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Towards universal access: scaling up priority HIV / AIDS interventions in the health sector. Progress report, April 2007.
Geneva, Switzerland, WHO, 2007 Apr. 88 p.Drawing on lessons from the scale-up of HIV interventions over the last few years, WHO, as the UNAIDS cosponsor responsible for the health sector response to HIV/AIDS, has established priorities for its technical work and support to countries on the basis of the following five Strategic Directions, each of which represents a critical area where the health sector must invest if significant progress is to be made towards achieving universal access. Enabling people to know their HIV status; Maximizing the health sector's contribution to HIV prevention; Accelerating the scale-up of HIV/AIDS treatment and care; Strengthening and expanding health systems; Investing in strategic information to guide a more effective response. In this context, WHO undertook at the World Health Assembly in May 2006 to monitor and evaluate the global health sector response in scaling up towards universal access and to produce annual reports. This first report addresses progress in scaling up the following health sector interventions. Antiretroviral therapy; Prevention of mother-to-child transmission of HIV (PMTCT); HIV testing and counseling; Interventions for injecting drug users (IDUs); Control of sexually transmitted infections (STIs) to prevent HIV transmission; Surveillance of the HIV/AIDS epidemic. (excerpt)
London, England, International Community of Women Living with HIV / AIDS, 2006.  p.WHO supported ICW to map positive women's experiences of access to care and treatment in three countries - Namibia, Kenya and Tanzania. The findings will contribute to advocacy for increased political support and resources to address gendered barriers to care, treatment and support. The project complements a mapping and database of civil society organizations (CSOs) providing treatment by the French consortium - SIDACTION. This mapping presents results from three focus group discussions with HIV positive women conducted in two districts of Tanzania - Arusha and Moshi (2006). Women who participated in these focus group discussions were aged between 30 to 45. Most of them came from villages Munduli (Arusha) and Seliani (Moshi). Three focus groups were also conducted with men only in Arusha. A mixed-sex focus group was conducted in Chalinze in the Bagamoyo district (Dar es Salaam coastal area) with men and women aged between 35 and 42. There were between 12 - 15 participants in each group in Arusha and Mosh. However, in Chalinze there were only 8 people. Results from the mixed sex and men only focus groups are presented here but the main emphasis is on the results from the women only focus groups. Medical personnel were also interviewed and their experiences are included. (excerpt)
Geneva, Switzerland, WHO, 2003.  p.The changing face of the HIV/AIDS epidemic has resulted in new opportunities, as well as new imperatives, to increase access to HIV testing and counselling and to knowledge of HIV status. Increased access to care and treatment, and decreased stigma and discrimination in many settings present important new opportunities associated with taking an HIV test. The fact that more and more of those infected with HIV need care and treatment based on knowledge of HIV status indicates new imperatives. HIV testing and counselling services must keep pace with the new opportunities if the increasing benefits of knowing your HIV status are to be accessed (see Box One). New approaches to HIV testing and counselling must now be implemented in more settings, and on a much larger scale than has so far been the case. WHO is advocating that health-care workers should offer testing and counselling to all those who might benefit from knowing their HIV status, and then benefit from advances in the treatment and prevention of HIV infection and HIV related diseases. As such benefits increase, there is an onus on national governments to provide good-quality testing and counselling services. The time has now come to implement HIV testing and counselling more widely using existing health-care settings, moving beyond the model of provision that relies entirely upon concerned individuals seeking out help for themselves to permit broader access for all. In this new approach, such services will become a routine part of health care, for example during attendance at antenatal clinics, or at diagnosis and treatment centres for tuberculosis and sexually transmitted infections (STIs). (excerpt)
Prophylactic use of cotrimoxazole against opportunistic infections in HIV-positive patients: knowledge and practices of health care providers in Cote d'Ivoire.
AIDS Care. 2003 Oct; 15(5):629-637.We present here the results of a survey conducted in Côte d’Ivoire, Africa, among health care providers, on the knowledge of prophylactic use of cotrimoxazole to prevent opportunistic infections in HIV-infected persons. The survey was conducted in 15 health centres, involved or not in the ‘initiative of access to treatment for HIV infected people’. Between December 1999 and March 2000, 145 physicians and 297 other health care providers were interviewed. In the analysis, the health centres were divided into three groups: health centres implicated in the initiative of access to treatment for HIV-infected people with a great deal of caring for HIV-infected people, health centres implicated in this initiative but caring for few HIV-infected people, and health centres not specifically involved in the care of HIV-infected people. Six per cent of physicians and 50% of other health care providers had never heard of cotrimoxazole prophylaxis. The level of information about this prophylaxis is related to the level of HIV-related activities in the health centre. Among health care providers informed, knowledge on the exact terms of prescription of the cotrimoxazole is poor. In conclusion, it appears that the recommendations for primary cotrimoxazole prophylaxis of HIV-infected people did not reach the whole health care provider population. Most physicians are informed but not other health workers, even if the latter are often the only contact of the patient with the health centre. The only medical staff correctly informed are the physicians already strongly engaged in the care of HIV-infected people. (author's)
In: Missing links: gender equity in science and technology for development, [compiled by] United Nations. Commission on Science and Technology for Development. Gender Working Group. Ottawa, Canada, International Development Research Centre [IDRC], 1995. 1-25.This document is the first chapter in a book complied by the UN Gender Working Group (GWG) that explores the overlay of science and technology (S&T), sustainable human development, and gender issues. The introduction defines these three domains and notes that the mandate of the GWG was to make S&T policy recommendations to national governments, suggest improvements to the UN system, and advise other organizations. The next section presents the GWG's diagnosis of gender inequity in education and careers in S&T and the gender-specific nature of technical changes. Section 3 describes the following: 1) improving gender equity in S&T education, 2) removing obstacles to women in S&T careers, 3) making science responsive to the needs of society, 4) making the S&T decision-making process more "gender aware," 5) relating better with local knowledge systems, 6) addressing ethical issues in S&T, and 7) improving the collection of gender-disaggregated data for policy makers. Section 4 reviews the conclusions the GWG made about the performance of the UN system and sets forth eight recommendations drawn from these conclusions. The chapter recommends that 1) all countries adopt a Declaration of Intent on Gender, Science, and Technology for Sustainable Human Development and 2) each country establish an ad hoc committee constituted with equitable participation of women and men and with the involvement of end users and stakeholders that will be charged with making recommendations on the implementation of the Declaration. In addition, each country should publish progress reports and all donor countries and agencies should help these national ad hoc committees target financial support to projects that enable countries to implement the recommendations of their committees.
Implementing a counseling training program to enhance quality of care in family planning programs in Ecuador.
[Unpublished] 1989. Presented at the 117th Annual Meeting of the American Public Health Association [APHA], Chicago, Illinois, October 22-26, 1989. 9,  p.To address the need to improve and expand the level of counseling offered trough family planning programs in Latin America, the Asociacion Pro-Bienestar de la Familia Ecuatoriana (APROFE), an affiliate of the International Planned Parenthood Federation, provided counseling and interpersonal communication training to its 149 staff members in 1988- 89. Before the workshops were held, 724 clients at 6 APROFE clinics were surveyed to provide a baseline assessment of the quality of care from the client's point of view. The 2-day workshops focused on counseling skills, values clarification activities in the area of human sexuality, and the importance of informed choice to the quality of client care. A KAP test was administered to staff before and after the training. The client surveys indicated overall satisfaction with APROFE in the areas addressed--cost, hours, privacy, informed consent, and attitudes of personnel--but pinpointed areas for change, including a preference for specific appointment times, more information on sexually transmitted diseases and acquired immunodeficiency syndrome, and a failure of some staff to provide information on the entire range of contraceptive choices. The clinic's director of counseling has become involved in the selection and training of new staff members. Workshop participants have expressed a need for additional training about ways to counsel clients on matters related to human sexuality and to overcome the sociocultural barriers to such discussions.
Washington, D.C., World Bank, 1984. 36 p. (International Conference on Population, 1984; Statements)In his address to national leaders in Nairobi, Kenya, Clausen expresses his views on population growth and development. Rapid population growth slows development in the developing countries. There is a strong link between population growth rates and the rate of economic and social development. The World Bank is determined to support the struggle against poverty in developing countries. Population growth will mean lower living standards for hundreds of millions of people. Proposals for reducing population growth raise difficult questions about the proper domain of public policy. Clausen presents a historical overview of population growth in the past 2 decades, and discusses the problem of imbalance between natural resources and people, and the effect on the labor force. Rapid population growth creates urban economic and social problems that may be unmanageable. National policy is a means to combat overwhelmingly high fertility, since governments have a duty to society as a whole, both today's generation and future ones. Peoples may be having more children than they actually want because of lack of information or access to fertility control methods. Family planning is a health measure that can significantly reduce infant mortality. A combination of social development and family planning is needed to teduce fertility. Clausen briefly reviews the effect of economic and technological changes on population growth, focusing on how the Bank can support an effective combination of economic and social development with extending and improving family planning and health services. The World Bank offers its support to combat rapid population growth by helping improve understanding through its economic and sector work and through policy dialogue with member countries; by supporting developing strategies that naturally buiild demand for smaller families, especially by improving opportunities in education and income generation; and by helping supply safe, effective and affordable family planning and other basic health services focused on the poor in both urban and rural areas. In the next few years, the Bank intends at least to double its population and related health lending as part of a major effort involving donors and developing countries with a primay focus on Africa and Asia. An effective policy requires the participation of many ministeries and clear direction and support from the highest government levels.
[Unpublished] 1982. Paper prepared for Conference on Vasectomy, Colombo, Sri Lanka, Oct. 4-7, 1982. 21 p.Discusses the factors responsible for the decline of male acceptance of vasectomy over the past decade. The Association for Voluntary Sterilization (AVS) is a nonprofit organization working in the United States which helps funding of similar programs in other developed and developing countries. Reasons for the decline of vasectomy acceptance include the lack of attention paid to male sterilization in countries with family planning programs, the introduction of new technology for female sterilization, the introduction of new effective methods of contraception, and the exaggerated sexual role of the male and the need to protect his virility. The author reviews successful vasectomy programs and finds that, to be successful, a program should have strong leadership, a focussed design, clinic hours that would not interfere with patients' working schedules, and should pay attention to the needs of men, e.g., emphasizing that vasectomy does not cause impotency. The program should also have a community-based orientation, since all the services are not hospital-based and can be brought to the client's home, thereby emphasizing the minor nature of the surgery. AVS believes that vasectomy as a means of family planning can be effective. It is safe, inexpensive, simple, and deliverable. A special fund was allocated in 1983 to stimulate the development of several pilot and demonstration projects in a variety of countries.