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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.
Geneva, Switzerland, WHO, 2017. 196 p.The World malaria report, published annually, provides a comprehensive update on global and regional malaria data and trends. The latest report, released on 29 November 2017, tracks investments in malaria programmes and research as well as progress across all intervention areas: prevention, diagnosis, treatment and surveillance. It also includes dedicated chapters on malaria elimination and on key threats in the fight against malaria. The report is based on information received from national malaria control programmes and other partners in endemic countries; most of the data presented is from 2016.
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.
Optimal feeding of low-birthweight infants in low- and middle-income countries: highlights from the World Health Organization 2011 guidelines.
[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.
Global guidance on criteria and processes for validation: Elimination of mother-to-child transmission of HIV and syphilis. Second edition.
Geneva, Switzerland,WHO, 2017. 52 p.This second edition of the EMTCT global validation guidance document provides standardized processes and consensus-developed criteria to validate EMTCT of HIV and syphilis, and to recognize high-HIV burden countries that have made significant progress on the path to elimination. The guidance places strong emphasis on country-led accountability, rigorous analysis, intensive programme assessment and multilevel collaboration, including the involvement of communities of women living with HIV. It provides guidance to evaluate the country’s EMTCT programme, the quality and accuracy of its laboratory and data collection mechanisms, as well as its efforts to uphold human rights and equality of women living with HIV, and their involvement in decision-making processes.
The relative roles of ANC and EPI in the continuous distribution of LLINs: a qualitative study in four countries.
Health Policy and Planning. 2017 May 1; 32(4):467-475.Background: The continuous distribution of long-lasting insecticidal nets (LLINs) for malaria prevention, through the antenatal care (ANC) and the Expanded Programme on Immunizations (EPI), is recommended by the WHO to improve and maintain LLIN coverage. Despite these recommendations, little is known about the relative strengths and weaknesses of the ANC and EPI-based LLIN distribution. This study aimed to explore and compare the roles of the ANC and EPI for LLIN distribution in four African countries. Methods: In a qualitative evaluation of continuous distribution through the ANC and EPI, semi-structured, individual and group interviews were conducted in Kenya, Malawi, Mali, and Rwanda. Respondents included national, sub-national, and facility-level health staff, and were selected to capture a range of roles related to malaria, ANC and EPI programmes. Policies, guidelines, and data collection tools were reviewed as a means of triangulation to assess the structure of LLIN distribution, and the methods of data collection and reporting for malaria, ANC and EPI programmes. Results: In the four countries visited, distribution of LLINs was more effectively integrated through ANC than through EPI because of a) stronger linkages and involvement between malaria and reproductive health programmes, as compared to malaria and EPI, and b) more complete programme monitoring for ANC-based distribution, compared to EPI-based distribution. Conclusions: Opportunities for improving the distribution of LLINs through these channels exist, especially in the case of EPI. For both ANC and EPI, integrated distribution of LLINs has the potential to act as an incentive, improving the already strong coverage of both these essential services. The collection and reporting of data on LLINs distributed through the ANC and EPI can provide insight into the performance of LLIN distribution within these programmes. Greater attention to data collection and use, by both the global malaria community, and the integrated programmes, can improve this distribution channel strength and effectiveness.
Geneva, Switzerland, World Health Organization [WHO], 2017. 73 p.This tool for Monitoring human rights in contraceptive services and programmes contributes to the World Health Organization’s (WHO’s) ongoing work on rights-based contraceptive programmes. This work builds directly on WHO’s 2014 Ensuring human rights within contraceptive programmes: a human rights analysis of existing quantitative indicators and the 2015 publication Ensuring human rights within contraceptive service delivery implementation guide by the United Nations Population Fund (UNFPA) and WHO. This tool is intended for use by countries to assist them in strengthening their human rights efforts in contraceptive programming. The tool uses existing commonly-used indicators to highlight areas where human rights have been promoted, neglected or violated in contraceptive programming; gaps in programming and in data collection; and opportunities for action within the health sector and beyond, including opportunities for partnership initiatives.
Programme reporting standards for sexual, reproductive, maternal, newborn, child and adolescent health.
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
Report 2017: Transformative accountability for adolescents: Accountability for health and human rights of women, children and adolescents in the 2030 agenda.
Geneva, Switzerland, World Health Organization, 2017. 64 p.Adolescents, who number 1.2 billion, or 1 in 6 of the global population, are the key for progress on the Sustainable Development Goals (SDGs). Every year, 1.2 million adolescents die, often from preventable causes—such as violence, suicide, pregnancy-related complications among girls, HIV/AIDS, road injuries and drowning, as well as diseases and respiratory infections. As the report states, however, high impact, cost effective solutions to improve adolescent health can yield huge benefits and billions in savings that can place them on better tracks for life, reaping demographic dividends. The Independent Accountability Panel (IAP), under its mandate by the UN Secretary-General to assess progress on the 2016-2030 Global Strategy on Women’s, Children’s and Adolescents’ Health in the context of the SDGs from the specific lens of who is accountable to whom, and for what, launched its 2017 report. The IAP’s six recommendations are to: 1) Leverage Accountability to Achieve the Global Strategy and the SDGs, 2) Make adolescents visible and measure what matters, 3) Foster whole-of-government accountability to adolescents, 4) Make universal health coverage work for adolescents, 5) Boost accountability for investments, including for adolescent health and well-being, and 6) Unleash the power of young people, by meaningfully engaging them in decision-making, and empowering them to seize the full potential of the digital age.
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.
Accelerating change by the numbers. 2016 annual report of the UNFPA-UNICEF Joint Programme on Female Genital Mutilation / Cutting: Accelerating change.
New York, New York, United Nations Population Fund [UNFPA], 2017 Jul. 92 p.The 2016 Annual Report for the UNFPA-UNICEF Joint Programme on Female Genital Mutilation / Cutting provides two perspectives. This main document, "By the Numbers," analyses progress in quantitative terms, using the Results Framework as a basis. It provides an account of how the budget was allocated and offers profiles of each of the 17 programme countries (excepting Yemen). The profiles present facts on the national context, summarize key achievements, and share operational and financial information.
Geneva, World Health Organization [WHO], 2017. 114 p.This report presents the first ever estimates of the population using ‘safely managed’ drinking water and sanitation services – meaning drinking water free from contamination that is available at home when needed, and toilets whereby excreta are treated and disposed of safely. It also documents progress towards ending open defecation and achieving universal access to basic services. The report identifies a number of critical data gaps that will need to be addressed in order to enable systematic monitoring of Sustainable Development Goal (SDG) targets and to realize the commitment to ‘leave no one behind’.
PLoS Medicine. 2017 Jun; 14(6):e1002328.Melanie Taylor and colleagues discuss global initiatives for surveillance of sexually transmitted diseases.
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. 116 p.The World Health Statistics series is WHO’s annual compilation of health statistics for its 194 Member States. World Health Statistics 2017 compiles data on 21 health-related Sustainable Development Goals (SDG) targets, with 35 indicators, as well as data on life expectancy. This edition also includes, for the first time, success stories from several countries that are making progress towards the health-related SDG targets.
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.
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.
WASH’Nutrition: A practical guidebook on increasing nutritional impact through integration of WASH and nutrition programmes for practitioners in humanitarian and developent contexts.
Paris, France, Action Contre la Faim [ACF], 2017. 156 p.Undernutrition is a multi-sectoral problem with multi-sectoral solutions. By applying integrated approaches, the impact, coherence and efficiency of the action can be improved. This operational guidebook demonstrates the importance of both supplementing nutrition programmes with WASH activities and adapting WASH interventions to include nutritional considerations i.e. making them more nutrition-sensitive and impactful on nutrition. It has been developed to provide practitioners with usable information and tools so that they can design and implement effective WASH and nutrition programmes. Apart from encouraging the design of new integrated projects, the guidebook provides support for reinforcing existing integrated interventions. It does not provide a standard approach or strict recommendations, but rather ideas, examples and practical tools on how to achieve nutrition and health gains with improved WASH. Integrating WASH and nutrition interventions will always have to be adapted to specific conditions, opportunities and constrains in each context. The guidebook primarily addresses field practitioners, WASH and Nutrition programme managers working in humanitarian and development contexts, and responds to the need for more practical guidance on WASH and nutrition integration at the field level. It can also be used as a practical tool for donors and institutions (such as ministries of health) to prioritise strategic activities and funding options. (Excerpt)
Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2017 Jan. 18 p. (Working Paper WP-17-171; USAID Cooperative Agreement No. AID-OAA-L-14-00004)In 2011, the U.S. Agency for International Development (USAID) published its Evaluation Policy. The policy emphasizes the need to conduct more evaluations of its programs to ensure greater accountability and learning, and it outlines best practices and requirements for conducting evaluations. Since releasing the policy, USAID has commissioned an increasing number of evaluations of its programs. The importance of evaluations for international public health programs has been long recognized, with demand for such evaluations coming from both internal and external sources. Donors or those external to program implementation seek evidence of accomplishments and accountability for resources spent, whereas those involved in program implementation seek evidence to inform and improve program design. Within USAID, the need for more evaluations was driven by the understanding that evaluations provide information and analysis that prevent mistakes from being repeated and increase the likelihood of greater yield from future investments. Finally, there is overall recognition that evaluations should be of high quality and driven by demand, and that results should be communicated to relevant stakeholders. Despite the increased demand for evaluations, there is limited evaluation capacity in many countries where international development programs are implemented. Before strategies to strengthen evaluation capacity can be implemented, it is important first to assess existing evaluation capacity and develop action plans accordingly. We conducted a review of existing assessment tools and guidance documents related to assessing organizations’ capacity to carry out evaluations of international public health programs in order to determine the adequacy of those materials. Here, we summarize the key findings of our review of the literature and provide recommendations for the development of future tools and guidance documents.