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Journal of Human Lactation. 2017 Feb; 33(1):140-148.BACKGROUND: Extended breastfeeding duration is common in India. Extended breastfeeding protects the infant from infectious disease and promotes child spacing. In the 1990s, the median breastfeeding duration in India was 24 months. Research aim: This study aimed to investigate the median duration of breastfeeding in India and to identify the factors associated with extended breastfeeding to 24 months as recommended by the World Health Organization. METHODS: This cross-sectional data analysis used nationally representative data from the 2011-2012 Indian Human Development Survey II. The outcome in this study was extended breastfeeding defined as breastfeeding to 24 months or more. Multivariate logistic regression was used to identify the factors associated with extended breastfeeding. RESULTS: The median duration of breastfeeding was 12 months; approximately 25% of women breastfed 24 months or more. Women were at greater odds of breastfeeding 24 months or more if the infant was a boy compared with a girl, if the women lived in a rural area compared with an urban area, if the women were married at a young age (< 17 vs. 20 years or older at marriage), and if the delivery was assisted by a friend or relative compared with a doctor. CONCLUSION: The median duration of breastfeeding has decreased by 50% from 1992-1993 to 2011-2012. The women who continue to breastfeed 24 months or more tend to be more traditional (i.e., living in rural areas, marrying young, and having family/friends as birth attendants). Further research to study the health effect of decreased breastfeeding duration is warranted.
Geneva, Switzerland, WHO, 2015 Nov. 2 p. (Pre-Exposure Prophylaxis (PrEP); Policy Brief)This policy brief defines PrEP, presents the World Health Organization's current recommendations for PrEP use and the evidence for it, discusses PrEP's expected cost-effectiveness, and lists considerations for PrEP implementation.
Accelerating change by the numbers. 2016 annual report of the UNFPA-UNICEF Joint Programme on Female Genital Mutilation / Cutting: Accelerating change.
New York, New York, United Nations Population Fund [UNFPA], 2017 Jul. 92 p.The 2016 Annual Report for the UNFPA-UNICEF Joint Programme on Female Genital Mutilation / Cutting provides two perspectives. This main document, "By the Numbers," analyses progress in quantitative terms, using the Results Framework as a basis. It provides an account of how the budget was allocated and offers profiles of each of the 17 programme countries (excepting Yemen). The profiles present facts on the national context, summarize key achievements, and share operational and financial information.
New York, New York, United Nations Population Fund [UNFPA], 2017. 80 p.The 2016 Annual Report for the UNFPA-UNICEF Joint Programme on Female Genital Mutilation / Cutting provides two perspectives: The main document analyses progress in quantitative terms, provides an account of how our budget was allocated and offers profiles of each of the 17 programme countries. This companion booklet uses a qualitative and narrative approach to examine more specifically the challenges, complexities and achievements on the ground. It explores the innovative approaches the Joint Programme teams, partners and activists employ to deconstruct the social norms that allow FGM / C to continue in many communities.
Adolescent girls in disaster and conflict. Interventions for improving access to sexual and reproductive health services.
New York, New York, UNFPA, 2016. 92 p.Safe spaces, mobile medical teams and youth engagement are effective ways to reach displaced, uprooted, crisis-affected girls at a critical time in their young lives. Adolescent Girls in Disaster & Conflict: Interventions for Improving Access to Sexual and Reproductive Health Services is a collection of UNFPA-supported humanitarian interventions for reaching adolescents when crisis heightens vulnerability to gender-based violence, unwanted pregnancy, HIV infection, early and forced marriage and other risks.
Ethical and safety recommendations for intervention research on violence against women. Building on lessons from the WHO publication, "Putting women first: ethical and safety recommendations for research on domestic violence against women".
Geneva, Switzerland, WHO, 2016. 43 p.As the evidence base on the magnitude, context and consequences of violence against women (VAW) has grown, research efforts and attention have begun to focus on decreasing the knowledge gap on effective responses through intervention research. Demonstrating this focus, in November 2012 the WHO Department of Reproductive Health and Research convened a group of experts to discuss health sector-based research to respond to violence against women. This global network of researchers, scientists and practitioners was brought together to enhance existing research efforts and to advocate for greater funding for research on interventions to address VAW and policies and programmes related to it. With the increased interest in and attention of the global community of researchers, practitioners and policy-makers regarding rigorous intervention research for preventing and responding to VAW, a discussion of the ethical considerations specific to this type of research is warranted. These recommendations have been developed to help answer questions specific to conducting research on health-based interventions to prevent and respond to VAW. Research on strategies that use health or health care as an entry point (regardless of the implementation setting, such as a clinic or community) is the focus. However, the discussion may be relevant to research on other kinds of VAW interventions.
Geneva, Switzerland, WHO, 2017. 4 p. (WHO/RHR/17.02)Strategic approaches to reduce maternal mortality in the past 15 years have mainly focused on clinical interventions and health system strengthening. The greatest attention has been on postpartum haemorrhage and hypertensive disorders, the two leading direct causes of maternal mortality. Further reducing maternal deaths is a priority for achieving the Sustainable Development Goals, implementing the UN Global Strategy for Women’s, Children’s and Adolescents’ Health and critical for the Strategies toward Ending Preventable Maternal Mortality (EPMM). However, the third most common direct cause of maternal mortality, maternal sepsis, received less attention, research and programming. Undetected or poorly managed maternal infections can lead to sepsis, death or disability for the mother and increased likelihood of early neonatal infection and other adverse outcomes. Recognizing the need to foster new thinking and to catalyse greater action to address this important cause of maternal and newborn mortality and morbidity, the World Health Organization (WHO) and Jhpiego have launched the Global Maternal and Neonatal Sepsis Initiative, dedicated to focusing additional effort, energizing stakeholders and accelerating progress in the area of maternal and neonatal infection and sepsis. This statement defines maternal sepsis and operationalizes the definition.
Managing complications in pregnancy and childbirth (MCPC): A guide for midwives and doctors. Highlights from the World Health Organization’s 2017 Second Edition.
[Geneva, Switzerland], WHO, 2017 May. 8 p. (WHO/MCA/17.02; USAID Cooperative Agreement No. AID-OAA-A-14-00028)Since it was first published in 2000, the World Health Organization’s (WHO’s) Managing Complications in Pregnancy and Childbirth (MCPC) manual has been used widely around the world to guide the care of women and newborns who have complications during pregnancy, childbirth and the immediate postnatal period. The MCPC manual targets midwives and doctors working in district-level hospitals. Selected chapters from the first edition of the MCPC were revised in 2016 based on new WHO recommendations, and the second edition of the MCPC manual is now available. This brief reviews the revision process and summarizes updated clinical guidelines for a subset of revised chapters, including: emotional and psychological support; hypertensive disorders of pregnancy; bleeding in early pregnancy and after childbirth; and prevention and management of infection in pregnancy and childbirth. (Excerpt)
Geneva, World Health Organization [WHO], 2017. 114 p.This report presents the first ever estimates of the population using ‘safely managed’ drinking water and sanitation services – meaning drinking water free from contamination that is available at home when needed, and toilets whereby excreta are treated and disposed of safely. It also documents progress towards ending open defecation and achieving universal access to basic services. The report identifies a number of critical data gaps that will need to be addressed in order to enable systematic monitoring of Sustainable Development Goal (SDG) targets and to realize the commitment to ‘leave no one behind’.
[HIV-1 resistance to antiretroviral drugs in pregnant women from Buenos Aires metropolitan area] Resistencia de HIV-1 a drogas antirretrovirales en gestantes del area Metropolitana de Buenos Aires.
Medicina. 2016; 76(6):349-354.The study aimed to determine the prevalence of antiretroviral resistance associated mutations in HIV-1 infected pregnant woman treated in Buenos Aires metropolitan area (period 2008-2014). A total of 136 women with viral load = 500 copies/ml were included: 77 (56.6%) were treatment-naive and 59 (43.4%) were antiretroviral-experienced patients either with current (n: 24) or previous (n = 35) antiretroviral therapy. Genotypic baseline resistance was investigated in plasma of antiretroviral-naive patients and antiretroviral-experienced patients. The resistance mutations were identified according to the lists of the World Health Organization and the International Antiviral Society, respectively. Frequencies of resistance associated mutations detected in 2008-2011 and 2012-2014 were compared. A total of 37 (27.2%) women presented at least one resistance associated mutation: 25/94 (26.5%) in 2008-2011 and 12/42 (28.5%) in 2012-2014 (p > 0.05). Among naives, 15 (19.5%) had at least one mutation: 10/49 (20.4%) in the period 2008-2011 and 5/28 (17.8%) in 2012-2014 (p > 0.05). The resistance mutations detected in naives were associated with non nucleoside reverse transcriptase inhibitors, being K103N the most common mutation in both periods. In antiretroviral experienced patients, 22/59 (37.3%) had at least one resistance mutation. This study demonstrates a high frequency of resistance associated mutations which remained stable in the period analyzed. These levels suggest an increased circulation of HIV-1 antiretroviral resistant strains in our setting compared to previous reports from Argentina.
[Sex education in Tunisia: students' expectations and teachers' conceptions] Education a la sexualite en Tunisie, attentes des eleves et conceptions des enseignants.
Sante Publique. 2017 Jul 10; 29(3):405-414.Health education, as defined by the World Health Organization (WHO 1983), includes sex education. In Tunisia, there is a growing interest in sexuality issues, in contrast with the reigning conservative culture, challenging the taboos and restrictions imposed by religion. A global sex education strategy is therefore required in Tunisian in schools to help students understand their body and its biological functions, construct a real sexual identity and adopt behaviours that promote a healthy and low-risk lifestyle. In this study, we wonder whether the objectives defined by official programmes and conveyed by biology teachers are consistent with the expectations of their students in terms of sex education. This questionnaire-based survey, conducted among 95 biology teachers and 735 students, with an average age of 18 years, shows to what extent the objectives of biology teachers differ from the expectations of students, illustrating to what extent sex education needs to be adapted.
[Washington, D.C.], United States Agency for International Development [USAID], 2017 Jul. 3 p.The purpose of this technical update is to summarize current evidence and the World Health Organization (WHO) revised guidance regarding use of hormonal contraception (HC) by women at high risk of acquiring HIV. On March 2, 2017, WHO issued revised guidance on the use of progestogen-only injectables (norethisterone enanthate [NET-EN] and depot medroxyprogesterone acetate [DMPA], in both intramuscular [IM] and subcutaneous [SC] forms) by women at high risk of HIV acquisition. The recommendation was previously a Category 1 with a clarification, meaning there was no restriction on the use of the progestogen-only injectables, but women at high risk of HIV should be informed that use of those contraceptive methods may or may not increase risk of HIV acquisition. With the revised guidance, progestogen-only injectables are now classified as Category 2 for women at high risk of HIV acquisition. (excerpt)
Piloting L3M for child marriage: Experience in monitoring results in equity systems (MoRES) in Bangladesh.
Bethesda, Maryland, Abt Associates Inc., Health Finance & Governance Project, 2014 Sep. 100 p.Monitoring Results for Equity Systems (MoRES) is UNICEF’s global monitoring framework that was recently introduced in Bangladesh and other countries. MoRES proposes a hierarchy of information to facilitate the monitoring and evaluation of UNICEF programs. Level 1 corresponds to a situational analysis, which intends to identify the major bottlenecks and barriers to the achievement of UNICEF goals. Level 2 creates a routine approach for monitoring implementation of UNICEF programs. Level 3-which is the subject of this report-monitors the extent to which UNICEF programs contribute to reductions in the barriers and bottlenecks identified in Level 1. Finally, Level 4 monitoring measures the impact of UNICEF programs on the broader goals. The level 3 monitoring approach (L3M) pilot for child marriage described in this report focuses on examining how two of UNICEF’s Child Protection activities -adolescent stipends and conditional cash transfers - contribute to reductions in three priority bottlenecks: social norms, financial access, and legislation/policy. The pilot contributes the methodology and content required for UNICEF to conduct regular, routine monitoring of its Child Protection Program, as part of an office-wide L3M exercise at UNICEF-Bangladesh. (excerpt)
Washington, D.C., PAI, 2015 Aug. 2 p.There are more people displaced in the world today than at any other point in history, and more than 75 percent of those needing humanitarian assistance are women and children. In humanitarian emergencies, many women want to avoid pregnancy; however they lack access to the services and supplies that would allow them to delay pregnancy. To meet the reproductive health needs of people in humanitarian emergencies, organizations and policymakers should know the answers to these 10 critical questions.
Washington, D.C., PAI, 2016 Oct. 2 p.When the Global Financing Facility (GFF) was announced in 2014, it promised a “pioneering” way to finance and improve the lives of women, adolescents, children and newborns through provision of reproductive, maternal newborn and child health programs and policies. Family planning advocates and implementers were interested in the possibility of additional funds particularly as a global contraceptives funding crisis is looming, and the Sustainable Development Goals (SDGs) are being operationalized. To date, the GFF has had three rounds of countries selected to receive funding. In the first round, Democratic Republic of the Congo, Ethiopia, Kenya and Tanzania were selected. In the second round, Bangladesh, Cameroon, Liberia, Mozambique, Nigeria, Senegal and Uganda were selected. In the third round, Guatemala, Guinea, Myanmar and Sierra Leone were selected. To better understand the role of the GFF in filling funding gaps for family planning and contraceptive procurement, we analyzed the four published investment cases for Kenya, Tanzania, Ethiopia and Uganda.
[Washington, D.C.], Center for Global Development, 2015 May 27. 6 p. (Essays)In September this year, world leaders will meet in New York at the United Nations General Assembly. Top of the agenda will be the passage of a resolution laying out global development goals for the fifteen years to 2030, covering progress in areas from poverty reduction to forestry preservation. They will follow on from the Millennium Development Goals (MDGs), which have become a common yardstick of global progress over the past decade and a half. The MDGs, born out of the Millennium Declaration agreed to at the UN General Assembly in 2000, are widely seen as a considerable success of the international system. And they may well have played a role in speeding global progress toward better health and education outcomes over the last few years. That alone might justify coming up with a new set of global goals for the post-2015 period. But the power of the original MDGs to motivate was in their simplicity and clarity. Sadly, the process that has created proposals for the new set of goals has guaranteed the opposite outcome. The over wrought and obese drafts proposed by negotiating committees so far almost ensure that the post-2015 goals will have comparatively limited value and impact. While it is probably too late for the process to be rescued, particular post-2015 goals and targets might still be useful, and the broader hopes for sustainable development may well be salvaged by other UN meetings this year.
Bonn, Germany, GTZ, 2016 Apr. 7 p.This factsheet summarises the results of the past collaboration between BACKUP and the International Planned Parenthood Federation (IPPF) on the ‘Shadows and Light’ project. BACKUP Health and the International Planned Parenthood Fed-eration (IPPF) have collaborated over many years to foster greater and more rapid action on SRH and HIV linkages within the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund). Recent collaborative work has highlighted gaps in addressing the specific needs of key populations within Global Fund pro-grammes. ‘Shadows and Light’, a three-year project funded by BACKUP Health, aims to address the linked SRH and HIV needs of key populations within four IPPF member associations. The project involved the Family Planning Association of India and transgender people, Reproductive Health Uganda and sex work-ers, Family Health Options Kenya and people who inject drugs, and the Cameroon National Association for Family Welfare and MSM. The project recognised that a comprehensive response to HIV must include initiatives that meet the needs of those who are marginalised, vulnerable, socially excluded and under-served. Based on these linkages, addressing SRH within HIV programmes and services funded by the Global Fund is a key opportunity to ensure sustainability in service provision to key populations.
Geneva, Switzerland, UNAIDS, 2016. 12 p.Gender inequalities and harmful gender norms are important drivers of the HIV epidemic, and they are major hindrances to an effective HIV response. While access to HIV services for women and girls remain a concern, a growing body of evidence also shows that men and adolescent boys have limited access to HIV services. Current effort to advance both gender equality and sexual and reproductive health and rights as key elements of the HIV response do not adequately reflect the ways that harmful gender norms and practices negatively affect men, women and adolescent body and girls in all their diversity. This in turn increases HIV-related vulnerability and risk among all of these groups.
[London, United Kingdom, IPPF], 2017 Jun. 3 p.The World Health Organization (WHO) issued revised guidance on the eligibility criteria for hormonal contraceptive use among women at high risk of acquiring HIV in March 2017. This update is critically important for women’s health, particularly in sub-Saharan Africa where HIV prevalence is high and injectable contraception is widely used.
Pakistan: increasing access to SRH services in fragile contexts for rural women in hard-to-reach areas.
London, United Kingdom, IPPF, 2015 Sep. 2 p.In some areas of Pakistan, girls and women are vulnerable to harmful traditional practices, like swara (now illegal, a form of reconciliation where a girl or woman is given in marriage to settle a dispute) and early marriage, and many of them face tremendous obstacles to basic services, including sexual and reproductive health (SRH) services.
London, United Kingdom, IPPF, 2015 Feb. 48 p.This report examines the links between sexual and reproductive health and rights and gender equality. It explores the different pathways of empowerment that girls and women experience, and analyzes how these pathways are affected by sexual and reproductive health and rights. Policy focus and attention given to gender equality and women’s empowerment has been growing over the last decade, and there are some areas where links are established more conclusively. Although there is strong documentation on the health benefits of investment in sexual and reproductive health, until recently the non medical benefits, such as higher levels of social and political participation, have been largely ignored, partly because they are difficult to measure. While the social and economic implications of sexual and reproductive health and rights are often overlooked, they are no less real. More attention is needed to explore the links between sexual and reproductive health and rights and other critical areas relating to gender equality, such as the representation of women in political and public life.
London, United Kingdom, IPPF, 2014 Nov. 8 p.This publication outlines how, following the London Summit on Family Planning in 2012, International Planned Parenthood Federation (IPPF) has worked to engage governments, with the aim of building a conducive environment to reach the most vulnerable groups, no matter how remote their location, in order to reach the key goal of ensuring 120 million more women have access to family planning by 2020.
Lancet. 2017 Jul 01; 390(10089):1.Add to my documents.
[London, United Kingdom, IPPF, 2015]. 2 p.The Family Planning Association of Bangladesh (FPAB, the IPPF Member Association in Bangladesh) and other civil society organizations (CSOs) have identified a number of ‘high priority’ pledges: progress towards these pledges is critical for increasing access to modern family planning (FP) methods. The government has made some progress towards its pledges, but existing efforts are not enough to deliver on its promises by 2020. In addition, other problems and gaps have emerged. The government must address these problems urgently. Civil society calls on the government to: Increase the budgetary allocation to family planning and reduce the resource gap for family planning by 50% by 2021. The government pledged US $40 million per year (or US $380 million by 2021), but since 2009, increases to the annual development budget have not met this commitment; Expand access to long-acting and reversible contraception (LARC) in order to ensure that vulnerable groups have access and choice of family planning methods; Empower women and girls to make family planning choices and freely exercise their sexual and reproductive rights.
[London, United Kingdom, IPPF, 2015]. 2 p.The Zimbabwe National Family Planning Council (ZNFPC, the IPPF Collaborating Partner in Zimbabwe) and other civil society organizations (CSOs) have identified a number of ‘high priority’ pledges: progress towards these pledges is critical for increasing access to modern family planning (FP) methods. Civil society calls on the government to: Facilitate the active participation of girls and young women, including those who are marginalized and those living with HIV, in all aspects of national programming and decision-making relating to HIV and AIDS; Strengthen commitment to women’s health by responding to the health impact of unsafe abortion, a major public health concern, by scaling up post-abortion care and reducing unintended pregnancies through expanded and improved family planning services; Implement evidence-based HIV prevention programmes that address the needs of girls and young women, especially those living in prison or detention centres, those involved in transactional sex or child marriages, survivors of gender-based violence and orphans.