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UNICEF's contribution to the adoption and implementation of option B+ for preventing mother-to-child transmission of HIV: a policy analysis.
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.
Health Research Policy and Systems. 2018 May 22; 16(1):42.BACKGROUND: As countries continue to improve their family planning (FP) programmes, they may draw on WHO's evidence-based FP guidance and tools (i.e. materials) that support the provision of quality FP services. METHODS: To better understand the use and perceived impact of the materials and ways to strengthen their use by countries, we conducted qualitative interviews with WHO regional advisors, and with stakeholders in Ethiopia and Senegal who use WHO materials. RESULTS: WHO uses a multi-faceted strategy to directly and indirectly disseminate materials to country-level decision-makers. The materials are used to develop national family planning guidelines, protocols and training curricula. Participants reported that they trust the WHO materials because they are evidence based, and that they adapt materials to the country context (e.g. remove content on methods not available in the country). The main barrier to the use of national materials is resource constraints. CONCLUSIONS: Although the system and processes for dissemination work, improvements might contribute to increased use of the materials. For example, providers may benefit from additional guidance on how to counsel women with characteristics or medical conditions where contraceptive method eligibility criteria do not clearly rule in or rule out a method.
[Knowledge, attitudes and condom use skills among youth in Burkina Faso] Utilisation du preservatif masculin : connaissances, attitudes et competences de jeunes burkinabè.
Sante Publique. 2017 Mar 06; 29(1):95-103.Introduction: Condom use is recognized by the WHO as the only contraceptive that protects against both HIV / AIDS and unwanted pregnancies. But to be effective, condoms must be used consistently and correctly. The objective of this study was to assess young people's skills in male condom used, to identify the challenges faced by them when using condoms to better guide future interventions.Methods: Based on a two-level sampling representing 94,947 households within Bobo-Dioulasso municipality, 573 youth aged between 15 and 24 were interviewed. This data collection was conducted from December 2014 to January 2015 in the three districts of the municipality. A questionnaire was used to assess the knowledge and attitudes of the youth.Results: Only 24% of surveyed know how to accurately use condoms despite their knowledge of condom effectiveness and although some of them are exposed to awareness-raising and information campaigns. Indeed, various handling errors and usage problems (breakage, slippage, leakage and loss of erection) had been identified during the oral demonstration performed by the surveyed. The older youth and with the highest level of education were the most likely to demonstrate increased skills in condom use. Moreover, girls were less competent than boys in terms of condom use.Conclusion: It is important to increase awareness-raising and information campaigns, adapting the content to the real needs of young people so as to transmit the skills required for effective prevention particularly in regard to condom use.
[Geneva, Switzerland], WHO, Department of Nutrition for Health and Development, 2017 May.  p.Nutrition is a direct contributor and target to Sustainable Development Goal 2 (“End hunger, achieve food security and improved nutrition, and promote sustainable agriculture”), a foundation and pre-requisite to Sustainable Development Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), and a decisive enabler to the remaining goals of the Sustainable Development Agenda 2030. The World Health Organization (WHO) supports all Member States to achieve “a world free of all forms of malnutrition where all people achieve health and well-being”, a vision supported by our work with Member States and their partners to ensure universal access to effective nutrition actions and to healthy and sustainable diets1, in the context of the overall effort to ensure universal health coverage2. To do this, WHO uses its convening power to help facilitate and align priority setting to mainstream nutrition in the health and development agenda; develop evidence-informed guidance supported by the highest quality science and ethical frameworks; support the adoption of guidance, its implementation and the integration of effective actions into existing or new delivery platforms in the health systems. WHO guidelines are documents developed by WHO containing recommendations for clinical practice or public health policy and programmes. A recommendation tells the intended end-user of the guideline what he or she can or should do in specific situations to achieve the best health and nutrition outcomes possible, individually or at the population level. It offers a choice among different interventions or measures having an anticipated positive impact on health and nutrition, and implications for the use of resources.3 The WHO Department of Nutrition for Health and Development (NHD) develops guidelines in accordance with the procedures established in the WHO Handbook for Guideline Development.2 The WHO guideline development process ensures that WHO guidelines are of high methodological quality and are developed through an independent, transparent, evidence-informed, consensual decision-making process. Though the process with which WHO develops guidelines is highly structured, systematic and transparent, the process for priority setting (i.e. prioritizing topics4 for guideline development) has been a dynamic one, in order to accommodate new and renewed high-level commitments from the WHO Secretariat as well as emerging issues arising from discussions among Member States in the Governing Body fora, such as the World Health Assembly (WHA). The priority issues are determined by their importance (i.e. magnitude, prevalence and distribution of disease or nutrition problems), or the existence of preventable or modifiable biological, behavioural and contextual determinants (risk factors). Updating guidelines is challenging if evidence has to be retrieved to support an increasing number of recommendations. In this situation it is important to give priority to assuring the principle of “primum non nocere” (first do no harm), to address controversial areas, and to set a position on areas in which new evidence has emerged and requires prompt action. Ensuring a well-understood and efficiently communicated prioritization process is therefore crucial as external partners and stakeholders play an important role in the WHO guideline implementation process. Independence and transparency of the prioritization process gives the Organization a means of providing assurance that the process is free of any undue influence that may affect the reputation and objectivity of WHO. Therefore, in an effort to maintain transparency in the normative work of WHO and to enhance the understanding of the process used to prioritize topics for guideline development among Member States and stakeholders, the Department of Nutrition for Health and Development (NHD) is leading the work on making the prioritization process more accessible and has developed an online tool to further facilitate the participation of Member States and their stakeholders in the guideline prioritization process. This process aims to complement the decisions of the World Health Assembly (WHA), the decision-making body of WHO. (Excerpts
[Quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in Zhoukou of Henan province].
Zhonghua Yu Fang Yi Xue Za Zhi [Chinese Journal of Preventive Medicine]. 2016 Apr; 50(4):339-45.OBJECTIVE: To investigate the quality of life and its related factors among HIV/AIDS patients from HIV serodiscordant couples in Zhoukou city of Henan province. METHODS: During January to May in 2015, by the convenience sample, World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF) (Chinese version) and a self-edited questionnaire were used to investigate 1 251 HIV/AIDS patients who were confirmed with HIV positive by local CDC, registered in"HIV serodiscordant family" and agreed to participate in a face-to-face interview with above 18 year-old based on the local CDC , township hospitals and village clinics of 9 counties and 1 district of Zhoukou city, excluding the HIV/AIDS patients who were in divorce, death by one side, unknowing about his HIV status, with mental illness and disturbance of consciousness, incorrectly understanding the content of the questionnaire, and reluctant to participate in this study. The scores of quality of life of physical, psychological, social relations, and environmental domain were calculated. The related factors of the scores of different domains were analyzed by Multiple Two Classification Unconditioned Logistic Regression. RESULTS: The scores of investigation objects in the physical, psychological, social relations, and environmental domain were 12.00+/- 2.02, 12.07 +/- 2.07, 11.87 +/- 1.99, and 11.09 +/- 1.84, respectively. The multiple Unconditioned Logistic Regression analysis indicated that age <40 years, on ART and no other sickness in last two weeks were beneficial factors associated with physical domain with OR (95%CI): 0.61 (0.35-1.06), 0.52 (0.30-0.90), and 1.66 (1.09-2.52), respectively. The possibility of no poverty and no other sickness in last two weeks increased to 0.15(0.09-0.26) and 1.57(1.06-2.33) times of those who was in poverty and with other sickness in last two weeks in physical domain. The possibility of participants who were below 40 years old and with children increased to 0.58 (0.34-0.98) and 0.37 (0.23-0.57) times of who were above 40 years old and without children in psychological domain. The factors of with AIDS related symptoms, no children and with other sickness in last two week were found to be significantly associated with environmental domain with OR (95%CI): 0.65 (0.48-0.88), 0.66 (0.51-0.85), and 0.65 (0.51-0.84), respectively . CONCLUSION: The scores of every domain of quality of life in HIV serodiscordant couples of Zhoukou city were good. Age, whether having AIDS related symptoms, whether to accept ART , children, status of poverty, and whether suffering from other diseases in last two weeks were the main factors associated with the quality of life.
Health Policy and Planning. 2015 Feb; 30(1):8-18.Kyrgyzstan has adopted a number of policy initiatives to deal with an accelerating HIV/AIDS epidemic. This article explores the main actors in HIV/AIDS policy-making, their interests, support and involvement and their current ability to set the agenda and influence the policy-making process. Fifty-four semi-structured interviews were conducted in the autumn of 2011, complemented by a review of policy documents and secondary sources on HIV/AIDS in Kyrgyzstan. We found that most stakeholders were supportive of progressive HIV/AIDS policies, but that their influence levels varied considerably. Worryingly, several major state agencies exhibited some resistance or lack of initiative towards HIV/AIDS policies, often prompting international agencies and local NGOs to conceptualize and drive appropriate policies. We conclude that, without clear vision and leadership by the state, the sustainability of the national response will be in question.
A number of factors explain why WHO guideline developers make strong recommendations inconsistent with GRADE guidance.
Journal of Clinical Epidemiology. 2016; 70:111-122.Objective: Many strong recommendations issued by the World Health Organization (WHO) are based on low- or very low-quality (low certainty) evidence (discordant recommendations). Many such discordant recommendations are inconsistent with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance. We sought to understand why WHO makes discordant recommendations inconsistent with GRADE guidance. Study Design and Setting: We interviewed panel members involved in guidelines approved by WHO (2007e2012) that included discordant recommendations. Interviews, recorded and transcribed, focused on use of GRADE including the reasoning underlying, and factors contributing to, discordant recommendations. Results: Four themes emerged: strengths of GRADE, challenges and barriers to GRADE, strategies to improve GRADE application, and explanations for discordant recommendations. Reasons for discordant recommendations included skepticism about the value of making conditional recommendations; political considerations; high certainty in benefits (sometimes warranted, sometimes not) despite assessing evidence as low certainty; and concerns that conditional recommendations will be ignored. Conclusion: WHO panelists make discordant recommendations inconsistent with GRADE guidance for reasons that include limitations in their understanding of GRADE. Ensuring optimal application of GRADE at WHO and elsewhere likely requires selecting panelists who have a commitment to GRADE principles, additional training of panelists, and formal processes to maximize adherence to GRADE principles. Copyright: 2016 Elsevier Inc.
American Journal of Public Health. 2013 Apr; 103(4):623-31.The low priority that most low-income countries give to neonatal mortality, which now constitutes more than 40% of deaths to children younger than 5 years, is a stumbling block to the world achieving the child survival Millennium Development Goal. Bangladesh is an exception to this inattention. Between 2000 and 2011, newborn survival emerged from obscurity to relative prominence on the government's health policy agenda. Drawing on a public policy framework, we analyzed how this attention emerged. Critical factors included national advocacy, government commitment to the Millennium Development Goals, and donor resources. The emergence of policy attention involved interactions between global and national factors rather than either alone. The case offers guidance on generating priority for neglected health problems in low-income countries.
PLoS ONE. 2013 May; 8(5):e63715.Background: Research in 2007 showed that World Health Organization (WHO) recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization’s own “Guidelines for Guidelines”. In response, the WHO established a “Guidelines Review Committee” (GRC) to implement and oversee internationally recognized standards. We examined the impact of these changes on WHO guideline documents and explored senior staff’s perceptions of the new procedures. Methods and Findings: We used the AGREE II guideline appraisal tool to appraise ten GRC-approved guidelines from nine WHO departments, and ten pre-GRC guidelines matched by department and topic. We interviewed 20 senior staff across 16 departments and analyzed the transcripts using the framework approach. Average AGREE II scores for GRC-approved guidelines were higher across all six AGREE domains compared with pre-GRC guidelines. The biggest changes were noted for “Rigour of Development” (up 37.6%, from 30.7% to 68.3%) and “Editorial Independence” (up 52.7%, from 20.9% to 73.6%). Four main themes emerged from the interviews: (1) high standards were widely recognized as essential for WHO credibility, particularly with regard to conflicts of interest; (2) views were mixed on whether WHO needed a single quality assurance mechanism, with some departments purposefully bypassing the procedures; (3) staff expressed some uncertainties in applying the GRADE approach, with departmental staff concentrating on technicalities while the GRC remained concerned the underlying principles were not fully institutionalized; (4) the capacity to implement the new standards varied widely, with many departments looking to an overstretched GRC for technical support. Conclusions: Since 2007, WHO guideline development methods have become more systematic and transparent. However, some departments are bypassing the procedures, and as yet neither the GRC, nor the quality assurance standards they have set, are fully embedded within the organization.
Paris, France, UNESCO, 2014.  p.This report builds on a program of work on sexuality education for young people initiated in 2008 by UNESCO. It is also informed by several other past and ongoing initiatives related to scaling up sexuality education, as well as drawing on case studies presented at the Bogota international consultation on sexuality education, convened by UNFPA in 2010. The report emphasizes the challenges for scaling-up in terms of integrating comprehensive sexuality education into the formal curricula of schools. It aims to provide conceptual and practical guidance on definitions and strategies of scaling-up; illustrate good practice and pathways for successful scale-up in light of diverse contextual parameters; and provide some principles of scaling up sexuality education that are of relevance internationally.
Washington, D.C., ICRW, 2010. 43 p.Girls receive a disproportionally small share of the total development dollars invested globally each year, but the field is primed for even greater action and investment. Before charting the way forward, it is important to understand more about current efforts underway on behalf of girls. ICRW designed a mapping exercise to identify the scope and range of work on issues related to girls being undertaken by key development actors. The exercise also helped analyze the core directions, opportunities, and gaps inherent across the efforts of multiple stakeholders. This report presents the key findings from this exercise, describing what we have learned about the donors and organizations engaged in working with girls, the policy and program efforts underway, and current and future directions for the field.
Washington, D.C., Futures Group, Health Policy Initiative, 2010 Sep.  p. (USAID Contract No. GPO-I-01-05-00040-00)The Global Fund to Fight AIDS, Tuberculosis and Malaria is a major funder of HIV programs worldwide, including programs that support orphans and vulnerable children (OVC). Following on a desk review of OVC-related content in Global Fund HIV / AIDS grants, this study in Kenya sought to explore the country-level processes and issues that affect inclusion of OVC goals and strategies in Global Fund country proposals and grants. The study involved interviews with 23 OVC stakeholders, including representatives of government ministries, international agencies, the country coordinating mechanism, principal and sub-recipients, NGOs, faith-based organizations, and OVC network members.
AIDS. 2008; 22 Suppl 2:S9-S17.The University of California, Los Angeles Program in Global Health performed a landscape analysis based on interviews conducted between November 2006 and February 2007 with 35 key informants from major international organizations conducting HIV/AIDS work. Institutions represented included multilateral organizations, foundations, and governmental and non-governmental organizations. The purpose of this analysis is to assist major foundations and other institutions to understand better the international HIV/AIDS policy landscape and to formulate research and development programmes that can make a significant contribution to moving important issues forward in the HIV/AIDS policy arena. Topics identified during the interviews were organized around the four major themes of the Ford Foundation's Global HIV/AIDS Initiative: leadership and leadership development; equity; accountability; and global partnerships. Key informants focused on the need for a visionary response to the HIV pandemic, the need to maintain momentum, ways to improve the scope of leadership development programmes, ideas for improving gender equity and addressing regional disparities and the needs of vulnerable populations, recommendations for strengthening accountability mechanisms among governments, foundations, and civil society and on calling for increased collaboration and partnership among key players in the global HIV/AIDS response. (Author's)
Identification of the obstacles to the signing and ratification of the UN Convention on the Protection of the Rights of All Migrant Workers: the Asia-Pacific Perspective.
[Paris, France], UNESCO, International Migration and Multicultural Policies Section, 2003 Oct. 68 p. (UNESCO Series of Country Reports on the Ratification of the UN Convention on Migrants; SHS/2003/MC/1 REV)The overall aim of this report is to investigate ways to gain wider acceptance of the ICMR in the specific context of the Asia Pacific region. This report: investigates why a sample of major sending and receiving countries in the Asia Pacific region have not ratified the Convention, and develops recommendations to encourage more ratifications in this region and beyond. The main research methods employed were semi-structured interviews with key informants in seven selected countries in the Asia Pacific region. Informants were sought from among the following groups: politicians and/or governmental officials (at national and local level), NGO representatives (migrant support groups and human rights groups), academics, embassy staff (labour attaches), lawyers (bar associations), trade unions and employers/industry organizations, and National Human Rights Commissions (see Appendix I for more details). Interviews were arranged with the assistance of local coordinators, most of whom are members of the APMRN. The actual interview schedule was designed to test the obstacles and opportunities created by ratifying the Convention from a legal, social and political perspective. This also included an examination of the role the media are playing in the acceptance of human rights for migrants. Other materials informing the report comes from websites, and from newspaper clippings and copies of legal and semi-legal documents provided by the country coordinators. (excerpt)
Lancet Infectious Diseases. 2008 Feb; 8(2):98-100.Kevin De Cock is director of WHO's HIV/AIDS department. Formerly director of the US Centers for Disease Control and Prevention in Kenya, he is an infectious disease specialist, with expertise in HIV/ AIDS, tuberculosis, liver disease, and tropical diseases such as yellow fever and viral haemorrhagic fevers. TLID: How has your time as WHO's HIV/AIDS director been? KDC: It has been extremely interesting. AIDS policy is always challenging and changing. WHO's HIV efforts up to 2005 were very much oriented around the 3 by 5 initiative. The G8 in 2005 made an announcement about working towards universal access, which became an AIDS rallying cry. So we've had to reorganise ourselves around that as a theme. Some internal reorganisation was necessary to focus not only on treatment, but also on broader issues. We now have five key strategic directions: increasing access to HIV testing and counselling, maximising prevention, accelerating treatment scale-up, strengthening health systems, and investing in strategic information. We have also been working on some important technical areas. One is the issuing of guidance on both provider-initiated testing and male circumcision. In April, 2007, we also issued a report, in response to a request from the World Health Assembly, on the health sector's progress towards universal access. (excerpt)
Development and Change. 2007 Sep; 38(5):865-888.A number of programmes and policies in Laos are promoting the internal resettlement of mostly indigenous ethnic minorities from remote highlands to lowland areas and along roads. Various justifications are given for this internal resettlement: eradication of opium cultivation, security concerns, access and service delivery, cultural integration and nation building, and the reduction of swidden agriculture. There is compelling evidence that it is having a devastating impact on local livelihoods and cultures, and that international aid agencies are playing important but varied and sometimes conflicting roles with regard to internal resettlement in Laos. While some international aid agencies claim that they are willing to support internal resettlement if it is 'voluntary', it is not easy to separate voluntary from involuntary resettlement in the Lao context. Both state and non-state players often find it convenient to discursively frame non-villager initiated resettlement as 'voluntary'. (author's)
[Baltimore, Maryland], Catholic Relief Services, 2006 Jul. 53 p. (USAID Development Experience Clearinghouse DocID / Order No. PN-ADJ-423)In Zambia, HIV&AIDS is still approached primarily as a health issue, and therefore, interventions focus mainly on prevention and treatment. The provision of affordable, accessible and reliable public services is essential in supporting health maintenance and reducing stress for people infected and affected with HIV&AIDS. Reliable delivery of good quality water and sound basic sanitation are critical in reducing exposure to pathogens to which HIV-positive people are particularly vulnerable. Where water services are inadequate or inaccessible, time and monetary costs of access to good quality water in sufficient quantities are high, particularly for HIV-infected people and their caregivers. CRS responded to an announcement by WHO to conduct an assessment on the adequacy of water, sanitation and hygiene in relation to home-based care strategies for people living with HIV&AIDS in Zambia. The assessment was commissioned by the WHO with the goal of producing evidence-based guidance on water and sanitation needs in home-based care strategies, particularly in resource-poor situations. In addition, WHO desired the assessments to lead to both practical and strategic recommendations to be made at the programme and policy levels, while also identifying the most critical measures to be taken by the health sector and the water and sanitation sector to provide short- and medium-term solutions in the area of water, sanitation and hygiene support to home-based care. (excerpt)
Knowledge, perceptions and attitudes of Islamic scholars towards reproductive health programs in Borno State, Nigeria.
African Journal of Reproductive Health. 2007; 11(1):98-106.Some reproductive health policies and activities of international development organizations continued to be criticized by some religious groups. Such criticisms can be serious obstacles in the provision of reproductive health and rights information and services in many communities. This study was conducted to find the knowledge, perception and attitude of Islamic scholars on reproductive health programs and to get some suggestions on the scholars' role in the planning and implementation of reproductive health advocacy and programming. The data were collected by in-depth interview with representative sample of selected Muslim scholars in and around Maiduguri town in Borno State, Nigeria. All the scholars had vague or no idea of what reproductive health is all about. When they were explaining reproductive health, most of the scholars mentioned some of the rights of women especially the need for maintaining the good health of women and their children as reproductive health. Even though they have poorknowledge, all the Muslim scholars interviewed believed that reproductive health is an essential component of healthy living and the programs of the international development organizations are mostly good, but they have reservations and concern to certain campaigns and programs. Scholars that promised their contributions in enhancing reproductive health have a common condition for their continuous support to any international development organization or reproductive health program. Conformity to Islamic norms and principles are prerequisites to their loyalties. The scholars also advised the international development organizations on the need to identify themselves clearly, so that people know from where they are coming, what are their background, and the program that they want to do and the reasons for doing the program in the community. (author's)
Lancet. 2007 Jun 2; 369(9576):1883-1889.WHO regulations, dating back to 1951, emphasise the role of expert opinion in the development of recommendations. However, the organisation's guidelines, approved in 2003, emphasise the use of systematic reviews for evidence of effects, processes that allow for the explicit incorporation of other types of information (including values), and evidence-informed dissemination and implementation strategies. We examined the use of evidence, particularly evidence of effects, in recommendations developed by WHO departments. We interviewed department directors (or their delegates) at WHO headquarters in Geneva, Switzerland, and reviewed a sample of the recommendation-containing reports that were discussed in the interviews (as well as related background documentation). Two individuals independently analysed the interviews and reviewed key features of the reports and background documentation. Systematic reviews and concise summaries of findings are rarely used for developing recommendations. Instead, processes usually rely heavily on experts in a particular specialty, rather than representatives of those who will have to live with the recommendations or on experts in particular methodological areas. Progress in the development, adaptation, dissemination, and implementation of recommendations for member states will need leadership, the resources necessary for WHO to undertake these processes in a transparent and defensible way, and close attention to the current and emerging research literature related to these processes. (author's)
Research Triangle Park, North Carolina, FHI, 2002.  p. (FHI Research Brief No. 6; RB-02-06E)Community-based workers worldwide use checklists to determine whether women are medically eligible to use combined oral contraceptives (COCs) or depot-medroxyprogesterone acetate (DMPA). However, problems may arise when outdated and inaccurate checklists are used. With input from dozens of experts, Family Health International developed new checklists that are easily understandable and consistent with the World Health Organization's (WHO) medical eligibility requirements. (author's)
AIDS Clinical Care. 2000 Jan; 12(1):1-3, 5.I am the Executive Director of UNAIDS and an Assistant Secretary General of the United Nations. I have an MD and a PhD in microbiology. I've been working in AIDS full-time since 1983, when I was in Zaire documenting the epidemic in central Africa, which was still quite new at the time and -- unlike in the West -- was being transmitted mostly through heterosexual intercourse. UNAIDS was established 4 years ago by the member states of the United Nations to coordinate the efforts of the richly diverse UN organizations in combating the AIDS epidemic. I think that it was quite forward looking for the member nations to establish this agency, because it wasn't entirely clear at that time that AIDS was going to become the major threat to development that it now represents in regions such as sub-Saharan Africa. UNAIDS is actually the secretariat of multi-agency effort including the World Bank, the WHO, UNICEF, UNESCO (UN Educational, Scientific, and Cultural Organization), and several others. Each organization is equipped to handle different aspects of the epidemic. The WHO focuses on blood safety, treatment of sexually transmitted diseases, and care for persons with AIDS. UNICEF deals with prevention of perinatal transmission, care for orphans, and mobilization of youth groups. UNESCO deals with disseminating prevention information through schools. The World Bank works on financing these programs. (excerpt)
Interdependent. 2006 Summer; 4(2):23-26.Nam Phund, who is only 11, begins her work day at 3 am when the night's harvest of shrimp arrives, hours before dawn breaks over the Gulf of Thailand. That's when 13-year-old Fa goes to work, too. She doesn't know exactly how long she works, peeling shrimp for a seafood processing factory, but she says the day has come and gone and the sky is dark again when she goes home. Fa and Nam Phund can't tell time. They can't read. They are among the tens of thousands of migrant workers from Myanmar who have fled the political repression and economic meltdown of a country once known as Burma, and they are not entitled to an education in Thailand. Instead, they work beside their mothers, or alone, on their feet for 14 hours a day or more. The stories of migrant workers in Thailand would not be unfamiliar to Americans, because many of the factors that have brought poor Asians here, often in family groups, are similar to the conditions that propel Mexicans and others to cross the southern United States border. Prosperous Thailand is a magnet, drawing the poor and hopeless from neighboring Cambodia, Laos and Myanmar. The booming Thai seafood processing industry needs workers and will pay brokers--many of them no more than illegal traffickers--to find that labor. The reservoir is large. The migrants are willing to do the work Thais no longer want, in the fishing industry, in homes, agriculture and restaurants. Cambodians, in particular, are often turned into beggars on Bangkok streets, under the control of begging syndicates. (excerpt)
United States. Exploring the environment / population links and the role of major donors, foundations and nongovernmental organizations.
In: No vacancy: global responses to the human population explosion, edited by Michael Tobias, Bob Gillespie, Elizabeth Hughes and Jane Gray Morrison. Pasadena, California, Hope Publishing House, 2006. 103-196.The mission of the World Bank is to fight poverty and improve the living standards of people in the developing world. It is a development bank which provides loans, policy advice, technical assistance and knowledge-sharing services to low- and middle-income countries to reduce poverty. It also promotes growth to create jobs and to empower poor people to take advantage of these opportunities. The World Bank works to bridge the economic divide between rich and poor countries. As one of the world's largest sources of development assistance, it supports the efforts of developing countries to build schools and health centers, provide water and electricity, fight disease and protect the environment. As one of the United Nations' specialized agencies, it has 184 member countries that are jointly responsible for how the institution is financed and how its money is spent. There are 10,000 development professionals from nearly every country in the world who work in its Washington DC headquarters and in its 109 country offices. The World Bank is the world's largest long-term financier of HIV/AIDS programs and its current commitments for HIV/AIDS amount to more than $1.3 billion --half of which is targeted for sub-Saharan Africa. (excerpt)
Geneva, Switzerland, UNAIDS, 2001 Aug. 31 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/01.43E)This report describes the aims, methods, and findings of the research, with a particular emphasis on the forms and determinants of DSD and the responses to it. We are particularly concerned with moving beyond previous research on DSD, which has had a tendency to focus only on individual cases or experiences, or on the role of nongovernmental organizations (NGOs) in exerting pressure on governments and national authorities to act to prevent further discrimination. This report, in contrast, aims to offer an account of how DSD operates, and what causes it, in a range of contexts in two contrasting regions. We highlight particular areas of concern and make recommendations to address them, so that efforts can be made to bring HIV/AIDS-related DSD to an end in Uganda. We very much hope that the way these issues have been addressed will be of some benefit to those in neighbouring countries with similar problems. (excerpt)
Geneva, Switzerland, UNAIDS, 2001 Aug. 66 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/01.46E)In India, as elsewhere, AIDS is perceived as a disease of "others" -- of people living on the margins of society, whose lifestyles are considered "perverted" and "sinful." Discrimination, stigmatization, and denial (DSD) are the expected outcomes of such values, affecting life in families, communities, workplaces, schools, and health care settings. Because of HIV/AIDS-related DSD, appropriate policies and models of good practice remain undeveloped. People living with HIV and AIDS (PLHA) continue to be burdened by poor care and inadequate services, while those with the power to help do little to make the situation better. Although there have been a small number of recent Indian studies on HIV/AIDS-related DSD, it remains the case that relatively little is known about the causes of these negative responses or how they can best be addressed. For this reason, the Joint United Nations Programme on HIV/AIDS provided financial and technical support to a research team from the Tata Institute of Social Sciences, Mumbai, in order that insights might be gained into the experiences of Indians living with HIV/AIDS, the negative social responses they encounter, and the roots of HIV/AIDS-related DSD. This report describes that research, conducted in Mumbai and Bangalore, India. (excerpt)