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Your search found 183 Results

  1. 1
    377652

    WHO guideline on health policy and system support to optimize community health worker programmes.

    World Health Organization [WHO]

    Geneva, Switzerland, World Health Organization [WHO], 2018. 116 p.

    The guideline uses state-of-the-art evidence to identify effective policy options to strengthen community health worker (CHW) programme performance through their proper integration in health systems and communities. The development of this guideline followed the standardized WHO approach. This entailed a critical analysis of the available evidence, including 16 systematic reviews of the evidence, a stakeholder perception survey to assess feasibility and acceptability of the policy options under consideration, and the deliberations of a Guideline Development Group which comprised representation from policy makers and planners from Member States, experts, labour unions, professional associations and CHWs. Critical to the success of these efforts will be ensuring appropriate labour conditions and opportunities for professional development, as well as creating a health ecosystem in which workers at different levels collaborate to meet health needs. Adapted to context, the guideline is a tool that supports optimizing health policies and systems to achieve significant gains to meet the ambition of universal access to primary health care services.
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  2. 2
    375980

    The World Health Organization Code and exclusive breastfeeding in China, India, and Vietnam.

    Robinson H; Buccini G; Curry L; Perez-Escamilla R

    Maternal and Child Health. 2018 Sep 8; [11] p.

    Promoting exclusive breastfeeding (EBF) is a highly feasible and cost-effective means of improving child health. Regulating the marketing of breastmilk substitutes is critical to protecting EBF. In 1981, the World Health Assembly adopted the World Health Organization International Code of Marketing of Breastmilk Substitutes (the Code), prohibiting the unethical advertising and promotion of breastmilk substitutes. This comparative study aimed to (a) explore the relationships among Code enforcement and legislation, infant formula sales, and EBF in India, Vietnam, and China; (b) identify best practices for Code operationalization; and (c) identify pathways by which Code implementation may influence EBF. We conducted secondary descriptive analysis of available national-level data and seven high level key informant interviews. Findings indicate that the implementation of the Code is a necessary but insufficient step alone to improve breastfeeding outcomes. Other enabling factors, such as adequate maternity leave, training on breastfeeding for health professionals, health systems strengthening through the Baby Friendly Hospital Initiative, and breastfeeding counselling for mothers, are needed. Several infant formula industry strategies with strong conflict of interest were identified as harmful to EBF. Transitioning breastfeeding programmes from donor-led to government-owned is essential for long-term sustainability of Code implementation and enforcement. We conclude that the relationships among the Code, infant formula sales, and EBF in India, Vietnam, and China are dependent on countries' engagement with implementation strategies and the presence of other enabling factors.
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  3. 3
    394382
    Peer Reviewed

    Evidence-Based Programs, Yes-But What About More Program-Based Evidence?

    Global Health, Science and Practice. 2018 Jun 27; 6(2):247-248.

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  4. 4
    394380
    Peer Reviewed

    Doing What We Do, Better: Improving Our Work Through Systematic Program Reporting.

    Koek I; Monclair M; Anastasi E; Ten Hoope-Bender P; Higgs E; Obregon R

    Global Health, Science and Practice. 2018 Jun 27; 6(2):257-259.

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  5. 5
    394128

    Adoption of the 2015 World Health Organization guidelines on antiretroviral therapy: Programmatic implications for India.

    Rewari BB; Agarwal R; Shastri S; Nagaraja SB; Rathore AS

    WHO South - East Asia Journal of Public Health. 2017 Apr; 6(1):90-93.

    The therapeutic and preventive benefits of early initiation of antiretroviral therapy (ART) for HIV are now well established. Reflecting new research evidence, in 2015 the World Health Organization (WHO) recommended initiation of ART for all people living with HIV (PLHIV), irrespective of their clinical staging and CD4 cell count. The National AIDS Control Programme (NACP) in India is currently following the 2010 WHO ART guidelines for adults and the 2013 guidelines for pregnant women and children. This desk study assessed the number of people living with HIV who will additionally be eligible for ART on adoption of the 2015 WHO recommendations on ART. Data routinely recorded for all PLHIV registered under the NACP up to 31 December 2015 were analysed. Of the 250 865 individuals recorded in pre-ART care, an estimated 135 593 would be eligible under the WHO 2013 guidelines. A further 100 221 would be eligible under the WHO 2015 guidelines. Initiating treatment for all PLHIV in pre-ART care would raise the number on ART from 0.92 million to 1.17 million. In addition, nearly 0.07 million newly registered PLHIV will become eligible every year if the WHO 2015 guidelines are adopted, of which 0.028 million would be attributable to implementation of the WHO 2013 guidelines alone. In addition to drugs, there will be a need for additional CD4 tests and tests of viral load, as the numbers on ART will increase significantly. The outlay should be seen in the context of potential health-care savings due to early initiation of ART, in terms of the effect on disease progression, complications, deaths and new infections. While desirable, adoption of the new guidance will have significant programmatic and resource implications for India. The programme needs to plan and strengthen the service-delivery mechanism, with emphasis on newer and innovative approaches before implementation of these guidelines.
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  6. 6
    393656
    Peer Reviewed

    UNICEF's contribution to the adoption and implementation of option B+ for preventing mother-to-child transmission of HIV: a policy analysis.

    Chersich MF; Newbatt E; Ng'oma K; de Zoysa I

    Globalization and Health. 2018 Jun 1; 14(1):55.

    BACKGROUND: Between 2011 and 2013, global and national guidelines for preventing mother-to-child transmission (PMTCT) of HIV shifted to recommend Option B+, the provision of lifelong antiretroviral treatment for all HIV-infected pregnant women. METHODS: We aimed to analyse how Option B+ reached the policy agenda, and unpack the processes, actors and politics that explain its adoption, with a focus on examining UNICEF's contribution to these events. Analysis drew on published articles and other documentation, 30 key informants interviews with staff at UNICEF, partner organisations and government officials, and country case studies. Cameroon, India, South Africa and Zimbabwe were each visited for 5-8 days. Interview transcripts were analysed using Dedoose software, reviewed several times and then coded thematically. RESULTS: A national policy initiative in Malawi in 2011, in which the country adopted Option B+, rather than existing WHO recommended regimens, irrevocably placed the policy on the global agenda. UNICEF and other organisations recognised the policy's potential impact and strategically crafted arguments to support it, framing these around operational considerations, cost-effectiveness and values. As 'policy entrepreneurs', these organisations vigorously promoted the policy through a variety of channels and means, overcoming concerted opposition. WHO, on the basis of scanty evidence, released a series of documents towards the policy's endorsement, paving the way for its widespread adoption. National-level policy transformation was rapid and definitive, distinct from previous incremental policy processes. Many organisations, including UNICEF, facilitated these changes in country, acting individually, or in concert. CONCLUSIONS: The adoption of the Option B+ policy marked a departure from established processes for PMTCT policy formulation which had been led by WHO with the support of technical experts, and in which recommendations were developed following shifts in evidence. Rather, changes were spurred by a country-level initiative, and a set of strategically framed arguments that resonated with funders and country-level actors. This bottom-up approach, supported by normative agencies, was transformative. For UNICEF, alignment between the organisation's country focus and the policy's underpinning values, enabled it to work with partners and accelerate widespread policy change.
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  7. 7
    375818

    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.

    World Health Organization [WHO]; Maternal and Child Survival Program [MCSP]

    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.
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  8. 8
    375798

    International technical guidance on sexuality education. An evidence-informed approach. Revised edition.

    UNESCO. Education Sector

    Paris, France, UNESCO, 2018. 139 p.

    The fully revised UN International technical guidance on sexuality education advocates for quality comprehensive sexuality education (CSE) to promote health and well-being, respect for human rights and gender equality, and empowers children and young people to lead healthy, safe and productive lives.It is a technical tool that presents the evidence base and rationale for delivering CSE to young people in order to achieve the global Sustainable Development Goals, among which are SGD3 for Health, SDG4 for Quality Education and SDG5 for Gender Equality.
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  9. 9
    379400
    Peer Reviewed

    National responses to global health targets: exploring policy transfer in the context of the UNAIDS '90-90-90' treatment targets in Ghana and Uganda.

    McRobie E; Matovu F; Nanyiti A; Nonvignon J; Abankwah DNY; Case KK; Hallett TB; Hanefeld J; Conteh L

    Health Policy and Planning. 2018 Jan 1; 33(1):17-33.

    Global health organizations frequently set disease-specific targets with the goal of eliciting adoption at the national-level; consideration of the influence of target setting on national policies, program and health budgets is of benefit to those setting targets and those intended to respond. In 2014, the Joint United Nations Program on HIV/AIDS set ‘ambitious’ treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by program, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to ‘90-90-90’. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in program-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90-90-90. Interviews were transcribed and analyzed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh’s policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90-90-90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of program activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised of global and local actors, mediated the adoption and adaptation, facilitating a shift in the HIV program from ‘business as usual’ to approaches targeting geographies and populations.
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  10. 10
    379387
    Peer Reviewed

    Multiple-micronutrient supplementation: evidence from large-scale prenatal programmes on coverage, compliance and impact.

    Berti C; Gaffey MF; Bhutta ZA; Cetin I

    Maternal and Child Nutrition. 2017 Dec 22; 1-11.

    Micronutrient deficiencies during pregnancy pose important challenges for public-health, given the potential adverse outcomes not only during pregnancy but across the life-course. Provision of iron-folic acid (IFA) supplements is the strategy most commonly practiced and recommended globally. How to successfully implement IFA and multiple micronutrient supplementation interventions among pregnant women and to achieve sustainable/permanent solutions to prenatal micronutrient deficiencies remain unresolved issues in many countries. This paper aims to analyze available experiences of prenatal IFA and multiple micronutrient interventions to distil learning for their effective planning and large-scale implementation. Relevant articles and programme-documentation were comprehensively identified from electronic databases, websites of major-agencies and through hand-searching of relevant documents. Retrieved documents were screened and potentially relevant reports were critically examined by the authors with the aim of identifying a set of case studies reflecting regional variation, a mix of implementation successes and failures, and a mix of programs and large-scale experimental studies. Information on implementation, coverage, compliance, and impact was extracted from reports of large-scale interventions in Central America, Southeast Asia, South Asia, and Sub-Saharan Africa. The WHO/CDC Logic-Model for Micronutrient Interventions in Public Health was used as an organizing framework for analyzing and presenting the evidence. Our findings suggest that to successfully implement supplementation interventions and achieve sustainable-permanent solutions efforts must focus on factors and processes related to quality, cost-effectiveness, coverage, utilization, demand, outcomes, impacts, and sustainability of programs including strategic analysis, management, collaborations to pilot a project, and careful monitoring, midcourse corrections, supervision and logistical-support to gradually scaling it up.
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  11. 11
    374729

    Optimal feeding of low-birthweight infants in low- and middle-income countries: highlights from the World Health Organization 2011 guidelines.

    Maternal and Child Survival Program [MCSP]

    [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.
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  12. 12
    374728

    Basic newborn resuscitation: highlights from the World Health Organization 2012 guidelines.

    Maternal and Child Survival Program [MCSP]

    [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.
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  13. 13
    374727

    Implementing malaria in pregnancy programs in the context of World Health Organization recommendations on antenatal care for a positive pregnancy experience.

    Maternal and Child Survival Program [MCSP]

    [Washington, D.C.], MCSP, 2017 Apr. 6 p.

    This technical brief highlights recommendations for the prevention and treatment of malaria in pregnancy (MiP) in the context of the World Health Organization (WHO) Recommendations on Antenatal Care for a Positive Pregnancy Experience, published in 2016. Also available in French and Portuguese.
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  14. 14
    390476

    Program Implementation of Option B+ at a President's Emergency Plan for AIDS Relief-Supported HIV Clinic Improves Clinical Indicators But Not Retention in Care in Mbarara, Uganda.

    Miller K; Muyindike W; Matthews LT; Kanyesigye M; Siedner MJ

    AIDS Patient Care and STDs. 2017 Aug; 31(8):335-341.

    2013 WHO guidelines for prevention of mother to child transmission recommend combination antiretroviral therapy (ART) for all pregnant women, regardless of CD4 count (Option B/B+). We conducted a retrospective analysis of data from a government-operated HIV clinic in Mbarara, Uganda before and after implementation of Option B+ to assess the impact on retention in care. We limited our analysis to women not on ART at the time of their first reported pregnancy with CD4 count >350. We fit regression models to estimate relationships between calendar period (Option A vs. Option B+) and the primary outcome of interest, retention in care. One thousand and sixty-two women were included in the analysis. Women were more likely to start ART within 6 months of pregnancy in the Option B+ period (68% vs. 7%, p < 0.0001) and had significantly greater increases in CD4 count 1 year after pregnancy (+172 vs. -5 cells, p < 0.001). However, there was no difference in the proportion of women retained in care 1 year after pregnancy (73% vs. 70%, p = 0.34). In models adjusted for age, distance to clinic, marital status, and CD4 count, Option B+ was associated with a nonsignificant 30% increased odds of retention in care at 1 year [adjusted odds ratio (AOR) = 1.30, 95% CI 0.98-1.73, p = 0.06]. After transition to an Option B+ program, pregnant women with CD4 count >350 were more likely to initiate combination therapy; however, interventions to mitigate losses from HIV care during pregnancy are needed to improve the health of women, children, and families.
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  15. 15
    390037
    Peer Reviewed

    Improving Adherence to Essential Birth Practices Using the WHO Safe Childbirth Checklist With Peer Coaching: Experience From 60 Public Health Facilities in Uttar Pradesh, India.

    Marx Delaney M; Maji P; Kalita T; Kara N; Rana D; Kumar K; Masoinneuve J; Cousens S; Gawande AA; Kumar V; Kodkany B; Sharma N; Saurastri R; Pratap Singh V; Hirschhorn LR; Semrau KE; Firestone R

    Global Health: Science and Practice. 2017 Jun 27; 5(2):217-231.

    BACKGROUND: Adherence to evidence-based essential birth practices is critical for improving health outcomes for mothers and newborns. The WHO Safe Childbirth Checklist (SCC) incorporates these practices, which occur during 4 critical pause points: on admission, before pushing (or cesarean delivery), soon after birth, and before discharge. A peer-coaching strategy to support consistent use of the SCC may be an effective approach to increase birth attendants' adherence to these practices. METHODS: We assessed data from 60 public health facilities in Uttar Pradesh, India, that received an 8-month staggered coaching intervention from December 2014 to September 2016 as part of the BetterBirth Trial, which is studying effectiveness of an SCC-centered intervention on maternal and neonatal harm. Nurse coaches recorded birth attendants' adherence to 39 essential birth practices. Practice adherence was calculated for each intervention month. After 2 months of coaching, a subsample of 15 facilities was selected for independent observation when the coach was not present. We compared adherence to the 18 practices recorded by both coaches and independent observers. RESULTS: Coaches observed birth attendants' behavior during 5,971 deliveries. By the final month of the intervention, 35 of 39 essential birth practices had achieved >90% adherence in the presence of a coach, compared with only 7 of 39 practices during the first month. Key behaviors with the greatest improvement included explanation of danger signs, temperature measurement, assessment of fetal heart sounds, initiation of skin-to-skin contact, and breastfeeding. Without a coach present, birth attendants' average adherence to practices and checklist use was 24 percentage points lower than when a coach was present (range: -1% to 62%). CONCLUSION: Implementation of the WHO Safe Childbirth Checklist with coaching improved uptake of and adherence to essential birth practices. Coordination and communication among facility staff, as well as behaviors with an immediate, tangible benefit, showed the greatest improvement. Difficult-to-perform behaviors and those with delayed or theoretical benefits were less likely to be sustained without a coach present. Coaching may be an important component in implementing the Safe Childbirth Checklist at scale.Note: At the time of publication of this article, the results of evaluation of the impact of the BetterBirth intervention were pending publication in another journal. After the impact findings have been published, we will update this article on the effect of the intervention on birth practices with a reference to the impact findings.
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  16. 16
    390028

    Maternal Death Surveillance and Response: A Tall Order for Effectiveness in Resource-Poor Settings [editorial]

    Koblinsky M

    Global Health: Science and Practice. 2017 Sep 27; 5(3):333-337.

    Most countries with high maternal (and newborn) mortality have very limited resources, overstretched health workers, and relatively weak systems and governance. To make important progress in reducing mortality, therefore, they need to carefully prioritize where to invest effort and funds. Given the demanding requirements to effectively implement the maternal death surveillance and response (MDSR) approach, in many settings it makes more sense to focus effort on the known drivers of high mortality, e.g., reducing geographic, financial, and systems barriers to lifesaving maternal and newborn care.
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  17. 17
    323932

    Updated WHO recommendation on tranexamic acid for the treatment of postpartum haemorrhage. Highlights and key messages from the World Health Organization's 2017 Global Recommendation.

    World Health Organization [WHO]. Department of Maternal, Newborn, Child and Adolescent Health

    Geneva, Switzerland, WHO, 2017 Oct. 5 p. (WHO/RHR/17.21)

    This summary brief highlights key messages from the updated World Health Organization’s recommendation on Tranexamic acid (TXA) for the treatment of postpartum haemorrhage (PPH), including policy and program implications for translating the TXA recommendation into action at the country level. In 2012, WHO published recommendations for the prevention and treatment of postpartum haemorrhage, including a recommendation on the use of tranexamic acid (TXA) for treatment of PPH. The 2017 updated WHO Recommendation on TXA is based on new evidence on use of TXA for treatment of PPH. Key messages include: 1) The World Health Organization (WHO) recommends early use of intravenous tranexamic acid (TXA) within 3 hours of birth in addition to standard care for women with clinically diagnosed postpartum haemorrhage (PPH) following vaginal birth or caesarean section; 2) Administration of TXA should be considered as part of the standard PPH treatment package and be administered as soon as possible after onset of bleeding and within 3 hours of birth. TXA for PPH treatment should not be initiated more than 3 hours after birth; 3) TXA should be used in all cases of PPH, regardless of whether the bleeding is due to genital tract trauma or other causes; 4) TXA should be administered at a fixed dose of 1 g in 10 mL (100 mg/mL) IV at 1 mL per minute (i.e., administered over 10 minutes), with a second dose of 1 g IV if bleeding continues after 30 minutes; and 5) TXA should be administered via an IV route only for treatment of PPH. Research on other routes of TXA administration is a priority.This summary brief is intended for policy-makers, programme managers, educators and providers.
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  18. 18
    323648

    WHO guideline on syphilis screening and treatment for pregnant women.

    World Health Organization [WHO]. Department of Reproductive Health and Research

    Geneva, Switzerland, World Health Organization [WHO], 2017. 56 p.

    Since the publication of the WHO Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management. This guideline provides updated recommendations for syphilis screening and treatment for pregnant women based on the most recent evidence and available serologic tests for syphilis. The objectives of this guideline are: 1) to provide evidence-based guidance on syphilis screening and treatment for pregnant women; and 2) to support countries to update their national guidelines for syphilis screening and treatment for pregnant women.
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  19. 19
    323639

    Programme reporting standards for sexual, reproductive, maternal, newborn, child and adolescent health.

    World Health Organization [WHO]. Department of Reproductive Health and Research

    Geneva, Switzerland, World Health Organization [WHO], 2017. 32 p.

    Information about design, context, implementation, monitoring and evaluation is central to understanding the processes and impacts of sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) programmes, in support of effective replication and scale-up of these efforts. Existing reporting guidelines do not demand sufficient detail in the reporting of contextual and implementation issues. We have, therefore, developed programme reporting standards (PRS) to provide guidance for complete and accurate reporting on the design, implementation, monitoring and evaluation processes of SRMNCAH programmes. The PRS can be used by SRMNCAH programme implementers and researchers. The PRS can be used prospectively to guide the reporting of a programme throughout its life cycle, or retrospectively to describe what was done, when, where, how and by whom. The PRS is intended as a guide for implementation researchers who need to document important details of implementation and context in addition to the results of their studies. The PRS is intended for programme managers and other staff or practitioners who have designed, implemented and/or evaluated SRMNCAH programmes. It can be used by governmental and nongovernmental organizations, bilateral and multilateral agencies, as well as by the private sector. The PRS is also intended as a guide for implementation researchers who need to document important details of implementation and context in addition to the results of their studies
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  20. 20
    389853
    Peer Reviewed

    Tracing Africa's progress towards implementing the Non-Communicable Diseases Global action plan 2013-2020: a synthesis of WHO country profile reports.

    Nyaaba GN; Stronks K; de-Graft Aikins A; Kengne AP; Agyemang C

    BMC Public Health. 2017 Apr 05; 17(1):297.

    BACKGROUND: Half of the estimated annual 28 million non-communicable diseases (NCDs) deaths in low- and middle-income countries (LMICs) are attributed to weak health systems. Current health policy responses to NCDs are fragmented and vertical particularly in the African region. The World Health Organization (WHO) led NCDs Global action plan 2013-2020 has been recommended for reducing the NCD burden but it is unclear whether Africa is on track in its implementation. This paper synthesizes Africa's progress towards WHO policy recommendations for reducing the NCD burden. METHODS: Data from the WHO 2011, 2014 and 2015 NCD reports were used for this analysis. We synthesized results by targets descriptions in the three reports and included indicators for which we could trace progress in at least two of the three reports. RESULTS: More than half of the African countries did not achieve the set targets for 2015 and slow progress had been made towards the 2016 targets as of December 2013. Some gains were made in implementing national public awareness programmes on diet and/or physical activity, however limited progress was made on guidelines for management of NCD and drug therapy and counselling. While all regions in Africa show waning trends in fully achieving the NCD indicators in general, the Southern African region appears to have made the least progress while the Northern African region appears to be the most progressive. CONCLUSION: Our findings suggest that Africa is off track in achieving the NCDs indicators by the set deadlines. To make sustained public health gains, more effort and commitment is urgently needed from governments, partners and societies to implement these recommendations in a broader strategy. While donors need to suit NCD advocacy with funding, African institutions such as The African Union (AU) and other sub-regional bodies such as West African Health Organization (WAHO) and various country offices could potentially play stronger roles in advocating for more NCD policy efforts in Africa.
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  21. 21
    389659

    Implementation effectiveness of revised (post-2010) World Health Organization guidelines on prevention of mother-to-child transmission of HIV using routinely collected data in sub-Saharan Africa: A systematic literature review.

    Gumede-Moyo S; Filteau S; Munthali T; Todd J; Musonda P

    Medicine. 2017 Oct; 96(40):e8055.

    BACKGROUND: To synthesize and evaluate the impact of implementing post-2010 World Health Organization (WHO) prevention of mother-to-child transmission (PMTCT) guidelines on attainment of PMTCT targets. METHODS: Retrospective and prospective cohort study designs that utilized routinely collected data with a focus on provision and utilization of the cascade of PMTCT services were included. The outcomes included the proportion of pregnant women who were tested during their antenatal clinic (ANC) visits; mother-to-child transmission (MTCT) rate; adherence; retention rate; and loss to follow-up (LTFU). RESULTS: Of the 1210 references screened, 45 met the inclusion criteria. The studies originated from 14 countries in sub-Saharan Africa. The highest number of studies originated from Malawi (10) followed by Nigeria and South Africa with 7 studies each. More than half of the studies were on option A while the majority of option B+ studies were conducted in Malawi. These studies indicated a high uptake of human immunodeficiency virus (HIV) testing ranging from 75% in Nigeria to over 96% in Zimbabwe and South Africa. High proportions of CD4 count testing were reported in studies only from South Africa despite that in most of the countries CD4 testing was a prerequisite to access treatment. MTCT rate ranged from 1.1% to 15.1% and it was higher in studies where data were collected in the early days of the WHO 2010 PMTCT guidelines. During the postpartum period, adherence and retention rate decreased, and LTFU increased for both HIV-positive mothers and exposed infants. CONCLUSION: Irrespective of which option was followed, uptake of antenatal HIV testing was high but there was a large drop off along later points in the PMTCT cascade. More research is needed on how to improve later components of the PMTCT cascade, especially of option B+ which is now the norm throughout sub-Saharan Africa.
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  22. 22
    374600

    Text and context: evaluating peace agreements for their ‘gender perspective’.

    Bell C

    New York, New York, UN Women, 2015 Oct. 32 p.

    Since approximately 1990, peace processes involving the negotiation of formal peace agreements between the protagonists to conflict have become a predominant way of ending violent conflicts, both within and between States. Between 1990 and 2015 1,168 peace agreements have been negotiated in around 102 conflicts, on a wide definition of peace agreements to include agreements at all stages of the negotiations. Peace agreements are therefore important documents with significant capacity to affect women’s lives. However, a range of obstacles for women seeking to influence their design and implementation persists. These include difficulties with accessing talks, achieving equal influence at talks, raising issues of concern for women, and achieving material gains for women as an outcome of the peace process. This report examines what ‘a gender perspective’ in peace agreements might mean, assesses numerous peace agreements from between 1 January 1990 and 1 January 2015 for their ‘gender perspective, and produces data on when women have been specifically mentioned in those peace agreements.
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  23. 23
    374571

    Implementing comprehensive HIV and STI programmes with transgender people: practical guidance for collaborative interventions.

    United Nations Development Programme [UNDP]; IRGT: A Global Network of Transgender Women and HIV; United Nations Population Fund [UNFPA]; University of California, San Francisco. Center of Excellence for Transgender Health; Johns Hopkins Bloomberg School of Public Health; World Health Organization [WHO]; Joint United Nations Programme on HIV / AIDS [UNAIDS]; United States Agency for International Development [USAID]

    New York, New York, UNDP, 2016 Apr. 212 p.

    This publication provides guidance to programme designers, implementers, policymakers and decision-makers on how to meaningfully engage adolescents in the AIDS response and in broader health programming. It also demonstrates why adolescents and youth are critical in efforts to end the AIDS epidemic by 2030. The publication additionally highlights what steps should be taken to implement programmes and policies that improve adolescent health outcomes (including for HIV) at the national, regional and global levels.
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  24. 24
    375727

    WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP).

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2015 Nov. 2 p. (Pre-Exposure Prophylaxis (PrEP); Policy Brief)

    This policy brief defines PrEP, presents the World Health Organization's current recommendations for PrEP use and the evidence for it, discusses PrEP's expected cost-effectiveness, and lists considerations for PrEP implementation.
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  25. 25
    374428

    Sustainable Development Goals: a SRHR CSO guide for national implementation.

    Barclay H; Dattler R; Lau K; Abdelrhim S; Marshall A; Feeney L

    London, United Kingdom, International Planned Parenthood Federation [IPPF], 2015 Nov. 20 p.

    The purpose of this paper is to set out what the new 2030 Agenda for Sustainable Development means for civil society organizations (CSOs) working on sexual and reproductive health and rights (SRHR) and how it can be used to push for progress at the national level. It details those targets that are relevant to our work, looks at how they relate to existing programmes and commitments and suggests ways to ensure that they are implemented. It describes specific actions that national advocates may want to consider taking to drive progress on the development and implementation of national plans, to play a role in monitoring and accountability of global commitments, and to support the measurement of progress. There is no “one size fits all” approach to implementing the Agenda at a national level because every country has a different system and way of working, and will have different focus areas with respect to sustainable development. Advocates are encouraged to use the information and recommendations in this paper in a way that is helpful to their national context, and to adapt them to reflect their circumstances.
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