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Parents as partners in adolescent HIV prevention in Eastern and Southern Africa: an evaluation of the current United Nations' approach.
International Journal of Adolescent Medicine and Health. 2016 Nov 10; 30(2)The United Nations's (UN) sustainable development goals (SDGs) include the target (3.3) of ending the HIV/AIDS epidemic by 2030. A major challenge in this regard is to curb the incidence of HIV among adolescents, the number two cause of their death in Africa. In Eastern and Southern Africa, they are mainly infected through heterosexual transmission. Research findings about parental influence on the sexual behavior of their adolescent children are reviewed and findings indicate that parental communication, monitoring and connectedness contribute to the avoidance of risky sexual behavior in adolescents. This article evaluates the extent to which these three dimensions of parenting have been factored in to current HIV prevention recommendations relating to adolescent boys and girls. Four pertinent UN reports are analyzed and the results used to demonstrate that the positive role of parents or primary caregivers vis-a-vis risky sexual behavior has tendentially been back-grounded or even potentially undermined. A more explicit inclusion of parents in adolescent HIV prevention policy and practice is essential - obstacles notwithstanding - enabling their indispensable partnership towards ending an epidemic mostly driven by sexual risk behavior. Evidence from successful or promising projects is included to illustrate the practical feasibility and fruitfulness of this approach.
AIDS and Behavior. 2017 Jul; 21(Suppl 1):62-71.BACKGROUND: Nigeria accounts for 9% of the global HIV burden and is a signatory to Millennium Development Goals as well as the post-2015 Sustainable Development Goals. This paper reviews maturation of her HIV M&E system and preparedness for monitoring of the post-2015 agenda. METHODS: Using the UNAIDS criteria for assessing a functional M&E system, a mixed-methods approach of desk review and expert consultations, was employed. RESULTS: Following adoption of a multi-sectoral M&E system, Nigeria experienced improved HIV coordination at the National and State levels, capacity building for epidemic appraisals, spectrum estimation and routine data quality assessments. National data and systems audit processes were instituted which informed harmonization of tools and indicators. The M&E achievements of the HIV response enhanced performance of the National Health Management Information System (NHMIS) using DHIS2 platform following its re-introduction by the Federal Ministry of Health, and also enabled decentralization of data management to the periphery. CONCLUSION: A decade of implementing National HIV M&E framework in Nigeria and the recent adoption of the DHIS2 provides a strong base for monitoring the Post 2015 agenda. There is however a need to strengthen inter-sectoral data linkages and reduce the rising burden of data collection at the global level.
Maternal and Child Nutrition. 2017 Dec 22; 1-9.The World Health Organization (WHO) recommends iron-folic acid (IFA) supplementation during pregnancy to improve maternal and infant health outcomes. Multiple micronutrient (MMN) supplementation in pregnancy has been implemented in select countries and emerging evidence suggests that MMN supplementation in pregnancy may provide additional benefits compared to IFA alone. In 2015, WHO, the United Nations Children's Fund (UNICEF), and the Micronutrient Initiative held a “Technical Consultation on MMN supplements in pregnancy: implementation considerations for successful incorporation into existing programmemes,” which included a call for indicators needed for monitoring, evaluation, and surveillance of MMN supplementation programs. Currently, global surveillance and monitoring data show that overall IFA supplementation programs suffer from low coverage and intake adherence, despite inclusion in national policies. Common barriers that limit the effectiveness of IFA-which also apply to MMN programs-include weak supply chains, low access to antenatal care services, low-quality behavior change interventions to support and motivate women, and weak or non-existent monitoring systems used for programme improvement. The causes of these barriers in a given country need careful review to resolve them. As countries heighten their focus on supplementation during pregnancy, or if they decide to initiate or transition into MMN supplementation, a priority is to identify key monitoring indicators to address these issues and support effective programs. National and global monitoring and surveillance data on IFA supplementation during pregnancy are primarily derived from cross-sectional surveys and, on a more routine basis, through health and logistics management information systems. Indicators for IFA supplementation exist; however, the new indicators for MMN supplementation need to be incorporated. We reviewed practice-based evidence, guided by the WHO/Centers for Disease Control and Prevention logic model for vitamin and mineral interventions in public health programs, and used existing manuals, published literature, country reports, and the opinion of experts, to identify monitoring, evaluation, and surveillance indicators for MMN supplementation programs. We also considered cross-cutting indicators that could be used across programme settings, as well as those specific to common delivery models, such as antenatal care services. We then described mechanisms for collecting these data, including integration within existing government monitoring systems, as well as other existing or proposed systems. Monitoring data needs at all stages of the programme lifecycle were considered, as well as the feasibility and cost of data collection. We also propose revisions to global-, national-, and subnational-surveillance indicators based on these reviews.
Using the international human rights system to protect and promote the rights of women migrant workers.
New York, New York, UN Women, . 7 p. (Policy Brief No. 6)This Brief provides an overview of the international human rights system as it applies to the promotion and protection of women migrant workers’ rights. Using examples from UN Women’s joint EU-funded project "Promoting and Protecting Women Migrant Workers’ Labour and Human Rights: Engaging with International, National Human Rights Mechanisms to Enhance Accountability" (the Project), which is anchored nationally in three pilot countries: Mexico, Moldova, and the Philippines, this Brief illustrates how these mechanisms can be used by governments, civil society and development partners, to enhance the rights of women migrant workers in law and practice.
London, United Kingdom, IPPF, 2015 Sep. 2 p.To hold the government to account for its FP2020 commitments, the Planned Parenthood Association of Zambia (PPAZ) developed a monitoring and accountability tool, called the FP annual score card, in collaboration with local partners. The score card measures the government’s annual performance against their commitments, using indicators such as ‘demand generated for FP’, ‘financing’ and ‘access to services’. The score card helps advocates to identify what the government has delivered to date and what it should be delivering, based on a trajectory towards 2020. Family planning organizations and champions, national and international, use the results in their advocacy messaging and monitoring.
Washington, D.C., Center for Global Development, 2016 Mar. 36 p. (CGD Policy Paper 077)This paper seeks to determine the degree to which a gender lens has been incorporated into World Bank projects and the success of individual projects according to gender equality-related indicators. We first examine the World Bank’s internal scoring of projects based on whether they encompass gender analysis, action, and monitoring and evaluation (M&E) components, as well as project development objective indicators and outcomes according to these indicators. We conclude that when indicators are defined, targets are specified, and outcomes are published, gender equality-related results appear largely positive. However, many projects (even those possessing a gender “theme” and perfect scores for the inclusion of gender analysis, action, and M&E components) lack gender-related indicators, and when such indicators are present, they often lack specified target goals. The paper concludes with a recommendation for increased transparency in gender-related project data (including data on the funding of gender equality-related components of projects) from donor institutions and a call for an increased number of gender-related indicators and targets in donor projects.
Who pays for cooperation in global health? A comparative analysis of WHO, the World Bank, the Global Fund to Fight HIV / AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance.
Lancet. 2017; 390:324-332.In this report we assess who pays for cooperation in global health through an analysis of the financial flows of WHO, the World Bank, the Global Fund to Fight HIV / AIDS, TB and Malaria, and Gavi, the Vaccine Alliance. The past few decades have seen the consolidation of influence in the disproportionate roles the USA, UK, and the Bill & Melinda Gates Foundation have had in financing three of these four institutions. Current financing flows in all four case study institutions allow donors to finance and deliver assistance in ways that they can more closely control and monitor at every stage. We highlight three major trends in global health governance more broadly that relate to this development: towards more discretionary funding and away from core or longer-term funding; towards defined multi-stakeholder governance and away from traditional government-centred representation and decision-making; and towards narrower mandates or problem-focused vertical initiatives and away from broader systemic goals.
Geneva, Switzerland, WHO, 2017. 56 p.The WHO Guidelines on Ethical Issues in Public Health Surveillance is the first international framework of its kind, it fills an important gap. The goal of the guideline development project was to help policymakers and practitioners navigate the ethical issues presented by public health surveillance. This document outlines 17 ethical guidelines that can assist everyone involved in public health surveillance, including officials in government agencies, health workers, NGOs and the private sector. Surveillance, when conducted ethically, is the foundation for programs to promote human well-being at the population level. It can contribute to reducing inequalities: pockets of suffering that are unfair, unjust and preventable cannot be addressed if they are not first made visible. But surveillance is not without risks for participants and sometimes poses ethical dilemmas. Issues about privacy, autonomy, equity, and the common good need to be considered and balanced, and knowing how to do so can be challenging in practice.
2016 Nov; New York, New York, UN Women, 2016 Nov. 2 p.Violence against women and girls is one of the most universal and pervasive human rights violations in the world, of pandemic proportions, with country data showing that about one third of women in the world report experiencing physical or sexual violence at some point in their lifetime, mainly by their partners. UN Women provides knowledge-based policy and programming guidance to a diverse array of stakeholders at international, regional and country levels often partnering with other UN agencies and stakeholders. UN Women’s work is broadly focused on a comprehensive approach to ending violence against women and girls that addresses legislation and policies, prevention, services for survivors, research and data. The briefs included in this package aim to summarize in a concise and friendly way, for advocates, programmers and policy makers, the essential strategies for addressing violence against women in general, for preventing violence and providing services to survivors in particular.
Design and initial implementation of the WHO FP umbrella project - to strengthen contraceptive services in the sub Saharan Africa.
Reproductive Health. 2017 Jun 15; 14(1):1-6.BACKGROUND: Strengthening contraceptive services in sub Saharan Africa is critical to achieve the FP 2020 goal of enabling 120 million more women and girls to access and use contraceptives by 2020 and the Sustainable Development Goals (SDG) targets of universal access to sexual and reproductive health (SRH) services including family planning by 2030. METHOD: The World Health Organization (WHO) and partners have designed a multifaceted project to strengthen health systems to reduce the unmet need of contraceptive and family planning services in sub Saharan Africa. The plan leverages global, regional and national partnerships to facilitate and increase the use of evidence based WHO guidelines with a specific focus on postpartum family planning. The four key approaches undertaken are i) making WHO Guidelines adaptable & appropriate for country use ii) building capacity of WHO regional/country staff iii) providing technical support to countries and iv) strengthening partnerships for introduction and implementation of WHO guidelines. This paper describes the project design and elaborates the multifaceted approaches required in initial implementation to strengthen contraceptive services. CONCLUSION: The initial results from this project reflect that simultaneous application these approaches may strengthen contraceptive services in Sub Saharan Africa and ensure sustainability of the efforts. The lessons learned may be used to scale up and expand services in other countries.
Progress with Scale-Up of HIV Viral Load Monitoring - Seven Sub-Saharan African Countries, January 2015-June 2016.
MMWR. Morbidity and Mortality Weekly Report. 2016 Dec 02; 65(47):1332-1335.The World Health Organization (WHO) recommends viral load testing as the preferred method for monitoring the clinical response of patients with human immunodeficiency virus (HIV) infection to antiretroviral therapy (ART) (1). Viral load monitoring of patients on ART helps ensure early diagnosis and confirmation of ART failure and enables clinicians to take an appropriate course of action for patient management. When viral suppression is achieved and maintained, HIV transmission is substantially decreased, as is HIV-associated morbidity and mortality (2). CDC and other U.S. government agencies and international partners are supporting multiple countries in sub-Saharan Africa to provide viral load testing of persons with HIV who are on ART. This report examines current capacity for viral load testing based on equipment provided by manufacturers and progress with viral load monitoring of patients on ART in seven sub-Saharan countries (Cote d'Ivoire, Kenya, Malawi, Namibia, South Africa, Tanzania, and Uganda) during January 2015-June 2016. By June 2016, based on the target numbers for viral load testing set by each country, adequate equipment capacity existed in all but one country. During 2015, two countries tested >85% of patients on ART (Namibia [91%] and South Africa [87%]); four countries tested <25% of patients on ART. In 2015, viral suppression was >80% among those patients who received a viral load test in all countries except Cote d'Ivoire. Sustained country commitment and a coordinated global effort is needed to reach the goal for viral load monitoring of all persons with HIV on ART.
Global Strategy for Women’s, Children’s and Adolescents’ Health (2016 2030): Adolescents’ health. Report by the Secretariat.
[Geneva, Switzerland], WHO, 2016 Dec 5. 6 p. (EB140/34)Pursuant to resolution WHA69.2 this report provides an update on the current status of women’s, children’s and adolescents’ health. It is aligned with the report on the Progress in the implementation of the 2030 Agenda for Sustainable Development (document EB140/32). The Secretariat in its regular reporting on progress towards women’s, children’s and adolescents’ health will choose a particular theme each year, focusing on priorities identified by Member States and topics for which there is new evidence to support country-led plans. For reporting to the Seventieth World Health Assembly, adolescent's health is the theme. (Excerpt)
Rome, Italy, Food and Agriculture Organization of the United Nations [FAO], 2016. 57 p.This compendium has been designed to support officers responsible for designing nutrition-sensitive food and agriculture investments, in selecting appropriate indicators to monitor if these investments are having an impact on nutrition (positive or negative) and if so, through which pathways. It provides an overview of indicators that can be relevant as part of a nutrition-sensitive approach, together with guidance to inform the selection of indicators. The purpose of this compendium is to provide a current compilation of indicators that may be measured for identified outcomes of nutrition-sensitive investments. This compendium does not provide detailed guidance on how to collect a given indicator but points to relevant guidance materials. This compendium does not represent official FAO recommendations for specific indicators or methodologies. It is intended only to provide information on the indicators, methodologies and constructs that may be relevant to consider in the monitoring and evaluation of nutrition-sensitive agriculture investments. It is not envisaged that a single project should collect data on all the indicators presented here. The selection will be informed by the type of intervention implemented, the anticipated intermediary outcomes and nutritional outcomes, as well as the feasibility of data collection in view of available resources and other constraints. The advice of M&E experts and subject matter specialists, should be sought in making the final choice of indicators and in planning the data collection and analysis, including sampling and design of questionnaires. This compendium deals with programmes, projects and investments. While some indicators may be relevant for routine monitoring at national scale, this document does not cover every indicator that would be needed to monitor nutrition sensitivity of policies. (Excerpt)
Bulletin of the World Health Organization. 2016 Nov; 94(11):787-787A.Add to my documents.
Targeted Spontaneous Reporting: Assessing Opportunities to Conduct Routine Pharmacovigilance for Antiretroviral Treatment on an International Scale.
Drug Safety. 2016 Jun 9; 1-18.Introduction: Targeted spontaneous reporting (TSR) is a pharmacovigilance method that can enhance reporting of adverse drug reactions related to antiretroviral therapy (ART). Minimal data exist on the needs or capacity of facilities to conduct TSR. Objectives: Using data from the International epidemiologic Databases to Evaluate AIDS (IeDEA) Consortium, the present study had two objectives: (1) to develop a list of facility characteristics that could constitute key assets in the conduct of TSR; (2) to use this list as a starting point to describe the existing capacity of IeDEA-participating facilities to conduct pharmacovigilance through TSR. Methods: We generated our facility characteristics list using an iterative approach, through a review of relevant World Health Organization (WHO) and Uppsala Monitoring Centre documents focused on pharmacovigilance activities related to HIV and ART and consultation with expert stakeholders. IeDEA facility data were drawn from a 2009/2010 IeDEA site assessment that included reported characteristics of adult and pediatric HIV care programs, including outreach, staffing, laboratory capacity, adverse event monitoring, and non-HIV care. Results: A total of 137 facilities were included: East Africa (43); Asia–Pacific (28); West Africa (21); Southern Africa (19); Central Africa (12); Caribbean, Central, and South America (7); and North America (7). Key facility characteristics were grouped as follows: outcome ascertainment and follow-up; laboratory monitoring; documentation—sources and management of data; and human resources. Facility characteristics ranged by facility and region. The majority of facilities reported that patients were assigned a unique identification number (n = 114; 83.2 %) and most sites recorded adverse drug reactions (n = 101; 73.7 %), while 82 facilities (59.9 %) reported having an electronic database on site. Conclusion: We found minimal information is available about facility characteristics that may contribute to pharmacovigilance activities. Our findings, therefore, are a first step that can potentially assist implementers and facility staff to identify opportunities and leverage their existing capacities to incorporate TSR into their routine clinical programs.
[Geneva, Switzerland], WHO, 2016 Feb.  p.WHO has launched a global Strategic Response Framework and Joint Operations Plan to guide the international response to the spread of Zika virus infection and the neonatal malformations and neurological conditions associated with it. The strategy focuses on mobilizing and coordinating partners, experts and resources to help countries enhance surveillance of the Zika virus and disorders that could be linked to it, improve vector control, effectively communicate risks, guidance and protection measures, provide medical care to those affected and fast-track research and development of vaccines, diagnostics and therapeutics.
Report on Ending Preventable Maternal Mortality (EPMM) Metrics Technical Meeting. Phase I: Developing a core set of maternal health indicators for GLOBAL monitoring and reporting.
[Unpublished] 2015 Sep 22.  p.In total, forty-five people participated in one or more stages of the process undertaken to reach consensus on a core set of priority, methodologically robust maternal health (MH) indicators with direct relevance for reducing preventable mortality (proximal to causes of death) for global monitoring and reporting by all countries. Consensus was reached on twelve maternal health indicators, with advancement on definitions that include the numerator, denominator, disaggregators, and data sources, which can contribute to a global monitoring framework for Ending Preventable Maternal Mortality (included as an Appendix to this meeting report). The definitions and data sources to accompany the Core Maternal Health Indicators for Global Monitoring and Reporting require further refinement, as per the outcomes of the meeting, and will be subject to ongoing review before finalization. There was consensus that it would be appropriate for WHO to put forward this core set of maternal health indicators in further member state consultation and deliberation through global processes, including integration and harmonization with core metrics from the Every Newborn Action Plan (ENAP) as part of a combined monitoring framework for maternal and newborn health. All participants pledged their support for these processes. Furthermore, agreement was reached on four priority areas in which immediate work is required to develop much needed indicators for global monitoring and reporting by all countries, through further refinement of definitions, further development of data sources, and further measure testing and validation. Such efforts should be undertaken in collaboration and coordination with other ongoing indicator development initiatives. Finally, a “parking lot” list of additional indicators of interest was generated. These represent indicators that are either desirable for use at different levels of the health system but not appropriate for global monitoring, or desirable for further research and development to enhance their validity or feasibility for future use in a global monitoring framework. (Excerpt)
WHO Collaborating Centre for Acquired Immunodeficiency Syndrome for the Eastern Mediterranean Regional Office, Faculty of Medicine, Kuwait University, Kuwait.
Medical Principles and Practice. 2014; 23 Suppl 1:47-51.In the early 1980s, the World Health Organization (WHO) designated the Virology Unit of the Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait, a collaborating centre for AIDS for the Eastern Mediterranean Regional Office (EMRO), recognizing it to be in compliance with WHO guidelines. In this centre, research integral to the efforts of WHO to combat AIDS is conducted. In addition to annual workshops and symposia, the centre is constantly updating and renewing its facilities and capabilities in keeping with current and latest advances in virology. As an example of the activities of the centre, the HIV-1 RNA viral load in plasma samples of HIV-1 patients is determined by real-time PCR using the AmpliPrep TaqMan HIV-1 test v2.0. HIV-1 drug resistance is determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene, using the TRUGENE HIV-1 Genotyping Assay on the OpenGene(R) DNA Sequencing System. HIV-1 subtypes are determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene using the genotyping assays described above. A fundamental program of Kuwait's WHO AIDS collaboration centre is the national project on the surveillance of drug resistance in human deficiency virus in Kuwait, which illustrates how the centre and its activities in Kuwait can serve the EMRO region of WHO. (c) 2014 S. Karger AG, Basel.
BJOG: An International Journal of Obstetrics and Gynaecology. 2014 Sep; 121 Suppl 4:11-4.In the World Health Organization (WHO) European region despite official high coverage of essential interventions for maternal and neonatal care, there are still significant gaps in the delivery of effective interventions. Since 2001, WHO designed and implemented the Making Pregnancy Safer programme, which includes hands-on training courses in effective perinatal care for maternity teams, development of clinical guidelines, maternal mortality and morbidity case reviews, and assessments of quality of care. This has contributed to enhancing capacity at country level to improve organisation and provision of care. This paper describes the programme's components, challenges, achievements and results. (c) 2014 Royal College of Obstetricians and Gynaecologists.
Releve Epidemiologique Hebdomadaire / Section D'hygiene Du Secretariat De La Societe Des Nations. 2014 Oct 31; 89(44):500-4.Add to my documents.
Monitoring health inequality: an essential step for achieving health equity. Illustrations of fundamental concepts.
Geneva, Switzerland, WHO, 2014.  p. (WHO/FWC/GER/2014.1)This booklet communicates fundamental concepts about the importance of health inequality monitoring, using text, figures, maps and videos. Following a brief summary of main messages, four general principles pertaining to health inequalities are highlighted: 1. Health inequalities are widespread; 2. Health inequality is multidimensional; 3. Benchmarking puts changes in inequality in context; and 4.Health inequalities inform policy. Each of the four principles is accompanied by figures or maps that illustrate the concept, a question that is posed as an extension and application of the material, and a link to a video, demonstrating the use of interactive visuals to answer the question. The videos are accessible online by scanning a QR code (a URL is also provided). The next section of the booklet outlines essential steps forward for achieving health equity, including the strengthening and equity orientation of health information systems through data collection, data analysis and reporting practices. The use of visualization technologies as a tool to present data about health inequality is promoted, accompanied by a link to a video demonstrating how health inequality data can be presented interactively. Finally, the booklet announces the upcoming State of inequality report, and refers readers to the Health Equity Monitor homepage on the WHO Global Health Observatory.
eHealth and innovation in women's and children's health: A baseline review. Based on the findings of the 2013 survey of CoIA countries by the WHO Global Observatory for eHealth. Executive summary.
[Geneva, Switzerland], WHO, 2014.  p. (WHO/HIS/KER/EHL/14.1)Improving the health of women and children is a global health imperative, reflected in two of the most compelling Millennium Development Goals which seek specifically to reduce maternal and infant deaths by 2015. This joint report by the World Health Organization (WHO) and the International Telecommunication Union (ITU), based on a 64-country survey, demonstrates -- as never before in such detail -- the vital role that information and communication technologies (ICTs) and particularly eHealth are playing today in helping achieve those targets. It demonstrates how, every day, eHealth is saving the lives of women, their babies and infants in the some of the most vulnerable populations around the world, in a wide variety of innovative ways.
Arlington, Virginia, JSI, DELIVER, 2013 Jan.  p.This brief describes the evolution of contraceptive procurement in the Latin America and Caribbean (LAC) region, highlighting how LAC countries monitored and evaluated key data when making performance improvements. By introducing and monitoring key indicators, they were able to smooth the procurement process and improve procurement performance.
[Geneva, Switzerland], WHO, 2013 May 1.  p. (A66/47)This report updates the report considered by the Executive Board at its 132nd session in January 2013. It summarizes processes that have been established in response to both mandates, focusing on the several streams of work taking place in the lead up to a final review of the current Goals at a high-level meeting during the sixty-eighth United Nations General Assembly, due to be held in September 2013. It also outlines an emerging narrative in relation to health, showing how health in the post-2015 environment can provide a link between concerns for sustainable development and poverty reduction -- meeting the needs of people and the planet. (Excerpt)
[Geneva, Switzerland], WHO, 2013 Mar 22.  p. (A66/19)The Executive Board at its 132nd session in January 2013, considered and noted an earlier version of this report. The present document has been amended in response to Board members’ comments and updated to include details of recent developments. It also reports on the status of progress made towards achieving the goals of the Decade of Vaccines. Four sets of activities are essential to put the plan into practice and to turn the actions into results: (1) development of guidance for putting the plan into practice; (2) completion and implementation of a mechanism for evaluation and accountability in alignment with the accountability framework for the United Nations Secretary-General’s Strategy for Women’s and Children’s Health; (3) securing commitments from stakeholders; and (4) publicizing the opportunities, while acknowledging the challenges, offered by the Decade of Vaccines. This report summarizes the progress made in these areas. (Excerpt)