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Geneva, Switzerland, World Health Organization [WHO], 2017. 73 p.This tool for Monitoring human rights in contraceptive services and programmes contributes to the World Health Organization’s (WHO’s) ongoing work on rights-based contraceptive programmes. This work builds directly on WHO’s 2014 Ensuring human rights within contraceptive programmes: a human rights analysis of existing quantitative indicators and the 2015 publication Ensuring human rights within contraceptive service delivery implementation guide by the United Nations Population Fund (UNFPA) and WHO. This tool is intended for use by countries to assist them in strengthening their human rights efforts in contraceptive programming. The tool uses existing commonly-used indicators to highlight areas where human rights have been promoted, neglected or violated in contraceptive programming; gaps in programming and in data collection; and opportunities for action within the health sector and beyond, including opportunities for partnership initiatives.
Updated WHO recommendation on tranexamic acid for the treatment of postpartum haemorrhage. Highlights and key messages from the World Health Organization's 2017 Global Recommendation.
Geneva, Switzerland, WHO, 2017 Oct. 5 p. (WHO/RHR/17.21)This summary brief highlights key messages from the updated World Health Organization’s recommendation on Tranexamic acid (TXA) for the treatment of postpartum haemorrhage (PPH), including policy and program implications for translating the TXA recommendation into action at the country level. In 2012, WHO published recommendations for the prevention and treatment of postpartum haemorrhage, including a recommendation on the use of tranexamic acid (TXA) for treatment of PPH. The 2017 updated WHO Recommendation on TXA is based on new evidence on use of TXA for treatment of PPH. Key messages include: 1) The World Health Organization (WHO) recommends early use of intravenous tranexamic acid (TXA) within 3 hours of birth in addition to standard care for women with clinically diagnosed postpartum haemorrhage (PPH) following vaginal birth or caesarean section; 2) Administration of TXA should be considered as part of the standard PPH treatment package and be administered as soon as possible after onset of bleeding and within 3 hours of birth. TXA for PPH treatment should not be initiated more than 3 hours after birth; 3) TXA should be used in all cases of PPH, regardless of whether the bleeding is due to genital tract trauma or other causes; 4) TXA should be administered at a fixed dose of 1 g in 10 mL (100 mg/mL) IV at 1 mL per minute (i.e., administered over 10 minutes), with a second dose of 1 g IV if bleeding continues after 30 minutes; and 5) TXA should be administered via an IV route only for treatment of PPH. Research on other routes of TXA administration is a priority.This summary brief is intended for policy-makers, programme managers, educators and providers.
Geneva, Switzerland, UNAIDS, 2017. 8 p.HIV testing services are an essential gateway to HIV prevention, treatment, care and support services. The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) endorse and encourage universal access to knowledge of HIV status. Increased access to and uptake of HIV testing is central to achieving the 90–90–90 targets1 endorsed in the 2016 United Nations Political Declaration on Ending AIDS. However, at the end of 2016, approximately 30% of people living with HIV were still unaware of their HIV status. Young people aged 15–24, adult males and people from key populations (men who have sex with men, transgender people, sex workers, people who inject drugs and people in prisons and other closed settings) often have significantly lower access to HIV testing services, are less likely to be linked to treatment and care and have lower levels of viral suppression. (excerpt)
Geneva Switzerland, World Health Organization [WHO], 2017. 8 p. (Information Note; WHO/RHR/17.01)This information note provides interim advice for countries using or planning to introduce dual HIV/syphilis rapid diagnostic test (RDT) in antenatal services and other testing sites pending forthcoming WHO programmatic guidance, including a WHO recommended testing strategy. This note also emphasizes the need to ensure the quality of HIV and syphilis testing using RDTs, as well as laboratory-based testing, to avoid false positive and false negative HIV and syphilis results
The importance of sexual and reproductive health and rights to prevent HIV in adolescent girls and young women in eastern and southern Africa.
Geneva Switzerland, World Health Organization [WHO], 2017. 24 p. (Evidence Brief; WHO/RHR/17.05)Over the last several years, countries in the eastern and southern Africa (ESA) region have made significant and commendable progress in preventing mother-to-child transmission (PMTCT) of HIV and in scaling up HIV treatment efforts. However, despite these gains, there have been no significant reductions in new HIV infections and the region continues to be the hardest hit by the epidemic, highlighting the need to place stronger emphasis on HIV prevention. The risk of HIV infection among adolescent girls and young women (AGYW) in the ESA region is of particular concern. The 2016 UNAIDS World AIDS Day report, Get on the Fast-Track – The life-cycle approach to HIV, stated that efforts to reduce new HIV infections among young people and adults have stalled, threatening to undermine progress towards ending AIDS as a global public health threat by 2030.
Geneva Switzerland, World Health Organization [WHO], 2017. 8 p. (Evidence-to-Action Brief; WHO/RHR/17.18)This policy brief is designed to help countries implement the Global STI Strategy. By taking action to build sustainable national and institutional capacity for addressing STIs, countries can ensure that key cost- effective interventions reach the greatest number of people in need.
Casting light on old shadows: Ending sexually transmitted infection epidemics as public health concerns by 2030.
Geneva Switzerland, World Health Organization [WHO], 2017. 8 p. (Advocacy Brief; WHO/RHR/17.17)Countries can boost the response to STIs and improve the health of millions of women, men and adolescents by adopting WHO’s Global STI Strategy. Some viral STIs, like human papillomavirus (HPV) and HIV, are still incurable and can be deadly, while some bacterial STIs – like chlamydia, gonorrhoea, syphilis and trichomoniasis – are curable if detected and treated. This brief provide milestones and targets and five strategic directions for countries to develop their own national plans.
Geneva, Switzerland, World Health Organization [WHO], 2017. 56 p.Since the publication of the WHO Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management. This guideline provides updated recommendations for syphilis screening and treatment for pregnant women based on the most recent evidence and available serologic tests for syphilis. The objectives of this guideline are: 1) to provide evidence-based guidance on syphilis screening and treatment for pregnant women; and 2) to support countries to update their national guidelines for syphilis screening and treatment for pregnant women.
Programme reporting standards for sexual, reproductive, maternal, newborn, child and adolescent health.
Geneva, Switzerland, World Health Organization [WHO], 2017. 32 p.Information about design, context, implementation, monitoring and evaluation is central to understanding the processes and impacts of sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) programmes, in support of effective replication and scale-up of these efforts. Existing reporting guidelines do not demand sufficient detail in the reporting of contextual and implementation issues. We have, therefore, developed programme reporting standards (PRS) to provide guidance for complete and accurate reporting on the design, implementation, monitoring and evaluation processes of SRMNCAH programmes. The PRS can be used by SRMNCAH programme implementers and researchers. The PRS can be used prospectively to guide the reporting of a programme throughout its life cycle, or retrospectively to describe what was done, when, where, how and by whom. The PRS is intended as a guide for implementation researchers who need to document important details of implementation and context in addition to the results of their studies. The PRS is intended for programme managers and other staff or practitioners who have designed, implemented and/or evaluated SRMNCAH programmes. It can be used by governmental and nongovernmental organizations, bilateral and multilateral agencies, as well as by the private sector. The PRS is also intended as a guide for implementation researchers who need to document important details of implementation and context in addition to the results of their studies
Geneva, Switzerland, World Health Organization [WHO], 2017. 86 p.Sexual abuse of children and adolescents is a gross violation of their rights and a global public health problem. It adversely affects the health of children and adolescents. Health care providers are in a unique position to provide an empathetic response to children and adolescents who have been sexually abused. Such a response can go a long way in helping survivors recover from the trauma of sexual abuse. WHO has published new clinical guidelines Responding to children and adolescents who have been sexually abused aimed at helping front-line health workers, primarily from low resource settings, in providing evidence-based, quality, trauma-informed care to survivors. The guidelines emphasize the importance of promoting safety, offering choices and respecting the wishes and autonomy of children and adolescents. They cover recommendations for post-rape care and mental health; and approaches to minimizing distress in the process of taking medical history, conducting examination and documenting findings.
Report 2017: Transformative accountability for adolescents: Accountability for health and human rights of women, children and adolescents in the 2030 agenda.
Geneva, Switzerland, World Health Organization, 2017. 64 p.Adolescents, who number 1.2 billion, or 1 in 6 of the global population, are the key for progress on the Sustainable Development Goals (SDGs). Every year, 1.2 million adolescents die, often from preventable causes—such as violence, suicide, pregnancy-related complications among girls, HIV/AIDS, road injuries and drowning, as well as diseases and respiratory infections. As the report states, however, high impact, cost effective solutions to improve adolescent health can yield huge benefits and billions in savings that can place them on better tracks for life, reaping demographic dividends. The Independent Accountability Panel (IAP), under its mandate by the UN Secretary-General to assess progress on the 2016-2030 Global Strategy on Women’s, Children’s and Adolescents’ Health in the context of the SDGs from the specific lens of who is accountable to whom, and for what, launched its 2017 report. The IAP’s six recommendations are to: 1) Leverage Accountability to Achieve the Global Strategy and the SDGs, 2) Make adolescents visible and measure what matters, 3) Foster whole-of-government accountability to adolescents, 4) Make universal health coverage work for adolescents, 5) Boost accountability for investments, including for adolescent health and well-being, and 6) Unleash the power of young people, by meaningfully engaging them in decision-making, and empowering them to seize the full potential of the digital age.
State of world population 2017. Worlds apart: Reproductive health and rights in an age of inequality.
New York, United Nations Population Fund [UNFPA], Division of Communications and Strategic Partnerships, 2017. 140 p.In most developing countries, the poorest women have the fewest options for family planning, the least access to antenatal care and are most likely to give birth without the assistance of a doctor or midwife. Limited access to family planning translates into 89 million unintended pregnancies and 48 million abortions in developing countries annually. This does not only harm women’s health, but also restricts their ability to join or stay in the paid labour force and move towards financial independence, the report argues. Lack of access to related services, such as affordable child care, also stops women from seeking jobs outside the home. For women who are in the labour force, the absence of paid maternity leave and employers’ discrimination against those who become pregnant amount to a motherhood penalty, forcing many women to choose between a career and parenthood. The UNFPA report recommends focusing on the furthest behind first, in line with the United Nations blueprint for achieving sustainable development and inclusive societies by 2030. The 2030 Agenda for Sustainable Development has “envisaged a better future, one where we collectively tear down the barriers and correct disparities,” the report states. “Reducing all inequalities needs to be the aim. Some of the most powerful contributions can come from realizing...women’s reproductive rights.” (excerpt)
Oral Diseases. 2016 Apr; 22 Suppl 1:42-5.Four million people of the global total of 35 million with HIV infection are from South-East Asia. ART is currently utilized by 15 million people and has led to a dramatic decline in the mortality rate, including those in low- and middle-income countries. A reduction in sexually transmitted HIV and in comorbidities including tuberculosis has also followed. Current recommendations for the initiation of antiretroviral therapy in people who are HIV+ are essentially to initiate ART irrespective of CD4 cell count and clinical stage. The frequency of HIV testing should be culturally specific and based on the HIV incidence in different key populations but phasing in viral load technology in LMIC is an urgent priority and this needs resources and capacity. With the availability of simplified potent ART regimens, persons with HIV now live longer. The recent WHO treatment guidelines recommending routine HIV testing and earlier initiation of treatment should be the stepping stone for ending the AIDS epidemic and to meet the UNAIDS mission of 90*90*90. (c) 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Tracing Africa's progress towards implementing the Non-Communicable Diseases Global action plan 2013-2020: a synthesis of WHO country profile reports.
BMC Public Health. 2017 Apr 05; 17(1):297.BACKGROUND: Half of the estimated annual 28 million non-communicable diseases (NCDs) deaths in low- and middle-income countries (LMICs) are attributed to weak health systems. Current health policy responses to NCDs are fragmented and vertical particularly in the African region. The World Health Organization (WHO) led NCDs Global action plan 2013-2020 has been recommended for reducing the NCD burden but it is unclear whether Africa is on track in its implementation. This paper synthesizes Africa's progress towards WHO policy recommendations for reducing the NCD burden. METHODS: Data from the WHO 2011, 2014 and 2015 NCD reports were used for this analysis. We synthesized results by targets descriptions in the three reports and included indicators for which we could trace progress in at least two of the three reports. RESULTS: More than half of the African countries did not achieve the set targets for 2015 and slow progress had been made towards the 2016 targets as of December 2013. Some gains were made in implementing national public awareness programmes on diet and/or physical activity, however limited progress was made on guidelines for management of NCD and drug therapy and counselling. While all regions in Africa show waning trends in fully achieving the NCD indicators in general, the Southern African region appears to have made the least progress while the Northern African region appears to be the most progressive. CONCLUSION: Our findings suggest that Africa is off track in achieving the NCDs indicators by the set deadlines. To make sustained public health gains, more effort and commitment is urgently needed from governments, partners and societies to implement these recommendations in a broader strategy. While donors need to suit NCD advocacy with funding, African institutions such as The African Union (AU) and other sub-regional bodies such as West African Health Organization (WAHO) and various country offices could potentially play stronger roles in advocating for more NCD policy efforts in Africa.
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.
A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: growth curve construction and longitudinal cohort study.
BMJ. 2017 Aug 03; 358:j3423.Objectives To construct growth curves for mid-upper-arm circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality.Design Growth curve construction and longitudinal cohort study.Setting United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe.Participants The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children aged 5-17 years participating in the Antiretroviral Research for Watoto (ARROW) trial in Uganda and Zimbabwe; and 1741 children aged 5-13 years discharged from a rural Kenyan hospital (3.8% HIV infected). Both cohorts were followed-up for survival during one year.Main outcome measures Concordance with WHO 2006 growth standards at age 60 months and survival during one year according to MUAC-for-age and body mass index-for-age z scores.Results The new growth curves transitioned smoothly with WHO growth standards at age 5 years. MUAC-for-age z scores of -2 to -3 and less than-3, compared with -2 or more, was associated with hazard ratios for death within one year of 3.63 (95% confidence interval 0.90 to 14.7; P=0.07) and 11.1 (3.40 to 36.0; P<0.001), respectively, among ARROW trial participants; and 2.22 (1.01 to 4.9; P=0.04) and 5.15 (2.49 to 10.7; P<0.001), respectively, among Kenyan children after discharge from hospital. The AUCs for MUAC-for-age and body mass index-for-age z scores for discriminating subsequent mortality were 0.81 (95% confidence interval 0.70 to 0.92) and 0.75 (0.63 to 0.86) in the ARROW trial (absolute difference 0.06, 95% confidence interval -0.032 to 0.16; P=0.2) and 0.73 (0.65 to 0.80) and 0.58 (0.49 to 0.67), respectively, in Kenya (absolute difference in AUC 0.15, 0.07 to 0.23; P=0.0002).Conclusions The MUAC-for-age z score is at least as effective as the body mass index-for-age z score for assessing mortality risks associated with undernutrition among African school aged children and adolescents. MUAC can provide simplified screening and diagnosis within nutrition and HIV programmes, and in research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
New York, New York, UN Women, . 4 p. (Policy Brief No. 7)There is broad-based agreement today that universal social protection systems are a desirable goal. For gender equality advocates, it is paramount to take advantage of this momentum to ensure that such systems benefit women by responding to their rights and needs. Well-designed social protection systems can narrow gender gaps in poverty rates, enhance women’s income security and access to personal income, and provide a lifeline for poor women, especially single mothers.1 The current context of economic stagnation and fiscal adjustment, however, places big constraints on the investments needed to achieve these goals. How can gender equality advocates engage with social protection advocacy in this context? This policy brief showcases the strategies that were used by UN Women’s Multi-Country Office in the Caribbean to promote gender-responsive social protection in a context where reforms have been driven mainly by efforts to reduce public debt and promote economic competitiveness.
‘Leaving no one behind’ in action: observations from FGE’sseven-year experience working with civil society.
New York, New York, UN Women, . 8 p.This brief contains observations from the Fund for Gender Equality’s (FGE) seven-year experience working with civil society. Gender equality is at the forefront of the 2030 Development Agenda. The Sustainable Development Goals include a stand-alone goal to advance equality, and gender-related targets mainstreamed across the Global Goals. If something has opened a door for drastic progress in the lives of women and girls worldwide, it is the principle of leaving no one behind. Leaving no one behind means prioritizing human beings’ dignity and placing the progress of the most marginalized communities first—women and girls being all too often at the top of the list. It urges us to address the structural causes of inequality and marginalization that affect them. This ambitious undertaking requires a collective effort to identify and share effective strategies to operationalize this concept. This brief offers practical insights based on the experience of the FGE in working with marginalized populations through its support to women-led civil society organizations (CSOs).
New York, New York, UN Women, . 7 p. (Policy Brief No. 1)UN Women’s project "Promoting and Protecting Women Migrant Workers’ Labour and Human Rights: Engaging with International, National Human Rights Mechanisms to Enhance Accountability" is a global project funded by the European Union (EU) and anchored nationally in three pilot countries: Mexico, Moldova, and the Philippines. The project promotes women migrant workers’ rights and their protection against exclusion and exploitation at all stages of migration. One of the key results of the project has been the production of high-quality knowledge products. These have provided the foundation of the project’s advocacy and capacity building objectives. This Brief draws from the project’s knowledge products and provides an overview of the key situational and policy concerns for women migrant workers in each of the three pilot countries.
Using the international human rights system to protect and promote the rights of women migrant workers.
New York, New York, UN Women, . 7 p. (Policy Brief No. 6)This Brief provides an overview of the international human rights system as it applies to the promotion and protection of women migrant workers’ rights. Using examples from UN Women’s joint EU-funded project "Promoting and Protecting Women Migrant Workers’ Labour and Human Rights: Engaging with International, National Human Rights Mechanisms to Enhance Accountability" (the Project), which is anchored nationally in three pilot countries: Mexico, Moldova, and the Philippines, this Brief illustrates how these mechanisms can be used by governments, civil society and development partners, to enhance the rights of women migrant workers in law and practice.
New York, New York, UN Women, . 4 p. (Policy Brief No. 3)Remittances and their potential to contribute to development are becoming a central focus of global migration governance. With women making up approximately half of all migrant workers globally, there is a shifting focus of many policies and programmes to include remittances sent by women. Based on research and lessons learned from the joint UN Women–EU-funded global project, “Promoting and protecting women migrant workers’ labour and human rights: Engaging with international, national human rights mechanisms to enhance accountability”, which is piloted in Mexico, Moldova and the Philippines, this Brief considers the different ways that women transfer and spend remittances, and provides recommendations to better understand and maximize these remittances.
New York, New York, UN Women, 2015 Oct. 32 p.Since approximately 1990, peace processes involving the negotiation of formal peace agreements between the protagonists to conflict have become a predominant way of ending violent conflicts, both within and between States. Between 1990 and 2015 1,168 peace agreements have been negotiated in around 102 conflicts, on a wide definition of peace agreements to include agreements at all stages of the negotiations. Peace agreements are therefore important documents with significant capacity to affect women’s lives. However, a range of obstacles for women seeking to influence their design and implementation persists. These include difficulties with accessing talks, achieving equal influence at talks, raising issues of concern for women, and achieving material gains for women as an outcome of the peace process. This report examines what ‘a gender perspective’ in peace agreements might mean, assesses numerous peace agreements from between 1 January 1990 and 1 January 2015 for their ‘gender perspective, and produces data on when women have been specifically mentioned in those peace agreements.
New York, New York, UN Women, 2017 Sep. 22 p.This background paper highlights the key barriers that contribute towards creating and sustaining the gender gap in innovation and technology, including the limited market awarenss and investment in innovations that meet the needs of women; the gender-blind approach to innovation; the under-representation of women as innovators and entrepreneurs; and the perceived high risk, low reward profile of investing in innovations for women and girls. The paper also outlines the concrete action that UN Women and its partners are taking to address them.
Guideline: use of multiple micronutrient powders for point-of-use fortification of foods consumed by pregnant women.
Geneva, Switzerland, WHO, 2016. 32 p.The guideline is intended for a wide audience, including governments, nongovernmental organizations, healthcare workers, scientists and donors involved in the design and implementation of micronutrient programmes and antenatal care services and their integration into national and subnational public health strategies and programmes. This WHO guideline states that routine use of multiple micronutrient powders during pregnancy is not recommended as an alternative to standard iron and folic supplementation during pregnancy for improving maternal and infant health outcomes.