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Guidance on ethical considerations in planning and reviewing research studies on sexual and reproductive health in adolescents.
Geneva, Switzerland, World Health Organization, 2018. 52 p.This document is intended to address commonly occurring situations and challenges that one faces in carrying out research with adolescents (people aged 10–19 years), the majority of whom are deemed not to have reached the recognized age of majority in their respective settings. To this end, adolescents aged 18 and 19 years are classified as adults in many settings and have the legal capacity to make autonomous decisions regarding their participation in research. In this document, the term “children” refers to people below the age of 18 years, and the term “minor adolescents” refers specifically to people aged 10-18 years.
[New York, New York], Guttmacher Institute, 2018 Apr. 2 p.The United States -- through its Agency for International Development (USAID) -- has long been a global leader in enabling women’s access to contraceptive services in the world’s poorest countries. Empowering women with control over their own fertility yields benefits for them, their children and their families. It means fewer unintended -- and often high-risk -- pregnancies and fewer abortions, which in poor countries are often performed under unsafe conditions. Better birth spacing also makes for healthier mothers, babies and families, and pays far-reaching dividends at the family, society and country levels.
An evidence map of social, behavioural and community engagement interventions for reproductive, maternal, newborn and child health.
Geneva, Switzerland, WHO, 2017. 190 p.The Every Woman Every Child (EWEC) Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) calls for action towards three objectives: Survive (end preventable deaths), Thrive (ensure health and well-being) and Transform (expand enabling environments). The strategy recognizes that “women, children and adolescents are potentially the most powerful agents for improving their own health and achieving prosperous and sustainable societies”. Social, behavioural and community engagement (SBCE) interventions are key to empowering individuals, families and communities to contribute to better health and well-being of women, children and adolescents. Policy-makers and development practitioners need to know which interventions work best. WHO has provided global guidance on some key SBCE interventions, and we recognize there is more work to be done as this will be an area of increasing importance in the era of the Sustainable Development Goals (SDGs) and the EWEC Global Strategy. This document provides an evidence map of existing research into a set of selected SBCE interventions for reproductive, maternal, newborn, and child health (RMNCH), the fruit of a collaboration between the WHO, the Partnership for Maternal, Newborn & Child Health (PMNCH) and the International Initiative for Impact Evaluations (3ie), supported by other partners. It represents an important way forward in this area, harnessing technical expertise, and academia to strengthen knowledge about the evidence base. The evidence map provides a starting point for making available existing research into the effectiveness of RMNCH SBCE interventions, a first step toward providing evidence for decision-making. It will enable better use of existing knowledge and pinpoint where new research investments can have the greatest impact. An online platform that complements the report provides visualization of the findings, displaying research concentrations and gaps.
Female genital mutilation as an issue of gender disparity in the 21st century: Leveraging opportunities to reverse current trends.
Ethiopian Medical Journal. 2016 Jul; 54(3):107-108.Add to my documents.
Optimal feeding of low-birthweight infants in low- and middle-income countries: highlights from the World Health Organization 2011 guidelines.
[Washington, D.C.], MCSP, 2017 Jun. 6 p. (USAID Cooperative Agreement No. AID-OAA-A-14-00028)This brief presents the updated WHO Guidelines on Optimal Feeding of Low Birth-Weight Infants in Low- and Middle-Income Countries, and highlights changes and best practices for optimal feeding of LBW infants. It is intended to assist policymakers, program managers, educators, and health care providers involved in caring for LBW infants to put the recommendations into action. It is hoped that such actions will contribute to improving the quality of care for LBW infants, thereby reducing LBW mortality and improving health outcomes for this group.
[Washington, D.C.], MCSP, 2017 Jun. 5 p. (USAID Cooperative Agreement No. AID-OAA-A-14-00028)This brief complements the 2012 WHO Guidelines on Basic Newborn Resuscitation, and highlights key changes and best practices for newborn resuscitation in resource-limited settings. Successful implementation of these recommendations at the time of birth is intended to improve the quality of care for newborns, and contribute to better health outcomes and reduce preventable newborn deaths and disabilities due to birth asphyxia.
Oral Diseases. 2016 Apr; 22 Suppl 1:42-5.Four million people of the global total of 35 million with HIV infection are from South-East Asia. ART is currently utilized by 15 million people and has led to a dramatic decline in the mortality rate, including those in low- and middle-income countries. A reduction in sexually transmitted HIV and in comorbidities including tuberculosis has also followed. Current recommendations for the initiation of antiretroviral therapy in people who are HIV+ are essentially to initiate ART irrespective of CD4 cell count and clinical stage. The frequency of HIV testing should be culturally specific and based on the HIV incidence in different key populations but phasing in viral load technology in LMIC is an urgent priority and this needs resources and capacity. With the availability of simplified potent ART regimens, persons with HIV now live longer. The recent WHO treatment guidelines recommending routine HIV testing and earlier initiation of treatment should be the stepping stone for ending the AIDS epidemic and to meet the UNAIDS mission of 90*90*90. (c) 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
New York, New York, UNICEF, 2017 Sep. 92 p.This report presents data and outlines best practices and policies that can put governments on the path to providing every child with the best start in life. It outlines the neuroscience of early childhood development (ECD), including the importance of nutrition, protection and stimulation in the early years. And it makes the case for scaling up investment, evaluation and monitoring in ECD programmes. The report concludes with a six-point call to action for governments and their partners to help maximize the potential of the children who will build the future – by making the most of the unparalleled opportunities offered by the early moments in life.
Contraceptives and condoms for family planning and STI & HIV prevention external procurement support report.
New York, New York, United Nations Population Fund [UNFPA], 2014 Dec. 86 p.Access to reproductive health, including family planning, is recognized as a human right. Support from donors is critical to improving and ensuring the security of essential contraceptives and other life-saving reproductive health commodities. Contraceptives procured through external support constitute a significant contribution to reproductive health, including family planning and, through the dual protection provided by condoms, the prevention of sexually transmitted infections (STIs) including HIV. This report, updated annually, is a rich source of data for development that can drive good planning for contraceptive supply, advocacy and resource mobilization. The report contains dozens of figures, tables, and graphs, along with information and analysis that can influence policy dialogue, advocacy and interagency work. It aims to enhance coordination among donors, improve partnerships between donors and national governments, and mobilize the resources needed to accelerate progress towards universal access to sexual and reproductive health, and in particular to reduce the unmet need for family planning. The report also analyses data received from individual donors and partner organizations about the support they have provided directly to developing countries for the procurement of contraceptives and condoms.
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. 2017 Jul 01; 390(10089):1.Add to my documents.
Maternal and Child Nutrition. 2017 Aug 10; 1-3.Written by the WHO/UNICEF NetCode author group, the comment focuses on the need to protect families from promotion of breast-milk substitutes and highlights new WHO Guidance on Ending Inappropriate Promotion of Foods for Infants and Young Children. The World Health Assembly welcomed this Guidance in 2016 and has called on all countries to adopt and implement the Guidance recommendations. NetCode, the Network for Global Monitoring and Support for Implementation of the International Code of Marketing of Breast-milk Substitutes and Subsequent Relevant World Health Assembly Resolutions, is led by the World Health Organization and the United Nations Children's Fund. NetCode members include the International Baby Food Action Network, World Alliance for Breastfeeding Action, Helen Keller International, Save the Children, and the WHO Collaborating Center at Metropol University. The comment frames the issue as a human rights issue for women and children, as articulated by a statement from the United Nations Office of the High Commissioner for Human Rights.
London, United Kingdom, International Planned Parenthood Federation [IPPF], 2016 Jun. 12 p.Governments have agreed a range of commitments to advance sustainable development, including promoting women’s and girls’ health and protecting human rights for all. Global commitments are important as they set a framework for funding to flow towards a particular issue and influence national development strategies and programming. As advocates, we can use global commitments to encourage coordination across national development plans, to push for funding and to increase political buy-in. This factsheet will focus on the linkages between the Sustainable Development Goals (SDGs) and Family Planning 2020 (FP2020) commitments.
Washington, D.C., Center for Global Development, 2016 Mar. 36 p. (CGD Policy Paper 077)This paper seeks to determine the degree to which a gender lens has been incorporated into World Bank projects and the success of individual projects according to gender equality-related indicators. We first examine the World Bank’s internal scoring of projects based on whether they encompass gender analysis, action, and monitoring and evaluation (M&E) components, as well as project development objective indicators and outcomes according to these indicators. We conclude that when indicators are defined, targets are specified, and outcomes are published, gender equality-related results appear largely positive. However, many projects (even those possessing a gender “theme” and perfect scores for the inclusion of gender analysis, action, and M&E components) lack gender-related indicators, and when such indicators are present, they often lack specified target goals. The paper concludes with a recommendation for increased transparency in gender-related project data (including data on the funding of gender equality-related components of projects) from donor institutions and a call for an increased number of gender-related indicators and targets in donor projects.
Geneva, Switzerland, WHO, 2015. 124 p.The report delivers both promising and disappointing messages about the situation in low- and middle-income countries. Within-country inequalities have narrowed, with a tendency for national improvements driven by faster improvements in disadvantaged subgroups. However, inequalities still persist in most reproductive, maternal, newborn and child health indicators. The extent of within-country inequality differed by dimension of inequality and by country, country income group and geographical region. There is still much progress to be made in reducing inequalities in RMNCH.
Using GRADE as a framework to guide research on the sexual and reproductive health and rights (SRHR) of women living with HIV - methodological opportunities and challenges.
AIDS Care. 2017 Sep; 29(9):1088-1093.In March 2016, WHO reviewed evidence to develop global recommendations on the sexual and reproductive health and rights (SRHR) of women living with HIV. Systematic reviews and a global survey of women living with HIV informed the guideline development decision-making process. New recommendations covered abortion, Caesarean section, safe disclosure, and empowerment and self-efficacy interventions. Identification of key research gaps is part of the WHO guidelines development process, but consistent methods to do so are lacking. Our method aimed to ensure consistency and comprised the systematic application of a framework based on GRADE (Grading of Recommendations, Assessment, Development and Evaluation) to the process. The framework incorporates the strength and quality rating of recommendations and the priorities reported by women in the survey to inform research prioritisation. For each gap, we also articulated: (1) the most appropriate and robust study design to answer the question; (2) alternative pragmatic designs if the ideal design is not feasible; and (3) the methodological challenges facing researchers through identifying potential biases. We found 12 research gaps and identified five appropriate study designs to address the related questions: (1) Cross-sectional surveys; (2) Qualitative interview-driven studies; (3) Registries; (4) Randomised controlled trials; and (5) Medical record audit. Methodological challenges included selection, recruitment, misclassification, measurement and contextual biases, and confounding. In conclusion, a framework based on GRADE can provide a systematic approach to identifying research gaps from a WHO guideline. Incorporation of the priorities of women living with HIV into the framework systematically ensures that women living with HIV can shape future policy decisions affecting their lives. Implementation science and participatory research are appropriate over-arching approaches to enhance uptake of interventions and to ensure inclusion of women living with HIV at all stages of the research process.
A tool for strengthening gender-sensitive national HIV and Sexual and Reproductive Health (SRH) monitoring and evaluation systems.
Geneva, Switzerland, WHO, 2016. 126 p.WHO and UNAIDS have released a new tool for strengthening gender-sensitive national HIV and sexual and reproductive health (SRH) monitoring and evaluation systems. The tool provides step-by-step guidance to strategic information specialists and monitoring and evaluation officers of HIV and SRH programmes on how to ask the right questions in order to uncover gender inequalities and their influence on health; identify and select gender-sensitive indicators; conduct gender-analysis of SRH and HIV data; and strengthen monitoring and evaluation systems to enable appropriate data collection and gender analysis. The tool has been used by nearly 30 country teams of strategic information specialists, civil society and HIV programme implementers to analyse their own SRH and HIV data from a gender equality perspective. It can be used for training monitoring and evaluation specialists as well as a resource guide for SRH and HIV programmes to develop gender profiles of their SRH and HIV situation. “Know your epidemic, know your response” has been the cornerstone of the HIV response. This tool supports this approach by helping identify inequities and underlying drivers and hence, improve evidence-informed SRH and HIV programmes for all, but particularly for women and girls.
WASH’Nutrition: A practical guidebook on increasing nutritional impact through integration of WASH and nutrition programmes for practitioners in humanitarian and developent contexts.
Paris, France, Action Contre la Faim [ACF], 2017. 156 p.Undernutrition is a multi-sectoral problem with multi-sectoral solutions. By applying integrated approaches, the impact, coherence and efficiency of the action can be improved. This operational guidebook demonstrates the importance of both supplementing nutrition programmes with WASH activities and adapting WASH interventions to include nutritional considerations i.e. making them more nutrition-sensitive and impactful on nutrition. It has been developed to provide practitioners with usable information and tools so that they can design and implement effective WASH and nutrition programmes. Apart from encouraging the design of new integrated projects, the guidebook provides support for reinforcing existing integrated interventions. It does not provide a standard approach or strict recommendations, but rather ideas, examples and practical tools on how to achieve nutrition and health gains with improved WASH. Integrating WASH and nutrition interventions will always have to be adapted to specific conditions, opportunities and constrains in each context. The guidebook primarily addresses field practitioners, WASH and Nutrition programme managers working in humanitarian and development contexts, and responds to the need for more practical guidance on WASH and nutrition integration at the field level. It can also be used as a practical tool for donors and institutions (such as ministries of health) to prioritise strategic activities and funding options. (Excerpt)
Management of childhood diarrhea by healthcare professionals in low income countries: An integrative review.
International Journal of Nursing Studies. 2017 Jan; 66:82-92.Background The significant drop in child mortality due to diarrhea has been primarily attributed to the use of oral rehydration solutions, continuous feeding and zinc supplementation. Nevertheless uptake of these interventions have been slow in developing countries and many children suffering from diarrhea are not receiving adequate care according to the World Health Organization recommended guidelines for the clinical management of childhood diarrhea. Objectives The aim of this integrative review is to appraise healthcare professionals’ management of childhood diarrhea in low-income countries. Design Whittemore and Knafl integrative review method was used, in conjunction with the Reporting of Observational Studies in Epidemiology (STROBE) checklist for reporting observational cohort, case control and cross sectional studies. Method A comprehensive search performed from December 2014 to April 2015 used five databases and focused on observational studies of healthcare professional's management of childhood diarrhea in low-income countries. Results A total of 21 studies were included in the review. Eight studies used a survey design while three used some type of simulated client survey referring to a fictitious case of a child with diarrhea. Retrospective chart reviews were used in one study. Only one study used direct observation of the healthcare professionals during practice and the remaining eight used a combination of research designs. Studies were completed in South East Asia (n = 13), Sub-Saharan Africa (n = 6) and South America (n = 2). Conclusion Studies report that healthcare providers have adequate knowledge of the etiology of diarrhea and the severe signs of dehydration associated with diarrhea. More importantly, regardless of geographical settings and year of study publication, inconsistencies were noted in healthcare professionals’ physical examination, prescription of oral rehydration solutions, antibiotics and other medications as well as education provided to the primary caregivers. Factors other than knowledge about diarrhea were shown to significantly influence prescriptive behaviors of healthcare professionals. This review demonstrates that “knowledge is not enough” to ensure the appropriate use of oral rehydration solutions, zinc and antibiotics by healthcare professionals in the management of childhood diarrhea.
Geneva, Switzerland, WHO, 2016. 96 p.The report addresses two overarching questions: What inequalities in childhood immunization coverage exist in low- and middle-income countries? And how have childhood immunization inequalities changed over the last 10 years? In answering these questions, this report draws on data about five childhood immunization indicators, disaggregated by four dimensions of inequality, and covering 69 countries. The findings of this report indicate that there is less inequality now than 10 years ago. Global improvements have been realized with variable patterns of change across countries and by indicator and dimension of inequality. The current situation in many countries shows that further improvement is needed to lessen inequalities; in particular, inequalities related to household economic status and mother’s education were the most prominent. (Excerpt)
Geneva, Switzerland, WHO, 2016. 172 p.The World Health Organization has released a new set of antenatal care (ANC) recommendations to improve maternal and perinatal health worldwide. The guidelines seek to reduce the global burden of stillbirths, reduce pregnancy complications and provide all women and adolescents with a positive pregnancy experience. High quality health care during pregnancy and childbirth can prevent deaths from pregnancy complications, perinatal deaths and stillbirths, yet globally, less than two-thirds of women receive antenatal care at least four times throughout their pregnancy. The new ANC model raises the recommended number of ANC visits from four to eight, thereby increasing the number of opportunities providers have to detect and address preventable complications related to pregnancy and childbirth. The guidelines provide 49 recommendations for routine and context-specific ANC visits, including nutritional interventions, maternal / fetal assessments, preventive measures, interventions for common physiological symptoms and health system interventions. Given that women around the world experience maternal care in a wide range of settings, the recommendations also outline several context-specific service delivery options, including midwife-led care, group care and community-based interventions.
2016 Nov; New York, New York, UNICEF, 2016 Nov. 77 p.Pneumonia and diarrhoea are responsible for the unnecessary loss of 1.4 million children each year. This report highlights current pneumonia and diarrhoea related mortality, and illustrates the startling divide between the children being reached and the considerable number of those left behind. By developing key protective, preventative and treatment interventions, collectively we are now equipped with the knowledge and the tools required to preventing child deaths due to these leading childhood killers. The report also provides recommendations to further accelerate progress in effective interventions and bridge the greatest gaps in equity.
[New recommendations from the World Health Organization (WHO) for the use of contraceptive methods] Nuevas recomendaciones de la Organizacion Mundial de la Salud (OMS) para el uso de los metodos anticonceptivos.
Gaceta Medica De Mexico. 2016 Sep - Oct; 152(5):601-603.The Medical Eligibility Criteria for Contraceptive Use of the World Health Organization have been updated recently. These criteria constitute a guideline for the selection of family planning methods appropriated for women and men with known medical conditions or personal characteristics of medical relevance. The guidelines last updating incorporates recommendations for the use of a new emergency contraceptive pill and three long-acting hormonal methods, and revises some previously established recommendations. This article provides information on the last edition of such document and aims to contribute to its dissemination.
[Washington, D.C.], FP2020, 2016. 139 p.This report marks the halfway point of the FP2020 initiative, and reflects the substantial progress made to date: 1) There are now more than 300 million women and girls using modern contraception in the world’s 69 poorest countries—a milestone that has taken decades to achieve. 2) More than 30 million of those users have been added since 2012, when FP2020 was launched. 3) In Eastern and Southern Africa, for the first time ever, more than 30% of women and girls are using a modern method of contraception. 4) In West Africa, where contraceptive use has been historically low, the Ouagadougou Partnership has surpassed its goal of reaching 1 million additional users between 2011 and 2015, and is now aiming to reach 2.2 million additional users between 2015 and 2020.
Obstetrics and Gynecology. 2016 Nov; 128(5):958-963.Female genital mutilation comprises all procedures that involve partial or total removal of the external female genitalia or injury to the female genital organs for nonmedical reasons. Health care providers for women and girls living with female genital mutilation have reported difficulties in recognizing, classifying, and recording female genital mutilation, which can adversely affect treatment of complications and discussions of the prevention of the practice in future generations. According to the World Health Organization, female genital mutilation is classified into four types, subdivided into subtypes. An agreed-upon classification of female genital mutilation is important for clinical practice, management, recording, and reporting, as well as for research on prevalence, trends, and consequences of female genital mutilation. We provide a visual reference and learning tool for health care professionals. The tool can be consulted by caregivers when unsure on the type of female genital mutilation diagnosed and used for training and surveys for monitoring the prevalence of female genital mutilation types and subtypes.