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    AIDS prevention: guidelines for MCH/FP programme managers. II. AIDS and maternal and child health.

    World Health Organization [WHO]. Global Programme on AIDS; World Health Organization [WHO]. Programme of Maternal and Child Health Including Family Planning

    Geneva, Switzerland, WHO, 1990 Oct. ix, 72 p. (WHO/MCH/GPA/90.2)

    Guidelines for medical professionals in supervisory, managerial and administrative positions in Maternal-Child Health/Family Planning programs (MCH/FP) in developing countries have been developed by the Division of Family Health, Programme of Maternal and Child Health including Family Planning and the Global Programme on AIDS of the World Health Organization (WHO) with the UN Population Fund (UNFPA). MCH/FP programmes occupy a unique position to help stop the spread of AIDS because they comprise the largest pool of health personnel already experienced in counseling, education and training in sexuality, contraception and STD prevention. The booklet begins with a review of HIV facts, with a few additions specifically for developing areas, such as a discussion of the possible increased risk to those who have undergone female circumcision. HIV prevention during pregnancy is as usual, with additional recommendations of measures to prevent the need for blood transfusions, e.g., iron and folic acid supplements, and malaria treatment. Recommendations for HIV containment in labor and delivery wards are the usual universal cautions for health workers, with additional suggestions for sterilization and disposal of materials in areas without conventional western waste facilities. Diagnosis of HIV infected newborns is based on a special WHO clinical case definition for pediatric AIDS, since laboratory tests are not accurate on infants. Treatment and care should be supportive since many HIV infected children can have months of years of quality life. HIV prevention in women and adolescents in terms of men, condoms and family planning is reviewed: no unique information is available for MCH programs. A section covering logistics and supplies suggests solutions to maximize the efficient use of condoms, plastic aprons, and particularly sterile and nonsterile gloves, by strict management at the local level. Suggestions include provision of a set number of paris for each delivering woman, and providing heavy work gloves semi-annually for cleaning staff. The chapter on training MCH staff in use of guidelines has specific curricula, and that on how to evaluate the implementation of these guidelines has several detailed questionnaires. The traditional services of MCH/FP are vital and must be expanded to include information, education and counseling on safer sex related to STD and HIV prevention.
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