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  1. 126
    300755

    HIV / AIDS, law and human rights: a handbook for Russian legislators.

    Narkevich MI; Polubinskaya SV

    Moscow, Russia, Transatlantic Partners Against AIDS, 2005. 52 p.

    The purpose of this Handbook is to assist members of the Federation Council and deputies of the State Duma of the Russian Federation, and other Russian officials on the federal and regional levels, in enacting appropriate legislation and legislative reform to address AIDS, whether they be initiatives prohibiting discrimination against PLWHA or members of highly vulnerable groups, laws guaranteeing reliable HIV prevention information for all Russian citizens, or other policy priorities — and ensuring adequate fiscal and other resources to support them. This Handbook provides examples of the best legislative and regulatory practices gathered from around the world. Best practices are given for each of the 12 guidelines contained in the International Guidelines on HIV/AIDS and Human Rights, published in 1998 by the Office of the United Nations High Commissioner for Human Rights (UNHCHR) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). The Handbook also presents detailed information on the Russian AIDS epidemic with regard to the establishment and implementation of these Guidelines. Most importantly, the Handbook outlines concrete recommendations on measures that legislators can take to protect human rights and promote public health in responding to the epidemic. (author's)
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  2. 127
    302603

    Evaluating a model for monitoring the virological efficacy of antiretroviral treatment in resource-limited settings. Authors' reply [letter]

    Colebunders R; Lynen L; Meya D; Reynolds S; Moses K

    Lancet Infectious Diseases. 2006 Jul; 6(7):387-388.

    We thank Duncan Smith-Rohrberg and colleagues and Stephen Lawn and co-workers for their comments concerning our algorithm and their pledge for the availability of more viral load testing in resource-limited settings. For the moment, however, we have to confront the reality faced by most countries struggling with antiretroviral treatment scale-up: viral load testing remains expensive, requires a well-equipped laboratory, well-trained personnel, and is not available in most resource-limited settings. For these reasons, WHO is still not recommending viral load tests for regular monitoring of antiretroviral treatment in resource-limited settings. Two randomised trials in Africa--the Centers for Disease Control and Prevention (CDC) study in Tororo, Uganda and the Development of Antiretroviral Therapy in Africa (DART) study in Uganda and Zimbabwe--were initiated in 2004, comparing clinical monitoring only with clinical and routine laboratory monitoring. Both studies are still ongoing, meaning the data safety monitoring boards have not stopped them because patients in the laboratory arm were doing better than patients in the clinical monitoring only arm. However, it is unlikely that these studies will provide a definite answer concerning the value of viral load testing to monitor antiretroviral therapy in resource-limited settings. Indeed, viral load testing is only done in one of the three study arms in the CDC Tororo study. Moreover, the primary outcomes of both studies are the development of an AIDS-defining illness or death and not drug resistance, a marker that may teach us more about the long-term outcome of the antiretroviral therapy. (excerpt)
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  3. 128
    302911
    Peer Reviewed

    The added value of a CD4 count to identify patients eligible for highly active antiretroviral therapy among HIV-positive adults in Cambodia.

    Lynen L; Thai S; De Munter P; Leang B; Sokkab A

    Journal of Acquired Immune Deficiency Syndromes. 2006 Jul; 42(3):322-324.

    In a retrospective study of 648 persons with HIV infection in Cambodia, we determined the sensitivity, specificity, and accuracy of the 2003 World Health Organization (WHO) criteria to start antiretroviral treatment based on clinical criteria alone or based on a combination of clinical symptoms and the total lymphocyte count. As a reference test, we used the 2003 WHO criteria, including the CD4 count. The 2003 WHO clinical criteria had a sensitivity of 96%, a specificity of 57%, and an accuracy of 89% to identify patients who need highly active antiretroviral therapy (HAART). In our clinic, with a predominance of patients with advanced disease, the 2003 WHO clinical criteria alone was a good predictor of those needing HAART. A total lymphocyte count as an extra criterion did not improve the accuracy. Nine percent of patients were wrongly identified to be in need of HAART. Among them, almost 50% had a CD4 count of more than 500 cells/KL, and 73% had weight loss of more than 10% as a stage-defining condition. Our data suggest that, in settings with limited access to CD4 count testing, it might be useful to target this test to patients in WHO stage 3 whose staging is based on weight loss alone, to avoid unnecessary treatment. (author's)
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  4. 129
    303073
    Peer Reviewed

    Global public health surveillance under new international health regulations.

    Baker MG; Fidler DP

    Emerging Infectious Diseases. 2006 Jul; 12(7):1058-1065.

    The new International Health Regulations adopted by the World Health Assembly in May 2005 (IHR 2005) represents a major development in the use of international law for public health purposes. One of the most important aspects of IHR 2005 is the establishment of a global surveillance system for public health emergencies of international concern. This article assesses the surveillance system in IHR 2005 by applying well-established frameworks for evaluating public health surveillance. The assessment shows that IHR 2005 constitutes a major advance in global surveillance from what has prevailed in the past. Effectively implementing the IHR 2005 surveillance objectives requires surmounting technical, resource, governance, legal, and political obstacles. Although IHR 2005 contains some provisions that directly address these obstacles, active support by the World Health Organization and its member states is required to strengthen national and global surveillance capabilities. (author's)
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  5. 130
    303032

    Implementation of the Declaration of Commitment on HIV / AIDS: core indicators. United Nations General Assembly Special Session on HIV / AIDS.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2002 Aug. [2] p.

    Global commitment and action: 1. Amount of funds spent by international donors on HIV/ AIDS in developing countries and countries in transition; 2. Amount of public funds available for research and development of vaccines and microbicides; 3. Percentage of transnational companies that are present in developing countries and that have HIV/AIDS workplace policies and programmes; 4. Percentage of international organizations that have HIV/AIDS workplace policies and programmes; 5. Assessment of HIV/AIDS advocacy efforts. (excerpt)
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  6. 131
    303034

    CRIS: Country Response Information System: overview of the system and its plan of establishment.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]. Country and Regional Support Department. CRIS Unit

    Geneva, Switzerland, UNAIDS, Country and Regional Support Department, CRIS Unit, 2003 Mar. 42 p.

    Improved information and informed analysis are critical for the development of expanded national responses to HIV/AIDS. Some countries have developed HIV/AIDS surveillance systems and countries are increasingly collecting information on resources allocated for HIV/AIDS programmes and projects. Responding to the needs at the national and global levels for improved information and analysis, UNAIDS has embarked on an ambitious plan to establish an information system to support national AIDS responses. This document describes the historical development of the Country Response Information System (CRIS), and the related activities scheduled by UNAIDS in 2002 and 2003. It describes the philosophy of the proposed CRIS development for policy-makers and potential CRIS users. This philosophy stems from ongoing efforts to follow a modular approach to establishing a country-level information system. The system will be housed in National AIDS Councils (or equivalents), will contain national and subnational indicators, as well as programmatic information and key data pertinent to each national response. CRIS will provide partners in the global response to HIV/AIDS with a user-friendly system consisting of an indicator database, a project/resource-tracking database, a research inventory database and other important information. In particular, the indicator database, as the first component of the system to be operational, provides countries with a tool for reporting on national follow-up to the UNGASS Declaration of Commitment on HIV/AIDS. (excerpt)
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  7. 132
    303039

    Implementation of the Declaration of Commitment on HIV / AIDS; core indicators. United Nations General Assembly Special Session on HIV / AIDS.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2005 Jul. [2] p.

    Expenditures: 1. Amount of national funds disbursed by governments in low- and middle-income countries. Policy Development and Implementation Status: 2. National Composite Policy Index: Areas covered: prevention, care and support, human rights, civil society involvement, and monitoring and evaluation Target groups: people living with HIV, women, youth, orphans, and most-at-risk populations. National Programmes: 3. Percentage of schools with teachers who have been trained in life-skills-based HIV education and who taught it during the last academic year. 4. Percentage of large enterprises/companies which have HIV/AIDS workplace policies and programmes. 5. Percentage of women and men with sexually transmitted infections at health care facilities who are appropriately diagnosed, treated and counseled. 6. Percentage of HIV-positive pregnant women receiving a complete course of antiretroviral prophylaxis to reduce the risk of mother-to-child transmission. (excerpt)
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  8. 133
    303041

    From advocacy to action: a progress report on UNAIDS at country level.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2005 Feb. 79 p. (UNAIDS/05.28E)

    This report summarizes UNAIDS' assistance to countries in 2004 and 2005. Drawn from the reports of UNAIDS' Country Coordinators from over 75 countries, the report is divided into five chapters. Basic information on UNAIDS and how it operates, especially at country-level. How UNAIDS is contributing to implementation of the "Three Ones" principles. The many ways in which UNAIDS has assisted countries in strengthening their responses to AIDS. How UNAIDS is working to enhance the United Nations system's capacity to assist countries in responding to AIDS. How UNAIDS plans to meet key challenges for the future. (excerpt)
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  9. 134
    303742

    UNAIDS: an overview.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 1996. 9 p. (Facts about UNAIDS)

    Around 6 million people worldwide have died of AIDS since the start of the epidemic. Well over 20 million are living with HIV, the virus that causes AIDS. Already, there are communities and even whole cities where one out of every three adults is infected, and the repercussions of these dense clusters of illness and death will linger for decades. The epidemic and its impact are becoming a permanent challenge to human ingenuity and solidarity. Since the first of January 1996, UNAIDS -- the Joint United Nations Programme on HIV/AIDS -- has carried the main responsibility within the UN system for helping countries strengthen their long-term capacity to cope with this challenge. Based in Geneva, Switzerland, the new programme is cosponsored by six organizations of the UN family -- United Nations Children's Fund (UNICEF), United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), United Nations Educational, Scientific and Cultural Organization (UNESCO), World Health Organization (WHO), and the World Bank. Together with its cosponsors and other partners around the world, UNAIDS is hard at work on its mission -- leading and catalysing an expanded response to the epidemic to improve prevention and care, reduce people's vulnerability to HIV/AIDS, and alleviate the epidemic's devastating social and economic impact. (excerpt)
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  10. 135
    303744

    Reaching regional consensus on improved behavioural and serosurveillance for HIV: report from a regional conference in East Africa.

    Pisani E; Carael M

    Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 1998. 12 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/98.9)

    This report documents a regional workshop on surveillance systems for HIV held in Nairobi, Kenya, on 10.13 February 1997. The UNAIDS-funded workshop gathered government epidemiologists, AIDS programme managers, and social scientists from Kenya, Malawi, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe as well as specialists from UNAIDS and other partner institutions. The group aimed to present current data and to work together to suggest practical guidelines for improving HIV surveillance systems in a maturing epidemic. (excerpt)
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  11. 136
    304947
    Peer Reviewed

    Health, development and the Millennium Development Goals.

    Dodd R; Cassels A

    Annals of Tropical Medicine and Parasitology. 2006 Jul-Sep; 100(5-6):379-387.

    The Millennium Development Goals (MDG), which emerged from the United Nations Millennium Summit in 2000, are increasingly recognized as the over-arching development framework. As such, the MDG are increasingly guiding the policies of poor countries and aid agencies alike. This article reviews the challenges and opportunities for health presented by the MDG. The opportunities include that three of the eight MDG relate to health -- a recognition that health is central to global agenda of reducing poverty, as well as an important measure of human well-being in its own right. A related point is that the MDG help to focus attention on those health conditions that disproportionally affect the poor (communicable disease, child health and maternal health), which should, in turn, help to strengthen the equity focus of health policies in low-income countries. Further, because the MDG are concrete, it is possible to calculate the cost of achieving them, which in turn strengthens the long-standing calls for higher levels of aid for health. The challenges include that, while the MDG focus on specific diseases and conditions, they cannot be achieved without strengthening health systems. Similarly, progress towards the MDG will require health to be prioritized within overall development and economic policies. In practice, this means applying a health 'lens' to processes such as civil-service reform, decentralization and the drawing-up of frameworks of national expenditure. Finally, the MDG cannot be met with the resources available in low-income countries. While the MDG framework has created pressure for donors to commit to higher levels of aid, the challenge remains to turn these commitments into action. Data are presented to show that, at current rates of progress, the health-related MDG will not be achieved. This disappointing trend could be reversed, however, if the various challenges outlined are met. (author's)
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  12. 137
    305660

    Guinea PRISM II Project: 2005 annual report (English).

    Diallo T

    Cambridge, Massachusetts, Management Sciences for Health [MSH], Guinea PRISM II Project, 2005 Oct. 59 p. (Development Experience Clearinghouse DocID / Order No: PD-ACH-471; USAID Cooperative Agreement No. 675-A-00-03-00037-00)

    The PRISM project (Pour Renforcer les Interventions en Santé Reproductive et MST/SIDA) is an initiative of the Republic of Guinea as part of its bilateral cooperation with the United States of America designed to increase the utilization of quality reproductive health services. The project is funded by the United States Agency for International Development (USAID) and is implemented by Management Sciences for Health (MSH) in collaboration with the John Hopkins University/Center for Communication Programs (JHU/CCP) and Engenderhealth. The project's intervention zones correspond to the natural region of Upper Guinea as well as Kissidougou prefecture, thus covering all of the 9 prefectures of Kankan and Faranah administrative regions. This annual report covers the activities and results of PRISM over the fiscal year 2005, October 1, 2004 to September 30, 2005. Like all of PRISM's activity reports, the present report is structured according to the 4 intermediate result areas: (1) increased access to reproductive health services and products, (2) improved quality of services at health facilities, (3) increased demand of reproductive health services and products (4) improved coordination of health interventions. The report consists of three parts. The first part presents the introduction, an executive summary, and the summary of the principal results attained over the course of the year in each of the four intermediate results (IR). The second part presents in detail for each IR the project's strategies and approaches, the implemented activities and the results attained over the course of the year. The third part presents the operational aspects having had an impact on the project over the course of the year. (excerpt)
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  13. 138
    305867

    Rational Pharmaceutical Management Plus. WHO Biregional Workshop on Monitoring, Training and Planning (MTP) for Improving Rational Use of Medicines, Yogyakarta, Indonesia, December 14-16, 2005: trip report.

    Walkowiak H

    Arlington, Virginia, Management Sciences for Health [MSH], Rational Pharmaceutical Management Plus, 2006 Jan 23. 53 p. (USAID Development Experience Clearinghouse DocID / Order No: PD-ACH-511; USAID Cooperative Agreement No. HRN-A-00-00-00016-00)

    The workshop on Monitoring, Training and Planning (MTP) for Improving Rational Use of Medicines was convened jointly by two World Health Organization (WHO) regional offices -- for the Western Pacific (WPRO) and South East Asia (SEARO). Recognizing that the problem-focused strategy of MTP has been field-tested in several countries and shown to have significant impact in reducing the overuse and misuse of antibiotics and injections, the second International Conference on Improving Use of Medicines held in Chaing Mai, Thailand from March 30 to April 2, 2004 recommended that the MTP strategy be scaled up and replicated in other countries. Ineffective and often harmful prescribing and use of medicines remains widespread in many countries in the Western Pacific and South-East Asia, and WHO is collaborating with Australian Government Overseas Aid Program (AusAID) to train participants from countries in the two regions to implement MTP. (excerpt)
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  14. 139
    306766

    UNION World Congress on Lung Health in Paris, France, October 19 -October 22, 2005: trip report.

    Moore T; Zagorskiy A; Barillas E; Owunna C; Burn R

    Arlington, Virginia, Management Sciences for Health [MSH], Rational Pharmaceutical Management Plus, 2005 Oct 27. 19 p. (USAID Development Experience Clearinghouse DocID / Order No: PD-ACH-068; USAID Cooperative Agreement No. HRN-A-00-00-00016-00)

    Many national TB programs continue to encounter problems in providing quality TB medicines to patients when they need them. While lack of financial resources may be one constraint for procuring all TB medicines needed, national programs experience a host of other problems in pharmaceutical management. Strong pharmaceutical management is one of the key pillars to effective tuberculosis (TB) control; without appropriate selection, effective procurement, distribution, stock management and rational use of TB medicines and related supplies, individuals will not be cured of the disease and countries will not reach global targets. Management Sciences for Health's Rational Pharmaceutical Management Plus (RPM Plus) program funded by USAID in collaboration with Stop TB Partnership's Global TB Drug Facility (GDF) housed at World Health Organization (WHO) Geneva conducted a workshop at the 36th International UNION World Congress on Tuberculosis and Lung Health on October 19th 2005 at Paris, France. This is the fourth year MSH and GDF have collaborated in such an event at the UNION congress due to popular demand by national TB programmes and their partners. (excerpt)
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  15. 140
    306832

    Unkept promises: what the numbers say about poverty and gender. An international citizen's progress report on poverty eradication and gender equity. Advance Social Watch report 2005.

    Bissio R

    Montevideo, Uruguay, Social Watch, 2005. 114 p. (Social Watch Report)

    Almost five years have passed since the largest gathering ever of heads of State and government made this solemn promise to the peoples of the world: "we will spare no effort to free our fellow men, women and children from the abject and dehumanizing conditions of extreme poverty."1 Almost ten years have passed since the leaders of the world solemnly committed themselves in Copenhagen "to the goal of eradicating poverty in the world, through decisive national actions and international cooperation, as an ethical, social, political and economic imperative of humankind."2 This is an ambitious agenda. So much so that it was compared by many leaders to the historic task of slavery abolition in the 19th century. Inspired by the Copenhagen Declaration and the complementary Beijing Platform for Action towards gender equity, 3 citizen groups from all over the world came together to form the Social Watch network. Every year since then, Social Watch has published a comprehensive report monitoring the governments' compliance with their international commitments. The findings of the national Social Watch coalitions in over 60 countries and the analysis of the available indicators coincide: the promises have remained largely unmet. Unless substantial changes are put in place soon, the targets set for the year 2015 will not be achieved. (excerpt)
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  16. 141
    306833

    Taking action: achieving gender equality and empowering women.

    Grown C; Gupta GR; Kes A

    London, England, Earthscan, 2005. [279] p.

    How can the global community achieve the goal of gender equality and the empowerment of women? This question is the focus of Goal 3 of the Millennium Development Goals endorsed by world leaders at the UN Millennium Summit in 2000 and of this report, prepared by the UN Millennium Project Task Force on Education and Gender Equality. The report argues that there are many practical steps that can reduce inequalities based on gender, inequalities that constrain the potential to reduce poverty and achieve high levels of well-being in societies around the world. There are also many positive actions that can be taken to empower women. Without leadership and political will, however, the world will fall short of taking these practical steps--and meeting the goal. Because gender inequality is deeply rooted in entrenched attitudes, societal institutions, and market forces, political commitment at the highest international and national levels is essential to institute the policies that can trigger social change and to allocate the resources necessary to achieve gender equality and women's empowerment. Many decades of organizing and advocacy by women's organizations and networks across the world have resulted in global recognition of the contributions that women make to economic development and of the costs to societies of persistent inequalities between women and men. The success of those efforts is evident in the promises countries have made over the past two decades through international forums. The inclusion of gender equality and women's empowerment as the third Millennium Development Goal is a reminder that many of those promises have not been kept, while simultaneously offering yet another international policy opportunity to implement them. (excerpt)
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  17. 142
    293629

    Longstanding nutrition programs provide tsunami disaster relief.

    Dasgupta K

    Global HealthLink. 2005 Mar-Apr; (132):8-9.

    HELEN KELLER INTERNATIONAL (HKI), a 90-year old organization with established programs worldwide that combat the causes and consequences of blindness and malnutrition, is focusing its tsunami disaster relief efforts on assisting survivors in Indonesia through two assistance activities with both immediate and long-term implications. These disaster response efforts are based on strategies and techniques that the agency already implements, capitalizing on its skills, expertise and experience. The most immediate threat facing the survivors of the earthquake and tsunami is the spread of water-borne and infectious diseases. Many of the survivors are displaced and living in accommodations with poor sanitation and hygiene, making them even more vulnerable to disease. Children are particularly vulnerable to disease and death in the aftermath of disasters, and diarrhea, pneumonia and malaria can become life-threatening problems. Yet, vitamin A and zinc &given to children under five years of age reduce mortality from diarrhea, measles and other causes by 23 percent to 50 percent, and lessen the severity and likelihood of contracting diarrhea, pneumonia and malaria by 30 to 40 percent. (excerpt)
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  18. 143
    309083

    Scaling-up the HIV / AIDS response: from alignment and harmonisation to mutual accountability.

    Buse K; Sidibe M; Whyms D; Huijts I; Jensen S

    London, England, Overseas Development Institute, 2006 Aug. [4] p. (ODI Briefing Paper No. 9)

    Without greater mutual accountability among all stakeholders, lack of harmonisation will continue to cost lives. The international community reiterated its commitment to Universal Access to HIV/AIDS prevention, treatment, care and support at the UN High Level Meeting on HIV/AIDS in May-June 2006. But without hastening the application of the 'Three Ones' principles to guide the national AIDS response, we face a collective failure to realise the Universal Access commitment. The 'Three Ones' principles address the prevailing dysfunctions in coordinating national HIV/AIDS responses. These dysfunctions often include weak national plans as well as the proliferation of strategies, coordination arrangements, financial management systems, monitoring and evaluation criteria and procedures, and aid modalities established by donors. The national AIDS response has too often been characterised by confusion, duplication, gaps, distorted priorities, high transaction costs, poor value-for-money and lower than optimal results. (excerpt)
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  19. 144
    309272
    Peer Reviewed

    The United Nations Process Indicators for emergency obstetric care: Reflections based on a decade of experience.

    Paxton A; Bailey P; Lobis S

    International Journal of Gynecology and Obstetrics. 2006 Nov; 95(2):192-208.

    The paper reviews the experience with the EmOC process indicators, and evaluates whether the indicators serve the purposes for which they were originally created -- to gather and interpret relatively accessible data to design and implement EmOC service programs. We review experience with each of the 6 process indicators individually, and monitoring change over time, at the level of the facility and at the level of a region or country. We identify problems encountered in the field with data collection and interpretation. While they have strengths and weaknesses, the process indicators in general serve the purposes for which they were developed. The data are easily collected, but some data problems were identified. We recommend several relatively minor modifications to improve data collection, interpretation and utility. The EmOC process indicators have been used successfully in a wide variety of settings. They describe vital elements of the health system and how well that system is functioning for women at risk of dying from major obstetric complications. (author's)
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  20. 145
    309917

    Action to prevent child trafficking in South Eastern Europe: a preliminary assessment.

    Dottridge M

    Geneva, Switzerland, UNICEF, Regional Office for CEE / CIS, Child Protection Unit, 2006. 89 p.

    This Report outlines some key findings and recommendations from an assessment of the efforts to prevent child trafficking in South Eastern Europe. Its main purpose is to increase understanding of the work prevention of child trafficking, by looking at the effectiveness of different approaches and their impacts. The assessment covered Albania, Republic of Moldova, Romania and the UN Administered Province of Kosovo. The Report is based on a review of relevant research and agency reports as well as interviews with organizations implementing prevention initiatives and with trafficked children from the region. The first part of the Report reviews key terms and definition related to child trafficking, as common understanding about what constitutes trafficking and who might be categorised as a victim is crucial to devising prevention initiatives and guaranteeing adequate protection for trafficked children. Furthermore, to intervene in any of the phases of the trafficking process it is essential to understand specific factors contributing to the situation and the key actors involved. Different approaches to understanding the causes of child trafficking and methods for developing prevention initiatives are also explored. The Report notes that all prevention efforts should incorporate the principles that have proved essential in designing and implementing other initiatives in the ares of child rights and protection. That is, good prevention initiatives should be rooted in child rights principles and provisions, use quality data and analysis, applying programme logic, forge essential partnerships, monitor and evaluate practice and measure the progress towards expected results. (excerpt)
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  21. 146
    311119

    Achieving the Millennium Development Goals in sub-Saharan Africa: a macroeconomic monitoring framework.

    Agenor PR; Bayraktar N; Moreira EP; El Aynaoui K

    World Economy. 2006; 29(11):1519-1547.

    3,000 Africans die every day of a mosquito bite. Can you think about that, malaria? That's not acceptable in the 21st century and we can stop it. And water-borne illnesses - dirty water takes another 3,000 lives - children, mothers, sisters . . . If we're to take this issue seriously, and we must, because in 50 years, you know, when they [G-8 Heads of State] look back at this moment . . . they'll talk about what we did or didn't do about this continent bursting into flames. It is the most extraordinary thing to watch people dying three in a bed, two on top and one underneath, as I have seen in Lilongwe, Malawi. I mean, it is an astonishing thing. And it's avoidable. It's an avoidable catastrophe. You saw what happened with the tsunami. You see the outpouring, you see the dramatic pictures. Well, there's a tsunami happening every month in Africa, but it's an avoidable catastrophe. It is not a natural calamity. (author's)
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  22. 147
    311833
    Peer Reviewed

    Rationale for developing a new international growth reference.

    Garza C; de Onis M

    Food and Nutrition Bulletin. 2004; 25 Suppl 1:S5-S14.

    The rationale for developing a new international growth reference derived principally from a Working Group on infant growth established by the World Health Organization (WHO) in 1990. It recommended an approach that described how children should grow rather than describing how children grow; that an international sampling frame be used to highlight the similarity in early childhood growth among diverse ethnic groups; that modern analytical methods be exploited; and that links among anthropometric assessments and functional outcomes be included to the fullest possible extent. Upgrading international growth references to resemble standards more closely will assist in monitoring and attaining a wide variety of international goals related to health and other aspects of social equity. In addition to providing scientifically robust tools, a new reference based on a global sample of children whose health needs are met will provide a useful advocacy tool to health-care providers and others with interests in promoting child health. (author's)
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  23. 148
    311836
    Peer Reviewed

    Assessment of gross motor development in the WHO Multicentre Growth Reference Study.

    Wijnhoven TM; de Onis M; Onyango AW; Wang T; Bjoerneboe GE

    Food and Nutrition Bulletin. 2004; 25 Suppl 1:S37-S45.

    The objective of the Motor Development Study was to describe the acquisition of selected gross motor milestones among affluent children growing up in different cultural settings. This study was conducted in Ghana, India, Norway, Oman, and the United States as part of the longitudinal component of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS). Infants were followed from the age of four months until they could walk independently. Six milestones that are fundamental to acquiring self-sufficient erect locomotion and are simple to evaluate were assessed: sitting without support, hands-and-knees crawling, standing with assistance, walking with assistance, standing alone, and walking alone. The information was collected by both the children's caregivers and trained MGRS fieldworkers. The caregivers assessed and recorded the dates when the milestones were achieved for the first time according to established criteria. Using standardized procedures, the fieldworkers independently assessed the motor performance of the children and checked parental recording at home visits. To ensure standardized data collection, the sites conducted regular standardization sessions. Data collection and data quality control took place simultaneously. Data verification and cleaning were performed until all queries had been satisfactorily resolved. (author's)
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  24. 149
    311835
    Peer Reviewed

    Measurement and standardization protocols for anthropometry used in the construction of a new international growth reference.

    de Onis M; Onyango AW; Van den Broeck J; Chumlea WC; Martorell R

    Food and Nutrition Bulletin. 2004; 25 Suppl 1:S27-S36.

    Thorough training, continuous standardization, and close monitoring of the adherence to measurement procedures during data collection are essential for minimizing random error and bias in multicenter studies. Rigorous anthropometry and data collection protocols were used in the WHO Multicentre Growth Reference Study to ensure high data quality. After the initial training and standardization, study teams participated in standardization sessions every two months for a continuous assessment of the precision and accuracy of their measurements. Once a year the teams were restandardized against the WHO lead anthropometrist, who observed their measurement techniques and retrained any deviating observers. Robust and precise equipment was selected and adapted for field use. The anthropometrists worked in pairs, taking measurements independently, and repeating measurements that exceeded preset maximum allowable differences. Ongoing central and local monitoring identified anthropometrists deviating from standard procedures, and immediate corrective action was taken. The procedures described in this paper are a model for research settings. (author's)
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  25. 150
    311687

    Fulfilling reproductive rights for women affected by HIV / AIDS. A tool for monitoring progress toward three Millennium Development Goals. Updated version.

    de Bruyn M

    Chapel Hill, North Carolina, Ipas, 2006 Aug. 20 p.

    In 2004, more than 25 national and international organizations presented a statement to the secretariat of the United Nations (UN) Commission on the Status of Women that highlighted relatively neglected areas in the reproductive health of women affected by HIV/AIDS. In collaboration with the International Community of Women Living with HIV/AIDS (ICW), the Center for Health and Gender Equity (CHANGE) and the Pacific Institute for Women's Health, Ipas used that statement and a literature review to develop this practical tool to help nongovernmental organizations (NGOs) address those neglected areas of reproductive health. Since the Millennium Development Goals (MDGs) have become a common framework for assessing progress in development, the tool links those areas of reproductive health to three of the MDGs related to empowering women, improving maternal health and combating HIV/AIDS. This document is an updated version of the original resource published in 2004. Changes were made after the eight partner NGOs listed below piloted the benchmarks in 11 developing countries. (excerpt)
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