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WHO recommendations on antenatal care for a positive pregnancy experience: Ultrasound examination. Highlights and key messages from the World Health Organization’s 2016 Global Recommendations.
Geneva, Switzerland, WHO, 2018 Jan. 4 p. (WHO/RHR/18.01; USAID Cooperative Agreement No. AID-OAA-A-14-00028)This brief highlights the WHO recommendation on routine antenatal ultrasound examination and the policy and program implications for translating this recommendation into action at the country level.
Brazzaville, Republic of the Congo, WHO, Regional Office for Africa, 2017. 23 p. (Policy Brief)Community health worker (CHW) programmes have seen a renaissance in the last two decades and now many countries in Africa boast of such national or substantial sub-national programmes. The 2013 Third Global Forum on Human Resources for Health concluded that CHWs and other frontline primary health care workers “play a unique role and can be essential to accelerating MDGs and achieving UHC”, and called for their integration into national health systems. The Ebola virus disease (EVD) outbreak of 2014-2015 highlighted the imperative of ensuring the functioning of the health systems at the community level for both their day-to-day resilience and disaster preparedness. The purpose of this policy brief is to inform discussions and decisions in the World Health Organization (WHO) African Region on policies, strategies and programmes to increase access to primary health care (PHC) services and make progress towards universal health coverage (UHC) by expanding the implementation of scaled-up CHW programmes. This brief summarizes the existing evidence on CHW programmes with a focus on sub-Saharan Africa and offers a number of context-linked policy options for countries seeking to scale up and improve the effectiveness of their CHW programmes, particularly with regard to needs such as those of Guinea, Liberia and Sierra Leone, the three countries that were the most affected by the 2014-2015 EVD outbreak. For the purposes of this policy brief, a broad definition of CHW is used. CHWs are individuals “carrying out the functions related to health care delivery [who are] trained in some way in the context of the intervention [but have] no formal professional or paraprofessional certificated or degreed tertiary education [in a health-related field]”). WHO states that CHWs “should be members of the communities where they work, selected by the communities, answerable to the communities for their activities, and supported by the health system but not necessarily a part of its organization”. For the purposes of this brief, a working definition for a scaled-up CHW programme has been developed, where the term refers to a programme that is designed to be more than a pilot or demonstration project and has the intention of covering a substantial population size or geographic area, depending on the country’s context. (Excerpts)
Expanding the evidence base for global recommendations on health systems: strengths and challenges of the OptimizeMNH guidance process.
Implementation Science. 2016 Jul 18; 11:98.BACKGROUND: In 2012, the World Health Organization (WHO) published recommendations on the use of optimization or "task-shifting" strategies for key, effective maternal and newborn interventions (the OptimizeMNH guidance). When making recommendations about complex health system interventions such as task-shifting, information about the feasibility and acceptability of interventions can be as important as information about their effectiveness. However, these issues are usually not addressed with the same rigour. This paper describes our use of several innovative strategies to broaden the range of evidence used to develop the OptimizeMNH guidance. In this guidance, we systematically included evidence regarding the acceptability and feasibility of relevant task-shifting interventions, primarily using qualitative evidence syntheses and multi-country case study syntheses; we used an approach to assess confidence in findings from qualitative evidence syntheses (the Grading of Recommendations, Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach); we used a structured evidence-to-decision framework for health systems (the DECIDE framework) to help the guidance panel members move from the different types of evidence to recommendations. RESULTS: The systematic inclusion of a broader range of evidence, and the use of new guideline development tools, had a number of impacts. Firstly, this broader range of evidence provided relevant information about the feasibility and acceptability of interventions considered in the guidance as well as information about key implementation considerations. However, inclusion of this evidence required more time, resources and skills. Secondly, the GRADE-CERQual approach provided a method for indicating to panel members how much confidence they should place in the findings from the qualitative evidence syntheses and so helped panel members to use this qualitative evidence appropriately. Thirdly, the DECIDE framework gave us a structured format in which we could present a large and complex body of evidence to panel members and end users. The framework also prompted the panel to justify their recommendations, giving end users a record of how these decisions were made. CONCLUSIONS: By expanding the range of evidence assessed in a guideline process, we increase the amount of time and resources required. Nevertheless, the WHO has assessed the outputs of this process to be valuable and is currently repeating the approach used in OptimizeMNH in other guidance processes.
Integrating poverty and gender into health programmes: a sourcebook for health professionals. Module on HIV / AIDS.
[Manila, Philippines], World Health Organization [WHO], Regional Office for the Western Pacific, 2008.  p.This module is designed to improve the awareness, knowledge and skills of health professionals on poverty and gender concerns in the field of HIV / AIDS. Experience increasingly shows that the socioeconomic factors contributing to the rapid spread of HIV in the Region include low education, limited access to health care services and increased mobility within and between countries -- factors that are largely determined by poverty and gender inequality. The growing commitment to curbing the HIV / AIDS epidemic requires that health professionals at community, provincial, national and international levels have the knowledge, skills and tools to more effectively respond to the health needs of poor and marginalized people and address the gender inequalities fuelling the epidemic. However, many health professionals in the Region are not adequately prepared to address these issues. This module is designed to help fill this gap.
[Geneva, Switzerland], WHO, 2009. 8 p.This report shows how countries with low prevalence of male circumcision but high prevalence of HIV have made progress to scale up male circumcision services.
Country experiences in the scale-up of male circumcision in the Eastern and Southern Africa Region: Two years and counting. A sub-regional consultation, Windhoek, Namibia, June 9-10 2009.
[Unpublished] 2009. 24 p.This report on a sub-regional consultation held in Windhoek, Namibia, 9-10 July 2009 summarises progress reports, lessons from programme experience, and priorities for the next year from nine countries.
Paris, France, UNESCO, 2006 Mar. 37 p. (Good Policy and Practice in HIV and AIDS and Education Booklet No. 3; ED-2006/WS/4; cld 26006)UNESCO recognizes the significant impact of HIV and AIDS on international development, and in particular on progress towards achieving Education For All (EFA). As the UN agency with a mandate in education and a co-sponsor of the Joint United Nations Programme on HIV and AIDS (UNAIDS), UNESCO takes a comprehensive approach to HIV and AIDS. It recognizes that education can play a critical role in preventing future HIV infections and that one of its primary roles is to help learners and educators in formal and non-formal education systems to avoid infection. It also recognizes its responsibility to address and respond to the impact of the epidemic on formal and non-formal education systems, and the need to expand efforts to address issues related to care, treatment and support of those infected and affected by HIV. UNESCO's global strategy for responding to HIV and AIDS is guided by four key principles, and focuses on five core tasks. The guiding principles that are the foundation of UNESCO's response to HIV and AIDS are: Work towards expanding educational opportunities and the quality of education for all; A multi-pronged approach that addresses both risk (individual awareness and behaviour) and vulnerability (contextual factors); Promotion and protection of human rights, promotion of gender equality, and elimination of violence (notably violence against women), stigma and discrimination; An approach to prevention based on providing information that is scientifically sound, culturally appropriate, and effectively communicated, and helping learners and educators to develop the skills they need to prevent HIV infection and to tackle HIV and AIDS-related discrimination. (excerpt)
On the front line: a review of policies and programmes to address HIV / AIDS among peacekeepers and uniformed services.
Copenhagen, Denmark, UNAIDS, Office on AIDS, Security and Humanitarian Response, 2003 Aug.  p. (UNAIDS Series: Engaging Uniformed Services in the Fight against HIV / AIDS; UNAIDS/03.44E)This initiative focuses on mitigating the impact of HIV/AIDS in three core areas: International security, with the focus on supporting HIV/AIDS interventions within United Nations peacekeeping operations; National security, targeting uniformed services with particular emphasis on young recruits, future peacekeepers and demobilizing personnel; Humanitarian response, which focuses on vulnerable populations in crisis settings and humanitarian workers. As part of its national security initiative, UNAIDS SHR, in collaboration with UN Theme Groups, is providing support to countries for the development and/or strengthening of national responses targeting national uniformed services and, in particular, young recruits, demobilized personnel and peacekeepers. Approximately 45 countries worldwide are currently supported through the Initiative on HIV/AIDS and Security. (excerpt)
Journal of Midwifery and Women's Health. 2004 Jul-Aug; 49(4):306-311.Traditional birth attendant (TBA) training commenced in many places in the non-Western world in the 1970s, supported by the World Health Organization and other funding bodies. By 1997, senior policy makers decided to refocus priorities on the provision of “skilled attendants” to assist birthing women. The definition of skilled attendants excluded TBAs and resulted in the subsequent withdrawal of funding for TBA training globally. A review of the health and sociological literature and international policy documents that address TBA training revealed how international policy and professional orientation are reflected in education programs designed for the TBA. Policy makers risk ignoring the important cultural and social roles TBAs fulfill in their local communities and fail to recognize the barriers to the provision of skilled care. The provision of skilled attendants for all birthing women cannot occur in isolation from TBAs who in themselves are also highly skilled. This article argues a legitimacy of alternative world views and acknowledges the contribution TBAs make to childbearing women across the world. (author's)
Using international guidelines to support national policy in maternal and newborn healthcare. Case Study No. 3.
In: Shaping policy for maternal and newborn health: a compendium of case studies, edited by Sandra Crump. Baltimore, Maryland, JHPIEGO, 2003 Oct. 29-36.One of the ways that national governments solidify and communicate their commitment to safe motherhood and newborn health is through their national policy and service delivery guidelines, which outline a management and service delivery approach for achieving specific standards of care in healthcare facilities. In developing these guidelines --and the facilities and providers to support them--policymakers at the national level generally look to expert opinion and international consensus regarding practices and models that have been proven effective in other countries. The collection, synthesis, and publication of internationally endorsed maternal and newborn healthcare practices can therefore provide an important support and catalyst for policy change at the national level. International guidelines can provide both a focus for national policy dialogue and development and a technical reference to help ensure that national policies follow current scientific evidence and thinking. This case study describes how the international guidelines in the World Health Organization's (WHO's) manual Managing Complications in Pregnanq and Childbirth: A Guide for Midwives and Doctors (MCPC) have influenced policy development in countries where JHPIEGO and the Maternal and Neonatal Health (MNI-1) Program have been working to increase the use of skilled care for women and newborns and increase maternal and newborn survival. The MCPC manual was published as part of WHO's Integrated Management of Pregnancy and Childbirth (IMPAC) series, the technical component of WHO's Making Pregnancy Safer strategy aimed at reducing maternal and perinatal mortality and morbidity and improving maternal and newborn health. (excerpt)