Your search found 51 Results

  1. 1

    WHO recommendations on antenatal care for a positive pregnancy experience.

    World Health Organization [WHO]. Department of Reproductive Health and Research; World Health Organization [WHO]. Department of Nutrition for Health and Development; World Health Organization [WHO]. Department of Maternal, Newborn, Child and Adolescent Health

    Geneva, Switzerland, WHO, 2016. 172 p.

    The World Health Organization has released a new set of antenatal care (ANC) recommendations to improve maternal and perinatal health worldwide. The guidelines seek to reduce the global burden of stillbirths, reduce pregnancy complications and provide all women and adolescents with a positive pregnancy experience. High quality health care during pregnancy and childbirth can prevent deaths from pregnancy complications, perinatal deaths and stillbirths, yet globally, less than two-thirds of women receive antenatal care at least four times throughout their pregnancy. The new ANC model raises the recommended number of ANC visits from four to eight, thereby increasing the number of opportunities providers have to detect and address preventable complications related to pregnancy and childbirth. The guidelines provide 49 recommendations for routine and context-specific ANC visits, including nutritional interventions, maternal / fetal assessments, preventive measures, interventions for common physiological symptoms and health system interventions. Given that women around the world experience maternal care in a wide range of settings, the recommendations also outline several context-specific service delivery options, including midwife-led care, group care and community-based interventions.
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  2. 2
    Peer Reviewed

    Stakeholders' opinions and expectations of the Global Fund and their potential economic implications.

    Galarraga O; Bertozzi SM

    AIDS. 2008 Jul; 22 Suppl 1:S7-S15.

    OBJECTIVES: To analyse stakeholder opinions and expectations of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and to discuss their potential economic and financial implications. DESIGN: The Global Fund commissioned an independent study, the '360 degrees Stakeholder Survey', to canvas feedback on the organization's reputation and performance with an on-line survey of 909 respondents representing major stakeholders worldwide. We created a proxy for expectations based on categorical responses for specific Global Fund attributes' importance to the stakeholders and current perceived performance. METHODS: Using multivariate regression, we analysed 23 unfulfilled expectations related to: resource mobilization; impact measurement; harmonization and inclusion; effectiveness of the Global Fund partner environment; and portfolio characteristics. The independent variables are personal and regional-level characteristics that affect expectations. RESULTS: The largest unfulfilled expectations relate to: mobilization of private sector resources; efficiency in disbursing funds; and assurance that people affected by the three diseases are reached. Stakeholders involved with the fund through the country coordinating mechanisms, those working in multilateral organizations and persons living with HIV are more likely to have unfulfilled expectations. In contrast, higher levels of involvement with the fund correlate with fulfilled expectations. Stakeholders living in sub-Saharan Africa were less likely to have their expectations met. CONCLUSIONS: Stakeholders' unfulfilled expectations result largely from factors external to them, but also from factors over which they have influence. In particular, attributes related to partnership score poorly even though stakeholders have influence in that area. Joint efforts to address perceived performance gaps may improve future performance and positively influence investment levels and economic viability.
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  3. 3

    Eradication of female genital mutilation in Somalia.


    [New York, New York], UNICEF, [2006]. [9] p.

    Female Genital Mutilation (FGM) is defined as procedures involving partial or total removal of female genitals or other injury to female genital organs. In Somalia, FGM prevalence is about 95 percent and is primarily performed on girls aged 4-11. FGM can have severely adverse effects on the physical, mental, and psycholsocial well being of those who undergo the practice. The health consequences of FGM are both immediate and life-long. Despite the many internationally recognized laws against FGM, lack of validation is Islam and global advocacy to eradicate the practice, it remains embedded in Somali culture. (excerpt)
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  4. 4

    Securing equality, engendering peace: a guide to policy and planning on women, peace and security (UN SCR 1325).

    Valasek K; Nelson K

    Santo Domingo, Dominican Republic, United Nations International Research and Training Institute for the Advancement of Women [INSTRAW], 2006. [77] p.

    What must be done in order to transform written words into reality? One of today's greatest development challenges is turning policy into practice. This is especially the case in the realm of women's rights and gender equality, where the commitments made at the international and national levels remain far from the day-to-day realities of women's lives. This guide examines one of the crucial steps on the path towards the full implementation of existing laws, namely the formation and implementation of concrete policies and plans. More specifically, this guide concentrates on the creation of action plans on the issue of women, peace and security (WPS). The purpose of this guide is to help facilitate the development of realistic action plans on women, peace and security through the provision of good practices, specific recommendations and a six-step model process. The guide is designed as a resource for governments, United Nations and regional organisations as well as non-governmental organisations (NGOs) who are interested in developing plans and policies on women, peace and security issues. (excerpt)
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  5. 5

    Supportive and palliative care for people living with HIV / AIDS.

    Schietinger H

    CommonHealth. 2005 Spring; 36-43.

    As defined by the World Health Organization (WHO):2 Palliative medicine is the study and management of patients with active, progressive, far advanced disease for whom the prognosis is limited and the focus of care is the quality of life. [It is] the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social, and spiritual problems, is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Many aspects of palliative care are applicable earlier in the course of the illness, in conjunction with treatment. Palliative care: Affirms life and regards dying as a normal process; Neither hastens, nor postpones, death; Provides relief from pain and other distressing symptoms; Integrates the psychological and spiritual aspects of patient care; Offers a support system to help patients live as actively as possible until death; and Offers a support system to help families cope during a patient's illness and with their own bereavement. In short, palliative care comprehensively addresses the physical, emotional, and spiritual impact a life-threatening illness has on a person, no matter the stage of the illness. It places the sick person and his/her family, however defined, at the center of care and aggressively addresses all of the symptoms and problems experienced by them. Many healthcare providers apply certain elements of the palliative care treatment approach-- such as comprehensive care and aggressive symptom management-- to the care of all of their patients, not only those who are terminally ill, offering the type of care we would all like to receive when we are sick. (excerpt)
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  6. 6

    AIDS: palliative care. UNAIDS technical update.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2000 Oct. 16 p. (UNAIDS Best Practice Collection; UNAIDS Technical Update)

    Palliative care aims to achieve the best quality of life for patients (and their families) suffering from life-threatening and incurable illness, including HIV/AIDS. Crucial elements are the relief of all pain- physical, psychological, spiritual and social and enabling and supporting caregivers to work through their own emotions and grief. Palliative care has relieved the intense, broad suffering of people living with HIV/AIDS but the latter brings a number of challenges to its philosophy and practice including: The complex disease process with its unpredictable course and wide range of complications, which means that palliative care has to balance acute treatment with the control of chronic symptoms; Complex treatments which can overstretch health services; The stigmatization and discrimination faced by most people living with HIV/AIDS; Complex family issues, such as infection of both partners; Role reversal in families, such as young children looking after their parents; Burdens on health care workers. (excerpt)
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  7. 7

    WHO Report: intimate partner violence most common form of abuse against women worldwide.

    Connections. 2006 Feb; [2] p.

    When most people think of the women they care about--their mothers, wives, sisters, or friends--they don't generally associate them with violence. The sad reality for an estimated one out of every six women worldwide, however, is that they will suffer physical or sexual abuse at the hands of an intimate partner at least once in their lifetime. According to a recent report issued by the World Health Organization (WHO), the number of women who have been victims of domestic violence ranges from 29 to 62 percent in most nations, developed and developing alike. This staggering statistic is a sad testament to the widespread and undiscriminating nature of intimate partner violence the world over. Some 24,000 women from both rural and urban areas in 10 countries--Bangladesh, Brazil, Ethiopia, Japan, Namibia, Samoa, Serbia and Montenegro, Tanzania, and Thailand--were interviewed for this global survey, which was conducted in collaboration with the London School of Hygiene and Tropical Medicine, PATH, and national research institutions in the participating countries. According to the resulting report-- WHO Multi-country Study on Women's Health and Domestic Violence Against Women--evidence of physical or sexual violence ranging from 15 percent of women in Japan to 71 percent in rural Ethiopia exists in each of these nations. (excerpt)
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  8. 8

    [Breastfeeding and growth] Allaitement et croissance.

    Lkhider M

    Psychologie de l'Éducation. 2000; (3):163-169.

    This article sheds light on the role of breastfeeding in child development and on the psychological aspects of breastfeeding. Indeed, in addition to bringing to infants the nutrients necessary for their growth, and some elements necessary to the maturity and to the integrity maintenance of several physiologic systems, breastfeeding also brings them affection and love. For the newborn, the first contact with the world is through its mother's skin, and assuming the leading role in this primary function, the breast is associated with the first gestures of love. Between the mother and the child, a double relation takes place: the first is the feeding properly speaking, and the other consists of the ensemble of little gestures of care that accompany breastfeeding. Indeed, the infant feels the need to communicate with its mother and to exchange affection with her; the affection is communicated through the breast and the bottle cannot communicate affection. The changes experienced by the pregnant woman's body include preparation for milk production. This milk is rich in sugars, proteins, lipids, vitamins and minerals. For a proper growth of the newborn, the mother must mobilize her own reserves in order to let them pass into the milk. In line with these ideas, the author of this article mentions several studies that have been conducted on maternal milk versus artificial milk with the intention of encouraging mothers to diversify their diet and sensitizing the pharmaceutical industry to the importance and the quality of the relation to the growth of infants. International health organizations have developed several study programs in various countries in order to draw up an inventory of the problems and to establish recommendations on the benefits. From a medical standpoint it is clear and obvious that breastfed children are less likely to contract infectious and digestive diseases in comparison to those fed with artificial milk. This fact is explained by the bacteriological purity of maternal milk. In addition it contains antibodies, immune cells, and bacteriostatic molecules inhibiting bacterial proliferation, while bottles prepared even with the greatest care are not able to prevent some infections. Consequently, WHO and UNICEF recommend breastfeeding children until they are at least two years old, given that the immune system does not reach full maturity before age five. And, in fact, the Koran recommended the same thing, long before them.
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  9. 9
    Peer Reviewed

    Initial steps to developing the World Health Organization's Quality of Life Instrument (WHOQOL) module for international assessment in HIV / AIDS. WHOQOL HIV Group.

    World Health Organization [WHO]. WHOQOL HIV Group

    AIDS Care. 2003 Jun; 15(3):347-357.

    This paper reports on the three initial steps taken to develop the World Health Organization’s Quality of Life instrument (WHOQOL) module for assessment of persons living with HIV/AIDS (PLWHA). First, a consultation of international experts was convened to review the suitability of the generic WHOQOL-100 for assessment of PLWHA. The experts proposed additional facets that are specific to the lives of PLWHA. Second, 42 focus groups (N=235) were conducted by six culturally diverse centres comprising of PLWHA, informal carers and health professionals to (1) review the adequacy of the WHOQOL for PLWHA, (2) review the additional facets proposed by the experts, and (3) write additional facets and items for a pilot instrument. Third, results of steps 1 and 2 were consolidated, and a total of 115 items, covering 25 new facets and sub-facets for assessment of QoL specific to PLWHA, were prepared for pilot testing. The new facets included symptoms of HIV, body image, sexual activities, work, social inclusion, disclosure, death and dying, and forgiveness. The implications of cross-cultural QoL assessment for PLWHA are discussed. (author's)
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  10. 10

    Public health and the Persian Gulf War.

    Hoskins E

    In: War and public health, edited by Barry S. Levy, Victor W. Sidel. Washington, D.C., American Public Health Association [APHA], 2000. 254-278.

    War has always been disastrous for civilians, and the Persian Gulf War was no exception. Yet the image that has been perpetuated in the West is that the Gulf War was somehow "clean" and fought with "surgical precision" in a manner that minimized civilian casualties. However, massive wartime damage to Iraq's civilian infrastructure led to a breakdown in virtually all sectors of society. Economic sanctions further paralyzed Iraq's economy and made any meaningful post-war reconstruction all but impossible. Furthermore, the invasion of Kuwait and the subsequent Gulf War unleashed internal political events that have been responsible for further suffering and countless human fights violations. The human impact of these events is incalculable. In 1996, more than five years after the end of the war, the vast majority of Iraqi civilians still subsist in a state of extreme hardship, in which health care, nutrition, education, water, sanitation, and other basic services are minimal. As many as 500,000 children are believed to have died since the beginning of the Persian Gulf War, largely due to malnutrition and a resurgence of diarrheal and vaccine- preventable diseases. Health services are barely functioning due to shortages of supplies and equipment. Medicines, including insulin, antibiotics, and anesthetics, are in short supply. The psychological impact of the war has had a damaging and lasting effect on many of Iraq's estimated eight million children. (excerpt)
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  11. 11

    Trauma and resilience during war: a look at the children and humanitarian aid workers of Bosnia.

    Berk JH

    Psychoanalytic Review. 1998 Aug; 85(4):639-658.

    This article will explore some of the issues of resilience in the child population of Bosnia during the recent war there. It will also look at similar issues in the humanitarian aid workers who came from outside the country as representatives of relief agencies. I, myself, worked for UNICEF, and it was my job to train members of the local population to work with Bosnian children in an attempt to increase their resilience under intense wartime stress and to reduce the traumatic impact to those children already harmed. (author's)
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  12. 12

    Report of Workshop on Personality Enhancement and Self Awareness for Grass-Root Level Workers (16th, 17th and 18th July, 1992).

    Project SMITA Society

    [Unpublished] 1992. [2], 16 p.

    The Safe Motherhood Immunization and Timely Action (SMITA) Society is a nongovernmental organization (NGO) working in effective communication for sustained behavioral and attitudinal change for social welfare and development programs. The project Communication Support to Programs for Urban Poor supported by UNICEF/UBS entailed collaborating with other NGOs for developing communication strategies applicable to urban slums in support of integrated community development programs. Projects SMITA has helped strengthen the communication skills of grass root level workers (GRLWs) of the 19 NGOs whose program for integrated community development was supported by UNICEF/UBS. During the interaction with GRLWs the need to enhance their confidence and motivation was perceived in order to make them effective communicators. Basti workers also needed to understand themselves and other people, their personality, and the value system. Project SMITA as well as the NGO training center deemed it important to organize a workshop on personality enhancement and self awareness. GRLWs of 18 NGOs working in urban slum areas of Delhi for integrated community development under assistance from UNICEF/UBS participated in the workshop. The objectives of the workshop, held on 3 days in July 1992, were: a) to motivate and enhance the general confidence levels of the Basti workers; b) to help workers become aware of their attitudes towards themselves and towards others, c) to provide the workers with skills necessary for management of conflicts. The areas of focus were: a) understanding others and interpersonal relations; b) achievement motivation; c) self awareness for personal growth; d) feeling and behavior; e) team building; f) resolving conflicts and problem-solving skills; and g) self-disclosure and trust building. Feedback from the participants indicated that the workshop was successful, and regular sessions were suggested by some participants.
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  13. 13

    Measuring reproductive morbidity. Report of a Technical Working Group, Geneva, 30 August - 1 September 1989.

    World Health Organization [WHO]. Division of Family Health

    [Unpublished] 1990. 41 p. (WHO/MCH/90.4; Safe Motherhood; UNFPA Project No. INT/88/P14)

    Reproduction morbidity is defined as any morbidity or dysfunction of the reproductive tract. Obstetric morbidity is related to pregnancy. Direct obstetric morbidity results from obstetric complications of pregnancy, such as ante- or postpartum hemorrhage, eclampsia, or sepsis. Indirect obstetric morbidity results from preexisting diseases, such as malaria, hepatitis, and tuberculosis. Psychological obstetric morbidity includes puerperal psychoses, or fear of pregnancy and childbirth. Direct gynecological morbidity includes reproductive cancers and bacterial or viral sexually transmitted diseases (STDs). Indirect gynecological morbidity includes traditional practices, such as circumcision. Psychological morbidity is associated with STDs, infertility, and dyspareunia. Contraceptive morbidity involves efforts that limit fertility. Some aspects of reproductive morbidity have been covered extensively (e.g., STDs), while studies of uterine prolapse, fistulas, urinary/fecal incontinence, and secondary infertility are few. In a study in India 92% of women had a gynecological problem upon examination, but only 55% reported it. Language is a major impediment to communication because of euphemisms used to describe an ailment. Morbidities tend to be underreported. In a sample of Egyptian women asked about specific problems, backache (47%), abdominal pain (42%), discharge (41%), prolapse (30%), and urinary tract infections (24%) were most common. Hospital studies are used most often to research maternal morbidity followed by community studies, cross-sectional surveys, and case-control studies with proper sample size. The validity of self-reported data greatly depend on the interviewer, but recall bias also has to be considered. It is recommended that WHO sponsor research into reproductive morbidity, develop standardized questionnaires, study a community-based health project, develop a series of "case histories," and plan a meeting during 1990-91.
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  14. 14

    Health effects of female circumcision.

    Institute for Development Training

    Chapel Hill, North Carolina, Institute for Development Training, 1986. 42, [3] p. (Training Course in Women's Health Module 5)

    Female circumcision encompasses a variety of surgical procedures performed on female children in Africa and the Middle East. Although female circumcision is a traditional practice, it is also a health issue because of its severe physical and psychological consequences. This women's health module seeks to provide health practitioners with information on recognizing the immediate and longterm consequences of female circumcision and to suggest ways of counteracting this practice. The module includes a pre-test and post-test and chapters on the following topics: types of female circumcision operations, immediate health effects of the practice, longterm consequences for general health, the effects of excision and infibulation on marriage and childbirth, health consequences of re-infibulation, and health education strategies. The module is self-instructional, allowing the student to learn at his or her own pace. An appended statement by the World Health Organization (WHO) states that WHO has consistently and unequivocally advised that female circumcision should not be practiced by any health professionals in any setting.
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  15. 15

    Research on the menopause.

    World Health Organization. Scientific Group

    World Health Organization Technical Report Series. 1981; (670):1-120.

    This report includes the collective views of a World Health Organization (WHO) Scientific Group on Research on the Menopause that met in Geneva during December 1980. It includes information on the following: 1) the endocrinology of the menopause and the postmenopausal period (changes in gonadotropins and estrogens immediately prior to the menopause and changes in gonadotropin and steroid hormone levels after the menopause); 2) the age distribution of the menopause (determining the age at menopause, factors influencing the age at menopause, and the range of ages at menopause and the definition of premature and delayed menopause); 3) sociocultural significance of the menopause in different settings; 4) symptoms associated with the menopause (vasomotor symptoms, psychological symptoms, disturbances of sexuality, and insomnia); 5) disorders resulting from, or possibly accelerated by, the menopause (osteoporosis, atherosclerotic cardiovascular disease, and arthritic disorders); 6) risks, with particular reference to neoplasia, of therapeutic estrogens and progestins given to peri- and postmenopausal women (endometrial cancer, breast cancer, and gallbladder disease); 7) fertility regulating methods for women approaching the menopause (fertility and the need for family planning in women approaching the menopause, problems of family planning in perimenopausal women, and considerations with regard to individual methods of family planning in women approaching the menopause); and 8) estrogen and the health care management of perimenopausal and postmenopausal women. At this time some controversy exists as to whether there is a menopausal syndrome of somatic and psychological symptoms and illness. There are virtually no data on the age distribution of the menopause and no information on its sociocultural significance in the developing countries. The subject of risks and benefits of estrogen therapy in peri- and postmenopausal women is of much importance in view of the large number of prescriptions issued for this medication in developed countries, which indicates their frequrnt use, and the different interpretations and opinions among epidemiologists and clinicians on both past and current studies on this subject. Specific recommendations made by the Scientific Group appear at the end of each section of the report. The following were among the general recommendations made: WHO sponsored research should be undertaken to determine the impact on health service needs of the rapidly increasing numbers of postmenopausal women in developing countries; uniform terminology should be adopted by health care workers with regard to the menopause; uniform endocrine standards should be developed which can be applied to the description of peri- and postmenopausal conditions and diseases; and descriptive epidemiological studies of the age at menopause should be performed in a variety of settings.
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  16. 16

    Organization of mental health services in developing countries.

    World Health Organization [WHO]. Expert Committee on Mental Health

    Geneva, WHO, 1975. (WHO Technical Report Series No. 564) 41 p.

    Studies indicate that seriously debilitating mental illness is likely to affect at least 1% of any population at any one time and at least 10% at some time in their life. Since about half the population in many developing countries is under age 15 there is a high quantity of child and adolescent disorders. The prevalence of organic brain damage will diminish with the introduction of public health services, but the same measures are liable to increase the number of surviving children with brain damage. The World Health Organization recommends the pooling of mental health experts to aid the developing countries lacking personnel and resources to cope with mental disorders. Pilot programs in mental care are also recommended to create awareness in communities that mental illness exists and can be treated.
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  17. 17

    Neuroendocrinology and reproduction in the human.

    World Health Organization [WHO]. Scientific Group

    Geneva, Switzerland, WHO, 1965. 19 p. (WHO Technical Report Series No. 304)

    This WHO technical report focuses on the 1) psychosomatic factors in human reproduction; 2) hypothalamo-hypophyseal system; 3) mechanism of sexual rhythm; 4) nervous influences on the hypothalamus; 5) hormonal influences on the hypothalamus; 6) neuroendocrine aspects of sexual behavior; and 7) effects of drugs on reproduction. After summarizing current research status on the above-mentioned topics, the following research needs are suggested: 1) assays of individual human endogenous gonadotropins, suitable for clinical application; 2) autoradiography, fluorescent-antibody, spectrophometric interference and histochemical and biochemical techniques for studying cells that supply axons to the primary capillary plexus of the hypophyseal portal system and for studying effects of different hormonal status on hypothalmic structure and function; 3) computer techniques for evaluating electrophysiological data; 4) improved lesioning techniques; 5) comparative studies of reproductive activity patterns, exteroceptive factors, neuroendocrine factors in sexual and related social behavior, and long-term or delayed effects of drugs administered during gestation on subsequent sexual development; 6) studies of synaptic connections of hypothalamic neurones; 7) studies of endogenous gonadal and gonadotropin production in prepuberal animals; 8) functional significance of regional distribution of hypophyseal portal system; 9) mechanisms involved in selective uptake of labeled hormones; 10) hypothalamic lesions in species with spontaneous ovulation and active luteal function; 11) direct effect of gonadal hormones on single hypothalamic neurones studied with combination of microinjection and unit recording devices; 12) studies of the possibility of a direct feedback of gonadotropic hormones on the hypothalamus; 13) studies of the receptor mechanisms involved in neuroendocrine reflexes; 14) wider exploration of brain structures, with regard to feedback action of gonadal hormones; 15) studies of pineal function; 16) further investigation of a possible role of the peripheral autonomic pathways in reproductive processes; and 17) research on the application of tissue culture techniques for studying problems of the origin and metabolic effects of neurohormonal mediators and the biochemcial and morphological changes induced by sex hormones.
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  18. 18

    Health problems of adolescence.

    World Health Organization [WHO]. Expert Committee on the Health Problems of Adolescence

    Geneva, World Health Organization, 1965. (Technical Report Series No. 308,) 28 p.

    This is a report of a World Health Organization (WHO) Expert Committee on the Health Problems of Adolescence which met in Geneva from November 3-9, 1964. Adolescence is characterized by a series of biochemical, anatomical and mental changes that are unique to this group which encompasses the age range of about 10-20. This report deals with the primary importance of the family in the life of the adolescent, the influence of the society, and the influence of socioeconomic factors under 1 heading. Also discussed are anatomical, physiological, mental, and emotional aspects of growth and development (such as the development of conseptual thought, search for a sense of personal identity, acquisition of proper sexual attitudes and behavior, etc.). Health needs such as nutrition, physical and mental fitness, the relation of health with school and employment, and health problems such as veneral disease and menstrual disorders are also discussed. The WHO Expert Committee recommends that further attention be given to the mental problems and needs of youth, ways of effective contribution for the establishment and development of school health services be provided for, and time be devoted to the organizational problems of caring for the physically and mentally handicapped individuals.
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  19. 19

    Psychosexual aspects of natural family planning as revealed in the World Health Organization multicenter trial of the ovulation method and the New Zealand Continuation Study.

    France MM

    In: Natural family planning: current knowledge and new strategies for the 1990s. Proceedings of a conference, Part II, Georgetown University, Washington, DC, December 10-14, 1990, edited by John T. Queenan, Victoria H. Jennings, Jeffrey M. Spieler, Helena von Hertzen. Washington, D.C., Georgetown University, Institute for International Studies in Natural Family Planning, [1991]. 118-20.

    Successful natural family planning (NFP) use depends upon the day-to-day sexual decision making of users. Given the important role of psychosexual factors in this decision making, they are an important influence in both the effectiveness of natural methods as well as in their acceptability as a means of family planning. The World Health Organization (WHO) Multicenter Study of the ovulation method was conducted in Auckland, New Zealand; Bangalore, India; Dublin, Ireland; Manila, the Philippines; and San Miguel, El Salvador with the secondary objective of obtaining psychosexual information to identify factors leading to the successful use of NFP. Findings were reported in 1987. This paper reviews some of the WHO findings and compares them with some preliminary findings of the current study in New Zealand on continuation rates of NFP users following the symptothermal method with the goal of determining rates of continuation and reasons for acceptability. The WHO study found that the more satisfied people were with NFP and the less difficulty they reported with abstinence, the more likely they were to be successful users, as measured by their avoidance of pregnancy. The New Zealand Study, however, indicates that for many couples abstinence may not be the main difficulty in using NFP, and that long-term acceptance is not necessarily influenced by pregnancy. The authors notes that the two studies involved different NFP methods. The challenge for the future of NFP services is to learn more about what leads to acceptability in different countries and cultures, remembering that for a natural method of family planning, success depends very much upon the decisions, attitudes, and resulting behavior of the couple involved.
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  20. 20

    Evaluation of two new neuropsychological tests designed to minimize cultural bias in the assessment of HIV-1 seropositive persons: a WHO study.

    Maj M; D'Elia L; Satz P; Janssen R; Zaudig M; Uchiyama C; Starace F; Galderisi S; Chervinsky A


    In preparation for a World Health Organizations (WHO) study of human immunodeficiency virus-1-associated neurological and psychiatric disorders in a variety of geographic and sociocultural settings, 2 new tests of neuropsychological performance were evaluated. The goal was to identify instruments that are not only able to tap the primary functional domains affected in symptomatic HIV-1 cases but also suitable for cross-cultural use. The WHO/UCLA Auditory Verbal Learning Test (AVLT) presents subjects with a list of words with universal familiarity drawn from 5 categories (body parts, animals, tools, household objects, and vehicles), while Color Trails 1 and 2 is based on the use of numbered colored circles and universal sign language symbols. These instruments represent modifications of the previously utilized Rey AVLT and Trail Making A and B tests. Both the new instruments and the reference tests were administered to healthy or HIV-infected volunteers in 2 developed country settings (Germany and Italy) and 2 developing country sites (Thailand and Zaire). There was a significant correlation between scores on each new test and those on the reference tests, indicating that the new instruments tap the same functional domains. The variance of the z-transformed scores from test site to site was reduced for the WHO/UCLA AVLT compared to the Rey AVLT and for the Color Trails 2 compared to the Trail Making B, suggesting that the new tests are more culture-fair than their predecessors. Finally, the percentage of impaired subjects identified through the new tests was significantly higher among seropositive than seronegative subjects, indicating that these instruments are indeed sensitive to HIV-21 associated cognitive damage across different cultures.
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  21. 21

    Conflicts and child survival.

    Padmanabhan BS

    ICCW NEWS BULLETIN. 1992 Jul-Dec; 40(3-4):66-7.

    An overview is provided of the gravity of the problems of trauma from conflicts and effects on the health and survival of children and the relevance for India. Article 39 of the convention of the Rights of the Child adopted by the UN General Assembly is an agreement "to promote physical and psychological recovery and social reintegration of a child victim of any form of neglect, exploitation, abuse, inhuman treatment, or armed conflicts." The World Summit expanded the provision to include protecting women and children from the effects of war and to work toward preventing future conflicts. Safe corridors must be secured in order to protect children and families from surrounding war or violence. Concern for children was first indicated in the formation of UNICEF in the aftermath of World War II. Since that time, civilians, mostly women and children, have been the dominant population suffering from the effects of war. By 1991, 80% of the 20 million killed and the 80 million wounded were women and children involved in 150 conflicts. In the recent past, the Gulf War had a disastrous impact on children. Infant mortality increased from 39/1000 to 111/1000 and low birth weight rose from 5% to 12%. Child mortality of these under 5 years increased from 48/1000 to 143/1000. Another impact of armed conflicts on children is psychological trauma and detachment from emotional ties and enjoyment, and sleeplessness. Other symptoms are described. Recent action to counteract children's trauma has been taken in Kuwait, Mozambique, and Sri Lanka. Community-based programs help to identify needy children through parent and teacher education and to offer counseling. Several manuals are available on how to help children affected by war. One strategy is the establishment of a trauma center. In the Philippines, programs have been developed to involve children in therapy through drama, painting, and dance. India has experienced severe rioting, which has left many women and children orphaned. Programs need to be developed to deal with the effects on women and children.
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  22. 22
    Peer Reviewed

    Epidemiological experience in the mission of the United Nations Transition Assistance Group (UNTAG) in Namibia.

    Steffen R; Desaules M; Nagel J; Vuillet F; Schubarth P; Jeanmaire CH; Huber A


    Medical reports modelled after the US Peace Corps surveillance form provided mortality and morbidity data of the United Nations Transition Assistance Group in Namibia in 1989-1990. Contingents included Australians, Canadians, Danes, Finns, Kenyans, Malays, Poles, Spaniards, and Britons. Traffic accidents, mostly those on long distance journeys caused 14 of 16 deaths. The fatality ratio was 0.21/million km driven which was considerably higher than that in Switzerland 0.02/million km driven. Even though heavy traffic was not a problem in Namibia, limited experience on unpaved roads; high speeds induced by long and tedious driving; and reduced visibility caused by climactic conditions, fatigue, and alcohol contributed to high fatality. The hospitalization rate of 5.2% (369 patients) was rather high for a young and healthy population. The leading reasons for hospitalization included fever of unknown origin, trauma, and respiratory tract infections. Swiss Medical Unit physicians transferred 25 patients to the State Hospital in Windhoek, most for orthopedic surgery. Injuries, psychiatric problems, and alcoholism resulted in repatriation for 66% of 46 repatriated patients. New consultations for treatment averaged 2.7/person and those for preventive measures averaged 0.8/person. Helicopter pilots was the largest group returning for 2nd visits (56% compared to 1% for logistics staff). The major reasons for attending outpatient clinics included immunizations (18.8%), dental problems (10.5%), and respiratory infections (10.5%). In addition to respiratory infections, other frequent communicable diseases included diarrhea or dysentery, dermatological infections, sexually transmitted diseases, and confirmed or suspected malaria. Preventive measures are needed to reduce mortality due to traffic accidents and the prevalence of psychological and dental problems.
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  23. 23

    The struggle to meet great needs. Interview: Mrs. Sadako Ogata.

    Hamand J

    PEOPLE. 1991; 18(4):10-2.

    The head of the United Nations High Commission for Refugees, Sadako Ogata, anticipates continued growth in the numbers of migrants and refugees in the 21st century, in part as a result of the collapse of the political and economic systems in developing countries and Eastern Europe. Development assistance that provides jobs, alleviates poverty, and seeks to maintain family structures in developing countries is necessary for both urban and rural areas, and nongovernmental organizations are being urged to prioritize education, training, and primary health care activities. Of particular concern are the special needs of refugees and migrants who are women and children. Children are most susceptible to the diseases, especially diarrhea and subsequent dehydration, that are prevalent in refugee camps. Needing further attention is the psychological trauma to refugee children created by dislocation and exposure to war. Maternal-child health care, including family planning, is another area in need of greater emphasis. Although women head most families in refugee camps, camp management tends to be male-dominated and the special needs of women and children are not receiving sufficient attention. Activities that go beyond basic sustainment of life will have beneficial effects in the longterm as well, as refugees are repatriated and reintegrated into the community.
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  24. 24

    Association for Voluntary Sterilization - Consultant Team. Trip report: the People's Republic of China, Beijing, Chongqing, Wuhan, Guangzhou, June 19-30, 1985.

    Huber D; Fathalla M; Gojaseni P; Goldstein M; Lippes J; Minor K; Rauff M; Sciarra J; Rauff A

    [Unpublished] 1985. 41, [6] p.

    The Association for Voluntary Sterilization consultant team visited Beijing, Chongqing, Wuhan and Guangzhou, China in June 1985, to review innovative nonsurgical methods of male and female sterilization. There are 2 variations on vasectomy, performed with special clamps that obviate a surgical incision. The 1st is a circular clamp for grasping the vas through the skin, and the 2nd is a small, curved, sharp hemostat for puncturing the skin and the vas sheath, used for ligation. Vas occlusion with 0.02 ml of a solution of phenol and cyanoacrylate has been performed on 500,000 men since 1972. The procedure is done under local anesthesia, and is controlled by injecting red and blue dye on contralateral sides. If urine is not brown, vasectomy by ligature is performed. The wound is closed with gauze only. Semen analysis is not done, but patients are advised to use contraception for the 1st 10 ejaculations. Pregnancy rates after vasectomy by percutaneous injection were reported as 0 in 5 groups of several hundred men each, 11.4% in 1 group and 2.4% in another group. The total complication rate after vasectomy by clamping was 1.8% in 121,000 men. 422 medical school graduates with surgical training have been certified in this vasectomy method. Chinese men are pleased with this method because it avoids surgery by knife, and asepsis, anesthesia and counseling are excellent. Female sterilization by blind transcervical delivery of a phenol-quinacrine mixture has been done on 200,000 women since 1970 by research teams in Guangzhou and Shanghai. A metal cannula is inserted into the tubal opening, tested for position by an injection of saline, and 0.1-0.12 ml of sclerosing solution is instilled. Correct placement is verified by x-ray, an IUD is inserted, and after 3 months a repeat hysteroscopy is done to test uterine pressure. Pregnancy rates have been 1-2.5%, generally in the 1st 2 years. Although this technique is tedious, requiring great skill and patient cooperation, it can be mastered by paramedicals. The WHO is assisting the Chinese on setting up large studies on safety and effectiveness, as well as toxicology studies needed, to export the methods to other countries.
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  25. 25

    Sexuality and family planning: report of a consultation and research findings.

    Langfeldt T; Porter M

    Copenhagen, Denmark, World Health Organization, Regional Office for Europe, 1986. 62 p.

    A Consultation on Sexuality was convened by the Regional Office for Europe of the World Health Organization (WHO) in Copenhagen in November 1983 to examine the sexual dimensions of health problems. Sexuality influences thoughts, feelings, actions, and interactions and thus physical and mental health. Since health is a fundamental human right, so must sexual health also be a basic human right. 3 basic elements of sexual health were identified: 1) a capacity to enjoy and control sexual and reproductive behavior in accordance with social and personal ethics; 2) freedom from fear, shame, guilt, false beliefs, and other psychological factors inhibiting sexual response and impairing sexual relationships; and 3) freedom from organic disorders, diseases, and deficiencies that interfere with sexual and reproductive functions. The purpose of sexual health care should be the enhancement of life and personal relationships, not only counseling or care related to procreation and sexually transmitted diseases. Barriers to sexual health include myths and taboos, sexual stereotypes, and changing social conditions. In addition, sexuality is repressed among groups such as the mentally handicapped, the physically disabled, the elderly, and those in institutions whose sexual needs are not acknowledged. Homosexuals are often stigmatized because their sexual expression is at variance with dominant cultural values. Sex education programs and health workers must broaden their traditional approach to sexual health so they can help people to plan and achieve their own goals. Family planning programs must expand from their traditional goal of avoiding unwanted births and help people balance the need for rational planning on the one hand and the satisfaction of irrational sexual desires on the other hand. Promoting sexual health is an integral part of the promotion of health for all.
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