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[Johannesburg, South Africa], University of the Witwatersrand, Centre for Health Policy, Health Systems Knowledge Network, 2007 Jul.  p.In this paper I discuss gender issues manifested within health occupations and across them. In particular, I examine gender dynamics in medicine, nursing, community health workers and home carers. I also explore from a gender perspective issues concerning delegation, migration and violence, which cut across these categories of health workers. These occupational categories and themes reflect priorities identified by the terms of reference for this review paper and also the themes that emerged from the accessed literature. This paper is based on a desk review of literature accessed through the internet, search engines, correspondence with other experts and reviewing bibliographies of existing material. These efforts resulted in a list of 534 articles, chapters, books and reports. Although most of the literature reviewed was in English, some of it was also in Spanish and Portuguese. Material related to training and interpersonal patient-provider relations that highlights how occupational inequalities affect the availability and quality of health care is covered by other review papers commissioned by the Women and Gender Equity Knowledge Network. (Excerpt)
Primary health care as a strategy for achieving equitable care: a literature review commissioned by the Health Systems Knowledge Network.
[Johannesburg, South Africa], University of the Witwatersrand, Centre for Health Policy, Health Systems Knowledge Network, 2007 Mar.  p.In this paper we want to explore the contribution that primary health care can make to address the social determinants of health in the context of a changing society. The concept of primary health care, endorsed by the World Health Organisation in the Alma Ata Declaration in 1978, has been implemented in very different ways all over the world. We look at the main features of primary health care: what are the conditions that enable the introduction of primary health care, what is the evidence of the primary health care approach to promote health equity and inter-sectoral action and how may the health systems enhance the impact of primary health care on health equity, taking account of contextual factors. The aim is to draw an operational framework that may contribute to further developments in health systems contributing to more equity. Addressing social determinants of health should take into account the actual evolutions in the changing society, in order to assess adequately the changing needs that will be presented to the health care system.. (Excerpt)
Challenging inequity through health systems. Final report: Knowledge Network on Health Systems. WHO Commission on the Social Determinants of Health.
[Johannesburg], South Africa, University of the Witwatersrand, Centre for Health Policy, Health Systems Knowledge Network, 2007 Jun.  p.The way that health systems are designed, financed and operated acts as a powerful determinant of health. The Health Systems Knowledge Network reviewed the evidence on different approaches to improving health equity outcomes through health systems. The focus was on innovative approaches that effectively incorporate action on the social determinants of health, and on strategies of policy development and implementation. Key themes were: Using the health sector to leverage inter-sectoral actions that address the social determinants of health; Enabling social empowerment in support of health equity; Identifying key elements of vision and health system architecture necessary to secure social protection and universal coverage; Building and maintaining national policy space for health policies that seek social justice; and Strengthening management and stewardship capacities within the health sector. The Health Systems Knowledge Network was chaired by Lucy Gilson of the Centre for Health Policy, and made up of 14 experienced policy-makers, academics and members of civil society from around the world. The Network engaged with other sections of the Commission and also commissioned a number of systematic reviews and case studies. This is the final report of the network.
Introducing WHO's sexual and reproductive health guidelines and tools into national programmes. Principles and processes of adaptation and implementation.
Geneva, Switzerland, World Health Organization [WHO], Department of Reproductive Health and Research, 2007. 25 p. (WHO/RHR/07.4)The Departments of Reproductive Health and Research (RHR) and Making Pregnancy Safer (MPS) at the World Health Organization (WHO) have developed a series of guidelines and tools to promote evidence-based practices in sexual and reproductive health within programs. The guidance developed by WHO/RHR and WHO/MPS includes: norms, standards and protocols designed to inform the development and revision of national policies and standards; programmatic guides to inform the development of sexual and reproductive health programs; tools and clinical guides designed to be used by health-care providers in clinical setting, according to evidence-based norms. The guidance covers a range of themes, including maternal and neonatal health, family planning, prevention and control of reproductive tract infections and sexually transmitted infections (RTIs/STIs) and the prevention of unsafe abortion. The various documents are based on scientific evidence and have been developed by WHO/RHR and WHO/MPS as generic global materials that are not specific to any one national context. (excerpt)
Public-private partnerships: Managing contracting arrangements to strengthen the Reproductive and Child Health Programme in India. Lessons and implications from three case studies.
Geneva, Switzerland, World Health Organization [WHO], 2007.  p.Strengthening management capacity and meeting the need for reproductive and child health (RCH) services is a major challenge for the national RCH program of India. Central and state governments are using multiple options to meet this challenge, responding to the complex issues in RCH, which include social, cultural and economic factors and reflect the immense geographical barriers to access for remote and rural population. Other barriers are also being addressed, including lessening financial burdens and creating public-private partnerships to expand access. For example, the National Rural Health Mission was initiated in order to focus on rural populations, although departments of health face a number of challenges in implementing this initiative. In this document, we focus on a key area: the development of management capacity for working with the private sector. We synthesize the lessons learnt from three case studies of public-private partnerships in RCH: two are state initiatives, in Gujarat and Andhra Pradesh, and the third is the national mother nongovernmental organization scheme. The case studies were conducted to determine how management capacity was developed in these three public-private partnerships in service delivery, by examining the structure and process of partnerships, understanding management capacity and competence in various public-private partnerships in RCH, and identifying the means for developing the management capacity of partners. (author's)
Geneva, Switzerland, World Health Organization [WHO], 2007.  p.Since the advent of penicillin, syphilis is not only preventable but also treatable. Despite this, it remains a global problem with an estimated 12 million people infected each year. Pregnant women who are infected with syphilis can transmit the infection to their fetus, causing congenital syphilis with serious adverse effects on the pregnancy in up to 80% of the cases. Yet simple, cost-effective screening and treatment options could prevent and eventually eliminate congenital syphilis. With the current international focus on the Millennium Development Goals (MDGs), there exists a unique opportunity to mobilize action to prevent, and subsequently eliminate, congenital syphilis. Congenital syphilis is a serious but preventable disease, which can be eliminated through effective screening of pregnant women for syphilis and treatment of those infected. More newborn infants are affected by congenital syphilis than by any other neonatal infection, including human immunodeficiency virus (HIV) infection and tetanus, which are currently receiving global attention. Yet the burden of congenital syphilis is still under-appreciated at both international and national levels. Unlike many neonatal infections, congenital syphilis can be effectively prevented by testing and treatment of pregnant women, which also provides immediate benefits to the mother and allows potentially infected partners to be traced and offered treatment. It has been clearly shown that screening of pregnant women for reactive syphilis serology, followed by treatment of seropositive women, is a cost-effective, inexpensive and feasible intervention for the prevention of congenital syphilis and improvement of child health. In 1995, the Pan American Health Organization (PAHO) began a regional campaign to reduce the rate of congenital syphilis in the Americas to less than 50 cases per 100 000 live births. The strategy was to: (1) increase the availability of antenatal care; (2) establish routine serological testing for syphilis during antenatal careand at delivery; and (3) promote the rapid treatment of infected pregnant women. (excerpt)
New York, New York, UNICEF, 2007 Dec.  p.Five years after the Special Session, more than 120 countries and territories have prepared reports on their efforts to meet the goals of 'A World Fit for Children' (WFFC). Most have developed these in parallel with reports on the Millennium Development Goals, carrying out two complementary exercises. Reports on the Millennium Development Goals highlight progress in poverty reduction and the principal social indicators, while the World Fit for Children reports go into greater detail on some of the same issues, such as education and child survival. But they also extend their coverage to child protection, which is less easy to track with numerical indicators. The purpose of this document is to assemble some of the information contained in these reports, along with the latest global data - looking at what has been done and what remains to be done. It is therefore organized around the four priority areas identified in A World Fit for Children, discussing each within the overall framework of the Millennium Development Goals. To appreciate the achievements for children over the past two decades, it is also useful to reflect briefly on how their world has changed. Children born in 1989, the year when the Convention on the Rights of the Child was adopted, are now on the brink of adulthood. They have lived through a remarkable period of social, political and economic transformation. (excerpt)
Geneva, Switzerland, UNAIDS, . 13 p.For over 25 years, our world has been living with HIV. And in just this short time, AIDS has become one of the make-or-break global crises of our age, undermining not just the health prospects of entire societies but also their ability to reduce poverty, promote development, and maintain national security. And in too many regions AIDS continues to expand - every single day 11 000 people are newly infected with HIV, and nearly 8 000 people die from AIDS-related illnesses. Yet, despite the magnitude of the AIDS crisis, today we are at a time of great hope and great opportunity to get ahead of the epidemic. Our crisis-response tactics have led to real progress against AIDS. Funding for efforts against AIDS has risen from 'millions' to 'billions' in just a decade. Political commitment and leadership on AIDS is higher than ever before. In more and more countries - including some of the world's poorest - we are seeing real results in terms of lives saved because effective HIV prevention and treatment programmes are being made widely available. Leaders of both developing and rich countries have now committed themselves to working together so as to get close to universal access to HIV prevention, treatment, care and support by 2010 - a critical stepping stone to halting the epidemic by 2015, as set out in the Millennium Development Goals. (excerpt)
Adolescents, social support and help-seeking behaviour: An international literature review and programme consultation with recommendations for action.
Geneva, Switzerland, World Health Organization [WHO], Department of Child and Adolescent Health and Development, 2007. 56 p. (WHO Discussion Papers on Adolescence)With this brief introduction and justification, this document presents: The findings from an international literature review on the topic of adolescents and help-seeking behaviour. The results of a programme consultation with 35 adolescent health programmes (including public health sector programmes, university-based adolescent health programmes and non-government organizations (NGO) working in adolescent health) from Latin America (10), the Western Pacific region (4), Asia (20), and the Middle East (1), and the results of six key informant interviews. These results are incorporated into the literature review where relevant. The complete report from this consultation of programmes is found in Appendix 1. Recommendations for action, including a brief outline for developing a set of guidelines for the rapid assessment of social supports to promote the help-seeking of adolescents. This document is part of a WHO project to identify and define evidence-based strategies for influencing adolescent help-seeking and identify research questions and activities to promote improved help-seeking behaviour by adolescents. To achieve this objective, the consultants, with WHO guidance: (1) carried out an international literature review of the topic; (2) sent 67 questionnaires and received 35 questionnaires back from adolescent health programmes on the topic of adolescents and help-seeking in the four regions; and (3) carried out key informant interviews with nine individuals (three in Latin America, three in the Pacific region and three in South Asia). The consultants also developed short case studies of illustrative approaches in promoting help-seeking behaviour. (excerpt)
Geneva, Switzerland, UNAIDS, 2007 Mar. 4 p. (UNAIDS Policy Brief)Nearly 40 million people in the world are living with HIV. In countries such as Botswana, Swaziland, and Lesotho people living with HIV make up a quarter or more of the population. People living with HIV are entitled to the same human rights as everyone else, including the right to access appropriate services, gender equality, self-determination and participation in decisions affecting their quality of life, and freedom from discrimination. All national governments and leading development institutions have committed to meeting the eight Millennium Development Goals, which include halving extreme poverty, halting and beginning to reverse HIV and providing universal primary education by 2015. GIPA or the Greater Involvement of People Living with HIV is critical to halting and reversing the epidemic; in many countries reversing the epidemic is also critical to reducing poverty. (excerpt)
Washington, D.C., Population Reference Bureau [PRB], 2007 Dec.  p.With continuing political turmoil, emergency rule declared, and concerns about how free and fair January elections will be, Pakistan has been under the spotlight recently. But the political arena isn't the only area where challenges persist. Beneath the surface, more problems are brewing in the sixth most populous country in the world. Some of the challenges are fueled by the country's rapidly growing population, which is making increasing demands on social services, especially the health care system. A comparison of population pyramids reflects how Pakistan has grown and how its needs will multiply. Between 1970 and 2000, Pakistan more than doubled in population to 144 million from 60 million. Its population ages 15 to 49 more than tripled to 68 million from 14 million. As the number of people in that age group rose, so did demand for maternal and child health care. And health care needs are likely to grow as the 2025 projection for those ages 15 to 49 rises to 121 million, nearly double the 2000estimate. (excerpt)
Journal of Health Communication. 2007; 12(8):705-706.Global health seems to be more firmly established, with a variety of organizations, professional publications, governments and foundations increasing the emphasis. Some of the increase in awareness can be attributed to recent concerns of health security- avian flu, SARS, bioterrorism, MDR-TB-as well as the moral imperatives to address the inequalities pervasive in the 21st Century. In the past five years alone, aid for health as more than doubled. Yet, there is a clouded leadership and approach-there is one truly global health organization-the World Health Organization with 191 member states. Yet, there are over 90 global health agencies, 40 bilateral donors, 26 UN agencies, and 20 global and regional funds. Countless foundations and others have entered the fray-some employing evidence informed approaches, with others based on ideology and multiple sources for engagement. The Bill and Melinda Gates Foundation has a budget dwarfing many governments as well as multilateral institutions dedicated to health. The Global Fund for AIDS, Tuberculosis and Malaria and the US President's Emergency Plan for AIDS Relief (PEPFAR) have helped galvanize and provide funding for specific diseases. Recently, the new UK Prime Minister Gordon Brown launched the International Health Partnership, another initiative to accelerate progress on health globally. (excerpt)
International Communication Gazette. 2007; 69(6):483-507.In the UN system, conflicts and contradictions seldom concern the Millennium Development Goals (MDGs) as such, but rather the means of achieving them. These differences of opinion about priorities, and about how much and to whom development aid or assistance should be directed, could be explained by analysing the ontological, epistemological and methodological assumptions underpinning the general perspectives in the communication for development (C4D) field. Theoretical changes in the perspective on development communication (modernization, dependency, multiplicity) have also reached the level of policy-makers. As a result, different methodologies and terminologies have evolved, which often make it difficult for agencies, even though they share a common commitment to the overall goals of development communication, to identify common ground, arrive at a full understanding of each other's objectives, or to cooperate effectively in operational projects. Consequently, it is difficult for development organizations in general and UN agencies in particular to reach a common approach and strategy. (author's)
Geneva, Switzerland, WHO, 2007. 8 p. (WHO/RHR/07.7)Faced with the challenge of putting into practice the ideals of the Millennium Development Goals, the International Conference on Population and Development (ICPD), and other global summits of the last decade, decision-makers and programme managers responsible for sexual and reproductive health ask how they can: improve access to and the quality of family planning and other sexual and reproductive health services; increase skilled attendance at birth and strengthen referral systems; reduce the recourse to abortion and improve the quality of existing abortion services; provide information and services that respond to young people's needs; and integrate the prevention and treatment of reproductive tract infections, including HIV/AIDS, with other sexual and reproductive health services. (excerpt)
Lancet. 2007 Oct 27; 370(9597):1471-1474.With the Paul Wolfowitz era behind it and new appointee Robert Zoellick at the helm, it is time for the World Bank to better define its role in an increasingly crowded and complex global health architecture, says Jennifer Prah Ruger, health economist and former World Bank speechwriter. Just 2 years after taking office as president of the World Bank, Paul Wolfowitz resigned amid allegations of favouritism, and is now succeeded by Robert Zoellick. Many shortcomings marked Wolfowitz's presidency, not the least of which were a tumultuous battle over family planning and reproductive health policy, significant reductions in spending and staffing, and poor performance in implementing health, nutrition, and population programmes. Wolfowitz did little to advance the bank's role in the health sector. With the Wolfowitz era behind it and heightened scrutiny in the aftermath, the World Bank needs to better define its role and seize the initiative in health at both the global and country levels. Can the bank have an effect in an increasingly plural and complex global health architecture? What crucial role can the bank play in global health governance in the years ahead? (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 2007.  p. (WHO Discussion Papers on Adolescence; Issues in Adolescent Health and Development)The World Health Organization (WHO) has been contributing to meeting the Millennium Development Goals (MDGs) by according priority attention to issues pertaining to the management of adolescent pregnancy. Three of the aims of the MDGs - empowerment of women, promotion of maternal health, and reduction of child mortality - embody WHO's key priorities and its policy framework for poverty reduction. The UN Special Session on Children has focused on some of the key issues affecting adolescents' rights, including early marriage, access to sexual and reproductive health services, and care for pregnant adolescents. This review of the literature was conducted to identify (1) the major factors affecting the pregnancy outcome among adolescents, related to their physical immaturity and inappropriate or inadequate healthcare-seeking behaviour, and (2) the socioeconomic and political barriers that influence their access to health-care services and information. The review also presents programmatic evidence of feasible measures that can be taken at the household, community and national levels to improve pregnancy outcomes among adolescents. (excerpt)
International Journal of Gynecology and Obstetrics. 2007 Nov; 99(2):157-161.National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny. (author's)
The Global Campaign for the Health MDGs: Challenges, opportunities, and the imperative of shared learning.
Lancet. 2007 Sep 22; 370(9592):1018-1020.On Sept 5, the International Health Partnership (IHP) was launched by the UK, and on Sept 26, Women and Children First: the Global Business Plan for Maternal, Newborn and Child Health will be launched by Norway. These two new efforts, along with the Canadian Catalytic Initiative to Save a Million Lives, have been packaged as part of a broader Global Campaign for the Health Millennium Goals (MDGs). Such an explosion of proposals, which is meant to accelerate action for achieving MDGs 4, 5, and 6, should be welcomed by the world's health community. The proposals are further recognition of the continued commitment by high-income countries to address key health challenges in low-income and middle-income countries. Building on a decade of expanding work in global health, we can hope that these high-profile initiatives will sustain interest and address major obstacles to improving the health of the poorest people in the magnitude and time-frame demanded by the MDGs. Nevertheless, as is often the case with new policy efforts, the main operative aspects of the proposals and their likely consequences can be difficult to identify. We frame questions on five key issues that these announcements highlight. (excerpt)
Traditional health practitioner and the scientist: Bridging the gap in contemporary health research in Tanzania.
Tanzania Health Research Bulletin. 2007 May; 9(2):115-120.Traditional health practitioners (THPs) and their role in traditional medicine health care system are worldwide acknowledged. Trend in the use of Traditional medicine (TRM) and Alternative or Complementary medicine (CAM) is increasing due to epidemics like HIV/AIDS, malaria, tuberculosis and other diseases like cancer. Despite the wide use of TRM, genuine concern from the public and scientists/biomedical heath practitioners (BHP) on efficacy, safety and quality of TRM has been raised. While appreciating and promoting the use of TRM, the World Health Organization (WHO), and WHO/Afro, in response to the registered challenges has worked modalities to be adopted by Member States as a way to addressing these concerns. Gradually, through the WHO strategy, TRM policy and legal framework has been adopted in most of the Member States in order to accommodate sustainable collaboration between THPs and the scientist/BHP. Research protocols on how to evaluate traditional medicines for safety and efficacy for priority diseases in Africa have been formulated. Creation of close working relationship between practitioners of both health care systems is strongly recommended so as to revamp trust among each other and help to access information and knowledge from both sides through appropriate modalities. In Tanzania, gaps that exist between THPs and scientists/BHP in health research have been addressed through recognition of THPs among stakeholders in the country's health sector as stipulated in the National Health Policy, the Policy and Act of TRM and CAM. Parallel to that, several research institutions in TRM collaborating with THPs are operating. Various programmed research projects in TRM that has involved THPs and other stakeholders are ongoing, aiming at complementing the two health care systems. This paper discusses global, regional and national perspectives of TRM development and efforts that have so far been directed towards bridging the gap between THPs and scientist/BHP in contemporary health research in Tanzania. (author's)
Report of the High-level consultation on improvement of sexual and reproductive health and rights of young people in Europe. Report on a WHO meeting, Copenhagen, Denmark, 11-12 December 2006.
Copenhagen, Denmark, WHO, Regional Office for Europe, 2007. 27 p. (EUR/07/5063690)Representatives nominated by the Ministries of Health from 23 Member States of the WHO European Region, the European Commission, the International Planned Parenthood Federation European Network (IPPF-EN) and Lund University attended a two day high-level consultation meeting to evaluate the midterm results of the project "The way forward: a European partnership to promote the sexual and reproductive health and rights of youth" (2004-2007). The situation on the trends in sexual and reproductive health status of young people in the European Union countries was analysed and tools developed by the WHO, IPPF EN and Lund University were presented. Country representatives discussed the draft policy framework on sexual and reproductive health and rights that will be presented in the final meeting of the project in October 2007 and many recommendations were received to prepare the document that would be an important tool for developing national policies and programs in the area of sexual and reproductive health of young people. (author's)
Research Observer. 2007 Spring; 22(1):25-51.This article highlights the progress in building a knowledge base on effective ways to increase access to justice for women who have experienced gender-based violence, offer quality services to survivors, and reduce levels of gender-based violence. While recognizing the limited number of high-quality studies on program effectiveness, this review of the literature highlights emerging good practices. Much progress has recently been made in measuring gender-based violence, most notably through a World Health Organization multicountry study and Demographic and Health Surveys. Even so, country coverage is still limited, and much of the information from other data sources cannot be meaningfully compared because of differences in how intimate partner violence is measured and reported. The dearth of high-quality evaluations means that policy recommendations in the short run must be based on emerging evidence in developing economies (process evaluations, qualitative evaluations, and imperfectly designed impact evaluations) and on more rigorous impact evaluations from developed countries. (excerpt)
Lancet Infectious Diseases. 2007 Aug; 7(8):508.A report from the Global HIV Prevention Working Group, a panel of leading AIDS experts, warns that prevention efforts are not keeping pace with the gains being made in treating people infected with HIV. New data outlined in the report show that by fully scaling up all scientifically proven prevention strategies, an estimated 30 million of the 60 million HIV infections expected to occur by 2015 could be averted. With expanded prevention, the annual number of new infections would drop to 2 million per year by 2015-a level that may cause the epidemic to move into long-term decline. "It is widely assumed that HIV continues to spread because prevention isn't effective, and that's simply not true", said David Serwadda (Institute of Public Health, Makerere University, Uganda). "The problem is that effective prevention isn't reaching the people who need it". According to the report, prevention strategies including those to reduce the risk of mother-to-child HIV transmission are accessible to fewer than one in five people who could benefit from them. (excerpt)
Journal of Infectious Diseases. 2007 Aug 15; 196 Suppl 1:S5-S14.Tuberculosis (TB) and human immunodeficiency virus (HIV) infection make each other's control significantly more difficult. Coordination in addressing this "cursed duet" is insufficient at both global and national levels. However, global policy for TB/HIV coordination has been set, and there is consensus around this policy from both the TB and HIV control communities. The policy aims to provide all necessary care for the prevention and management of HIV-associated TB, but its implementation is hindered by real technical difficulties and shortages of resources. All major global-level institutions involved in HIV care and prevention must include TB control as part of their corporate policy. Country-level decision makers need to work together to expand both TB and HIV services, and civil society and community representatives need to hold those responsible accountable for their delivery. The TB and HIV communities should join forces to address the health-sector weaknesses that confront them both. (author's)
Lancet. 2007 Jul 7; 370(9581):15-16.A new spirit of cooperation and coordination between the key global players in the fight against HIV/AIDS was cemented at a meeting for programme implementers in Kigali, Rwanda, in mid-June. The partnership comes amidst concerns about rising infection rates in some countries where infections had slowed, as well as worries about the unpredictability of funding for HIV/AIDS activities. The collaboration is expected to curb duplication of efforts and wastage of resources, and to ultimately scale-up AIDS prevention and treatment. The meeting-usually an annual gathering for the US President's Emergency Plan for AIDS Relief (PEPFAR) and its grantees-opened up for the first time to include the Global Fund to Fight AIDS, Tuberculosis and Malaria, UNAIDS, the World Bank, UNICEF, WHO, and the Global Network of People Living with HIV/AIDS (GNP+), who were all co-sponsors of the conference. (excerpt)
Ensuring the sexual and reproductive health of people living with HIV: Policies, programmes and health services.
Reproductive Health Matters. 2007 May; 15(29 Suppl 1):1-3.IN 2006, there were some 39.7 million people living with HIV, half of them under the age of 25.* People living with HIV have sexual and reproductive health needs and concerns, some of which are related to having HIV and others which they have in common with their noninfected peers. Yet sexual and reproductive health policies, programmes and services often fail to take into consideration the needs and wishes of people living with HIV. Most programmes currently revolve around voluntary testing and counselling for HIV, access to antiretroviral and other AIDS-related treatment, and hospital and home-based care for those with HIV- and AIDS-related illnesses. In relation to sexual and reproductive health care, HIV prevention predominates. There are condom social marketing and other safer sex promotion programmes and recent initiatives to promote family planning for people with HIV. Prevention of mother-to-child transmission of HIV in antenatal and delivery care has also begun to get greater programmaticattention and support. (excerpt)