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Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study.
BMC Health Services Research. 2014; 14:525.BACKGROUND: The World Health Organisation has designed a pregnancy registry to investigate the effect of maternal drug use on pregnancy outcomes in resource-limited settings. In this sentinel surveillance system, detailed health and drug use data are prospectively collected from the first antenatal clinic visit until delivery. Over and above other clinical records, the registry relies on accurate participant reports about the drugs they use. Qualitative methods were incorporated into a pilot registry study during 2010 and 2011 to examine barriers to women reporting these drugs and other exposures at antenatal clinics, and how they might be overcome. METHODS: Twenty-seven focus group discussions were conducted in Ghana, Kenya and Uganda with a total of 208 women either enrolled in the registry or from its source communities. A question guide was designed to uncover the types of exposure data under- or inaccurately reported at antenatal clinics, the underlying reasons, and how women prefer to be asked questions. Transcripts were analysed thematically. RESULTS: Women said it was important for them to report everything they had used during pregnancy. However, they expressed reservations about revealing their consumption of traditional, over-the-counter medicines and alcohol to antenatal staff because of anticipated negative reactions. Some enrolled participants' improved relationship with registry staff facilitated information sharing and the registry tools helped overcome problems with recall and naming of medicines. Decisions about where women sought care, which influenced medicines used and antenatal clinic attendance, were influenced by pressure within and outside of the formal healthcare system to conform to conflicting behaviours. Conversations also reflected women's responsibilities for producing a healthy baby. CONCLUSIONS: Women in this study commonly take traditional medicines in pregnancy, and to a lesser extent over-the-counter medicines and alcohol. The World Health Organisation pregnancy registry shows potential to enhance their reporting of these substances at the antenatal clinic. However, more work is needed to find optimal techniques for eliciting accurate reports, especially where the detail of constituents may never be known. It will also be important to find ways of sustaining such drug exposure surveillance systems in busy antenatal clinics.
Public Health Nutrition. 2005 Oct; 8(7A):932-939.This background paper considers the extent to which the development of new recommendations for dietary energy requirements needs to account for the macronutrient (fat, carbohydrate, protein and alcohol) profiles of different diets. The issues are discussed from the dual perspectives of avoiding under-nutrition and obesity. It is shown that, in practice, human metabolic processes can adapt to a wide range of fuel supply by altering fuel selection. It is concluded that, at the metabolic level, only diets with the most extreme macronutrient composition would have any consequences by exceeding the natural ability to modify fuel selection. However, diets of different macronutrient composition and energy density can have profound implications for innate appetite regulation and hence overall energy consumption. (author's)
Paris, France, UNESCO, Division of Basic Education, Literacy and Non-Formal Education Section, 2003 Sep.  p. (Literacy, Gender and HIV / AIDS Series)This booklet is one of an ever-growing series of easy-to-read materials produced at a succession of UNESCO workshops. The workshops are based on the appreciation that gender-sensitive literacy materials are powerful tools for communicating messages on HIV/AIDS to poor rural people, particularly illiterate women and out-of-school girls. Based on the belief that HIV/AIDS is simultaneously a health and a social, cultural and economic issue, the workshops train a wide range of stakeholders in HIV/AIDS prevention including literacy, health and other development workers, HIV/AIDS specialists, law enforcement officers, material developers and media professionals. Before a workshop begins, the participants select their target communities and carry out needs assessments of their potential readers. (excerpt)
New York Times. 2002 Oct 31;  p..The World Health Organization today identified 10 major health risks it said accounted for up to 40 percent of the 56 million deaths around the world each year. The 10 risks are lack of food, unsafe sex, high blood pressure, smoking, alcohol, unsafe water or sanitation, high cholesterol, nutritional deficiencies, obesity and indoor smoke from cooking or heating fires, predominantly in Africa and South Asia. (excerpt)
Geneva, Switzerland, WHO, 1996 Aug. 6 p. (Fact Sheet N 127)This fact sheet presents trends in substance use and associated health problems, facts about alcohol, tobacco addiction, and WHO programs that address these social problems.
WOMEN 2000. 1987; (2):1-18.It has become clear that, although many groups and organizations are concerned with the general question of drug abuse, there has been little effort made to consider the problem with special reference to women. This issue draws attention to some of the elements that particularly concern women. The 1st section discusses the proceedings of the UN International Conference On Drug Abuse And Illicit Trafficking. Special attention is paid to the Comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control and the Declaration of the International Conference on Drug Abuse and Illicit Trafficking. The next section was prepared by the Division of Narcotic Drugs of the UN. It stresses maternal drug abuse and implications for intervention. The 3rd section discusses the activities of the Un Fund For Drug Abuse Control. The 4th section outlines rehabilitation approaches to drug and alcohol dependence including the ecological approach, survival skills training, assertiveness training, and health promotion. Finally the role of the Food and Agriculture Organizazion of the UN in combating drug abuse is analyzed.
Alcohol related problems and their prevention with particular reference to adolescence. Report of the Task Force meeting Geneva, 31 August - 4 September 1984.
[Unpublished] 1984. 46 p. (MNH/NAT/84.1.)Cultural, socioeconomic, and biological factors all influence alcohol use by adolescents and their experience of alcohol-related problems. Although the assessment of these problems presents methodological difficulties, strategies for prevention based on educational and legislative approaches both promise some measure of success. Further research is required to establish adequate data bases and to test the effectiveness of interventions. A number of specific research proposals were developed. These included epidemiological studies, with particular emphasis on longitudinal surveys, biomedical investigations and comparative evaluations of preventive interventions. In view of the increasing concern about alcohol-related problems in many developing countries, it was recommended that priority be given to the development of approaches applicable in such settings. It was also recommended that research projects should be facilitated which rely upon a strong multicentric approach. (author's)
[Unpublished] 1990 Jan 26. vii, 169 p.In 1988, research teams from 17 countries from all regions of Africa met in Ethiopia to assess how to develop a broad, adaptable knowledge, attitudes, beliefs, and practices (KAP) survey and interview schedule for AIDS research. Subsequently, researchers from North and South America and Europe have been involved in adapting the African KAP surveys to their regions. This document presents the research documents resulting from that work. Organized into four parts, this WHO draft document has been prepared to permit researchers to follow a standardized approach to this type of research and to generate information that will be comparable between countries. Part one covers the introduction. Part two deals with the study design, including the conceptual framework, objectives, training, ethical issues, and information dissemination. The interviewers' manual is described in part three. This section includes information on locating subjects in the community, conducting interviews, fieldwork, training interviewers, and detailed notes on the individual questionnaire. Finally, part four presents models of each of the tabulation plans.
Interview schedule for Knowledge, Attitudes, Beliefs and Practices on AIDS. Phase I: African countries. A. Household form. B. Community characteristics. C. Individual questionnaire.
[Unpublished] 1989 Feb. 28 p.The household interview form has spaces in which to designate a household's location and track interviewer visits with notation of visit results. Basic information can be recorded about the people over age 10 years who usually live in the household or who slept in the household on the preceding night. Data are then taken on the community characteristics form on the type of locality, travel time to the nearest large town, and facilities available in the community. The individual questionnaire is for people aged 15-64 years who slept in the household on the preceding night and is comprised of the following sections: identification; individual characteristics; awareness of AIDS; knowledge on AIDS; sources of information; beliefs, attitudes, and behavior; knowledge of and attitudes toward condoms; sexual practices; injection practices; locus of control; IV drug use; and drinking habits.
Risk factors related to HIV transmission: sexually transmitted diseases, alcohol consumption and medically-related injections.
In: Sexual behaviour and AIDS in the developing world, edited by John Cleland and Benoit Ferry. London, England, Taylor and Francis, 1995. 193-207. (Social Aspects of AIDS)This chapter discusses sexually transmitted diseases (STD), alcohol consumption, and medically-related injection practices as they relate to the risk of HIV transmission. Most HIV transmission in the developing world occurs through unprotected sexual contact. It is now established that infection of one or both partners with other STDs may be a powerful co-factor in HIV transmission. It is important to study STDs among general populations because the predominant mode of transmission of both HIV infection and other STDs is sexual. Many of the measures for preventing the sexual transmission of HIV and STD are the same, as are the target audiences for the interventions. STD clinical services are important access points for persons at high risk of both HIV and other STDs. Alcohol consumption can diminish inhibitions and self control. Such consumption is common in many parts of the world. It is therefore wise to study the levels of consumption and the links with sexual activity especially in the form of nonregular and commercial sex contacts. Finally, a very large proportion of the population in the world receives medically-related injections every year. The risk of HIV transmission through this route is limited, but there may be dangers of infection, especially in countries where sterilized materials are not systematically available or used.
Epidemiological experience in the mission of the United Nations Transition Assistance Group (UNTAG) in Namibia.
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1992; 70(1):129-33.Medical reports modelled after the US Peace Corps surveillance form provided mortality and morbidity data of the United Nations Transition Assistance Group in Namibia in 1989-1990. Contingents included Australians, Canadians, Danes, Finns, Kenyans, Malays, Poles, Spaniards, and Britons. Traffic accidents, mostly those on long distance journeys caused 14 of 16 deaths. The fatality ratio was 0.21/million km driven which was considerably higher than that in Switzerland 0.02/million km driven. Even though heavy traffic was not a problem in Namibia, limited experience on unpaved roads; high speeds induced by long and tedious driving; and reduced visibility caused by climactic conditions, fatigue, and alcohol contributed to high fatality. The hospitalization rate of 5.2% (369 patients) was rather high for a young and healthy population. The leading reasons for hospitalization included fever of unknown origin, trauma, and respiratory tract infections. Swiss Medical Unit physicians transferred 25 patients to the State Hospital in Windhoek, most for orthopedic surgery. Injuries, psychiatric problems, and alcoholism resulted in repatriation for 66% of 46 repatriated patients. New consultations for treatment averaged 2.7/person and those for preventive measures averaged 0.8/person. Helicopter pilots was the largest group returning for 2nd visits (56% compared to 1% for logistics staff). The major reasons for attending outpatient clinics included immunizations (18.8%), dental problems (10.5%), and respiratory infections (10.5%). In addition to respiratory infections, other frequent communicable diseases included diarrhea or dysentery, dermatological infections, sexually transmitted diseases, and confirmed or suspected malaria. Preventive measures are needed to reduce mortality due to traffic accidents and the prevalence of psychological and dental problems.
Report from Consultation on Psychosocial Research Needs in HIV Infection and AIDS, Geneva, 25-28 May 1987.
[Unpublished] 1989. 18 p. (WHO/GPA/SBR/89.2)A meeting was held to review the state of research upon the behavioral aspects of HIV transmission, the social factors associated with it, and the effectiveness of control measures, and to consider priorities and future social and behavioral research directions. Despite advances in the virology and immunology of AIDS, much research is called for regarding behavioral aspects of HIV transmission and the impact of AIDS on individual and community life. Such knowledge may be applied in developing effective intervention strategies. The report discusses the nature of the problem, followed by specific topics in the social and behavioral aspects of HIV transmission. Sexual behavior, homosexuality, prostitution, substance abuse, and injections and other skin piercing practices are covered. Social perceptions and explanatory systems are explored, along with coping strategies broken into family children, psychosocial expression, counselling, and family, marriage and reproduction subtopics. Recommendations for research are set forth in the report, aimed at high risk behavior, explanatory models/systems, and coping responses. A variety of research methodologies are suggested, and include population-based surveys, psychometric, ethnographic, and other psychosocial approaches as well as focus group methods. Brief closing mention is made of translating research into action, technical working groups, collaborating centers, a research steering committee, and communications/information.