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Under-served and over-looked: prioritizing contraceptive equity for the poorest and most marginalized women and girls.
London, United Kingdom, IPPF, 2017 Jul. 40 p.This report is a synthesis of evidence revealed from a literature review, including 68 reports from 34 countries. The results are dire: the poorest women and girls, in the poorest communities of the poorest countries are still not benefitting from the global investment in family planning and the joined up actions of the global family planning movement. Women in the poorest countries who want to avoid pregnancy are one-third as likely to be using a modern method as those living in higher-income developing countries.
WHO / World Bank convene ministerial meeting to discuss best practices for moving forward on universal health coverage. Joint WHO / World Bank statement.
Geneva, Switzerland, WHO, 2013 Feb 19.  p.Top officials from health and finance ministries from 27 countries joined other high-level health and development stakeholders at a two-day meeting this week in Geneva to discuss ways that countries are progressing towards universal health coverage. The meeting was convened jointly by the World Health Organization (WHO) and the World Bank and took place just weeks after the United Nations General Assembly adopted a resolution supporting universal health coverage. Delegates at the Geneva meeting expressed strong support for the ideas underlying universal health coverage: that everyone, irrespective of their ability to pay, should have access to the health services they need, without putting their families at financial risk. The meeting also discussed strategies to ensure an adequate supply of good quality and affordable essential medicines and technologies, noting the value of using financial incentives to promote efficiency and quality of health services. The participants agreed on the importance of improving information systems and holding governments and health care providers more accountable for delivering results. The importance of monitoring progress towards universal health coverage was also a recurrent theme, as was the important role played by researchers, civil society, and international agencies. The WHO and the World Bank are working together at global, regional and country levels, and stand by ready to help countries confront the numerous challenges that the meeting highlighted in accelerating progress toward universal health coverage. In response to country demand, the WHO and the World Bank are already developing a monitoring framework that will help countries track their countries’ progress toward universal health coverage in a way that explicitly captures the potential importance of universal health coverage in achieving better health and higher living standards for everyone. The framework will be available for consultation with countries and other partners later this year. The UN General Assembly resolution urges Member States to develop health systems that avoid significant direct payments at the point of care. It further encourages them to establish mechanisms for pooling risks to avoid catastrophic health expenditures that drive households into poverty. (Excerpts)
A nongovernmental organization's national response to HIV: the work of the All-Ukrainian Network of People Living with HIV.
Geneva, Switzerland, UNAIDS, 2007 Jul. 47 p. (UNAIDS Best Practice Collection; UNAIDS/07.23E; JC1305E)The All-Ukrainian Network of People Living with HIV/AIDS (the 'Network') was formed in the late 1990s by HIV-positive individuals alarmed at the surging HIV epidemic in their country and the lack of resources and support for themselves and others living with the virus. It has grown rapidly and steadily since then, providing services and support to more than 14 000 people living with HIV. Its roots are in the self-help ethos, based on the belief that people living with HIV must be directly involved in leading national and local responses to HIV. The Network's four key strategy components are: increasing access to non-medical care, treatment and support; lobbying and advocating to protect the rights of people living with HIV; seeking to increase acceptance towards people living with HIV throughout society; and enhancing the organizational capacity of the Network. (excerpt)
Geneva, Switzerland, UNAIDS, 2007 Jul. 64 p. (UNAIDS/07.XXE; JC1364E)Great strides have been made in reaching communities affected by biomedical HIV prevention trials with information, discussion fora and skills-building that effectively empower them to work as partners with researchers in critical aspects of trial design and conduct. However, there is no existing, standard and internationally recognized guidance that primarily addresses 'Good Participatory Practice' and community engagement in biomedical HIV prevention trials. Increasing the awareness of researchers, funders, trial participants, and community stakeholders of essential good practices for community engagement through these guidelines can help reduce unnecessary conflict, confusion, or non-constructive criticism and ensure that research is meaningful, applicable, and correctly interpreted. Serving as a reference for agreements about basic Good Participatory Practice elements for optimum trial conduct and related investments of necessary human and financial resources, this guidance document for those who conduct, fund, participate in and assess trial conduct can act as a positive incentive for all parties to strive for effective community involvement. (excerpt)
Towards universal access to prevention, treatment and care: experiences and challenges from the Mbeya region in Tanzania -- a case study.
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2007 Mar. 49 p. (UNAIDS Best Practice Collection; UNAIDS/07.11E; JC1291E)This study takes stock of the situation in Mbeya in 2005, documenting the region's continuing efforts to build on the Regional Programme's strong comprehensive prevention approaches to further increase their coverage while strengthening the new district focus, expanding multisectoral work and making available antiretroviral treatment. In doing so, this study describes Mbeya's progress towards universal access and identifies ongoing challenges. Through its comprehensive, decentralized and multisectoral approaches and the continuing efforts of a variety of actors, the region appears to be in a better position to reach universal access than other parts of Tanzania and Africa in general. The experiences of the Mbeya region to date can serve as lessons learnt to other parts of the country and, more broadly, the continent. This publication is neither a scientific study nor an evaluation of the Regional Programme. It is an analytical description of HIV control activities in the region to date and their status to date. Its focus is mainly on access. The programmes presented here follow national and international recommendations. The quality of the individual programmes, however, has not been assessed for the purpose of this publication. (excerpt)
Geneva, Switzerland, WHO, 2007. 8 p. (WHO/RHR/07.7)Faced with the challenge of putting into practice the ideals of the Millennium Development Goals, the International Conference on Population and Development (ICPD), and other global summits of the last decade, decision-makers and programme managers responsible for sexual and reproductive health ask how they can: improve access to and the quality of family planning and other sexual and reproductive health services; increase skilled attendance at birth and strengthen referral systems; reduce the recourse to abortion and improve the quality of existing abortion services; provide information and services that respond to young people's needs; and integrate the prevention and treatment of reproductive tract infections, including HIV/AIDS, with other sexual and reproductive health services. (excerpt)
Paris, France, UNESCO, 2006 Mar. 37 p. (Good Policy and Practice in HIV and AIDS and Education Booklet No. 3; ED-2006/WS/4; cld 26006)UNESCO recognizes the significant impact of HIV and AIDS on international development, and in particular on progress towards achieving Education For All (EFA). As the UN agency with a mandate in education and a co-sponsor of the Joint United Nations Programme on HIV and AIDS (UNAIDS), UNESCO takes a comprehensive approach to HIV and AIDS. It recognizes that education can play a critical role in preventing future HIV infections and that one of its primary roles is to help learners and educators in formal and non-formal education systems to avoid infection. It also recognizes its responsibility to address and respond to the impact of the epidemic on formal and non-formal education systems, and the need to expand efforts to address issues related to care, treatment and support of those infected and affected by HIV. UNESCO's global strategy for responding to HIV and AIDS is guided by four key principles, and focuses on five core tasks. The guiding principles that are the foundation of UNESCO's response to HIV and AIDS are: Work towards expanding educational opportunities and the quality of education for all; A multi-pronged approach that addresses both risk (individual awareness and behaviour) and vulnerability (contextual factors); Promotion and protection of human rights, promotion of gender equality, and elimination of violence (notably violence against women), stigma and discrimination; An approach to prevention based on providing information that is scientifically sound, culturally appropriate, and effectively communicated, and helping learners and educators to develop the skills they need to prevent HIV infection and to tackle HIV and AIDS-related discrimination. (excerpt)
UN System HIV workplace programmes. HIV prevention, treatment and care for UN System employees and their families.
Geneva, Switzerland, UNAIDS, 2006 Feb.  p. (UNAIDS Best Practice Collection; UNAIDS/06.04E)Today, more than 20 years since the first cases of HIV infection were recognized, the epidemic continues to expand relentlessly. Despite early and ongoing efforts to contain its spread and to find a cure, 20 million people have died and an estimated 40.3 million people worldwide are living with HIV. In the latter half of 2004, the number of people on antiretroviral therapy in low-income and transitional countries increased dramatically, but still only about 12% of the 5.8 million people in developing and transitional countries who need treatment are getting treatment. The far-reaching social and economic consequences of the epidemic are having an impact on individuals, communities and the workplace. The UN, like many employers all over the world, is faced with major challenges related to the direct and indirect costs of the epidemic: increasing medical costs, absenteeism related to illness, high staff turnover, increasing recruitment and training costs, strained labour relations and the ever-increasing erosion of human capital. Many UN staff come from and/or work in countries with high HIV prevalence and perform duties that may put them at increased risk of exposure to the virus. The UN recognizes its duty as a socially responsible employer and has thus committed to protecting the rights of its staff by making HIV in the UN workplace a priority. (excerpt)
Developing World Bioethics. 2001 Nov; 1(2):121-134.Four key guidance points in the UNAIDS guidance document, Ethical Considerations in HIV Preventive Vaccine Research, are compared with analogous statements in three other recently issued documents dealing with international research. Those documents are: the Declaration of Helsinki, as revised in 2000; the report of the U.S. National Bioethics Advisory Commission, issued in 2001; and a current (2001) draft revision of the 1993 CIOMS International Ethical Guidelines for Biomedical Research Involving Human Subjects. The four guidance points compared with statements on similar issues in the other three documents are Guidance Point 2, which deals with making available a safe and effective vaccine after trials are completed; the second half of Guidance Point 4, which requires that the desired outcome should potentially benefit the population from which research participants are drawn; Guidance Point 11, which discusses what should be provided to a control group in a vaccine trial; and Guidance Point 16, which addresses the care and treatment to be provided for trial participants who become infected with HIV during the trial. The analysis and comparison concludes that the UNAIDS guidance points are at least as ethically sound as analogous points in these other documents, and for the most part are ethically superior in providing greater benefits to research participants and to others. Nevertheless, they are subject to the criticism that they are too `aspirational' and not sufficiently `pragmatic'. (author's)
Studies in Family Planning. 2005 Dec; 36(4):311-315.Women in many countries are often denied vital family planning services if they are not menstruating when they present at clinics, for fear that they might be pregnant. A simple checklist based on criteria approved by the World Health Organization has been developed to help providers rule out pregnancy among such clients, but its use is not yet widespread. Researchers in Guatemala, Mali, and Senegal conducted operations research to determine whether a simple, replicable introduction of this checklist improved access to contraceptive services by reducing the proportion of clients denied services. From 2001 to 2003, sociodemographic and service data were collected from 4,823 women from 16 clinics in three countries. In each clinic, data were collected prior to introduction of the checklist and again three to six weeks after the intervention. Among new family planning clients, denial of the desired method due to menstrual status decreased significantly from 16 percent to 2 percent in Guatemala and from 11 percent to 6 percent in Senegal. Multivariate analyses and bivariate analyses of changes within subgroups of nonmenstruating clients confirmed and reinforced these statistically significant findings. In Mali, denial rates were essentially unchanged, but they were low from the start. Where denial of services to nonmenstruating family planning clients was a problem, introduction of the pregnancy checklist significantly reduced denial rates. This simple, inexpensive job aid improves women's access to essential family planning services. (author's)
Ancient remedies, new disease: involving traditional healers in increasing access to AIDS care and prevention in East Africa. UNAIDS Case Study.
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2002 Jun.  p. (UNAIDS Best Practice Collection; UNAIDS Case Study; UNAIDS/02.16E; PN-ACP-802)In the 20 years that it has been with us, AIDS has continued its relentless spread across continents. By the end of 2000, the United Nations Joint Programme on HIV/AIDS (UNAIDS) reported that 36.1 million men, women and children were living with HIV around the world and 21.8 million had died. Though AIDS is now found in every country, it has most seriously affected sub-Saharan Africa—home to 70% of all adults and 80% of all children living with HIV, and the continent with the fewest medical resources in the world. AIDS is now the primary cause of death in Africa and it has had a devastating impact on villages, communities and families on the continent. In many African countries, the numbers of new infections are increasing at a rate that threatens to destroy the social fabric. Life expectancies are decreasing rapidly in many of these countries as a result of AIDS-related illnesses and socioeconomic hardships. And of the 13.2 million children orphaned by HIV/AIDS worldwide, 12.1 million are in Africa. In the past, AIDS-control activities relied on giving information about HIV transmission, and imparting practical skills to enable individuals to reduce their risk of HIV infection and care for themselves if infected. There is a growing awareness, however, that sociocultural factors surrounding the individual need to be considered in designing both prevention and care interventions. As the epidemic continues to ravage the low- and middle-income world, it becomes increasingly evident that diverse strategies to confront the wide-ranging and complex social, cultural, environmental and economic contexts in which HIV continues to spread must be researched, tested, evaluated, adapted and adopted. (excerpt)