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Geneva, Switzerland, World Health Organization [WHO], 2018. 116 p.The guideline uses state-of-the-art evidence to identify effective policy options to strengthen community health worker (CHW) programme performance through their proper integration in health systems and communities. The development of this guideline followed the standardized WHO approach. This entailed a critical analysis of the available evidence, including 16 systematic reviews of the evidence, a stakeholder perception survey to assess feasibility and acceptability of the policy options under consideration, and the deliberations of a Guideline Development Group which comprised representation from policy makers and planners from Member States, experts, labour unions, professional associations and CHWs. Critical to the success of these efforts will be ensuring appropriate labour conditions and opportunities for professional development, as well as creating a health ecosystem in which workers at different levels collaborate to meet health needs. Adapted to context, the guideline is a tool that supports optimizing health policies and systems to achieve significant gains to meet the ambition of universal access to primary health care services.
An evidence map of social, behavioural and community engagement interventions for reproductive, maternal, newborn and child health.
Geneva, Switzerland, WHO, 2017. 190 p.The Every Woman Every Child (EWEC) Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) calls for action towards three objectives: Survive (end preventable deaths), Thrive (ensure health and well-being) and Transform (expand enabling environments). The strategy recognizes that “women, children and adolescents are potentially the most powerful agents for improving their own health and achieving prosperous and sustainable societies”. Social, behavioural and community engagement (SBCE) interventions are key to empowering individuals, families and communities to contribute to better health and well-being of women, children and adolescents. Policy-makers and development practitioners need to know which interventions work best. WHO has provided global guidance on some key SBCE interventions, and we recognize there is more work to be done as this will be an area of increasing importance in the era of the Sustainable Development Goals (SDGs) and the EWEC Global Strategy. This document provides an evidence map of existing research into a set of selected SBCE interventions for reproductive, maternal, newborn, and child health (RMNCH), the fruit of a collaboration between the WHO, the Partnership for Maternal, Newborn & Child Health (PMNCH) and the International Initiative for Impact Evaluations (3ie), supported by other partners. It represents an important way forward in this area, harnessing technical expertise, and academia to strengthen knowledge about the evidence base. The evidence map provides a starting point for making available existing research into the effectiveness of RMNCH SBCE interventions, a first step toward providing evidence for decision-making. It will enable better use of existing knowledge and pinpoint where new research investments can have the greatest impact. An online platform that complements the report provides visualization of the findings, displaying research concentrations and gaps.
[Washington, D.C.], United States Agency for International Development [USAID], 2017 Jul. 3 p.The purpose of this technical update is to summarize current evidence and the World Health Organization (WHO) revised guidance regarding use of hormonal contraception (HC) by women at high risk of acquiring HIV. On March 2, 2017, WHO issued revised guidance on the use of progestogen-only injectables (norethisterone enanthate [NET-EN] and depot medroxyprogesterone acetate [DMPA], in both intramuscular [IM] and subcutaneous [SC] forms) by women at high risk of HIV acquisition. The recommendation was previously a Category 1 with a clarification, meaning there was no restriction on the use of the progestogen-only injectables, but women at high risk of HIV should be informed that use of those contraceptive methods may or may not increase risk of HIV acquisition. With the revised guidance, progestogen-only injectables are now classified as Category 2 for women at high risk of HIV acquisition. (excerpt)
Lancet. 2017 Jul 01; 390(10089):1.Add to my documents.
Selected practice recommendations for contraceptive use. Third edition 2016. Web annex: Development of updated guidance for the third edition.
Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2016. 50 p.Over the past 40 years, there have been significant advances in the development of new contraceptive technologies, including changes in formulations and dosing, schedules for administration and novel delivery systems. However, current policies and health-care practices in some countries are based on scientific studies of contraceptive products that are no longer in wide use, on long-standing theoretical concerns that have never been substantiated or on the personal preference or bias of service providers. These outdated policies or practices often result in limitations to both the quality of and the access to family planning services for clients. The goal of this document is to improve access to and quality of family planning services by providing policy-makers and decision-makers with a set of recommendations on how to use family planning methods safely and effectively once they are deemed medically appropriate. Because country situations and programme environments vary so greatly, it is inappropriate to set firm international guidelines on criteria for contraceptive use. However, it is expected that national programmes will use these recommendations for updating or developing their own contraceptive guidelines according to national health policies, needs, priorities and resources, while reflecting upon local values and preferences. There are a total of four World Health Organization (WHO) guidance documents (cornerstones) pertaining to contraception: two focusing on evidenced-based recommendations (primarily targeted towards policy-makers and programme managers) and two focusing on application of the recommendations (primarily targeted towards health-care providers). All four cornerstones are best interpreted and used in a broader context of reproductive and sexual health care. These documents are updated periodically to reflect changes in medical and scientific knowledge. (excerpt)
Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2016. 72 p.This document is part of the process for improving the quality of care in family planning. Specifically, it is one of two evidence-based cornerstones (guidance documents) of the World Health Organization’s (WHO’s) initiative to develop and implement family planning guidelines for national programmes. The first cornerstone, the Medical eligibility criteria for contraceptive use (MEC, now in its fifth edition), provides thorough information and guidance on the safety of various contraceptive methods for use in the context of specific health conditions and characteristics. This document, Selected practice recommendations for contraceptive use, third edition (SPR third edition), is the second cornerstone; it provides guidance for how to use contraceptive methods safely and effectively once they are deemed to be medically appropriate. For recommendations issued in the SPR, safety considerations include common barriers to safe, correct and consistent use of contraception and the benefits of preventing unintended or unwanted pregnancy.
Geneva, Switzerland, WHO, 2016.  p. (WHO/HIS/HSR/16.1)On its own, the availability of more and better knowledge about health systems does little to change how that information is used to strengthen the performance of health systems. By engaging national and local decision-makers, health policy and systems researchers, scientists from other disciplines, health workers and implementers, development partners, donors and civil society, the Alliance is seeking improved results that are more sustainable, translatable across contexts, and available for all communities. It builds partnerships with institutions that share its mission: to strengthen the health systems in low- and middle-income countries by promoting the generation and use of health policy and systems research. This strategy outlines a challenging and exciting agenda to provide a unique forum for decision-makers in health policy and systems research, support institutional capacity for training and mentorship, stimulate knowledge generation and innovation, and encourage the demand for and use of research. In this way, the Alliance plays a unique role in serving local and global communities to strengthen health system development and contribute to the SDGs. It is indeed changing mindsets. [Excerpt]
Geneva, Switzerland, WHO, 2015.  p.The goal of the present guideline is to consolidate guidance for effective interventions that are needed to reduce the global burden of maternal infections and their complications around the time of childbirth. This forms part of WHO’s efforts to improve the quality of care for leading causes of maternal death, especially those clustered around the time of childbirth, in the post-MDG era. Specifically, it presents evidence-based recommendations on interventions for preventing and treating genital tract infections during labour, childbirth or the puerperium, with the aim of improving outcomes for both mothers and newborns.The primary audience for this guideline is health professionals who are responsible for developing national and local health protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to those directly providing care to pregnant women, including obstetricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for both pre- and inservice training of health workers to enhance their delivery of care to prevent and treat maternal peripartum infections. (Excerpts)
Controlling maternal anemia and malaria. Ensuring pregnant women receive effective interventions to prevent malaria and anemia: What program managers and policymakers should know.
[Washington, D.C.], Maternal and Child Survival Program, 2015 Apr.  p. (USAID Cooperative Agreement No. AID-OAA-A-14-00028)This brief describes WHO recommendations for IPTp (intermittent preventive treatment of malaria in pregnancy) to prevent MIP (malaria in pregnancy) and iron-folic acid (IFA) supplementation to prevent iron deficiency anemia in sub-Saharan Africa (SSA) countries, with an emphasis on giving the correct dose of folic acid to maximize the effectiveness of interventions to prevent malaria. The brief is for program managers of health programs and policymakers to guide them in designing programs and developing policies. (Excerpts)
Strength of recommendations in WHO guidelines using GRADE was associated with uptake in national policy.
Journal of Clinical Epidemiology. 2015;  p.Objectives: This study assesses the extent to which the strength of a recommendation in a World Health Organization (WHO) guideline affects uptake of the recommendation in national guidelines. Study Design and Setting: The uptake of recommendations included in HIV and TB guidelines issued by WHO from 2009 to 2013 was assessed across guidelines from 20 low- and middle-income countries in Africa and Southeast Asia. Associations between characteristics of recommendations (strength, quality of the evidence, type) and uptake were assessed using logistic regression. Results: Eight WHO guidelines consisting of 109 strong recommendations and 49 conditional ecommendations were included, and uptake assessed across 44 national guidelines (1,255 recommendations) from 20 countries. Uptake of WHO recommendations in national guidelines was 82% for strong recommendations and 61% for conditional recommendations. The odds of uptake comparing strong recommendations and conditional recommendations was 1.9 (95% confidence interval: 1.4, 2.7), after adjustment for quality of evidence. Higher levels of evidence quality were associated with greater uptake, independent of recommendation strength. Conclusion: Guideline developers should be confident that conditional recommendations are frequently adopted. The fact that strong recommendations are more frequently adopted than conditional recommendations underscores the importance of ensuring that such recommendations are justified.
Journal of the International AIDS Society. 2013; 16(1):18452.Introduction: The female condom is the only evidence-based AIDS prevention technology that has been designed for the female body; yet, most women do not have access to it. This is remarkable since women constitute the majority of all HIV-positive people living in sub-Saharan Africa, and gender inequality is seen as a driving force of the AIDS epidemic. In this study, we analyze how major actors in the AIDS prevention field frame the AIDS problem, in particular the female condom in comparison to other prevention technologies, in their discourse and policy formulations. Our aim is to gain insight into the discursive power mechanisms that underlie the thinking about AIDS prevention and women's sexual agency. Methods: We analyze the AIDS policies of 16 agencies that constitute the most influential actors in the global response to AIDS. Our study unravels the discursive power of these global AIDS policy actors, when promoting and making choices between AIDS prevention technologies. We conducted both a quantitative and qualitative analysis of how the global AIDS epidemic is being addressed by them, in framing the AIDS problem, labelling of different categories of people for targeting AIDS prevention programmes and in gender marking of AIDS prevention technologies. Results: We found that global AIDS policy actors frame the AIDS problem predominantly in the context of gender and reproductive health, rather than that of sexuality and sexual rights. Men's sexual agency is treated differently from women's sexual agency. An example of such differentiation and of gender marking is shown by contrasting the framing and labelling of male circumcision as an intervention aimed at the prevention of HIV with that of the female condom. Conclusions: The gender-stereotyped global AIDS policy discourse negates women's agency in sexuality and their sexual rights. This could be an important factor in limiting the scale-up of female condom programmes and hampering universal access to female condoms.
Ending overly broad criminalisation of HIV non-disclosure, exposure and transmission: Critical scientific, medical and legal considerations.
Geneva, Switzerland, UNAIDS, 2013 May.  p. (Guidance Note 2013; UNAIDS / JC2351E)The overly broad application of criminal law to HIV non-disclosure, exposure and transmission raises serious human rights and public health concerns. Because of these concerns, the Joint United Nations Programme on HIV / AIDS (UNAIDS) urges States to (i) concentrate their efforts on expanding the use of proven and successful evidence-informed and rights-based public health approaches to HIV prevention, treatment and care, and (ii) limit any application of criminal law to truly blameworthy cases where it is needed to achieve justice. States should strengthen HIV programmes that enable people to know how to protect themselves from HIV and to avoid transmitting it, and they should help people access the services and commodities they need for HIV prevention, treatment, care and support. (Excerpt)
Preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. WHO guidelines.
Geneva, Switzerland, WHO, Department of Maternal, Newborn, Child and Adolescent Health, 2011. 195 p.The purpose of these guidelines is to improve adolescent morbidity and mortality by reducing the changes of early pregnancy and its resulting poor health outcomes. The publication's two main objectives are to: 1) identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and acces to maternal health services by adolescents; and 2) provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions that are most appropriate for the needs of their countries and contexts. The document provides a summary of the recommendations for each of the six major outcomes presented in this guideline. Both action and research recommendations are listed.
Geneva, Switzerland, WHO, 2013.  p. (WHO Guidance Note)This WHO Guidance Note advocates for a comprehensive approach to prevention and control of cervical cancer and is aimed at senior policymakers and program managers. It describes the need to deliver effective interventions across the female lifespan. These interventions include community education; social mobilization; HPV vaccination; and cancer screening, treatment, and palliative care. The document outlines complementary strategies for comprehensive prevention and control, and it highlights collaboration across national health programs (particularly immunization, reproductive health, cancer control and adolescent health), organizations, and partners.
New York, New York, United Nations Population Fund [UNFPA], 2012.  p.This report is a call to decision-makers, parents, communities and to the world to end child marriage. It documents the current scope, prevalence and inequities associated with child marriage. The document argues that child marriage jeopardizes girls' rights and stands in the way of girls living educated, healthy and productive lives. Furthermore, early marriage also excludes girls from fundamental decisions, such as the timing of marriage and choice of spouse. Early marriage also put girls more at risk of contracting HIV and other STIs. The author argues that social norms that legitimize early marriage need to change in order for there to be any real improvement, and in order to help countries reach the Millennium Development Goals.
World Health Organization's 2010 recommendations for HIV treatment: Natiional guideline revision challenges and lessons learned.
Arlington, Virginia, John Snow [JSI], AIDS Support and Technical Assistance Resources [AIDSTAR-One], 2012 Feb.  p. (Technical Brief; USAID Contract No. GHH-I-00–07–00059–00)In 2010, the World Health Organization released revised recommendations for adult and adolescent HIV treatment. This technical brief provides HIV policy makers and program managers with a point of reference as they adapt and implement revised national HIV treatment guidelines. Approaches that worked well, challenges and lessons learned from Sub-Saharan Africa, Latin America, and South-East Asia are highlighted. Links to key resources for countries revising guidelines and implementing revisions are also provided.
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.
Towards a green economy: Pathways to sustainable development and poverty eradication. A synthesis for policy makers.
Nairobi, Kenya, UNEP, 2011.  p.We argue in UNEP's forthcoming Green Economy Report, and in this extracted Synthesis for Policy Makers, that the rewards of greening the world's economies are tangible and considerable, that the means are at hand for both governments and the private sector, and that the time to engage the challenge is now. In this report, we explored through a macroeconomic model the impacts of investments in greening the economy as against investments in "business as usual" -- measuring results not only in terms of traditional GDP but also impacts on employment, resource intensity, emissions and ecological impact. We estimated, based on several studies, that the annual financing demand to green the global economy was in the range of US$ 1.05-2.59 trillion. To place this demand in perspective, it is less than one-tenth of the total global investment per year (as measured by global Gross Capital Formation). Taking an annual level of US$ 1.3 trillion (i.e. 2% of global GDP) as a target reallocation from "brown" investment to "green" investment, our macroeconomic model suggests that over time, investing in a green economy enhances long-run economic performance and can increase total global wealth. Significantly, it does so while enhancing stocks of renewable resources, reducing environmental risks, and rebuilding our capacity to generate future prosperity. Our report, Towards a Green Economy, focuses on 10 key economic sectors because we see these sectors as driving the defining trends of the transition to a green economy, including increasing human well-being and social equity, and reducing environmental risks and ecological scarcities. Across many of these sectors, we have found that greening the economy can generate consistent and positive outcomes for increased wealth, growth in economic output, decent employment, and reduced poverty. (Excerpts)
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.
Supporting country-led initiatives to strengthen national health information systems in East Africa.
Washington, D.C., Futures Group, Health Policy Initiative, 2009 Oct.  p. (USAID Contract No. GPO-I-01-05-00040-00)In response to a growing recognition of the importance of reliable and timely health information systems (HIS) to support improved decisionmaking for public health action and health systems strengthening, USAID supported a regional forum in East Africa that focused on engaging HIS champions from key public sectors -- including health, finance, telecommunications, and vital statistics -- and supporting country ownership of HIS. Toward that end, delegations from six focus countries (Ethiopia, Kenya, Malawi, Rwanda, Tanzania, and Uganda, with Namibia and Sudan as observers) convened for a three-day workshop, "Country Ownership Strategies: Leadership Forum on Health Information Systems," in Addis Ababa from August 10-13, 2009. As part of the preparation and planning for this forum, the USAID |Health Policy Initiative, Task Order 1 designed and executed a semi-structured qualitative survey to capture the current state of HIS in each of the six focus countries. This report highlights the results of that survey and includes background materials that supported the survey process. Given the overall success of the first forum, USAID is exploring ways to replicate this activity in other regions and continue to provide country-specific technical and financial assistance for HIS strengthening..
[Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2007 Dec. 21 p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00)Much of the programmatic and research experience gained over the past two decades has focused on increasing understanding of supply-side factors that limit the provision and use of the IUD, for example, developing training programs, demonstrating the ability of lower level medical staff to provide the method, and assessing the interaction between IUDs, STIs and, more recently, HIV. There is now sufficient empirical evidence from a range of settings to allow program managers and technical assistance organizations to develop guidelines and plans for strengthening the systems necessary to support country-level introduction or 'rehabilitation'; of the IUD within a program offering a range of contraceptive choices. The objectives were: To conduct a meeting of researchers and program managers from three continents and several international organizations to review reasons for under-utilization of the IUD and recent experiences in increasing awareness about the IUD; To develop proposals for operations research projects to test the most promising interventions to introduce and expand access to IUD services and to implement the projects with national partner organizations; To disseminate results of the successful strategies. (Excerpts]
Reproductive and sexual health rights: 15 years after the International Conference on Population and Development [editorial]
International Journal of Gynaecology and Obstetrics. 2009 Aug; 106(2): p.For the past 15 years, the World Report on Women's Health has been published in the International Journal of Gynecology and Obstetrics (IJGO) every 3 years to mark the occasion of the FIGO World Congress. The topic of the 2006 World Report was promoting partnerships to improve access to women's reproductive and sexual health. It is fitting that, following the International Conference on Population and Development (ICPD) held in Cairo in 1994, the 2009 World Report addresses reproductive and sexual health rights 15 years after this significant conference took place. Despite some of the progress made in achieving reproductive and sexual health rights in many countries, many agenda items from the ICPD Programme of Action remain unfinished, and these are now emphasized in the health-related Millennium Development Goals (MDGs) 4, 5, and 6. The WHO Reproductive Health Research division has indicated that the core elements for improvement include improving prenatal, delivery, post partum, and newborn care; providing high-quality services for family planning including infertility services; eliminating unsafe abortion; combating sexually transmitted infections including HIV, reproductive tract infections, cervical cancer, and other gynecological morbidities; and promoting sexual health. It identified 6 areas of action including strengthening the capacity of health systems, improving the information base for priority settings, mobilizing political will, creating supportive legislation and regulatory frameworks, and strengthening, monitoring, evaluation, and accountability. The 2009 World Report provides the reader with a comprehensive and concise overview of what has been achieved in women's reproductive and sexual health rights since the ICPD, unmet needs, obstacles, and the feasible actions in the countdown to 2015 as outlined in the ICPD Programme of Action and the health-related MDGs. The July 2008 Summit Declaration of the G8 countries called for reproductive health to be "widely accessible," for closer links between HIV/AIDS and family planning programs, and strengthening of health systems. It is hoped that the latest global economic crisis will not negatively impact the commitments of rich countries to reproductive and sexual health programs in low-resource countries to reduce mortality and improve the quality-of-life of women and newborns around the world. (excerpt)
Lancet. 2009 May 2; 373(9674):1500-2.The world is off track to achieve the health-related targets of the Millennium Development Goals (MDGs) by 2015. Maternal mortality has stagnated for two decades, child mortality is not declining fast enough, HIV/AIDS still infects people faster than the pace of antiretroviral treatment roll-out, and inequalities are widening within and across countries. Addressing these crises will require increased funding and more efficient spending. The next Board meetings of the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance, scheduled for May and June, respectively, present an opportunity to tackle these issues. We propose that the exceptional approach created for the fight against AIDS should be expanded: the entire global health agenda must adopt a rights-based approach, which in some countries requires challenging the model of national financial autonomy. We therefore recommend that the Global Fund and the GAVI Alliance gradually move towards becoming a global fund for all the health MDGs, which will require substantially greater resources to address the broader mandate. As a first step the next Global Fund and GAVI Alliance board meetings should expand the review of their architecture to provide greater support to national health plans, including co-financing non-disease-specific human resources for health. A global fund for the health MDGs would eventually allow the delivery of prevention and treatment services for specific diseases through revamped general health services, reducing transaction costs and streamlining the global health architecture. Such radical, yet rational, action is our best chance of meeting-or at least making significant progress toward-the health-related MDG targets by 2015.
Asia and the Pacific Regional Forum on Strengthening Partnerships with Faith-Based Organisations in Addressing ICPD, Kuala Lumpur, Malaysia, 5-6 May, 2008. A report on the conference proceedings.
[New York, New York], United Nations Population Fund [UNFPA], 2008. 60 p.Building on a legacy spanning three decades, UNFPA Country Offices in the Asia-Pacific region and their faith-based partners came together for a two-day consultation to assess the nature and impact of these partnerships in the areas of maternal health, gender equality, migration and youth welfare. This report documents the experiences and lessons learned from the varied initiatives of faith-based organizations, as well as the best practices emanating from these strategic alliances around the region. The discussions, recommendations for action and the many voices of critical faith-based actors, are all documented in this report.