Your search found 170 Results
Health Research Policy and Systems. 2018 May 22; 16(1):42.BACKGROUND: As countries continue to improve their family planning (FP) programmes, they may draw on WHO's evidence-based FP guidance and tools (i.e. materials) that support the provision of quality FP services. METHODS: To better understand the use and perceived impact of the materials and ways to strengthen their use by countries, we conducted qualitative interviews with WHO regional advisors, and with stakeholders in Ethiopia and Senegal who use WHO materials. RESULTS: WHO uses a multi-faceted strategy to directly and indirectly disseminate materials to country-level decision-makers. The materials are used to develop national family planning guidelines, protocols and training curricula. Participants reported that they trust the WHO materials because they are evidence based, and that they adapt materials to the country context (e.g. remove content on methods not available in the country). The main barrier to the use of national materials is resource constraints. CONCLUSIONS: Although the system and processes for dissemination work, improvements might contribute to increased use of the materials. For example, providers may benefit from additional guidance on how to counsel women with characteristics or medical conditions where contraceptive method eligibility criteria do not clearly rule in or rule out a method.
Improving care for women with obstetric fistula: new WHO recommendation on duration of bladder catheterisation after the surgical repair of a simple obstetric urinary fistula.
BJOG. 2018 Nov; 125(12):1502-1503.Under the Sustainable Development Goals (SDGs) and universal health coverage, the "survive, thrive, transform" agenda moves beyond reducing mortality and focuses on the importance of maternal morbidity.((1) ) An obstetric fistula, one of the most devastating types of maternal morbidity, is usually caused by injury during childbirth from prolonged or obstructed labour. The prolonged compression of the fetal head against the pelvic bones can cause ischaemic necrosis of parts of the bladder, urethra or vagina, resulting in an abnormal opening between a woman's genital tract and her urinary tract that leads to the continuous flow of urine through the vagina.((2)) Women with obstetric urinary fistula are often faced with serious social problems including abandonment by their partners, families and communities mainly due to persistent odour of urine as they are constantly wet and unable to control their urinary function.((3)) While these fistulae are almost non-existent in high-income countries, it remains a public health problem that affects over one million women, their families and communities in Sub-Saharan Africa and South Asia with poorly-resourced health systems and inadequate intrapartum care services. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Female genital mutilation as an issue of gender disparity in the 21st century: Leveraging opportunities to reverse current trends.
Ethiopian Medical Journal. 2016 Jul; 54(3):107-108.Add to my documents.
A Simplified Regimen Compared with WHO Guidelines Decreases Antenatal Calcium Supplement Intake for Prevention of Preeclampsia in a Cluster-Randomized Noninferiority Trial in Rural Kenya.
Journal of Nutrition. 2017 Oct; 147(10):1986-1991.Background: To prevent preeclampsia, the WHO recommends antenatal calcium supplementation in populations with inadequate habitual intake. The WHO recommends 1500-2000 mg Ca/d with iron-folic acid (IFA) taken separately, a complex pill-taking regimen. Objective: The objective of this study was to test the hypothesis that simpler regimens with lower daily dosages would lead to higher adherence and similar supplement intake.Methods: In the Micronutrient Initiative Calcium Supplementation study, we compared the mean daily supplement intake associated with 2 dosing regimens with the use of a parallel, cluster-randomized noninferiority trial implemented in 16 primary health care facilities in rural Kenya. The standard regimen was 3 x 500 mg Ca/d in 3 pill-taking events, and the low-dose regimen was 2 x 500 mg Ca/d in 2 pill-taking events; both regimens included a 200 IU cholecalciferol and calcium pill and a separate IFA pill. We enrolled 990 pregnant women between 16 and 30 wk of gestation. The primary outcome was supplemental calcium intake measured by pill counts 4 and 8 wk after recruitment. We carried out intention-to-treat analyses with the use of mixed-effect models, with regimen as the fixed effect and health care facilities as a random effect, by using a noninferiority margin of 125 mg Ca/d.Results: Women in facilities assigned to the standard regimen consumed a mean of 1198 mg Ca/d, whereas those assigned to the low-dose regimen consumed 810 mg Ca/d. The difference in intake was 388 mg Ca/d (95% CI = 341, 434 mg Ca/d), exceeding the prespecified margin of 125 mg Ca/d. The overall adherence rate was 80% and did not differ between study arms.Conclusions: Contrary to our expectation, a simpler, lower-dose regimen led to significantly lower supplement intake than the regimen recommended by the WHO. Further studies are needed to precisely characterize the dose-response relation of calcium supplementation and preeclampsia risk and to examine cost effectiveness of lower and simpler regimens in program settings. This trial was registered at clinicaltrials.gov as NCT02238704. (c) 2017 American Society for Nutrition.
Implementation effectiveness of revised (post-2010) World Health Organization guidelines on prevention of mother-to-child transmission of HIV using routinely collected data in sub-Saharan Africa: A systematic literature review.
Medicine. 2017 Oct; 96(40):e8055.BACKGROUND: To synthesize and evaluate the impact of implementing post-2010 World Health Organization (WHO) prevention of mother-to-child transmission (PMTCT) guidelines on attainment of PMTCT targets. METHODS: Retrospective and prospective cohort study designs that utilized routinely collected data with a focus on provision and utilization of the cascade of PMTCT services were included. The outcomes included the proportion of pregnant women who were tested during their antenatal clinic (ANC) visits; mother-to-child transmission (MTCT) rate; adherence; retention rate; and loss to follow-up (LTFU). RESULTS: Of the 1210 references screened, 45 met the inclusion criteria. The studies originated from 14 countries in sub-Saharan Africa. The highest number of studies originated from Malawi (10) followed by Nigeria and South Africa with 7 studies each. More than half of the studies were on option A while the majority of option B+ studies were conducted in Malawi. These studies indicated a high uptake of human immunodeficiency virus (HIV) testing ranging from 75% in Nigeria to over 96% in Zimbabwe and South Africa. High proportions of CD4 count testing were reported in studies only from South Africa despite that in most of the countries CD4 testing was a prerequisite to access treatment. MTCT rate ranged from 1.1% to 15.1% and it was higher in studies where data were collected in the early days of the WHO 2010 PMTCT guidelines. During the postpartum period, adherence and retention rate decreased, and LTFU increased for both HIV-positive mothers and exposed infants. CONCLUSION: Irrespective of which option was followed, uptake of antenatal HIV testing was high but there was a large drop off along later points in the PMTCT cascade. More research is needed on how to improve later components of the PMTCT cascade, especially of option B+ which is now the norm throughout sub-Saharan Africa.
Decreased emergence of HIV-1 drug resistance mutations in a cohort of Ugandan women initiating option B+ for PMTCT.
PloS One. 2017; 12(5):e0178297.BACKGROUND: Since 2012, WHO guidelines for the prevention of mother-to-child transmission (PMTCT) of HIV-1 in resource-limited settings recommend the initiation of lifelong antiretroviral combination therapy (cART) for all pregnant HIV-1 positive women independent of CD4 count and WHO clinical stage (Option B+). However, long-term outcomes regarding development of drug resistance are lacking until now. Therefore, we analysed the emergence of drug resistance mutations (DRMs) in women initiating Option B+ in Fort Portal, Uganda, at 12 and 18 months postpartum (ppm). METHODS AND FINDINGS: 124 HIV-1 positive pregnant women were enrolled within antenatal care services in Fort Portal, Uganda. Blood samples were collected at the first visit prior starting Option B+ and postpartum at week six, month six, 12 and 18. Viral load was determined by real-time RT-PCR. An RT-PCR covering resistance associated positions in the protease and reverse transcriptase HIV-1 genomic region was performed. PCR-positive samples at 12/18 ppm and respective baseline samples were analysed by next generation sequencing regarding HIV-1 drug resistant variants including low-frequency variants. Furthermore, vertical transmission of HIV-1 was analysed. 49/124 (39.5%) women were included into the DRM analysis. Virological failure, defined as >1000 copies HIV-1 RNA/ml, was observed in three and seven women at 12 and 18 ppm, respectively. Sequences were obtained for three and six of these. In total, DRMs were detected in 3/49 (6.1%) women. Two women displayed dual-class resistance against all recommended first-line regimen drugs. Of 49 mother-infant-pairs no infant was HIV-1 positive at 12 or 18 ppm. CONCLUSION: Our findings suggest that the WHO-recommended Option B+ for PMTCT is effective in a cohort of Ugandan HIV-1 positive pregnant women with regard to the low selection rate of DRMs and vertical transmission. Therefore, these results are encouraging for other countries considering the implementation of lifelong cART for all pregnant HIV-1 positive women.
BJOG. 2018 Feb; 125(3):288.Against a background of an increasing demand for surgical intervention for the treatment of FGM/C related complications, Berg et al
Note for typesetter: Please update reference when assigned to an issue.have conducted a systematic review of 62 studies involving 5829 women, to assess the effectiveness of defibulation, excision of cysts and clitoral reconstructive surgery. Berg et al report that defibulation showed a lower risk of Caesarean section and perineal tears; excision of cysts commonly resulted in resolution of symptoms; and clitoral reconstruction resulted in most women self-reporting improvements in their sexual health. However, Berg et al highlight that they had little confidence in the effect estimate for all outcomes as most of the studies were observational and conclude that there is currently poor quality of evidence on the benefits and/or harm of surgical interventions to be able to counsel women appropriately. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Scaling up proven innovative cervical cancer screening strategies: Challenges and opportunities in implementation at the population level in low- and lower-middle-income countries.
International Journal of Gynaecology and Obstetrics. 2017 Jul; 138 Suppl 1:63-68.The problem of cervical cancer in low- and lower-middle-income countries (LLMICs) is both urgent and important, and calls for governments to move beyond pilot testing to population-based screening approaches as quickly as possible. Experiences from Zambia, Bangladesh, Guatemala, Honduras, and Nicaragua, where scale-up of evidence-based screening strategies is taking place, may help other countries plan for large-scale implementation. These countries selected screening modalities recommended by the WHO that are within budgetary constraints, improve access for women, and reduce health system bottlenecks. In addition, some common elements such as political will and government investment have facilitated action in these diverse settings. There are several challenges for continued scale-up in these countries, including maintaining trained personnel, overcoming limited follow-up and treatment capacity, and implementing quality assurance measures. Countries considering scale-up should assess their readiness and conduct careful planning, taking into consideration potential obstacles. International organizations can catalyze action by helping governments overcome initial barriers to scale-up. (c) 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Lancet. 2016 Nov 26; 388(10060):2579.Add to my documents.
New York, Evaluation Office, United Nations Population Fund [UNFPA], 2016. 24 p.This evaluation focuses on how UNFPA performed in the area of family planning during the period covered by the UNFPA Strategic Plan 2008-2013. It provides valuable insights and learning which can be used to inform the current UNFPA family planning strategy as well as other relevant programmes, including UNFPA Supplies (2013-2020). All the countries where UNFPA works in family planning were included, but the evaluation focuses on the 69 priority countries identified in the 2012 London Summit on Family Planning as having low rates of contraceptive use and high unmet needs. The evaluation took place in 2014-2016 and was conducted by Euro Health Group in collaboration with the Royal Tropical Institute Netherlands. It involved a multidisciplinary team of senior evaluators and family planning and sexual and reproductive health and rights specialists, which was supervised and guided by the Evaluation Office in consultation with the Evaluation Reference Group. The outputs include a thematic evaluation report, an evaluation brief and country case study notes for Bolivia, Burkina Faso, Cambodia, Ethiopia and Zimbabwe.
Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study.
BMC Health Services Research. 2014; 14:525.BACKGROUND: The World Health Organisation has designed a pregnancy registry to investigate the effect of maternal drug use on pregnancy outcomes in resource-limited settings. In this sentinel surveillance system, detailed health and drug use data are prospectively collected from the first antenatal clinic visit until delivery. Over and above other clinical records, the registry relies on accurate participant reports about the drugs they use. Qualitative methods were incorporated into a pilot registry study during 2010 and 2011 to examine barriers to women reporting these drugs and other exposures at antenatal clinics, and how they might be overcome. METHODS: Twenty-seven focus group discussions were conducted in Ghana, Kenya and Uganda with a total of 208 women either enrolled in the registry or from its source communities. A question guide was designed to uncover the types of exposure data under- or inaccurately reported at antenatal clinics, the underlying reasons, and how women prefer to be asked questions. Transcripts were analysed thematically. RESULTS: Women said it was important for them to report everything they had used during pregnancy. However, they expressed reservations about revealing their consumption of traditional, over-the-counter medicines and alcohol to antenatal staff because of anticipated negative reactions. Some enrolled participants' improved relationship with registry staff facilitated information sharing and the registry tools helped overcome problems with recall and naming of medicines. Decisions about where women sought care, which influenced medicines used and antenatal clinic attendance, were influenced by pressure within and outside of the formal healthcare system to conform to conflicting behaviours. Conversations also reflected women's responsibilities for producing a healthy baby. CONCLUSIONS: Women in this study commonly take traditional medicines in pregnancy, and to a lesser extent over-the-counter medicines and alcohol. The World Health Organisation pregnancy registry shows potential to enhance their reporting of these substances at the antenatal clinic. However, more work is needed to find optimal techniques for eliciting accurate reports, especially where the detail of constituents may never be known. It will also be important to find ways of sustaining such drug exposure surveillance systems in busy antenatal clinics.
Journal of Women's Health. 2011 Nov; 20(11):1655-1661.Background: The practice of female genital cutting (FGC) is widespread in Nigeria and varies from one ethnic group to another. In 1994, Nigeria joined members of the 47th World Health Assembly in a resolution to eliminate the practice, and since then, several steps has been taken to achieve this objective. Methods: Nigeria joined members of the 47th World Health Assembly sixteen years ago in a resolution to eliminate female genital mutilation. This study uses data from 420 women aged 15-49 years who had at least one surviving daughter to investigate changes in FGC prevalence among mothers and daughters. The sample was systematically selected through stratified random sampling across the six states of southwest Nigeria. Focus group discussion, and an in-depth interview with fourteen women considered to be specialist in FGC were also held to compliment data generated from the interview. Results: The analysis indicated an FGC prevalence rate of 75% and 71% for mothers and daughters, respectively. It further indicated that the practice is rooted in tradition despite the fact that 52% of the respondents are aware of the health hazards of FGC. Educated mothers were found to be less likely to favor the cutting of their daughters. Conclusions: It is suggested that educational campaigns aimed toward parents should be intensified. Legal recourse, prohibition of operations, improvement in women's status, and sex education are also suggested as means of eradicating the practice.
Turning gender and HIV commitments into action for results: an update on United Nations interagency activities on women, girls, gender equality and HIV.
[Geneva, Switzerland], UNAIDS, 2009 Dec. 4 p.In September 2000, 189 UN Member States committed to achieving the Millennium Development Goals (MDGs) by 2015. Among these goals is a commitment to promoting gender equality and empowering women and combating HIV, malaria, and other diseases. Today, almost 10 years on, addressing gender inequality and AIDS remains the most significant challenge to achieving the MDGs, as well as broader health, human rights, and development goals. This update highlights key 2009 interagency initiatives, all of which operate at the intersection of gender equality, women's empowerment, and HIV.
Development. 2010; 53(2):267-273.Successive post-independence governments have embraced women's empowerment in one form or another, either because of their own ideological positioning, or because of demands by their 'donor friends/partners' and/or organized domestic groups and NGOs. What has emerged is a varied landscape on women's rights and empowerment work comprising the state bureaucracy, multilateral and bilateral agencies, NGOs, and women's rights organizations, with their accompanying discourses. In the Ghanaian context, Nana Akua Anyidoho and Takyiwaa Manuh look at what the discourses of empowerment highlight, ignore or occlude, the convergences and divergences among them, and how they speak to or accord with the lived realities of the majority of Ghanaian women. Given that the policy landscape in Ghana is highly influenced by donors, they ask which discourses dominate, and how are they used for improving women's lives in ways that are meaningful to them.
[Unpublished] 2004. Presented at the Conference on Gender Justice in Post-Conflict Situations, "Peace Needs Women and Women Need Justice”. Co-organized by the United Nations Development Fund for Women [UNIFEM] and the International Legal Assistance Consortium. New York, New York, September 15-17, 2004. 5 p.Why Women and Peace? The theme imposed itself. The last year of the 20th century represented an invitation and challenge to recapitulate and remember as well as to compare scores and balance sheets of the turbulent epoch we were leaving behind. No doubt, the 20th century was the century of wars. As never before in human history civilians paid the highest price of conflicts and conflagrations. In the two world wars and innumerable local wars, interventions, internal ethnic clashes, revolutions and coups, more than 100 million people were killed - the vast majority of them being civilians. Sometimes they were directly targeted; at other times they were "collateral damage" - to use an ugly euphemism coined by NATO during its 1999 intervention against Yugoslavia. From Hiroshima and Nagasaki to Vietnam to Pol Pot's Cambodia to Iran-Iraq to Afghanistan to Liberia to Sierra Leone to Rwanda to Burundi to Colombia to Iraq again... it is the civilians who suffered the most and among them, women and childrenas the most vulnerable ones. (excerpt)
[Unpublished] 2004. Presented at the Conference on Gender Justice in Post-Conflict Situations, "Peace Needs Women and Women Need Justice”. Co-organized by the United Nations Development Fund for Women [UNIFEM] and the International Legal Assistance Consortium. New York, New York, September 15-17, 2004. 4 p.Unfortunately, this is extremely well documented in countries in conflict. Many of the reports submitted to the Security Council include mention of the use of rape as a weapon of war. Recently, a report of the United Nations Organization Mission in the Democratic Republic of the Congo (MONUC) on the situation of human rights in Ituri provided information on this problem which is as specific as it is frightening. But, paradoxically, in countries which are not in conflict, the issue of violence against women is often neglected, where it is not concealed. But the private sphere cannot be an area where rights do not apply. (excerpt)
[Unpublished] 2004. Presented at the Conference on Gender Justice in Post-Conflict Situations, "Peace Needs Women and Women Need Justice”. Co-organized by the United Nations Development Fund for Women [UNIFEM] and the International Legal Assistance Consortium. New York, New York, September 15-17, 2004. 5 p.When wars occur, women are usually the most abused, aggrieved and powerless. In the vast majority of countries, women play no significant role in the decision-making process of whether war is warranted or lawful. When hostilities break out, women are exposed not only to the forms of violence and devastation that accompany any war but also to forms of violence directed specifically at women on account of their gender. The use of sexual violence and sexual slavery as tactics and weapons of war remains at a high level in spite of tremendous strides made by the global community over the past decade. It is imperative to acknowledge the immeasurable injury to body, mind and spirit that is inflicted by these acts. The overall deterioration in the conditions of women in armed conflict situations is due not only to the collapse of social restraints and the general mayhem that armed conflict causes, but also to a strategic decision on the part of combatants to intimidate and destroy the enemy as a whole byraping and enslaving women who are identified as members of the other warring party. (excerpt)
New York, New York, United Nations Population Fund [UNFPA], 2007.  p.The influence behind faith-based organizations is not difficult to discern. In many developing countries, FBOs not only provide spiritual guidance to their followers; they are often the primary providers for a variety of local health and social services. Situated within communities and building on relationships of trust, these organizations have the ability to influence the attitudes and behaviours of their fellow community members. Moreover, they are in close and regular contact with all age groups in society and their word is respected. In fact, in some traditional communities, religious leaders are often more influential than local government officials or secular community leaders. Many of the case studies researched for the UNFPA publication Culture Matters showed that the involvement of faith-based organizations in UNFPA-supported projects enhanced negotiations with governments and civil society on culturally sensitive issues. Gradually, these experiences are being shared across countries andacross regions, which has facilitated interfaith dialogue on the most effective approaches to prevent the spread of HIV. Such dialogue has also helped convince various faith-based organizations that joining together as a united front is the most effective way to fight the spread of HIV and lessen the impact of AIDS. This manual is a capacity-building tool to help policy makers and programmers identify, design and follow up on HIV prevention programmes undertaken by FBOs. The manual can also be used by development practitioners partnering with FBOs to increase their understanding of the role of FBOs in HIV prevention, and to design plans for partnering with FBOs to halt the spread of the virus. (excerpt)
Geneva, Switzerland, UNAIDS, 2007.  p. (UNAIDS/07.07E; JC1274E)These Practical Guidelines for Intensifying HIV Prevention: Towards Universal Access are designed to provide policy makers and planners with practical guidance to tailor their national HIV prevention response so that they respond to the epidemic dynamics and social context of the country and populations who remain most vulnerable to and at risk of HIV infection. They have been developed in consultation with the UNAIDS cosponsors, international collaborating partners, government, civil society leaders and other experts. They build on Intensifying HIV Prevention: UNAIDS Policy Position Paper and the UNAIDS Action Plan on Intensifying HIV Prevention. In 2006, governments committed themselves to scaling up HIV prevention and treatment responses to ensure universal access by 2010. While in the past five years treatment access has expanded rapidly, the number of new HIV infections has not decreased - estimated at 4.3 (3.6-6.6) million in 2006 - with many people unable to access prevention services to prevent HIV infection. These Guidelines recognize that to sustain the advances in antiretroviral treatment and to ensure true universal access requires that prevention services be scaled up simultaneously with treatment. (excerpt)
Facing the future together: Report of the Secretary General's Task Force on Women, Girls and HIV / AIDS in Southern Africa. Advocacy version.
Johannesburg, South Africa, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2004 Jul. 26 p. (UNAIDS/04.33E)Southern Africa is the epicenter of the global HIV/AIDS pandemic. After growing steadily for two decades, the prevalence rates appear at last to have stabilised - but at shockingly high levels of prevalence. By 2002, more than 20 percent of pregnant women tested were HIV-positive, with several countries in the sub-region reporting a rate of infection in antenatal care clinics of more than 25 percent. Sub-Saharan Africa is also the only region in the world in which HIV infection rates are higher among women than men. For every ten men with the HIV virus, thirteen women are infected. The impact on young women and girls aged 15-24 - those who have only recently become sexually active - is even more dramatic. They are two and a half times more likely to be infected than males in the same age group. The gap is larger still in Southern Africa, where in Zambia and Zimbabwe girls and young women make up close to a staggering eighty percent of all young people aged 15-24 who are living with HIV/AIDS. What are the reasons for this enormous disparity? Why are women and young girls bearing the brunt of the pandemic in Southern Africa? The answers lie in poverty, violence and gender inequality. (excerpt)
Collection of international instruments and other legal texts concerning refugees and others of concern to UNHCR. 3. Regional instruments: Africa, Middle East, Asia, Americas. Provisional release.
Geneva, Switzerland, UNHCR, 2006 Nov.  p.The first edition of the Collection of International Instruments Concerning Refugees was published in 1979. Thereafter, the compilation was updated regularly as new developments took place in the international law relating to refugees and other persons of concern to UNHCR. The 2006 edition takes account of the increasingly apparent inter-relationship and complimentarity between, on one hand, international refugee law and, on the other, human rights, humanitarian, criminal and other bodies of law. The Collection features over 240 instruments and legal texts drawn from across this broad spectrum. Compared to the earlier edition of the Collection, this edition includes many international instruments and legal texts relating to issues such as statelessness, the internally displaced and the asylum-migration debate (such as trafficking, smuggling, maritime and aviation law and migrants) as well as matters such as torture, discrimination, detention and the protection of women and children. The range of relevant regional instruments and legal texts have also been enhanced, not least to ensure that they are used more effectively while advocating for refugees and others of concern to UNHCR. Today, users can access veritable reference resources by electronic means. The Collection itself is accessible on-line. For users not able to access electronic facilities, it provides, in hard copy, the most important instruments in a manner easy to use in daily work. Indeed, even for those otherwise able to take advantage of electronic facilities, the availability of these instruments systematically in a single source offers unique facility and benefits. (excerpt)
Paris, France, UNESCO, 2006. 71 p. (Policy Paper Poverty Series No. 14.1 (E); SHS/CCT/2006/PI/H/3)Trafficking in human beings, especially women and girls, is not new. Historically, it has taken many forms, but in the context of globalization, has acquired shocking new dimensions. It is a complex, multi-faceted phenomenon involving multiple stakeholders at the institutional and commercial level. It is a demand-driven global business with a huge market for cheap labour and commercial sex confronting often insufficient or unexercised policy frameworks and trained personnel to prevent it. Mozambique is but one of an estimated 10 African countries (Angola, Botswana, DRC, Lesotho, Malawi, Mozambique, Swaziland, Tanzania, Zambia and Zimbabwe) that fuel the human trafficking business that feeds South Africa, the regional magnet. The recent history of armed conflict, extremes of dislocation and loss, reconstruction, political upheaval and deep social scars, together with its particular geography and the AIDS pandemic make Mozambique an inviting target for organized crime. The impact of these events on women and children, together with systemic gender discrimination and the absence of protective legislation make them particularly exposed to human trafficking. (excerpt)
Paris, France, UNESCO, 2006. 70 p. (Policy Paper Poverty Series No. 14.2 (E); SHS/CCT/2006/PI/H/2)Trafficking in human beings, especially women and girls, is not new. Historically it has taken many forms, but in the context of globalization, has acquired shocking new dimensions. It is a complex, multi-faceted phenomenon involving multiple stakeholders at the institutional and commercial level. It is a demand-driven global business with a huge market for cheap labour and commercial sex confronting often insufficient or unexercised policy frameworks or trained personnel to prevent it. Nigeria has acquired a reputation for being one of the leading African countries in human trafficking with cross-border and internal trafficking. Trafficking of persons is the third largest crime after economic fraud and the drug trade. Decades of military regimes in Nigeria have led to the institutionalized violation of human rights and severe political, social and economic crises. This negatively impacts the development of community participation, especially of women and children, despite international institutions designed to advance their causes. In addition, the oil boom in the 1970s created opportunities for migration both inside and outside of the country. This created avenues for exploitation, for international trafficking in women and children, for forced labor and for prostitution. (excerpt)
Contraception Report. 1998 Sep; 9(4): p..Current recommendations suggest IUDs should not be the first method of choice for women with HIV infection. The World Health Organization and International Planned Parenthood Federation recommend that HIV-infected women not use the IUD for contraception. These recommendations are based upon theoretical concerns about an increased risk of infection and possible increased risk of female-to-male HIV transmission from increased menstrual blood loss. The recommendation also reflects concern about behavioral characteristics that may make some HIV-positive women more susceptible to STDs and PID. Research conducted in Kenya by Family Health International suggests that carefully selected HIV-infected women may safely use the IUD for contraception. Researchers enrolled 649 women who otherwise met eligibility criteria for IUD insertion, including a low risk of STDs. Women came from two family planning clinics in Nairobi, Kenya. (excerpt)
Using UN process indicators assess needs in emergency obstetric services:Gabon, Guinea-Bissau, and The Gambia.
International Journal of Gynecology and Obstetrics. 2007 Mar; 96(3):233-240.We report on assessments of the needs for emergency obstetric care in 3 West African countries. All (or almost all) medical facilities were visited to determine whether there are sufficient facilities of adequate quality to manage the expected number of obstetric emergencies. Medical facilities able to provide emergency obstetric care were poorly distributed and often were unable to provide needed procedures. Too few obstetricians and other providers, lack of on-the-job training and supervision were among the challenges faced in these countries. (author's)