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New York, New York, UN Women, . 4 p. (Policy Brief No. 7)There is broad-based agreement today that universal social protection systems are a desirable goal. For gender equality advocates, it is paramount to take advantage of this momentum to ensure that such systems benefit women by responding to their rights and needs. Well-designed social protection systems can narrow gender gaps in poverty rates, enhance women’s income security and access to personal income, and provide a lifeline for poor women, especially single mothers.1 The current context of economic stagnation and fiscal adjustment, however, places big constraints on the investments needed to achieve these goals. How can gender equality advocates engage with social protection advocacy in this context? This policy brief showcases the strategies that were used by UN Women’s Multi-Country Office in the Caribbean to promote gender-responsive social protection in a context where reforms have been driven mainly by efforts to reduce public debt and promote economic competitiveness.
Sexual health in the International Classification of Diseases (ICD): implications for measurement and beyond.
Reproductive Health Matters. 2015 Nov; 23(46):185-92.This paper examines different dimensions of sexual health as related to the measurement of sexual health indicators and the proposed changes in the International Classification of Diseases to address issues related to sexuality and sexual health with an aim of informing health policy-making and programming. The lack of mechanisms for monitoring and evaluating sexual health outcomes has impeded the development of policies and programmes that support sexual health. The potential impact of changes to the ICD-11 is major and far-reaching given that the ICD is used by countries to define eligibility and access to health services and to formulate relevant policies and laws, and is used by health professionals as a basis for conceptualizing health conditions, treatments and outcomes. Improving the measurement of sexual health-related indicators builds the evidence base on scientific knowledge of sex, sexuality, sexual health and rights. As we stand on the cusp of the post-2015 era and the development agenda transitions to the Sustainable Development Goals, a unique opportunity presents itself to further consider how sexual health is defined, conceptualized, and monitored.
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.
Geneva, Switzerland, WHO, 2015.  p.The World Health Organization (WHO) calls on enhanced global efforts to improve health in some of the world’s poorest and most vulnerable communities by tackling the root causes of disease and health inequalities. In order to address this and to spur up action, raise awareness and facilitate implementation of a Health in All Policies (HiAP) approach WHO launched this week a Health in All Policies training manual. This manual is a training resource to increase understanding of the importance of Health in All Policies among health and other professionals. The material will form the basis of 2- and 3-day workshops, which will: build capacity to promote, implement and evaluate HiAP; encourage engagement and collaboration across sectors; facilitate the exchange of experiences and lessons learned; promote regional and global collaboration on HiAP; and promote dissemination of skills to develop training courses for trainers.
Washington, D.C., Center for Global Development, 2013.  p.Food security has arisen again on the development agenda. High and volatile food prices took a toll in 2007–08, and in many low-income countries agricultural yields have risen little, if at all, in the last decade. Moreover, food production in these poor countries is especially vulnerable to climate change. Meeting this demand is a global challenge. The Food and Agriculture Organization of the United Nations (FAO) is expected to lead the way in meeting this challenge and, with the arrival in 2012 of the first new director-general in 18 years, it has an opening to restructure itself to do so. In this report, the CGD Working Group on Food Security considers how the FAO might be reenergized and restructured for greater impact on the global challenge of boosting agricultural productivity. It points out that the FAO, despite its respected status as the premier global food agency, risks squandering its potential at a time when demand for food is rising fast, supplies are under threat, and hundreds of millions of people already don’t have enough to eat.
Progress in the establishment and strengthening of national immunization technical advisory groups: Analysis from the 2013 WHO/UNICEF joint reporting form, data for 2012.
Vaccine. 2013 Nov 4; 31(46):5314-5320.The majority of industrialized and some developing countries have established National Immunization Technical Advisory Groups (NITAGs). To enable systematic global monitoring of the existence and functionality of NITAGs, in 2011, WHO and UNICEF included related questions in the WHO/UNICEF Joint Reporting Form (JRF) that provides an official means to globally collect indicators of immunization program performance. These questions relate to six basic process indicators. According to the analysis of the 2013 JRF, data for 2012, notable progress was achieved between 2010 and 2012 and by the end of 2012, 99 countries (52%) reported the existence of a NITAG with a formal legislative or administrative basis (with a high of 86% in the Eastern Mediterranean Region - EMR), among the countries that reported data in the NITAG section of the JRF.There were 63 (33%) countries with a NITAG that met six process indicators (47% increase over the 43 reported in 2010) including a total of 38 developing countries. 11% of low income countries reported a NITAG that meets all six process criteria, versus 29% of middle income countries and 57% of the high income ones. Countries with smaller populations reported the existence of a NITAG that meets all six process criteria less frequently than more populated countries (23% for less populated countries versus 43% for more populated ones).However, progress needs to be accelerated to reach the Global Vaccine Action Plan (GVAP) target of ensuring all countries have support from a NITAG. The GVAP represents a major opportunity to boost the institutionalization of NITAGs. A special approach needs to be explored to allow small countries to benefit from sub-regional or other countries advisory groups.
Washington, D.C., Center for Strategic and International Studies, 2013 May.  p.This report tracks the evolution of the MDGs and their impact on global health policy in the Bush and Obama administrations. While the Bush administration had a mixed reaction to the goals, they were embraced by President Obama. Despite the shift, the goals appear to have had little direct effect on global health programming in either administration. Nonetheless, they helped focus resources toward long-standing U.S. priorities including maternal and child health and infectious disease control. As policy makers consider the next wave of priorities, such as universal health coverage and prevention and treatment of noncommunicable diseases, a global consensus beyond the MDGs could help guide an effective response while ensuring the unmet needs associated with the current goals are not forgotten.
Global policy and programme guidance on maternal nutrition: what exists, the mechanisms for providing it, and how to improve them?
Paediatric and Perinatal Epidemiology. 2012 Jul; 26 Suppl 1:315-25.Undernutrition in one form or another affects the majority of women of reproductive age in most developing countries. However, there are few or no effective programmes trying to solve maternal undernutrition problems. The purpose of the paper is to examine global policy and programme guidance mechanisms for nutrition, what their content is with regard to maternal nutrition in particular, as well as how these might be improved. Almost all countries have committed themselves politically to ensuring the right of pregnant and lactating women to good nutrition through the Convention on the Elimination of all Forms of Discrimination Against Women. Despite this, the World Health Organization (WHO) has not endorsed any policy commitments with regard to maternal nutrition. The only policy guidance coming from the various technical departments of WHO relates to the control of maternal anaemia. There is no policy or programme guidance concerning issues of maternal thinness, weight gain during pregnancy and/or low birthweight prevention. Few if any countries have maternal nutrition programmes beyond those for maternal anaemia, and most of those are not effective. The lack of importance given to maternal nutrition is related in part to a weakness of evidence, related to the difficulty of getting ethical clearance, as well as a generalised tendency to downplay the importance of those interventions found to be efficacious. No priority has been given to implementing existing policy and programme guidance for the control of maternal anaemia largely because of a lack of any dedicated funding, linked to a lack of Millennium Development Goals indicator status. This is partly due to the poor evidence base, as well as to the common belief that maternal anaemia programmes were not effective, even if efficacious. The process of providing evidence-based policy and programme guidance to member states is currently being revamped and strengthened by the Department of Nutrition for Health and Development of WHO through the Nutrition Guidance Expert Advisory Group processes. How and if programme guidance, as well as policy commitment for improved maternal nutrition, will be strengthened through the Nutrition Guidance Expert Advisory Group process is as yet unclear. The global movement to increase investment in programmes aimed at maternal and child undernutrition called Scaling Up Nutrition offers an opportunity to build developing country experience with efforts to improve nutrition during pregnancy and lactation. All member states are being encouraged by the World Health Assembly to scale-up efforts to improve maternal infant and young child nutrition. Hopefully Ministries of Health in countries most affected by maternal and child undernutrition will take leadership in the development of such plans, and ensure that the control of anaemia during pregnancy is given a great priority among these actions, as well as building programme experience with improved nutrition during pregnancy and lactation. For this to happen it is essential that donor support is assured, even if only to spearhead a few flagship countries. (c) 2012 Blackwell Publishing Ltd.
HIV treatment as prevention: how scientific discovery occurred and translated rapidly into policy for the global response.
Health Affairs. 2012 Jul; 31(7):1439-49.In 2011 interim results of HIV Prevention Trials Network study 052, a National Institutes of Health study designed to test the effectiveness of antiretroviral treatment against the spread of HIV, were reported. These results showed that in a stable relationship in which one member of the couple was infected with HIV, treatment of the infected partner with antiretroviral drugs, combined with couples counseling and condom use, resulted in a 96 percent reduction in sexual transmission of HIV-1. This finding led to the use of antiretroviral treatment as a cornerstone of HIV prevention. Independent advisory committees of the President's Emergency Plan for AIDS Relief (PEPFAR) and the World Health Organization (WHO) have since issued analyses that set the stage for broader use of antiretroviral agents in treatment and prevention. This article describes the separate PEPFAR and WHO recommendations and outlines the design of prospective new trials to test how best to maximize the benefits of early treatment for prevention.
Health in the post-2015 development agenda. Report of the Global Thematic Consultation on Health. Draft for public comment.
[Unpublished] 2013 Feb 1.  p.The purpose of this report is to present a summary of the main themes and messages that have emerged from the consultation and to make recommendations to inform the deliberations of the High-Level Panel of Eminent Persons and the UN Secretary-General’s report to the General Assembly. Annex 1 captures in more detail the depth and breadth of the analyses and proposals in the more than 100 papers and meeting reports that were submitted to the consultation; all the inputs and a digest summarizing the papers are available from www.worldwewant2015.org/health. Chapter 2 describes the consultation process, detailing the processes that were used to reach out to different constituencies. Chapters 3-5 explain why health should be at the centre of the post-2015 development agenda. Chapter 3 summarizes the inputs about the successes and shortcomings of the MDGs, many of which were unintended and only became apparent with the benefit of hindsight. Important lessons can be learned from this assessment. Chapter 4 describes the interdependent linkages between health and development. Chapter 5 considers some of the most significant changes that have happened (and in some cases continue to happen at an accelerated pace) since the MDGs were launched in 2000. Understanding how the world, global health and priority health needs have changed and what changes are likely in the next 15 years is critical to defining the health agenda for the coming years in terms of both what needs to be done (the content) and how (the approach). Chapter 6 presents guiding principles for the post-2015 development agenda and the various options for health goals and indicators that were put forward during the consultation. Chapter 7 focuses on the importance of accountability, inclusive partnerships, innovation, and learning. Chapter 8 includes the report’s main recommendations on how to frame the future agenda for health. The contributors to this consultation are looking in the same general direction: all agree that the new development agenda needs strong and visible health goals supported by measurable indicators. The recommendations in this chapter are those that garnered the most support during the consultation. Chapter 9 concludes by suggesting concrete actions that could be taken between now and 2015 by those advocating for health to feature prominently in the next development agenda. (Excerpt)
Optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting. WHO recommendations.
Geneva, Switzerland, World Health Organization [WHO], 2012.  p.The World Health Organization’s recommendations on optimizing the roles of health workers aim to help address critical health workforce shortages that slow down progress towards the health-related Millennium Development Goals. A more rational distribution of tasks and responsibilities among cadres of health workers can significantly improve both access and cost-effectiveness -- for example by training and enabling ‘mid-level’ and ‘lay’ health workers to perform specific interventions otherwise provided only by cadres with longer (and sometimes more specialized) training. These recommendations are intended for health policy-makers, managers and other stakeholders at a regional, national and international level. WHO hopes that countries will adapt and implement them to meet local needs. The recommendations were developed through a formal, structured process including a thorough review of available evidence. The process and the recommendations are described in the related documents.
Geneva, Switzerland, WHO, 2012.  p.This document has three broad aims. First, it seeks to unify the worlds of research and decision-making and connect the various disciplines of research that generate knowledge to inform and strengthen health systems. Second, the strategy contributes to a broader understanding of this field by clarifying the scope and role of HPSR. It provides insight into the dynamic processes through which HPSR evidence is generated and used in decision-making. Finally, it is hoped that this strategy will serve as an agent for change and calls for a more prominent role for HPSR at a time when the health systems mandate is evolving towards broader goals of universal health coverage and equity. This strategy on health policy and systems research is intended to augment and amplify WHO’s previous affirmations on the importance of health research, by explaining how this evolving field is sensitive and responsive to the needs of those who are responsible for the planning and performance of national health systems -- decision-makers, health practitioners, citizens and civil society.
New York, New York, UN Women, 2012.  p.The Handbook for National Action Plans on Violence against Women brings together current knowledge on effective policy for the prevention of, and response to, violence against women, and concretely demonstrates how States have developed and implemented such policy in their own contexts. Although not a model plan itself , this publication sets out guidelines to help policy makers and advocates formulate effective plans. It is based on good practices in States’ plans and the advice of experts from different countries and regions. It first outlines the international and regional legal and policy framework which mandates States to adopt and implement National Action Plans to address violence against women. It then presents a model framework for National Action Plans on violence against women, which sets out recommendations, accompanied by explanatory commentaries and good practice examples.
Social determinants of health: Outcome of the World Conference on Social Determinants of Health (Rio de Janeiro, Brazil, October 2011). Report by the Secretariat.
[Geneva, Switzerland], World Health Organization [WHO]. 2012 Mar 22.  p. (A65/16)In 2009, the Health Assembly adopted resolution WHA62.14 on reducing health inequities through action on the social determinants of health. It requested the Director-General to provide support to Member States in measures that included convening a global event, with the assistance of Member States, before the Sixty-fifth World Health Assembly in order to discuss renewed plans for redressing the alarming trends of health inequities through actions on the social determinants of health. This report describes the process and outcome of the resulting event, the World Conference on Social Determinants of Health (Rio de Janeiro, Brazil, 19-21 October 2011), and also summarizes progress on the implementation of resolution WHA62.14. (Excerpt)
Brighton, United Kingdom, University of Sussex, Institute of Development Studies [IDS], 2011 Sep.  p. (IDS Practice Paper in Brief 7; ILT Brief 7)This paper draws on a study conducted on capturing innovation and lessons from across a ‘multi-sited’ organisation. The lessons in question were about effective social protection programmes, however the paper focuses on the general principles of learning in an international organisation spread across many countries. The study was undertaken in collaboration with UNICEF and Irish Aid. The implementing team developed an action research programme exploring how to capture, share and use findings and lessons, in an organisation like UNICEF. The paper describes the processes and limitations of studies like this in building an institutional learning environment.
Guidance for evidence-informed policies about health systems: Linking guidance development to policy development.
PLoS Medicine. 2012 Mar; 9(3):e1001186.Contextual factors are extremely important in shaping decisions about health systems, and policy makers need to work through all the pros and cons of different options before adopting specific health systems guidance. A division of labour between global guidance developers, global policy developers, national guidance developers, and national policy developers is needed to support evidence-informed policy-making about health systems. A panel charged with developing health systems guidance at the global level could best add value by ensuring that its output can be used for policy development at the global and national level, and for guidance development at the national level. Rigorous health systems analyses and political systems analyses are needed at the global and national level to support guideline and policy development. Further research is needed into the division of labour in guideline development and policy development and on frameworks for supporting system and political analyses. This is the second paper in a three-part series in PLoS Medicine on health systems guidance.
Rio Political Declaration on Social Determinants of Health, Rio de Janeiro, Brazil, 21 October 2011.
Rio de Janeiro, Brazil, World Conference on Social Determinants of Health, 2011.  p.The Rio Political Declaration on Social Determinants of Health expresses global political commitment for the implementation of a social determinants of health approach to reduce health inequities and to achieve other global priorities. It will help to build momentum within WHO Member States for the development of dedicated national action plans and strategies. On 15 August 2011, the text was circulated to Geneva-based Permanent Missions of Member States. The first meeting of Member States, convened by the Government of Brazil, was held at WHO headquarters on 7 September, 2011. This was followed by a series of informal consultations attended by representatives of Permanent Missions. The text of the declaration was finalized during the conference in Rio de Janeiro on 19-21 October, 2011.
Closing the gap: Policy into practice on social determinants of health. Discussion paper to inform proceedings at the World Conference on Social Determinants of Health, Rio de Janeiro, Brazil, 19-21 October, 2011.
Geneva, Switzerland, World Health Organization [WHO}, 2011.  p.This discussion paper aims to inform proceedings at the World Conference on Social Determinants of Health about how countries can implement action on social determinants of health, including the recommendations of the Commission on Social Determinants of Health. Evidence from countries that have made progress in addressing social determinants and reducing health inequities shows that action is required across all of five key building blocks, which have been selected as the five World conference themes: 1. Governance to tackle the root causes of health inequities: implementing action on social determinants of health; 2. Promoting participation: community leadership for action on social determinants; 3. The role of the health sector, including public health programmes, in reducing health inequities; 4. Global action on social determinants: aligning priorities and stakeholders; 5. Monitoring progress: measurement and analysis to inform policies and build accountability on social determinants. (Excerpt)
London, United Kingdom, IPPF, 2011 Jan.  p.Girls Decide: Choices on Sex and Pregnancy explores innovative projects for girls and young women that offer great potential for making a difference on a large scale. These projects empower girls and young women, and affect all areas of their development, by implementing a positive approach towards their sexual and reproductive health and rights. When girls and young women understand that their sexual identities, feelings, emotions, sexual behaviour and aspirations are legitimate and respected, they are empowered. When they have access to the knowledge and the opportunities to make choices about relationships, sexuality and pregnancy, and when communities and societies give girls and young women the space and support they need to become confident, decision-making individuals, everyone benefits. It is time for policy- and decision-makers, educators, service providers and community leaders to re-think strategies for girls and young women: invest in, protect and promote policies, programmes, services and research that incorporate a positive approach to their choices around all aspects of sex, sexuality and pregnancy.
Global Health Action. 2010; 3:5720.Background: Population health is a primary goal of sustainable development. United Nations international conferences like the Beijing Platform for Action have highlighted the key role of women in ensuring sustainable development. In the context of climate change, women are affected the most while they display knowledge and skills to orient themselves toward climate adaptation activities within their societies. Objective: To investigate how the gender perspective is addressed as an issue in research and policymaking concerning climate change and global health. Methods: A broad literature search was undertaken using the databases Pubmed and Web of Science to explore the terms 'climate change,' 'health,' 'gender,' and 'policy.' Climate change and health-related policy documents of the World Health Organization (WHO) and National Communications and National Adaptation Programs of Action reports submitted to the United Nations Framework Convention on Climate Change of selected countries were studied. Assessment guidelines to review these reports were developed from this study's viewpoint. Results: The database search results showed almost no articles when the four terms were searched together. The WHO documents lacked a gender perspective in their approach and future recommendations on climate policies. The reviewed UN reports were also neutral to gender perspective except one of the studied documents. Conclusion: Despite recognizing the differential effects of climate change on health of women and men as a consequence of complex social contexts and adaptive capacities, the study finds gender to be an underrepresented or non-existing variable both in research and studied policy documents in the field of climate change and health.
World Policy Journal. 2010 Summer; 27(2):41-46.Leaders should forget all about quick fixes, because quick fixes will never solve the most pressing global health challenges. World leaders cannot assume, "Oh, we are providing nets, so the nets are going to solve the entire malaria problem." Quite the opposite: just because the nets are being provided does not mean that they are being used. And therefore, we must listen to whoever would fund the strategies, policies and strategic plans developed within those countries to maximize impact. In Uganda, for instance, we have a forum where we have both the donors and the Ugandan government sitting together agreeing on the priorities. So let us address the priorities of the country together rather than having outside organizations say, "This is what we think is correct, we will dictate it to you, and we expect it to work." I've said many times that this does not work. Whatever health crisis is being addressed must be approached with the understanding that we are living in a global community. We must understand that whatever is happening in one country can easily spread to and affect almost anywhere in a very short period of time. We need to bear in mind that we are not only protecting the people we are providing services to, but we are also protecting ourselves. (Excerpt)
Bulletin of the World Health Organization. 2010 Jan; 88(1):3.The rationale for strengthening linkages between sexual and reproductive health and HIV programs is well recognized, and benefits that have accrued from these linkages have been discussed in the November 2009 issue of the Bulletin of the World Health Organization and elsewhere. However, real progress in scaling up such approaches has been modest and slow to materialize.
A guide for developing national policies on young people’s sexual andreproductive health and rights.
Entre Nous. 2009; 69:8-9.IPPF European Network (IPPF EN) has been a lead advocate for young people's sexual health and rights (SRHR) over the years and its Member Associations have piloted initiatives to provide sexuality education, information and services and promote a right based approach towards the SRHR of young people. IPPF EN and like-minded organizations consider that sustainable gains in ensuring young people's SRHR can only be obtained if there is a solid framework of sound and comprehensive policies. Therefore building on evidence, research and our expertise we developed, together with WHO, a set of tools to assist policy and decision makers in providing such a framework.
Geneva, Switzerland, UNICEF, Regional Office for CEE / CIS, 2008 Jan.  p. (Evaluation Working Papers Issue No. 12)This collection of articles by UNICEF brings together the vision and lessons learned from different stakeholders on the strategic role of monitoring and evaluation in evidence-based policymaking. These stakeholders are policymakers (as users of evidence) and researchers and evaluators (as suppliers of evidence). The use of strong evidence can achieve recognition of a policy issue, inform the design and choice of policy, forecast the future, monitor policy implementation, and evaluate policy impact.