of free primary education and quality education an obligation for governments to respect for children and youth up to the age of 18 years. The strong case for promoting universal rights and gender equality in education has been supported in more recent international documents. Girls' and women's education has been embedded in these international visions of development priorities. Two goals lay out the priorities for attention to gender issues in education. These are: (a) eliminating gender disparities in primary and secondary education by 2005; and (b) achieving gender equality in education by 2015. These goals have developed from the 1990 Jomtien World Conference on Education for All (EFA), and expanded in the follow-up World Education Forum (WEF), held in Dakar in 2000. They are supported by the Millennium Development Goal (MDG) for gender equality and women's empowerment. (excerpt)
Johannesburg, South Africa, ActionAid International, 2004.  p.Violence or the fear of violence is an important reason for girls not attending school. Besides being in itself an infringement of girls' rights, violence is also denying girls their right to education. ActionAid has carried out an initial study of the violence that girls encounter in and around schools and on the way to school, in 12 countries in Africa and Asia. It indicates that much violence against girls goes unreported and the scale of the problem has been underestimated. Violence against girls is a serious obstacle to the attainment of internationally agreed education goals including the Millennium Development Goals (MDGs) (UN 2000). Violence against girls takes many forms including rape, sexual harassment, intimidation, teasing and threats. It affects all girls, regardless of age, race, class, caste or location. Poverty, war and long journeys to school put girls at additional risk. The causes are rooted in male-dominated cultures which belittle or condone violence against girls and women. Violence is used as a tool for imposing male power. Girls themselves often regard violence as inevitable and feel powerless to complain. (excerpt)