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Guideline: use of multiple micronutrient powders for point-of-use fortification of foods consumed by pregnant women.
Geneva, Switzerland, WHO, 2016. 32 p.The guideline is intended for a wide audience, including governments, nongovernmental organizations, healthcare workers, scientists and donors involved in the design and implementation of micronutrient programmes and antenatal care services and their integration into national and subnational public health strategies and programmes. This WHO guideline states that routine use of multiple micronutrient powders during pregnancy is not recommended as an alternative to standard iron and folic supplementation during pregnancy for improving maternal and infant health outcomes.
The state of food security and nutrition in the world 2017: building resilience for peace and food security.
Rome, Italy, FAO, 2017. 133 p.This report has been jointly published by the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP) and the World Health Organization (WHO). The 2017 edition marks the beginning of a new era in monitoring efforts to achieve a world without hunger and malnutrition within the framework of the Sustainable Development Goals (SDGs). The report will henceforth monitor progress towards the targets on both ending hunger (SDG Target 2.1) and ending all forms of malnutrition (SDG Target 2.2). It will also include analyses of how food security and nutrition are related to progress on other SDG targets.
An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting.
Washington, D.C., International Bank for Reconstruction and Development / The World Bank, 2017 Apr. 258 p.The report estimates the costs, impacts and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs $70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between $4 and $35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets -- especially those for reducing stunting in children and anemia in women -- are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000 day window of early childhood are inalienable and portable and will pay lifelong dividends -- not only for children directly affected but also for us all in the form of more robust societies -- that will drive future economies.
2016; Geneva, Switzerland, WHO, 2016. 38 p.This guideline provides a global, evidence-informed recommendation on iron supplementation in postpartum women, as a public health intervention for the purpose of improving maternal and infant health outcomes. The guideline aims to help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions to achieve the Sustainable Development Goals (SDGs), in particular, Goal 2: End hunger, achieve food security and improved nutrition and promote sustainable agriculture.
World Health Organization. Comprehensive Implementation Plan on Maternal, Infant, and Young Child Nutrition. Geneva, Switzerland, 2014.
Advances In Nutrition. 2015 Jan; 6(1):134-5.Add to my documents.
Geneva, Switzerland, WHO, 2015.  p.This document provides estimates of the prevalence of anaemia for the year 2011 in preschool-age children (6-59 months) and women of reproductive age (15-49 years), by pregnancy status, and by regions of the United Nations and World Health Organization (WHO), as well as by country. This document may serve as a resource for estimating the baseline prevalence of anaemia in women of reproductive age, in working towards achieving the second global nutrition target 2025, a 50% reduction of anaemia in women of reproductive age, as outlined in the Comprehensive implementation plan on maternal, infant and young child nutrition and endorsed by the Sixty-fifth World Health Assembly, in resolution WHA65.6.
Geneva, Switzerland, WHO, 2014.  p. (WHO/NMH/NHD/14.2)Recognizing that accelerated global action is needed to address the pervasive and corrosive problem of the double burden of malnutrition, in 2012 the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan on maternal, infant and young child nutrition, which specified a set of six global nutrition targets that by 2025 aim to: achieve a 40% reduction in the number of children under-5 who are stunted; achieve a 50% reduction of anaemia in women of reproductive age; achieve a 30% reduction in low birth weight; ensure that there is no increase in childhood overweight; increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%; reduce and maintain childhood wasting to less than 5%. As part of its efforts, the World Health Organization (WHO) has developed a series of six policy briefs, linked to each of the global targets, to guide national and local policy-makers on what actions should be taken at scale, in order to achieve the targets. Recognizing that the six targets are interlinked, many evidence-based, effective interventions can help make progress toward multiple targets. The purpose of these briefs is to consolidate the evidence around which interventions and areas of investment need to be scaled up, and to guide decision-makers on what actions need to be taken in order to achieve real progress toward improving maternal, infant and young child nutrition. (Excerpts)
Geneva, Switzerland, WHO, 2014.  p. (WHO/NMH/NHD/14.4)In 2012, the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan on maternal, infant and young child nutrition, which specified six global nutrition targets for 2025 . This policy brief covers the second target: a 50% reduction of anaemia in women of reproductive age. The purpose of this policy brief is to increase attention to, investment in, and action for a set of cost-effective interventions and policies that can help Member States and their partners in reducing the rates of anaemia among women of reproductive age. (Excerpts)
Global policy and programme guidance on maternal nutrition: what exists, the mechanisms for providing it, and how to improve them?
Paediatric and Perinatal Epidemiology. 2012 Jul; 26 Suppl 1:315-25.Undernutrition in one form or another affects the majority of women of reproductive age in most developing countries. However, there are few or no effective programmes trying to solve maternal undernutrition problems. The purpose of the paper is to examine global policy and programme guidance mechanisms for nutrition, what their content is with regard to maternal nutrition in particular, as well as how these might be improved. Almost all countries have committed themselves politically to ensuring the right of pregnant and lactating women to good nutrition through the Convention on the Elimination of all Forms of Discrimination Against Women. Despite this, the World Health Organization (WHO) has not endorsed any policy commitments with regard to maternal nutrition. The only policy guidance coming from the various technical departments of WHO relates to the control of maternal anaemia. There is no policy or programme guidance concerning issues of maternal thinness, weight gain during pregnancy and/or low birthweight prevention. Few if any countries have maternal nutrition programmes beyond those for maternal anaemia, and most of those are not effective. The lack of importance given to maternal nutrition is related in part to a weakness of evidence, related to the difficulty of getting ethical clearance, as well as a generalised tendency to downplay the importance of those interventions found to be efficacious. No priority has been given to implementing existing policy and programme guidance for the control of maternal anaemia largely because of a lack of any dedicated funding, linked to a lack of Millennium Development Goals indicator status. This is partly due to the poor evidence base, as well as to the common belief that maternal anaemia programmes were not effective, even if efficacious. The process of providing evidence-based policy and programme guidance to member states is currently being revamped and strengthened by the Department of Nutrition for Health and Development of WHO through the Nutrition Guidance Expert Advisory Group processes. How and if programme guidance, as well as policy commitment for improved maternal nutrition, will be strengthened through the Nutrition Guidance Expert Advisory Group process is as yet unclear. The global movement to increase investment in programmes aimed at maternal and child undernutrition called Scaling Up Nutrition offers an opportunity to build developing country experience with efforts to improve nutrition during pregnancy and lactation. All member states are being encouraged by the World Health Assembly to scale-up efforts to improve maternal infant and young child nutrition. Hopefully Ministries of Health in countries most affected by maternal and child undernutrition will take leadership in the development of such plans, and ensure that the control of anaemia during pregnancy is given a great priority among these actions, as well as building programme experience with improved nutrition during pregnancy and lactation. For this to happen it is essential that donor support is assured, even if only to spearhead a few flagship countries. (c) 2012 Blackwell Publishing Ltd.
Geneva, Switzerland, WHO, 2010.  p.The World Health Organization Guidelines for the treatment of malaria provides evidence-based and up-to-date recommendations for countries on malaria diagnosis and treatment which help countries formulate their policies and strategies. In scope, the Guidelines cover the diagnosis and treatment of uncomplicated and severe malaria caused by all types of malaria, including in special groups (young children, pregnant women, HIV / AIDS), in travellers (from non-malaria endemic regions) and in epidemics and complex emergency situations. The first edition of the Guidelines for the treatment of malaria were published in 2006. The second edition introduces a new 5th ACT to the four already recommended for the treatment of uncomplicated malaria. Furthermore, the Guidelines recommend a parasitological confirmation of diagnosis in all patients suspected of having malaria before treating. The move towards universal diagnostic testing of malaria is a critical step forward in the fight against malaria as it will allow for the targeted use of ACTs for those who actually have malaria. This will help to reduce the emergence and spread of drug resistance. It will also help identify patients who do not have malaria, so that alternative diagnoses can be made and appropriate treatment provided. The new Guidelines will therefore help improve the management of not only malaria, but other childhood febrile illnesses.
Archives of Gynecology and Obstetrics. 2007 Dec; 276(6):583-589.The objective was to evaluate quality of life (QOL) and identify its associated factors in a cohort of women with gynecologic cancer. A cross-sectional study was conducted, including 103 women with cervical or endometrial cancer, aged between 18 and 75 years who were receiving their entire treatment at the institution where the investigation was carried out. QOL was measured by the World Health Organization's QOL instrument-abbreviated version (WHOQOL-BREF). Clinical and sociodemographic characteristics, in addition to prevalence of cancer-related symptoms prior to radiotherapy were investigated. Bivariate analysis was performed, applying the Mann-Whitney test. Multivariate analysis was used to identify factors associated with QOL. The mean age of the participants was 56.8 plus or minus 11.6 years. The study included 67 (65%) women with cervical cancer and 36 (35%) women with endometrial cancer. Most participants were at an advanced stage (63.1%). The most common complaints were pain (49.5%) and vaginal bleeding (36.9%). The prevalence of anemia was 22.3%. On multivariate analysis, it was observed that anemia (P = 0.006) and nausea and/or vomiting (P = 0.010) determined impairment in physical domain. Pain negatively influenced physical domain (P = 0.001), overall QOL (P = 0.024), and general health (P = 0.013), while the history of surgery positively affected general health (P = 0.001). Cancer-related symptoms were factors that most interfered with QOL in women with gynecologic cancer. Therefore, more attention should be focused on identifying these symptoms, adopting measures to minimize their repercussions on QOL. (author's)
Food and Nutrition Bulletin. 2003; 24 Suppl 4:S99-S103.Iron deficiency is considered to be one of most prevalent forms of malnutrition, yet there has been a lack of consensus about the nature and magnitude of the health consequences of iron deficiency in populations. This paper presents new estimates of the public health importance of iron-deficiency anemia (IDA), which were made as part of the Global Burden of Disease (GBD) 2000 project. Iron deficiency is considered to contribute to death and disability as a risk factor for maternal and perinatal mortality, and also through its direct contributions to cognitive impairment, decreased work productivity, and death from severe anemia. Based on meta-analysis of observational studies, mortality risk estimates for maternal and perinatal mortality are calculated as the decreased risk in mortality for each 1 g/dl increase in mean pregnancy hemoglobin concentration. On average, globally, 50% of the anemia is assumed to be attributable to iron deficiency. Globally, iron deficiency ranks number 9 among 26 risk factors included in the GBD 2000, and accounts for 841,000 deaths and 35,057,000 disability-adjusted life years lost. Africa and parts of Asia bear 71% of the global mortality burden and 65% of the disability-adjusted life years lost, whereas North America bears 1.4% of the global burden. There is an urgent need to develop effective and sustainable interventions to control iron-deficiency anemia. This will likely not be achieved without substantial involvement of the private sector. (author's)
MOTHERCARE MATTERS. 1993 Apr-May; 3(1-2):13-4.This paper presents some of the recommendations from a recent World Health Organization technical meeting examining issues involved in detecting and managing anemia at the community, health center, and hospital levels. A woman at the community level should be asked whether she feels tired or breathless after doing a normal day's work, whether she experienced more than a cup full of vaginal bleeding in the pregnancy, if she delivered a child in the preceding twelve months, whether the pregnant woman is a young primigravida, if she required a blood transfusion for her last pregnancy, and if she had problems delivering the placenta during the last pregnancy. Affirmative responses to one or more of these questions indicate that the woman may be anemic. The pallor of her conjunctiva, tongue, palms of hands, and nail beds should be examined. A woman with no high risk factor and who is not pale should receive a standard dose of iron and folate for one month, malaria chemoprophylaxis according to the local situation, and should be seen again in one month. If the woman's history shows risk factors or she looks pale, she should be given an higher dose of iron and folate for one month, malaria chemoprophylaxis according to the local situation, and antihelminth if hookworm is endemic to the area, and she should be referred to the health center for supervision. Advice should be given on diet. Iron rich foods should be eaten with some animal foods or fresh fruit or tuber staples. She should avoid tea or coffee with her meal. The standard and higher doses of iron and folate are presented, followed by recommendations for action at the health center and district hospital levels.