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Normal CD4+ T lymphocyte levels in HIV seronegative individuals in the Manya / Yilo Krobo communities in the eastern region of Ghana.
Viral Immunology. 2006; 19(2):260-266.The goal of this study was to determine the normal levels of CD4+ T lymphocytes in healthy individuals who were HIV seronegative in the Manya and Yilo Krobo Districts of Ghana's Eastern Region. This enabled comparisons with normal CD4 count ranges established by the World Health Organization (WHO). The study population consisted of 249 HIV-seronegative clients from a mobile free Voluntary Counseling and Testing (VCT) service in communities of the two districts during a one-month period. The mean CD4 count of these individuals was 1067 cells/µl with women demonstrating higher baseline CD4 counts than men. This study found a WHO comparable HIV seronegative baseline CD4 count as well as gender-based differences in the CD4 count and CD4/CD8 ratio. Establishment of the adult baseline for the country provides important demographic data and indicates the appropriateness of current global treatment guidelines with regards to CD4 levels in Ghana. (author's)
Moving up the food chain: lessons from gender mainstreaming at the World Food Programme. A study by the Women's Commission for Refugee Women and Children.
New York, New York, Women's Commission for Refugee Women and Children, 2006 Aug. 55 p.The Women's Commission for Refugee Women and Children has been partnering with UNHCR on the global rollout of UNHCR's Age, Gender and Diversity Mainstreaming initiative. As part of this partnership, the Women's Commission has undertaken a research project on the World Food Programme's (WFP) gender mainstreaming efforts to assess what UNHCR can learn from another UN organization and what WFP could learn from UNHCR's own mainstreaming efforts. The research is a "desk study" based on a review of available resource materials, those publicly available on the WFP Web site, those non-public documents secured directly through WFP and through direct contact with the gender unit at WFP headquarters in Rome. This paper, based on the research and findings, considers how WFP mainstreams gender and offers recommendations on enhancing mainstreaming efforts by WFP and UNHCR in the context of food security and displacement. It provides an overview of WFP's age and gender mainstreaming policies and highlights organizational efforts to implement those policies. The study notes areas of progress and limitations of WFP's mainstreaming efforts in relation to food assistance and food security for displaced populations. It also seeks to ascertain how those efforts complement and reinforce UNHCR's age and gender mainstreaming efforts. (excerpt)
The practice of antenatal care: comparing four study sites in different parts of the world participating in the WHO Antenatal Care Randomised Controlled Trial. [Práctica de controles prenatales: comparación de cuatro centros de estudio en diferentes lugares del mundo que participaron en el Estudio Controlado Aleatorizado de Control Prenatal de la OMS]
Paediatric and Perinatal Epidemiology. 1998; 12 Suppl 2:116-141.In the preparation of a randomised controlled trial to evaluate a new programme of antenatal care (ANC) in different parts of the world, we conducted a baseline survey of the ANC procedures in all 53 clinics participating in the trial. There were two components of this survey: (1) description of clinic characteristics and services offered: the staff of each clinic was interviewed and direct observation was made by field supervisors, and (2) the actual use of services by pregnant women attending these clinics: we reviewed a random sample of 2913 clinical histories. The clinical units surveyed were offering most of the activities, screening, laboratory tests and interventions recommended as effective according to the Cochrane Pregnancy and Childbirth Database (PCD), although some of these were not available in some sites. On the other hand, some tests and interventions that are considered not effective according to these criteria are reportedly offered. There was a difference across sites in the availability and offer to low-risk women of vaginal examination, evaluation of pelvic size, dental examination, external version for breech presentation and formal risk score classification, and a notable difference in the type of principal provider of ANC. There was a large variation in the actual use of screening and laboratory tests and interventions that should be offered to all women according to Cochrane PCD criteria: some of these are simply not available in a site; others are available, but only a fraction of women attending the clinics are receiving them. The participating sites all purport to follow the traditional `Western' schedule for ANC, but in three sites we found that a high percentage of women initiate their ANC after the first trimester, and therefore do not have either the recommended minimum number of visits during pregnancy or the minimum first trimester evaluation. It is concluded that the variability and heterogeneity of ANC services provided in the four study sites are disturbing to the profession and cast doubts on the rationale of routine ANC. (author's)
Coverage of selected health services for HIV / AIDS prevention and care in less developed countries in 2001.
Geneva, Switzerland, World Health Organization [WHO], 2002 Nov. v, 38 p.The Declaration of Commitment on HIV/AIDS adopted by the United Nations General Assembly Special Session on HIV/AIDS in June 2001 commits Member States and the global community to taking strong and immediate action to address the HIV/AIDS crisis. It calls for achieving a number of specific goals, including reducing HIV prevalence among young men and women, expanding care and support and protecting human rights. The Millennium Development Goals adopted at the Millennium Summit in September 2000 call for expanded efforts to halt and reverse the spread of HIV/AIDS by 2015. Other important documents, such as the Abuja Declaration and Framework for Action on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases adopted at the African Summit on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases in 2001, declare regional and national commitments to confront the epidemic. Progress towards achieving these goals requires significantly expanding HIV/AIDS programmes to foster a supportive environment, to prevent new infections, to care for those already infected and to mitigate the social and economic consequences of the epidemic. One measure of progress is the percentage of people living in low- and middle income countries who have access to key prevention and care services. This report presents the results of an assessment of the coverage of several key health services in 2001. It is intended to serve as a baseline against which future progress can be measured. This report includes about 70 countries, including most low- and middle income countries with more than 10 000 people living with HIV/AIDS in 2001. The information presented here relies on service statistics and on expert assessment and is therefore much less precise than estimates based on population-based surveys. The results should be interpreted with caution but are useful in indicating the starting point in efforts to achieve future goals. (excerpt)
The practice of antenatal care: comparing four study sites in different parts of the world participating in the WHO Antenatal Care Randomised Controlled Trial.
PAEDIATRIC AND PERINATAL EPIDEMIOLOGY.. 1998 Oct; 12 Suppl 2:116-41.This paper reports the results of an antenatal care (ANC) baseline survey in four study sites in different parts of the world participating in the WHO ANC randomized controlled trial. The health care units surveyed are providing most of the activities, screening, laboratory tests and interventions recommended as effective based on the Cochrane Pregnancy and Childbirth Database (PCD), although some of these are not available in some clinics. Some tests and interventions that are considered ineffective according to the PCD criteria are reportedly offered. A variation is observed across sites in the availability and offer to low-risk women of vaginal exam, pelvic size assessment, dental exam, external version for breech presentation, and formal risk score classification. Moreover, there is a significant difference in the type of principal ANC provider and a great variation in the actual performance of screening and laboratory tests and interventions that should be provided to all women according to these criteria. This is partly due to the unavailability of these services in the site, or only a fraction of women attending the clinics are receiving them. The participating clinics all declared to follow the traditional Western schedule for ANC; however, three clinics are found to have a high percentage of women who begin their ANC after the first trimester of pregnancy. It is generalized that the variability and heterogeneity of ANC services offered in the four sites are annoying to the profession and cast doubts on the rationale behind routine ANC.