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Guidance on ethical considerations in planning and reviewing research studies on sexual and reproductive health in adolescents.
Geneva, Switzerland, World Health Organization, 2018. 52 p.This document is intended to address commonly occurring situations and challenges that one faces in carrying out research with adolescents (people aged 10–19 years), the majority of whom are deemed not to have reached the recognized age of majority in their respective settings. To this end, adolescents aged 18 and 19 years are classified as adults in many settings and have the legal capacity to make autonomous decisions regarding their participation in research. In this document, the term “children” refers to people below the age of 18 years, and the term “minor adolescents” refers specifically to people aged 10-18 years.
From Research to Policy: the WHO with developing guidelines on the potential risk of HIV acquisition and progestogen-only contraception use.
Global Health: Science and Practice. 2017 Dec; 5(4):540-546.Add to my documents.
Ethical and safety recommendations for intervention research on violence against women. Building on lessons from the WHO publication, "Putting women first: ethical and safety recommendations for research on domestic violence against women".
Geneva, Switzerland, WHO, 2016. 43 p.As the evidence base on the magnitude, context and consequences of violence against women (VAW) has grown, research efforts and attention have begun to focus on decreasing the knowledge gap on effective responses through intervention research. Demonstrating this focus, in November 2012 the WHO Department of Reproductive Health and Research convened a group of experts to discuss health sector-based research to respond to violence against women. This global network of researchers, scientists and practitioners was brought together to enhance existing research efforts and to advocate for greater funding for research on interventions to address VAW and policies and programmes related to it. With the increased interest in and attention of the global community of researchers, practitioners and policy-makers regarding rigorous intervention research for preventing and responding to VAW, a discussion of the ethical considerations specific to this type of research is warranted. These recommendations have been developed to help answer questions specific to conducting research on health-based interventions to prevent and respond to VAW. Research on strategies that use health or health care as an entry point (regardless of the implementation setting, such as a clinic or community) is the focus. However, the discussion may be relevant to research on other kinds of VAW interventions.
Policy brief on the case for investing in research to increase access to and use of contraception among adolescents.
Seattle, Washington, PATH, 2015 Mar. 4 p.This document outlines why governments and donors should invest now in research to help determine and implement the most effective and efficient ways to enable adolescents to access and use contraception. It summarizes the findings of a longer technical report.
WHO Guidelines on preventing early pregancy and poor reproductive outcomes among adolescents in developing countries.
Journal of Adolescent Health. 2013 May; 52(5):517-522.Adolescent pregnancy and its consequences represent a major public health concern in many low- to middle-income countries of the world. The World Health Organization has recently developed evidence-based guidelines addressing six areas: preventing early marriage; preventing early pregnancy through sexuality education; increasing education opportunities and economic and social support programs; increasing the use of contraception; reducing coerced sex; preventing unsafe abortion; and increasing the use of prenatal care childbirth and postpartum care. In each of these areas, the World Health Organization recommends directions for future research. The summary concludes with a brief look at global and regional initiatives that provide a window of opportunity for stepping up action in this important area.
The special programme of research in human reproduction: forty years of activities to achieve reproductive health for all.
Gynecologic and Obstetric Investigation. 2012; 74(3):190-217.The Special Programme of Research in Human Reproduction (HRP), co-sponsored by the UNDP, UNFPA, WHO, and the World Bank, is celebrating 40 years of activities with an expansion of its mandate and new co-sponsors. When it began, in 1972, the main focus was on evaluating the acceptability, effectiveness, and safety of existing fertility-regulating methods, as well as developing new, improved modalities for family planning. In 1994, HRP not only made major contributions to the Plan of Action of the International Conference on Population and Development (ICPD); it also broadened its scope of work to include other aspects of health dealing with sexuality and reproduction, adding a specific perspective on gender issues and human rights. In 2002, HRP's mandate was once again broadened to include sexually transmitted infections and HIV/AIDS and in 2003 it was further expanded to research activities on preventing violence against women and its many dire health consequences. Today, the work of the Programme includes research on: the sexual and reproductive health of adolescents, women, and men; maternal and perinatal health; reproductive tract and sexually transmitted infections (including HIV/AIDS); family planning; infertility; unsafe abortion; sexual health; screening for cancer of the cervix in developing countries, and gender and reproductive rights. Additional activities by the Programme have included: fostering international cooperation in the field of human reproduction; the elaboration of WHO's first Global Reproductive Health Strategy; work leading to the inclusion of ICPD's goal 'reproductive health for all by 2015' into the Millennium Development Goal framework; the promotion of critical interagency statements on the public health, legal, and human rights implications of female genital mutilation and gender-biased sex selection. Finally, HRP has been involved in the creation of guidelines and tools, such as the 'Medical eligibility criteria for contraceptive use', the 'Global handbook for family planning providers', the 'Definition of core competencies in primary health care', and designing tools for operationalizing a human rights approach to sexual and reproductive health programmes. Copyright (c) 2012 S. Karger AG, Basel.
Geneva, Switzerland, WHO, 2012.  p.This document has three broad aims. First, it seeks to unify the worlds of research and decision-making and connect the various disciplines of research that generate knowledge to inform and strengthen health systems. Second, the strategy contributes to a broader understanding of this field by clarifying the scope and role of HPSR. It provides insight into the dynamic processes through which HPSR evidence is generated and used in decision-making. Finally, it is hoped that this strategy will serve as an agent for change and calls for a more prominent role for HPSR at a time when the health systems mandate is evolving towards broader goals of universal health coverage and equity. This strategy on health policy and systems research is intended to augment and amplify WHO’s previous affirmations on the importance of health research, by explaining how this evolving field is sensitive and responsive to the needs of those who are responsible for the planning and performance of national health systems -- decision-makers, health practitioners, citizens and civil society.
PLoS Medicine. 2011 Nov; 8(11):e1001115. .Based on extensive review of global evidence, the recommendations of the WHO Commission on Social Determinants of Health highlight the need for strengthening research on health equity with a focus on social determinants of health. To do so requires a paradigm shift that explicitly addresses social, political, and economic processes that influence population health; this shift is under way and complements existing research in medicine, the life sciences, and public health. Reflecting further synthesis and stakeholder consultations, an agenda for future research on health equity is outlined in four distinct yet interrelated areas: (1) global factors and processes that affect health equity; (2) structures and processes that differentially affect people’s chances to be healthy within a given society; (3) health system factors that affect health equity; and (4) policies and interventions to reduce health inequity. Influencing regional and national research priorities on equity and health and their implementation requires joint efforts towards creating a critical mass of researchers, expanding collaborations and networks, and refining norms and standards, with WHO having an important role given recent mandates.
Global Health Action. 2010; 3:5720.Background: Population health is a primary goal of sustainable development. United Nations international conferences like the Beijing Platform for Action have highlighted the key role of women in ensuring sustainable development. In the context of climate change, women are affected the most while they display knowledge and skills to orient themselves toward climate adaptation activities within their societies. Objective: To investigate how the gender perspective is addressed as an issue in research and policymaking concerning climate change and global health. Methods: A broad literature search was undertaken using the databases Pubmed and Web of Science to explore the terms 'climate change,' 'health,' 'gender,' and 'policy.' Climate change and health-related policy documents of the World Health Organization (WHO) and National Communications and National Adaptation Programs of Action reports submitted to the United Nations Framework Convention on Climate Change of selected countries were studied. Assessment guidelines to review these reports were developed from this study's viewpoint. Results: The database search results showed almost no articles when the four terms were searched together. The WHO documents lacked a gender perspective in their approach and future recommendations on climate policies. The reviewed UN reports were also neutral to gender perspective except one of the studied documents. Conclusion: Despite recognizing the differential effects of climate change on health of women and men as a consequence of complex social contexts and adaptive capacities, the study finds gender to be an underrepresented or non-existing variable both in research and studied policy documents in the field of climate change and health.
Priorities for research on equity and health: Implications for global and national priority setting and the role of WHO to take the health equity research agenda forward. Final report.
Geneva, Switzerland, World Health Organization [WHO], 2010 Nov.  p.The current issues paper was commissioned by the Equity Analysis and Research Unit of WHO, Geneva, to update the advice provided in 2005. It sets forth the broad parameters for a global research agenda on equity and health, taking stock of contemporary efforts, stakeholder discussions, relevance to Member States and expected innovations. Organised in three sections (Background, Research priorities, and Next steps), this paper aims to stimulate further thinking, debate and refinement of strategic approaches focussing WHO support and collaborations to advance global research on equity and health. It is not a comprehensive review of research in the area of equity and health, nor of approaches to support research policies and their implementation in this area. Key strategic issues on which this paper aims to stimulate discussion are: 1. Based on recommendations and learning from the Commission on Social Determinants of Health, the Knowledge Networks set up to support the CSDH, and other contemporary efforts, what areas of research could WHO concentrate support on to best advance greater health equity? 2. What aspects of research, including the development of concepts, methods, norms and standards, and synthesis approaches could best benefit from global collaboration? 3. How can WHO support and guide collaborations to maximise the relevance of global research on equity and health to specific countries and sub-populations; and 4. What core strategies and innovative opportunities could increase research collaborations and the uptake of research, involving a wider range of investigators, institutions and civil society organisations from low- and middle-income countries? (Excerpts)
Contraception. 2010 Jul; 82(1):113-8.This article aims to stimulate research to address gaps in the Medical Eligibility Criteria for Contraceptive Use so that more women have access to the most appropriate contraceptive methods, based on safety and effectiveness, for their particular condition and characteristics. It identifies the three conditions for which further research is needed; contraception for obese women, contraception for breastfeeding women, and contraception for women with HIV or AIDS. Copyright © 2010 Elsevier Inc. All rights reserved.
[Geneva, Switzerland], International AIDS Society, 2010 Mar. 5 p.Substantial progress has been made in expanding access to antiretroviral therapy (ART) for adults and children living with HIV and preventing vertical transmission. However, the scale-up of ART programs has also drawn attention to a number of knowledge gaps related to clinical management and ART program delivery for women and children. This document includes 20 recommendations for expanding and improving responses to HIV-related challenges facing women and children worldwide.
Positive indicators of child well-being: a conceptual framework, measures, and methodological issues.
Florence, Italy, UNICEF Innocenti Research Centre, 2009.  p. (Innocenti Working Paper No. IWP-2009-21)This paper highlights a number of frameworks for developing indicators that examine the positive well-being of children, rather than just indicators that reflect negative behavior (like drug use, smoking, and others).
Priorities for research on equity and health: Implications for global and national priority setting and the role of WHO to take the health equity research agenda forward.
[Geneva, Switzerland], World Health Organization [WHO], 2009 Sep 9. 36 p. (Discussion Paper)The report of the WHO Commission on Social Determinants of Health was released in August, 2008. Subsequently, a group led by Sweden’s Piroska Östlin, comprising 14 researchers who were actively involved with the Knowledge Networks that supported the Commission, was commissioned by WHO to update an earlier (2005) report on priorities for health equity research. The new (September 9, 2009) discussion paper observes that: "The bulk of global health research has focused on biological disciplines, to develop medical solutions, to be provided through clinical, individual patient care. The past two decades have witnessed a rise in a new public health paradigm, enlarging disciplinary perspectives, stakeholder analysis, and recognition that health systems can be designed more effectively through new knowledge. This paradigm shift represents a second wave of global health research. With the 10/90 gap embraced by many organisations as an objective to be reversed and the CSDH's report widely distributed, among other contemporary efforts, this paper argues that we are on the cusp of a third wave in global health research, one that explicitly links broader social, political and economic determinants with improvements in equity in health, within and across countries".
WHO ethical and safety recommendations for researching, documenting and monitoring sexual violence in emergencies.
Geneva, Switzerland, WHO, 2007.  p.Sexual violence in humanitarian emergencies, such as armed conflict and natural disasters, is a serious, even life-threatening, public health and human rights issue. Growing concern about the scale of the problem has led to increased efforts to learn more about the contexts in which this particular form of violence occurs, its prevalence, risk factors, its links to HIV infection, and also how best to prevent and respond to it. Recent years have thus seen an increase in the number of information gathering activities that deal with sexual violence in emergencies. These activities often involve interviewing women about their experiences of sexual violence. It is generally accepted that the prevalence of sexual violence is underreported almost everywhere in the world. This is an inevitable result of survivors' well-founded anxiety about the potentially harmful social, physical, psychological and/or legal consequences of disclosing their experience of sexual violence. In emergency situations, which arecharacterized by instability, insecurity, fear, dependence and loss of autonomy, as well as a breakdown of law and order, and widespread disruption of community and family support systems, victims of sexual violence may be even less likely to disclose incidents. (excerpt)
Bethesda, Maryland, Abt Associates, Partners for Health Reform Plus, .  p. (USAID Contract No. HRN-C-00-00-00019-00)The Global Fund to Fight AIDS, TB and Malaria aims to attract, manage, and disburse resources that will make a significant and sustainable impact on the three focal diseases. The Global Fund has also stated its commitment to support programs that address the three diseases "in ways that contribute to the strengthening of health systems." The Global Fund is likely to have a variety of direct and indirect effects upon health care systems that could be positive or negative in nature. To be effective and sustainable in the long run, interventions will depend upon well-functioning health systems. This is true not only for the Global Fund, but also for other initiatives, such as the World Bank Multisectoral AIDS Program (MAP), the President's Emergency Plan for AIDS Relief, and others that aim to substantially increase the scale of response to specific diseases, particularly HIV/ AIDS. (excerpt)
Traditional health practitioner and the scientist: Bridging the gap in contemporary health research in Tanzania.
Tanzania Health Research Bulletin. 2007 May; 9(2):115-120.Traditional health practitioners (THPs) and their role in traditional medicine health care system are worldwide acknowledged. Trend in the use of Traditional medicine (TRM) and Alternative or Complementary medicine (CAM) is increasing due to epidemics like HIV/AIDS, malaria, tuberculosis and other diseases like cancer. Despite the wide use of TRM, genuine concern from the public and scientists/biomedical heath practitioners (BHP) on efficacy, safety and quality of TRM has been raised. While appreciating and promoting the use of TRM, the World Health Organization (WHO), and WHO/Afro, in response to the registered challenges has worked modalities to be adopted by Member States as a way to addressing these concerns. Gradually, through the WHO strategy, TRM policy and legal framework has been adopted in most of the Member States in order to accommodate sustainable collaboration between THPs and the scientist/BHP. Research protocols on how to evaluate traditional medicines for safety and efficacy for priority diseases in Africa have been formulated. Creation of close working relationship between practitioners of both health care systems is strongly recommended so as to revamp trust among each other and help to access information and knowledge from both sides through appropriate modalities. In Tanzania, gaps that exist between THPs and scientists/BHP in health research have been addressed through recognition of THPs among stakeholders in the country's health sector as stipulated in the National Health Policy, the Policy and Act of TRM and CAM. Parallel to that, several research institutions in TRM collaborating with THPs are operating. Various programmed research projects in TRM that has involved THPs and other stakeholders are ongoing, aiming at complementing the two health care systems. This paper discusses global, regional and national perspectives of TRM development and efforts that have so far been directed towards bridging the gap between THPs and scientist/BHP in contemporary health research in Tanzania. (author's)
A research agenda for childhood tuberculosis. Improving the management of childhood tuberculosis within national tuberculosis programmes: research priorities based on a literature review.
Geneva, Switzerland, World Health Organization [WHO], 2007.  p. (WHO/HTM/TB/2007.381; WHO/FCH/CAH/07.02)Childhood TB is a neglected aspect of the TB epidemic, despite constituting 20% or more of the TB case-load in many countries with high TB incidence. This "orphan disease" exists in the shadow of adult TB and is a significant child health problem, but is neglected because it is usually smear-negative and is thus considered to make a relatively minor contribution to the spread of TB. In order to redress this neglect and integrate childhood TB into the mainstream of TB control activities, research priorities are identified that will assist in improving the prevention and management of childhood TB as a part of national TB programmes (NTPs). The proposed research agenda seeks to better define childhood TB, to optimize the treatment of childhood TB and to identify the best management practices by which childhood TB can be accurately documented and recorded, and efficiently managed within NTPs. (excerpt)
Lancet. 2007 Apr 14; 369(9569):1240-1243.Every year, 11 million mothers and newborn infants die, and a further 4 million infants are stillborn. Much is known about the efficacy of single interventions to increase survival under well-managed conditions, much less about how to integrate programmes at scale in poor populations. Funds for maternal, neonatal, and child health are limited, and research is needed to clarify the most cost-effective solutions. In 2003, the Bill & Melinda Gates Foundation?s grand challenges in global health focused on scientific and technological solutions to prevent, treat, and cure diseases of the developing world. The disappointing progress towards the Millennium Development Goals (MDGs) 4 and 5 to reduce child and maternal mortality led us to do a similar exercise to engage creative minds from development and health professionals-ie, those who work in the front line-about how research might accelerate progress towards meeting these MDGs. (excerpt)
Kimberley, South Africa, South African San Institute, 2006. 85 p. (CLT-2006/WS/1)South Africa has one of the fastest growing HIV infection rates in the world. The epidemic, which has been making its way down the continent, is now well established in the urban areas and some rural areas. The migratory labour practices draw the viral infections into rural communities with devastating results. The high incidence of teenage pregnancies, lack of proper knowledge about the virus and methods of transmission and various cultural malpractice compounds the problem. Whereas there are specialized clinics, anti-retroviral programmes and other care and support programmes in the major metropolitan areas, the rural areas of South Africa are typically poorly serviced. The southern Kalahari region is one of the most remote areas of this country. It has a low density population of some 1000 adults covering a vast area of which a few hundred are resettled on reclaimed land and more are moving into the area. This project represents the first practical experience of the South African San Institute (SASI) in implementing the conceptual and methodological framework of the joint UNESCO/UNAIDS Project ?A Cultural Approach to HIV/AIDS Prevention and Care?, with a view to contribute to sustainable human development in South Africa. (excerpt)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:31-41.The focus of the present study is the Brazilian response within science, technology and innovation to the targets formulated in the UNGASS document. An analysis was made of items 70-73 of the UNGASS Draft Declaration of Commitment on HIV/ AIDS (2001), which defined science, technology and innovation targets relating to HIV/AIDS. The main topics listed in these items were put into operation in the form of keywords, in order to guide systematic searches within the standard biomedicine databases, also including the subdivisions of the Web of Science relating to natural and social sciences. The success of Brazilian research within the field of characterization and isolation of HIV-1 is undeniable. Phase II/III vaccine studies have been developed in Rio de Janeiro, Belo Horizonte and São Paulo. Empirical studies on the monitoring of primary resistance have been developed in specific populations, through the Brazilian HIV Resistance Monitoring Network. Within the field of monitoring secondary resistance, initiatives such as the National Genotyping Network have been highlighted. Two national systems - the Mortality Information System and the Notifiable Diseases Information System-AIDS - and some studies with wider coverage have given rise to work on trends within the epidemic. The production of high-quality generic medications and their free distribution to patients have been highlighted. Brazil has implemented a consistent and diversified response within the field of HIV/AIDS, with studies relating to the development of vaccines, new medications and monitoring of the epidemic. (author's)
Sexual and reproductive health -- laying the foundation for a more just world through research and action: biennial report, 2004-2005.
Geneva, Switzerland, WHO, 2006.  p.This report presents an overview of RHR's work over the biennium 2004--2005. For the first time, we have produced a consolidated report, covering both the Department's research activities -- coordinated by the UNDP/UNFPA/WHO/ World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) -- and its technical support initiatives. HRP activities are presented on white sheets and those relating to technical programme support to countries (Programme Development in Reproductive Health -- PDRH) are presented on blue pages. (excerpt)
Turning research into practice: suggested actions from case-studies of sexual and reproductive health research.
Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2006. 99 p.The present document identifies common concerns related to research utilization from the perspectives of a range of stakeholders: researchers, donors, policy-makers, and sexual and reproductive health programme managers. The central component of this document is a conceptual framework which highlights a variety of issues and processes that influence the utilization of research results at various stages of the research process. This framework was developed through an analysis of the definitions, determinants and key elements of research utilization as well as of the conceptual pathways to the use of research. The conceptual framework incorporates utilization-related issues at three phases of the research process: preresearch, during research and post-research. Also factored in are contextual influences on research utilization, including the important role of stakeholders and communication in the uptake of research results. The conceptual framework captures many diverse elements of the research-to-policy process and should be considered a generic guide which will need to be adapted depending on the setting. The framework should assist researchers in incorporating actions into their research process and into the process of dissemination of findings so that the actions promote the utilization of the findings to improve sexual and reproductive health. A complete chapter is devoted to guidance for researchers in using the conceptual framework to identify activities aimed at promoting research utilization. Another chapter provides a checklist for policy-makers and programme managers to help them define the potential for utilization of research. (excerpt)
London, England, Overseas Development Institute, 2005 Apr.  p. (Working Paper No. 244)The Research and Policy in Development (RAPID) programme at the Overseas Development Institute (ODI) has been working since 1999 to promote development policy-making processes that are evidence-based and focused on the needs of the poor. One of the key dimensions of the RAPID programme at ODI is 'knowledge and learning systems in development agencies'. This study synthesises existing research on knowledge and learning in the development sector, and draws out eight key questions for examining related strategies and systems in development agencies. Together, these questions make up a comprehensive Knowledge Strategies Framework, which bears close resemblance to the framework used by the ODI to assess complex processes of change within the development and humanitarian sector. The dimensions of this new Knowledge Strategies Framework are mapped out as Organisational knowledge, Organisational links, Organisational contexts, and External factors. The study then presents the analysis of data collected on current knowledge and learning practices in 13 selected case study organisations1. This data was gathered via desk based reviews, interviews, consultations with agency staff and focus groups. The Knowledge Strategies Framework is used to analyse and synthesise these findings, to formulate the recommendations of the study, and to suggest key next steps. (excerpt)
Lancet. 2006 Dec 23; 368(9554):2193-2195.The global incidence of dengue has increased exponentially over past decades. Fuelled by conditioning factors such as rapid urbanisation, demographic change, large-scale migration, and travel, the disease is now endemic in most countries of the tropics, and about 925 million people now live in urban areas that are at risk of dengue infection. The increasing incidence, intensity, and geographical expansion of dengue epidemics pose a growing threat to the health and economic well-being of populations living in endemic areas, where the introduction of new virus strains to regions affected by existing serotypes is a risk factor for outbreaks and severe disease. Dengue is a major international public-health concern, as expressed in World Health Assembly resolution WHA 55.17 and in the 2005 revision of the International Health Regulations (WHA 58.3). We do have strategies, methods, and guidelines with which we can greatly reduce dengue case-fatality rates and virus transmission, but weak implementation of these plans and an inability to respond effectively to conditioning factors (such as those mentioned above) outside the health sector is causing concern. (excerpt)