Your search found 16 Results
Comparison of the new World Health Organization growth standards and the National Center for Health Statistics growth reference regarding mortality of malnourished children treated in a 2006 nutrition program in Niger.
Archives of Pediatrics and Adolescent Medicine. 2009 Feb; 163(2):126-30.OBJECTIVE: To compare the National Centre for Health Statistics (NCHS) international growth reference with the new World Health Organization (WHO) growth standards for identification of the malnourished (wasted) children most at risk of death. DESIGN: Retrospective data analysis. SETTING: A Medecins Sans Frontieres (Doctors Without Borders) nutrition program in Maradi, Niger, in 2006 that treated moderately and severely malnourished children. PARTICIPANTS: A total of 53 661 wasted children aged 6 months to 5 years (272 of whom died) in the program were included. INTERVENTIONS: EpiNut (Epi Info 6.0; Centers for Disease Control and Prevention, Atlanta, Georgia) software was used to calculate the percentage of the median for the NCHS reference group, and the WHO (igrowup macro; Geneva, Switzerland) software was used to calculate z scores for the WHO standards group of the 53 661 wasted children. OUTCOME MEASURES: The main outcome measures are the difference in classification of children as either moderate or severely malnourished according to the NCHS growth reference and the new WHO growth standards, specifically focusing on children who died during the program. RESULTS: Of the children classified as moderately wasted using the NCHS reference, 37% would have been classified as severely wasted according to the new WHO growth standards. These children were almost 3 times more likely to die than those classified as moderately wasted by both references, and deaths in this group constituted 47% of all deaths in the program. CONCLUSIONS: The new WHO growth standards identifies more children as severely wasted compared with the NCHS growth reference, including children at high mortality risk who would potentially otherwise be excluded from some therapeutic feeding programs.
International Family Planning Perspectives. 2008 Jun; 34(2):101-102.At the midpoint of the 15-year timetable for achieving the Millennium Development Goals, the majority of countries with high levels of maternal and child mortality are not on track to meet the targets for reductions in these outcomes by 2015, according to a recent analysis.1 Among the 68 countries that account for the vast majority of maternal and child deaths, only 16 are on track to reduce mortality among children younger than five to one-third of its 1990 level (Goal 4). Progress toward reducing maternal mortality by three-quarters (Goal 5) has been slow as well: In all 41 Sub-Saharan African countries included in the analysis, at least 300 maternal deaths occur per 100,000 live births. The research was conducted by Countdown to 2015, a collaboration of researchers, policymakers and other stakeholders that has been tracking progress toward the Millennium Development Goals in the 68 countries in which 97% of deaths among women of childbearing age and children younger than five occur. Researchers focused on determining coverage rates (the proportion of individuals in each country who need a service and are able to obtain it) for interventions that have been proven to avert maternal, newborn and child deaths, that can be widely implemented in resource-poor countries, and whose levels can be reliably estimated across countries and over time; these interventions include provision of contraceptive and STI services, skilled care during childbirth, and pre- and postnatal care. Most of the data were obtained through nationally representative household surveys. (excerpt)
Geneva, Switzerland, WHO, Department of Child and Adolescent Health and Development, 2008. 20 p.The first few days and weeks of life are among the most critical for child survival. Every year, an estimated 4 million children die during the first month of life. Almost all of these deaths (98%) occur in developing countries. Most neonatal deaths are due to ore-term birth, asphyxia and infections such as sepsis, tetanus and pneumonia. In 2006-2007, to support efforts by countries and regions to reduce newborn deaths, we worked to build capacity for the planning and delivery of improved newborn care services in health facilities and communities, to provide tools and guidance for extending population coverage, and to evaluate the impact of all those actions. (excerpt)
Monitoring the Declaration of Commitment on HIV / AIDS. Guidelines on construction of core indicators. 2008 reporting.
Geneva, Switzerland, UNAIDS, 2007 Apr. 139 p. (UNAIDS/07.12E; JC1318E)The primary purpose of this document is to provide key constituents who are actively involved in a country's response to AIDS with essential information on core indicators that measure the effectiveness of the national response. These guidelines will also help ensure the consistency and transparency of the process used by national governments. In addition, this information can be used by UNAIDS to prepare regional and global progress reports on implementation of the United Nations General Assembly Special Session (UNGASS) Declaration of Commitment on HIV/AIDS. Countries are strongly encouraged to integrate the core indicators into their ongoing monitoring and evaluation activities. These indicators are designed to help countries assess the current state of their national response while simultaneously contributing to a better understanding of the global response to the AIDS pandemic, including progress towards meeting the targets in the Declaration of Commitment on HIV/ AIDS. Given the dual purposes of the indicators, the guidelines in this document are designed to improve the quality and consistency of data collected at the country level, which will enhance the accuracy of conclusions drawn from the data at both national and global levels. This document also includes an overview of global indicators that will be used by UNAIDS and its partners to assess key components of the response that are best measured on a worldwide basis. (excerpt)
Towards universal access to prevention, treatment and care: experiences and challenges from the Mbeya region in Tanzania -- a case study.
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2007 Mar. 49 p. (UNAIDS Best Practice Collection; UNAIDS/07.11E; JC1291E)This study takes stock of the situation in Mbeya in 2005, documenting the region's continuing efforts to build on the Regional Programme's strong comprehensive prevention approaches to further increase their coverage while strengthening the new district focus, expanding multisectoral work and making available antiretroviral treatment. In doing so, this study describes Mbeya's progress towards universal access and identifies ongoing challenges. Through its comprehensive, decentralized and multisectoral approaches and the continuing efforts of a variety of actors, the region appears to be in a better position to reach universal access than other parts of Tanzania and Africa in general. The experiences of the Mbeya region to date can serve as lessons learnt to other parts of the country and, more broadly, the continent. This publication is neither a scientific study nor an evaluation of the Regional Programme. It is an analytical description of HIV control activities in the region to date and their status to date. Its focus is mainly on access. The programmes presented here follow national and international recommendations. The quality of the individual programmes, however, has not been assessed for the purpose of this publication. (excerpt)
Bulletin of the World Health Organization. 2007 Oct; 85(10):734.posited that the process of development entails changes in incomes over time. Larger income levels achieved via positive economic growth, appropriately discounted for population growth, would constitute higher levels of development. As many have noted, however, the income measure fails to adequately reflect development in that per-capita income, in terms of its levels or changes to it, does not sufficiently correlate with measures of (human) development, such as life expectancy, child/infant mortality and literacy. The United Nations Development Programme's (UNDP) human development index (HDI) constitutes an improved measure for development. HDI has been modified to be gender-sensitive with variants that reflect gender inequality. Various measures reflecting Sen's "capability" concept, such as civil and political rights, have also been incorporated. Countries where the level of poverty is relatively large tend also to exhibit low values of human development, thus lowering the mean values of the development measures. Where inequalities of development indicators are very large, however, the average values may not sufficiently reflect the conditions of the poor, requiring the need to concentrate on poverty per se. (excerpt)
African Population Studies/Etude de la Population Africaine. 2006; 21(1):19-36.Relatively scant knowledge is available on the situations of older persons in sub-Saharan Africa. Reliable and accessible demographic and health statistics are needed to inform policy making for the older population. The process and outcome of a project to create a minimum data set (MDS) on ageing and older persons to provide an evidence base to inform policy are described. The project was initiated by the World Health Organization and conducted in Ghana, South Africa, Tanzania and Zimbabwe. A set of indicators was established to constitute a sub-regional MDS, populated from data sources in the four countries; a national MDS was produced for each country. Major gaps and deficiencies were identified in the available data and difficulties were experienced in accessing data. Specific gaps, and constraints against the production and access of quality data in the subregion are examined. The project and outcome are evaluated and lessons are drawn. Tasks for future phases of the project to complete and maintain the MDS are outlined. (author's)
Monitoring and evaluating actions implemented to confront AIDS in Brazil: civil society's participation.
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:88-93.The United Nations Declaration of Commitment on HIV/AIDS recommends that governments conduct periodic analysis of actions undertaken in confronting the HIV/ AIDS epidemic that involve civil society's participation. Specific instruments and mechanisms should be created towards this end. This paper examines some of the responses of the Brazilian government to this recommendation. Analysis contemplates the Declaration's proposals as to civil society's participation in monitoring and evaluating such actions and their adequacy with respect to Brazilian reality. The limitations and potentials of MONITORAIDS, the matrix of indicators created by Brazil's Programa Nacional de DST/AIDS [National Program for STD/AIDS] to monitor the epidemic are discussed. Results indicate that MONITORAIDS's complexity hampers its use by the conjunction of actors involved in the struggle against AIDS. The establishment of mechanisms that facilitate the appropriation of this system by all those committed to confronting the epidemic in Brazil is suggested. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:80-87.The paper critically analyzes, from the gender standpoint, official results presented in the Brazilian government report to the Joint United Nations Programme on HIV/ AIDS (UNAIDS). Specifically, the fulfillment of 2003 targets set forth in the United Nations Declaration of Commitment on HIV/AIDS, under the category of Human Rights and Reduction of the Economic and Social Impact of AIDS, are evaluated. Key concepts are highlighted, including indicators and strategies that may help civilian society better monitor these targets until 2010. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:94-100.The objective of this study was to analyze, on the national level, the process of monitoring the proposed UNGASS indicators through the use of the Brazilian National Program for STD/AIDS's indicators. Two groups of proposed indicators were analyzed in 2002 and 2005 respectively, as part of the monitoring of the progress of the UNGASS Declaration of Commitment. The availability of information and limitations in calculating the proposed indicators in Brazil were analyzed and the appropriateness of the indicators for monitoring the epidemic in Brazil was discussed. Of the 13 quantitative indicators originally proposed by UNGASS, five were not included in the National Program. One was not included due to its qualitative nature. Two of the indicators were considered to be of little use and two were not included due to the lack of available data needed for their calculation. As the epidemic in Brazil is characterized as being concentrated, within the second group of proposed UNGASS indicators those that refer to the accompaniment of epidemic among high-risk population groups were prioritized. The study highlights that the National Program concentrates its efforts in the development, adaptation, and sharing of sampling methodologies for hard to reach populations. Such activities are geared towards estimating the size of vulnerable population groups, as well as obtaining more information regarding their knowledge, attitudes, and practices. The study concludes that by creating the possibility of international comparisons between advances achieved, the proposal of supranational indicators stimulates countries to discuss and make their construction viable. In a complementary way, the national monitoring systems should focus on program improvement by covering areas that permit the evaluation of specific control and intervention actions. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S53-S59.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) South American site was Pelotas, Brazil. The sample for the longitudinal component was drawn from three hospitals that account for approximately 90% of the city's deliveries. The cross-sectional sample was drawn from a community survey based on households that participated in the longitudinal sample. One of the criteria for site selection was the availability of a large, community based sample of children whose growth was unconstrained by socioeconomic conditions. Local work done in 1993 demonstrated that children of families with incomes at least six times the minimum wage had a stunting rate of 2.5%. Special public relations and implementation activities were designed to promote the acceptance of the study by the community and its successful completion. Among the major challenges of the site were serving as the MGRS pilot site, low baseline breastfeeding initiation and maintenance rates, and reluctance among pediatricians to acknowledge the relevance of current infant feeding recommendations to higher socioeconomic groups. (author's)
Measurement and standardization protocols for anthropometry used in the construction of a new international growth reference.
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S27-S36.Thorough training, continuous standardization, and close monitoring of the adherence to measurement procedures during data collection are essential for minimizing random error and bias in multicenter studies. Rigorous anthropometry and data collection protocols were used in the WHO Multicentre Growth Reference Study to ensure high data quality. After the initial training and standardization, study teams participated in standardization sessions every two months for a continuous assessment of the precision and accuracy of their measurements. Once a year the teams were restandardized against the WHO lead anthropometrist, who observed their measurement techniques and retrained any deviating observers. Robust and precise equipment was selected and adapted for field use. The anthropometrists worked in pairs, taking measurements independently, and repeating measurements that exceeded preset maximum allowable differences. Ongoing central and local monitoring identified anthropometrists deviating from standard procedures, and immediate corrective action was taken. The procedures described in this paper are a model for research settings. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S37-S45.The objective of the Motor Development Study was to describe the acquisition of selected gross motor milestones among affluent children growing up in different cultural settings. This study was conducted in Ghana, India, Norway, Oman, and the United States as part of the longitudinal component of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS). Infants were followed from the age of four months until they could walk independently. Six milestones that are fundamental to acquiring self-sufficient erect locomotion and are simple to evaluate were assessed: sitting without support, hands-and-knees crawling, standing with assistance, walking with assistance, standing alone, and walking alone. The information was collected by both the children's caregivers and trained MGRS fieldworkers. The caregivers assessed and recorded the dates when the milestones were achieved for the first time according to established criteria. Using standardized procedures, the fieldworkers independently assessed the motor performance of the children and checked parental recording at home visits. To ensure standardized data collection, the sites conducted regular standardization sessions. Data collection and data quality control took place simultaneously. Data verification and cleaning were performed until all queries had been satisfactorily resolved. (author's)
BMJ. British Medical Journal. 2006 May 6; 332(7549):1052.New growth charts for infants and young children can be applied globally, says the World Health Organization. The charts will enable doctors and others to detect and tackle growth related conditions, such as undernutrition, overweight, and obesity, at an early stage. The new child growth standards confirm that children given healthy growth conditions born anywhere in the world--be it India, Brazil, or Norway--have the potential to develop to within the same range of height and weight. They prove that differences in children's growth to the age of 5 are influenced more by nutrition, feeding practices, environment, and health care than by genetics and ethnic group. "The WHO child growth standards provide new means to support every child to get the best chance to develop in the most important formative years," said Dr Lee Jong-wook, WHO's director general. "In this regard, this tool will serve to reduce death and disease in infants and young children." (excerpt)
Indicators for monitoring the Millennium Development Goals: definitions, rationale, concepts and sources.
New York, New York, United Nations, 2003 Oct.  p.This handbook contains basic metadata on the agreed list of quantitative indicators for monitoring progress towards the 8 goals and 18 targets derived from the Millennium Declaration. The list of indicators, developed using several criteria, is not intended to be prescriptive but to take into account the country setting and the views of various stakeholders in preparing country-level reports. Five main criteria guided the selection of indicators. They should: Provide relevant and robust measures of progress towards the targets of the Millennium Development Goals. Be clear and straightforward to interpret and provide a basis for international comparison. Be broadly consistent with other global lists and avoid imposing an unnecessary burden on country teams, governments and other partners. Be based to the greatest extent possible on international standards, recommendations and best practices. Be constructed from well-established data sources, be quantifiable and be consistent to enable measurement over time. The handbook is designed to provide the United Nations country teams and national and international stakeholders with guidance on the definitions, rationale, concepts and sources of the data for the indicators that are being used to monitor the Millennium Development Goals. Just as the indicator list is dynamic and will necessarily evolve in response to changing national situations, so will the metadata change over time as concepts, definitions and methodologies change. (excerpt)
Journal of Interdisciplinary History. 1983 Autumn; 14(2):409-11.When food intake falls chronically below the amounts required for physiological energy balance, tissue wasting is inevitable, and eventually death must ensue. Most malnutrition and hunger remains hidden, as populations remain unaware of their inadequate food energy. The World Health Organization (WHO), and Food and Agriculture Organization (FAO), have estimated that most populations are consuming an average of 10 to 20% fewer calories than their bodily requirements; for many individuals, the intake is far less than this average. Yet these populations are not wasting away or dying of starvation. They have adapted physiologically, mainly by reducing their physical activity, and are in overall energy balance but at a social cost. Because work activities must be maintained for survival, it is discretionary activities which are sacrificed first. Yet it is these activities that are needed most for the future improvement of social infrastructure and the community, for ancillery economic activities and home improvement. For children, such adaptation means less interaction with their environment at a critical age, and as a consequence, permanent cognitive deficiencies. The FAO/WHO in 1975 pointed out that very sedentary individuals could survive at levels averaging only 50% above their basal metabolic rate, although this type of existence precludes work or discretionary activities. It has been demonstrated that 15 times the basal metabolic rate is not sufficient either for productive economic activity or for long term maintenance of health. Thus, indicators of nutritional status such as physical growth and development, physical capacity, work output, cognitive performance, morbidity and mortality from infectious diseases, and energy available for social development should be part of the judgment of the significance of food-consumption patterns in any society at any period of time.