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Geneva, Switzerland, World Health Organization [WHO], 2007.  p.Since the advent of penicillin, syphilis is not only preventable but also treatable. Despite this, it remains a global problem with an estimated 12 million people infected each year. Pregnant women who are infected with syphilis can transmit the infection to their fetus, causing congenital syphilis with serious adverse effects on the pregnancy in up to 80% of the cases. Yet simple, cost-effective screening and treatment options could prevent and eventually eliminate congenital syphilis. With the current international focus on the Millennium Development Goals (MDGs), there exists a unique opportunity to mobilize action to prevent, and subsequently eliminate, congenital syphilis. Congenital syphilis is a serious but preventable disease, which can be eliminated through effective screening of pregnant women for syphilis and treatment of those infected. More newborn infants are affected by congenital syphilis than by any other neonatal infection, including human immunodeficiency virus (HIV) infection and tetanus, which are currently receiving global attention. Yet the burden of congenital syphilis is still under-appreciated at both international and national levels. Unlike many neonatal infections, congenital syphilis can be effectively prevented by testing and treatment of pregnant women, which also provides immediate benefits to the mother and allows potentially infected partners to be traced and offered treatment. It has been clearly shown that screening of pregnant women for reactive syphilis serology, followed by treatment of seropositive women, is a cost-effective, inexpensive and feasible intervention for the prevention of congenital syphilis and improvement of child health. In 1995, the Pan American Health Organization (PAHO) began a regional campaign to reduce the rate of congenital syphilis in the Americas to less than 50 cases per 100 000 live births. The strategy was to: (1) increase the availability of antenatal care; (2) establish routine serological testing for syphilis during antenatal careand at delivery; and (3) promote the rapid treatment of infected pregnant women. (excerpt)
Safe, voluntary, informed male circumcision and comprehensive HIV prevention programming. Guidance for decision-makers on human rights, ethical and legal considerations. Pre-publication.
Geneva, Switzerland, UNAIDS, 2008 Mar. 28 p. (UNAIDS/08.19E / JC1552E)Throughout the world, HIV prevalence is generally lower in populations that practise male circumcision than in populations where most men are uncircumcised. This has been observed over the years of the HIV epidemic and has now been confirmed through three randomized controlled trials concluded in 2005-2006. The trials showed that male circumcision reduces by 60% the transmission of HIV from women to circumcised men. The results have led to the conclusion that male circumcision is an effective risk-reduction measure for men, and should be used in addition to other known strategies for the prevention of heterosexually acquired HIV infection in men. (excerpt)
Lancet Infectious Diseases. 2008 Feb; 8(2):98-100.Kevin De Cock is director of WHO's HIV/AIDS department. Formerly director of the US Centers for Disease Control and Prevention in Kenya, he is an infectious disease specialist, with expertise in HIV/ AIDS, tuberculosis, liver disease, and tropical diseases such as yellow fever and viral haemorrhagic fevers. TLID: How has your time as WHO's HIV/AIDS director been? KDC: It has been extremely interesting. AIDS policy is always challenging and changing. WHO's HIV efforts up to 2005 were very much oriented around the 3 by 5 initiative. The G8 in 2005 made an announcement about working towards universal access, which became an AIDS rallying cry. So we've had to reorganise ourselves around that as a theme. Some internal reorganisation was necessary to focus not only on treatment, but also on broader issues. We now have five key strategic directions: increasing access to HIV testing and counselling, maximising prevention, accelerating treatment scale-up, strengthening health systems, and investing in strategic information. We have also been working on some important technical areas. One is the issuing of guidance on both provider-initiated testing and male circumcision. In April, 2007, we also issued a report, in response to a request from the World Health Assembly, on the health sector's progress towards universal access. (excerpt)
New York, New York, UNICEF, 2007 Dec.  p.Five years after the Special Session, more than 120 countries and territories have prepared reports on their efforts to meet the goals of 'A World Fit for Children' (WFFC). Most have developed these in parallel with reports on the Millennium Development Goals, carrying out two complementary exercises. Reports on the Millennium Development Goals highlight progress in poverty reduction and the principal social indicators, while the World Fit for Children reports go into greater detail on some of the same issues, such as education and child survival. But they also extend their coverage to child protection, which is less easy to track with numerical indicators. The purpose of this document is to assemble some of the information contained in these reports, along with the latest global data - looking at what has been done and what remains to be done. It is therefore organized around the four priority areas identified in A World Fit for Children, discussing each within the overall framework of the Millennium Development Goals. To appreciate the achievements for children over the past two decades, it is also useful to reflect briefly on how their world has changed. Children born in 1989, the year when the Convention on the Rights of the Child was adopted, are now on the brink of adulthood. They have lived through a remarkable period of social, political and economic transformation. (excerpt)
Eliminating female genital mutilation: an interagency statement. OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO.
Geneva, Switzerland, World Health Organization [WHO], 2008. 41 p.The term 'female genital mutilation' (also called 'female genital cutting' and 'female genital mutilation/cutting') refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. Between 100 and 140 million girls and women in the world are estimated to have undergone such procedures, and 3 million girls are estimated to be at risk of undergoing the procedures every year. Female genital mutilation has been reported to occur in all parts of the world, but it is most prevalent in: the western, eastern, and north-eastern regions of Africa, some countries in Asia and the Middle East and among certain immigrant communities in North America and Europe. Female genital mutilation has no known health benefits. On the contrary, it is known to be harmful to girls and women in many ways. First and foremost, it is painful and traumatic. The removal of or damage to healthy, normal genital tissue interferes with the natural functioning of the body and causes several immediate and long-term health consequences. For example, babies born to women who have undergone female genital mutilation suffer a higher rate of neonatal death compared with babies born to women who have not undergone the procedure. (excerpt)
Sulphadoxine / pyrimethamine versus amodiaquine for treating uncomplicated childhood malaria in Gabon: A randomized trial to guide national policy.
Malaria Journal. 2008 Feb 12; 7:31.In Gabon, following the adoption of amodiaquine/artesunate combination (AQ/AS) as first-line treatment of malaria and of sulphadoxine/pyrimethamine (SP) for preventive intermittent treatment of pregnant women, a clinical trial of SP versus AQ was conducted in a sub-urban area. This is the first study carried out in Gabon following the WHO guidelines. A random comparison of the efficacy of AQ (10 mg/kg/day x 3d) and a single dose of SP (25 mg/kg of sulphadoxine/1.25 mg/kg of pyrimethamine) was performed in children under five years of age, with uncomplicated falciparum malaria, using the 28-day WHO therapeutic efficacy test. In addition, molecular genotyping was performed to distinguish recrudescence from reinfection and to determine the frequency of the dhps K540E mutation, as a molecular marker to predict SP-treatment failure. The day-28 PCR-adjusted treatment failures for SP and AQ were 11.6% (8/69; 95% IC: 5.5-22.1) and 28.2% (20/71; 95% CI: 17.7-38.7), respectively This indicated that SP was significantly superior to AQ (P= 0.019) in the treatment of uncomplicated childhood malaria and for preventing recurrent infections. Both treatments were safe and well-tolerated, with no serious adverse reactions recorded. The dhps K540E mutation was not found among the 76 parasite isolates tested. The level of AQ-resistance observed in the present study may compromise efficacy and duration of use of the AQ/AS combination, the new first-line malaria treatment. Gabonese policy-makers need to plan country-wide and close surveillance of AQ/AS efficacy to determine whether, and for how long, these new recommendations for the treatment of uncomplicated malaria remain valid. (author's)
Geneva, Switzerland, UNAIDS, . 13 p.For over 25 years, our world has been living with HIV. And in just this short time, AIDS has become one of the make-or-break global crises of our age, undermining not just the health prospects of entire societies but also their ability to reduce poverty, promote development, and maintain national security. And in too many regions AIDS continues to expand - every single day 11 000 people are newly infected with HIV, and nearly 8 000 people die from AIDS-related illnesses. Yet, despite the magnitude of the AIDS crisis, today we are at a time of great hope and great opportunity to get ahead of the epidemic. Our crisis-response tactics have led to real progress against AIDS. Funding for efforts against AIDS has risen from 'millions' to 'billions' in just a decade. Political commitment and leadership on AIDS is higher than ever before. In more and more countries - including some of the world's poorest - we are seeing real results in terms of lives saved because effective HIV prevention and treatment programmes are being made widely available. Leaders of both developing and rich countries have now committed themselves to working together so as to get close to universal access to HIV prevention, treatment, care and support by 2010 - a critical stepping stone to halting the epidemic by 2015, as set out in the Millennium Development Goals. (excerpt)
Adolescents, social support and help-seeking behaviour: An international literature review and programme consultation with recommendations for action.
Geneva, Switzerland, World Health Organization [WHO], Department of Child and Adolescent Health and Development, 2007. 56 p. (WHO Discussion Papers on Adolescence)With this brief introduction and justification, this document presents: The findings from an international literature review on the topic of adolescents and help-seeking behaviour. The results of a programme consultation with 35 adolescent health programmes (including public health sector programmes, university-based adolescent health programmes and non-government organizations (NGO) working in adolescent health) from Latin America (10), the Western Pacific region (4), Asia (20), and the Middle East (1), and the results of six key informant interviews. These results are incorporated into the literature review where relevant. The complete report from this consultation of programmes is found in Appendix 1. Recommendations for action, including a brief outline for developing a set of guidelines for the rapid assessment of social supports to promote the help-seeking of adolescents. This document is part of a WHO project to identify and define evidence-based strategies for influencing adolescent help-seeking and identify research questions and activities to promote improved help-seeking behaviour by adolescents. To achieve this objective, the consultants, with WHO guidance: (1) carried out an international literature review of the topic; (2) sent 67 questionnaires and received 35 questionnaires back from adolescent health programmes on the topic of adolescents and help-seeking in the four regions; and (3) carried out key informant interviews with nine individuals (three in Latin America, three in the Pacific region and three in South Asia). The consultants also developed short case studies of illustrative approaches in promoting help-seeking behaviour. (excerpt)
Geneva, Switzerland, UNAIDS, 2007 Mar. 4 p. (UNAIDS Policy Brief)Nearly 40 million people in the world are living with HIV. In countries such as Botswana, Swaziland, and Lesotho people living with HIV make up a quarter or more of the population. People living with HIV are entitled to the same human rights as everyone else, including the right to access appropriate services, gender equality, self-determination and participation in decisions affecting their quality of life, and freedom from discrimination. All national governments and leading development institutions have committed to meeting the eight Millennium Development Goals, which include halving extreme poverty, halting and beginning to reverse HIV and providing universal primary education by 2015. GIPA or the Greater Involvement of People Living with HIV is critical to halting and reversing the epidemic; in many countries reversing the epidemic is also critical to reducing poverty. (excerpt)
Washington, D.C., Population Reference Bureau [PRB], 2007 Dec.  p.With continuing political turmoil, emergency rule declared, and concerns about how free and fair January elections will be, Pakistan has been under the spotlight recently. But the political arena isn't the only area where challenges persist. Beneath the surface, more problems are brewing in the sixth most populous country in the world. Some of the challenges are fueled by the country's rapidly growing population, which is making increasing demands on social services, especially the health care system. A comparison of population pyramids reflects how Pakistan has grown and how its needs will multiply. Between 1970 and 2000, Pakistan more than doubled in population to 144 million from 60 million. Its population ages 15 to 49 more than tripled to 68 million from 14 million. As the number of people in that age group rose, so did demand for maternal and child health care. And health care needs are likely to grow as the 2025 projection for those ages 15 to 49 rises to 121 million, nearly double the 2000estimate. (excerpt)
Journal of Health Communication. 2007; 12(8):705-706.Global health seems to be more firmly established, with a variety of organizations, professional publications, governments and foundations increasing the emphasis. Some of the increase in awareness can be attributed to recent concerns of health security- avian flu, SARS, bioterrorism, MDR-TB-as well as the moral imperatives to address the inequalities pervasive in the 21st Century. In the past five years alone, aid for health as more than doubled. Yet, there is a clouded leadership and approach-there is one truly global health organization-the World Health Organization with 191 member states. Yet, there are over 90 global health agencies, 40 bilateral donors, 26 UN agencies, and 20 global and regional funds. Countless foundations and others have entered the fray-some employing evidence informed approaches, with others based on ideology and multiple sources for engagement. The Bill and Melinda Gates Foundation has a budget dwarfing many governments as well as multilateral institutions dedicated to health. The Global Fund for AIDS, Tuberculosis and Malaria and the US President's Emergency Plan for AIDS Relief (PEPFAR) have helped galvanize and provide funding for specific diseases. Recently, the new UK Prime Minister Gordon Brown launched the International Health Partnership, another initiative to accelerate progress on health globally. (excerpt)
International Communication Gazette. 2007; 69(6):483-507.In the UN system, conflicts and contradictions seldom concern the Millennium Development Goals (MDGs) as such, but rather the means of achieving them. These differences of opinion about priorities, and about how much and to whom development aid or assistance should be directed, could be explained by analysing the ontological, epistemological and methodological assumptions underpinning the general perspectives in the communication for development (C4D) field. Theoretical changes in the perspective on development communication (modernization, dependency, multiplicity) have also reached the level of policy-makers. As a result, different methodologies and terminologies have evolved, which often make it difficult for agencies, even though they share a common commitment to the overall goals of development communication, to identify common ground, arrive at a full understanding of each other's objectives, or to cooperate effectively in operational projects. Consequently, it is difficult for development organizations in general and UN agencies in particular to reach a common approach and strategy. (author's)
Geneva, Switzerland, WHO, 2007. 8 p. (WHO/RHR/07.7)Faced with the challenge of putting into practice the ideals of the Millennium Development Goals, the International Conference on Population and Development (ICPD), and other global summits of the last decade, decision-makers and programme managers responsible for sexual and reproductive health ask how they can: improve access to and the quality of family planning and other sexual and reproductive health services; increase skilled attendance at birth and strengthen referral systems; reduce the recourse to abortion and improve the quality of existing abortion services; provide information and services that respond to young people's needs; and integrate the prevention and treatment of reproductive tract infections, including HIV/AIDS, with other sexual and reproductive health services. (excerpt)
Lancet. 2007 Oct 27; 370(9597):1471-1474.With the Paul Wolfowitz era behind it and new appointee Robert Zoellick at the helm, it is time for the World Bank to better define its role in an increasingly crowded and complex global health architecture, says Jennifer Prah Ruger, health economist and former World Bank speechwriter. Just 2 years after taking office as president of the World Bank, Paul Wolfowitz resigned amid allegations of favouritism, and is now succeeded by Robert Zoellick. Many shortcomings marked Wolfowitz's presidency, not the least of which were a tumultuous battle over family planning and reproductive health policy, significant reductions in spending and staffing, and poor performance in implementing health, nutrition, and population programmes. Wolfowitz did little to advance the bank's role in the health sector. With the Wolfowitz era behind it and heightened scrutiny in the aftermath, the World Bank needs to better define its role and seize the initiative in health at both the global and country levels. Can the bank have an effect in an increasingly plural and complex global health architecture? What crucial role can the bank play in global health governance in the years ahead? (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 2007.  p. (WHO Discussion Papers on Adolescence; Issues in Adolescent Health and Development)The World Health Organization (WHO) has been contributing to meeting the Millennium Development Goals (MDGs) by according priority attention to issues pertaining to the management of adolescent pregnancy. Three of the aims of the MDGs - empowerment of women, promotion of maternal health, and reduction of child mortality - embody WHO's key priorities and its policy framework for poverty reduction. The UN Special Session on Children has focused on some of the key issues affecting adolescents' rights, including early marriage, access to sexual and reproductive health services, and care for pregnant adolescents. This review of the literature was conducted to identify (1) the major factors affecting the pregnancy outcome among adolescents, related to their physical immaturity and inappropriate or inadequate healthcare-seeking behaviour, and (2) the socioeconomic and political barriers that influence their access to health-care services and information. The review also presents programmatic evidence of feasible measures that can be taken at the household, community and national levels to improve pregnancy outcomes among adolescents. (excerpt)
International Journal of Gynecology and Obstetrics. 2007 Nov; 99(2):157-161.National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny. (author's)
The Global Campaign for the Health MDGs: Challenges, opportunities, and the imperative of shared learning.
Lancet. 2007 Sep 22; 370(9592):1018-1020.On Sept 5, the International Health Partnership (IHP) was launched by the UK, and on Sept 26, Women and Children First: the Global Business Plan for Maternal, Newborn and Child Health will be launched by Norway. These two new efforts, along with the Canadian Catalytic Initiative to Save a Million Lives, have been packaged as part of a broader Global Campaign for the Health Millennium Goals (MDGs). Such an explosion of proposals, which is meant to accelerate action for achieving MDGs 4, 5, and 6, should be welcomed by the world's health community. The proposals are further recognition of the continued commitment by high-income countries to address key health challenges in low-income and middle-income countries. Building on a decade of expanding work in global health, we can hope that these high-profile initiatives will sustain interest and address major obstacles to improving the health of the poorest people in the magnitude and time-frame demanded by the MDGs. Nevertheless, as is often the case with new policy efforts, the main operative aspects of the proposals and their likely consequences can be difficult to identify. We frame questions on five key issues that these announcements highlight. (excerpt)
Bethesda, Maryland, Abt Associates, Partners for Health Reform Plus, .  p. (USAID Contract No. HRN-C-00-00-00019-00)The Global Fund to Fight AIDS, TB and Malaria aims to attract, manage, and disburse resources that will make a significant and sustainable impact on the three focal diseases. The Global Fund has also stated its commitment to support programs that address the three diseases "in ways that contribute to the strengthening of health systems." The Global Fund is likely to have a variety of direct and indirect effects upon health care systems that could be positive or negative in nature. To be effective and sustainable in the long run, interventions will depend upon well-functioning health systems. This is true not only for the Global Fund, but also for other initiatives, such as the World Bank Multisectoral AIDS Program (MAP), the President's Emergency Plan for AIDS Relief, and others that aim to substantially increase the scale of response to specific diseases, particularly HIV/ AIDS. (excerpt)
Support to mainstreaming AIDS in development. UNAIDS Secretariat strategy note and action framework, 2004-2005.
Geneva, Switzerland, UNAIDS, . 10 p.Twenty years into the pandemic, there is now ample evidence for the complex linkages between AIDS and development: development gaps increase people's susceptibility to HIV transmission and their vulnerability to the impact of AIDS; inversely, the epidemic itself hampers or even reverses development progress so as to pose a major obstacle to the achievement of the Millennium Development Goals. The growing understanding of this two-way relationship between AIDS and development has led to the insight that, in addition to developing programmes that specifically address AIDS, there is a need to strengthen the way in which existing development programmes address both the causes and effects of the epidemic in each country-specific setting. The process through which to achieve this is called 'Mainstreaming AIDS'. In recognition of this, the 2001 United Nations General Assembly Special Session Declaration of Commitment on HIV/AIDS requires countries to integrate their AIDS response into the national development process, including poverty reduction strategies, budgeting instruments and sectoral programmes. (excerpt)
London, England, ActionAid International, . 27 p. (P1625/01/04)UNAIDS estimated that in Africa in 2003, more than 2.3 million people died from AIDS, 3 million were newly infected and a total of 12 million children were orphaned. Antiretroviral drugs are reaching a mere 50,000 of those with AIDS in developing countries. The HIV/AIDS pandemic is clearly a human and developmental disaster. This paper looks at the response to the HIV/AIDS crisis by the World Bank as a key member of the international donor/lending community, a leader in the international health community, and as Africa's principal development partner. In its seminal document, Intensifying Action Against HIV/AIDS, the World Bank acknowledges both its special leadership role in fighting HIV/AIDS and the need that it be held accountable for its stewardship. (excerpt)
Joint UNFPA-UNICEF-WHO Meeting on Prevention and Control of Sexually Transmitted Infections in the Pacific, 8-11 November 2005, Nadi, Fiji.
Manila, Philippines. WHO, Regional Office for the Western Pacific, .  p. ((WP)HSI/ICP/HSI/3.5/001; Report Series No. RS/2005/GE/36(FIJ))The Joint UNFPA-UNICEF-WHO Meeting on Prevention and Control of Sexually Transmitted Infections in the Pacific was held at the Mocambo Hotel in Nadi, Fiji, from 8 to 11 November 2005 with the following objectives: to review the current sexually transmitted infection (STI) situation in the Pacific island countries and areas; to share experiences, lessons learnt and the latest developments in STI prevention and control; and to identify issues, gaps and key actions needed for effective prevention and control of STI in the Pacific island countries and areas. The programme included technical presentations, situation reports from countries and partners and open forum discussion across a broad range of issues related to the epidemiology, prevention and control of STIs: the status of STIs in countries in the Pacific region; new STI case management strategies; the role of laboratories in STI case management, screening and surveillance systems; special needs for dealing with STIs in high-risk groups like antenatal women, sex workers and their clients, and youth; the integration of STIs into reproductive health services; and Pacific STI networking, both current and planned. Meeting participants reached a number of conclusions and made recommendations. These included: recognition of the important individual and public health hazards that STIs present in the Pacific region; the special clinical and epidemiological challenges that are presented by chlamydiosis; the utility of syndromic case management in controlling STIs, the importance of STI intervention programmes targeting "core" and "bridging" groups; and the role of partnerships and STI networks in the Pacific region. Each participating country identified its immediate priority needs as well as priorities for regional support. (author's)
Workshop on Gender and Rights in Reproductive and Maternal Health, convened by World Health Organization, Regional Office for the Western Pacific, Kuala Lumpur, Malaysia, 28 November - 2 December 2005. Report.
Manila, Philippines. WHO, Regional Office for the Western Pacific, 2006 Mar. 40 p. ((WP)RPH/ICP/RPH/3.4/001/RPH(3)/2005-E; Report Series No. RS/2005/GE/43(MAA))More than a decade after the International Conference on Population and Development (ICPD) in 1994 and the Fourth World Conference on Women in 1995, governments are expressing their commitment to women's health, in particular to sexual and reproductive health. Unfortunately, high maternal and neonatal mortality remains a feature in many countries in the Western Pacific Region. The complex issues of reproductive and maternal health extend beyond technical and medical factors. Social determinants, such as gender and rights, though recognized as important factors in maternal mortality and morbidity, have not been considered in health services planning, perhaps because of a lack of understanding and inadequate capacity to operationalize the concepts. To achieve the Millennium Development Goals (MDG), it is essential that the gender and rights dimensions are fully understood and mainstreamed in policy, programmes and services. Recognizing the urgency of the situation, the WHO Western Pacific Regional Office decided to organize a workshop in collaboration with the Ministry of Health Malaysia as the host in Kuala Lumpur from 28 November to 2 December 2005. The Workshop on Gender and Rights in Reproductive and Maternal Health was the first ever organized by the Regional Office. Unlike other workshops, this was a training workshop aimed at introducing Concepts as well as some basics kills and tools to enable participants to bring a gender and rights perspective in to their programme services. (excerpt)
New York, New York, United Nations, Department of Economic and Social Affairs, .  p.This Toolkit is meant for national youth organizations and/or representatives working with youth. It can be used as a tool to: Assess your country's progress in reaching the WPAY goals; Prioritize your organization's work, based on your findings; Initiate actions at the national level. This Toolkit should be used as a starting point for determining what your government, and civil society, has done to better the lives of young people, since 1995. In addition to providing methods for evaluating this progress, the Toolkit also contains concrete tools to further your youth work. As such, we hope that you will find it both informative and useful, and a good resource for your organization. (excerpt)
Traditional health practitioner and the scientist: Bridging the gap in contemporary health research in Tanzania.
Tanzania Health Research Bulletin. 2007 May; 9(2):115-120.Traditional health practitioners (THPs) and their role in traditional medicine health care system are worldwide acknowledged. Trend in the use of Traditional medicine (TRM) and Alternative or Complementary medicine (CAM) is increasing due to epidemics like HIV/AIDS, malaria, tuberculosis and other diseases like cancer. Despite the wide use of TRM, genuine concern from the public and scientists/biomedical heath practitioners (BHP) on efficacy, safety and quality of TRM has been raised. While appreciating and promoting the use of TRM, the World Health Organization (WHO), and WHO/Afro, in response to the registered challenges has worked modalities to be adopted by Member States as a way to addressing these concerns. Gradually, through the WHO strategy, TRM policy and legal framework has been adopted in most of the Member States in order to accommodate sustainable collaboration between THPs and the scientist/BHP. Research protocols on how to evaluate traditional medicines for safety and efficacy for priority diseases in Africa have been formulated. Creation of close working relationship between practitioners of both health care systems is strongly recommended so as to revamp trust among each other and help to access information and knowledge from both sides through appropriate modalities. In Tanzania, gaps that exist between THPs and scientists/BHP in health research have been addressed through recognition of THPs among stakeholders in the country's health sector as stipulated in the National Health Policy, the Policy and Act of TRM and CAM. Parallel to that, several research institutions in TRM collaborating with THPs are operating. Various programmed research projects in TRM that has involved THPs and other stakeholders are ongoing, aiming at complementing the two health care systems. This paper discusses global, regional and national perspectives of TRM development and efforts that have so far been directed towards bridging the gap between THPs and scientist/BHP in contemporary health research in Tanzania. (author's)
Bethesda, Maryland, Abt Associates. Private Sector Partnerships-One [PSP-One], 2006 Dec. 48 p. (Technical Report No. 6; USAID Contract No. GPO-I-00-04-00007-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ADI-754)Government health sectors in many countries face an uphill battle to reach the Millennium Development Goals (MDGs) set for 2015. In the last six years, Ministries of Health (MOHs) in many less developed countries (LDCs) have been unable to invest sufficiently in their health systems. To achieve the MDGs despite inadequate resources, new approaches for delivering critical clinical services must be considered. This paper explores the potential for private-sector midwives to provide services beyond their traditional scope of care during pregnancies and births to address shortcomings in LDCs' ability to reach MDGs. This paper examines factors that support or constrain private practice midwives' (PPMWs') ability to offer expanded services in order to inform the policy and donor communities about PPMWs' potential. Data was collected through literature reviews, stakeholder interviews, and field-based, semi-structured interviews in Ghana, Indonesia, Peru, Uganda, and Zambia. Ghana, Indonesia, and Uganda were chosen because they are countries where PPMWs provide expanded services. Peru and Zambia were selected as examples where midwives have struggled to develop private practices or they provide expanded services despite issues about midwives' roles and legal sanctions for private practices. (excerpt)