Your search found 14048 Results

  1. 201
    320196

    Responding to intimate partner violence and sexual violence against women. WHO clinical and policy guidelines.

    World Health Organization [WHO]

    Geneva, Switzerland, World Health Organization [WHO], 2013. 68 p.

    A health-care provider is likely to be the first professional contact for survivors of intimate partner violence or sexual assault. Evidence suggests that women who have been subjected to violence seek health care more often than non-abused women, even if they do not disclose the associated violence. They also identify health-care providers as the professionals they would most trust with disclosure of abuse. These guidelines are an unprecedented effort to equip healthcare providers with evidence-based guidance as to how to respond to intimate partner violence and sexual violence against women. They also provide advice for policy makers, encouraging better coordination and funding of services, and greater attention to responding to sexual violence and partner violence within training programmes for health care providers. The guidelines are based on systematic reviews of the evidence, and cover: 1) identification and clinical care for intimate partner violence; 2) clinical care for sexual assault; 3) training relating to intimate partner violence and sexual assault against women; 4) policy and programmatic approaches to delivering services; and 5) mandatory reporting of intimate partner violence. The guidelines aim to raise awareness of violence against women among health-care providers and policy-makers, so that they better understand the need for an appropriate health-sector response. They provide standards that can form the basis for national guidelines, and for integrating these issues into health-care provider education.
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  2. 202
    320187

    Strengthening the capacity of community health workers to deliver care for sexual, reproductive, maternal, newborn, child and adolescent health.

    World Health Organization [WHO]; United Nations Fund for Population Activities [UNFPA]

    Geneva, Switzerland, World Health Organization [WHO], 2015. 20 p.

    Government institutions, United Nations agencies, and global partners have been repositioning the role that community health workers (CHWs) can play in increasing access to essential quality health services in the context of national primary health care and universal health coverage. Given the growing momentum and interest in training CHWs, the United Nations health agencies (H4+) have developed this technical brief to orient country programme managers and global partners as to key elements for strengthening the capacity of CHWs, including health system and programmatic considerations, core competencies, and evidence-informed interventions for CHWs along the SR/MNCAH continuum of care. These key elements need to be adapted and contextualized by countries to reflect the structure, gaps, and opportunities of the national primary health care system, the interaction between the health sector with other sectors, and the specific roles and competencies that CHWs already have within that system. These key elements should also guide H4+ members and partners to take a joint and harmonized approach to supporting countries in their capacity-development efforts. Annex 1 lists SR/MNCAH interventions that CHWs can perform based on the best available evidence and existing WHO guidance.
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  3. 203
    375642

    Managing complications in pregnancy and childbirth: a guide for midwives and doctors. Second edition.

    World Health Organization [WHO]; United Nations Population Fund [UNFPA]; UNICEF

    Geneva, Switzerland, WHO, 2017. 492 p. (Integrated Management Of Pregnancy And Childbirth)

    Since the first edition was published in 2000, the 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 World Health Organization recommendations, resulting in this second edition.
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  4. 204
    375638

    Ending AIDS: Progress towards the 90-90-90 targets. Global AIDS update -- 2017.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2017. 198 p. (UNAIDS/JC2900E)

    Since they were launched at the 20th International AIDS Conference in Melbourne, Australia, in 2014, the 90-90-90 targets have become a central pillar of the global quest to end the AIDS epidemic. The targets reflect a fundamental shift in the world’s approach to HIV treatment, moving it away from a focus on the number of people accessing antiretroviral therapy and towards the importance of maximising viral suppression among people living with HIV. This shift was driven by greater understanding of the benefits of viral suppression -- not only does treatment protect people living with HIV from AIDS-related illness, but it also greatly lowers the risk of transmitting the virus to others.
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  5. 205
    375636
    Peer Reviewed

    Who pays for cooperation in global health? A comparative analysis of WHO, the World Bank, the Global Fund to Fight HIV / AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance.

    Clinton C; Sridhar D

    Lancet. 2017; 390:324-332.

    In this report we assess who pays for cooperation in global health through an analysis of the financial flows of WHO, the World Bank, the Global Fund to Fight HIV / AIDS, TB and Malaria, and Gavi, the Vaccine Alliance. The past few decades have seen the consolidation of influence in the disproportionate roles the USA, UK, and the Bill & Melinda Gates Foundation have had in financing three of these four institutions. Current financing flows in all four case study institutions allow donors to finance and deliver assistance in ways that they can more closely control and monitor at every stage. We highlight three major trends in global health governance more broadly that relate to this development: towards more discretionary funding and away from core or longer-term funding; towards defined multi-stakeholder governance and away from traditional government-centred representation and decision-making; and towards narrower mandates or problem-focused vertical initiatives and away from broader systemic goals.
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  6. 206
    344649

    State of inequality: Reproductive, maternal, newborn and child health.

    World Health Organization [WHO]. Department of Health Statistics and Information Systems

    Geneva, Switzerland, WHO, 2015. 124 p.

    The report delivers both promising and disappointing messages about the situation in low- and middle-income countries. Within-country inequalities have narrowed, with a tendency for national improvements driven by faster improvements in disadvantaged subgroups. However, inequalities still persist in most reproductive, maternal, newborn and child health indicators. The extent of within-country inequality differed by dimension of inequality and by country, country income group and geographical region. There is still much progress to be made in reducing inequalities in RMNCH.
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  7. 207
    344641

    World health statistics 2017. Monitoring health for the SDGs, Sustainable Development Goals.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO , 2017. 116 p.

    The World Health Statistics series is WHO’s annual compilation of health statistics for its 194 Member States. World Health Statistics 2017 compiles data on 21 health-related Sustainable Development Goals (SDG) targets, with 35 indicators, as well as data on life expectancy. This edition also includes, for the first time, success stories from several countries that are making progress towards the health-related SDG targets.
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  8. 208
    375609

    WHO guidelines on ethical issues in public health surveillance.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2017. 56 p.

    The WHO Guidelines on Ethical Issues in Public Health Surveillance is the first international framework of its kind, it fills an important gap. The goal of the guideline development project was to help policymakers and practitioners navigate the ethical issues presented by public health surveillance. This document outlines 17 ethical guidelines that can assist everyone involved in public health surveillance, including officials in government agencies, health workers, NGOs and the private sector. Surveillance, when conducted ethically, is the foundation for programs to promote human well-being at the population level. It can contribute to reducing inequalities: pockets of suffering that are unfair, unjust and preventable cannot be addressed if they are not first made visible. But surveillance is not without risks for participants and sometimes poses ethical dilemmas. Issues about privacy, autonomy, equity, and the common good need to be considered and balanced, and knowing how to do so can be challenging in practice.
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  9. 209
    379257
    Peer Reviewed

    Integrated person-centered health care for all women during pregnancy: implementing World Health Organization recommendations on antenatal care for a positive pregnancy experience.

    de Masi S; Bucagu M; Tuncalp O; Pena-Rosas JP; Lawrie T; Oladapo OT; Gulmezoglu M

    Global Health: Science and Practice. 2017 Jun 27; 5(2):197-201.

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  10. 210
    377504
    Peer Reviewed

    Potential impact of multiple interventions on HIV incidence in a hyperendemic region in Western Kenya: a modelling study.

    Blaizot S; Maman D; Riche B; Mukui I; Kirubi B; Ecochard R; Etard JF

    BMC Infectious Diseases. 2016 Apr 29; 16:189.

    BACKGROUND: Multiple prevention interventions, including early antiretroviral therapy initiation, may reduce HIV incidence in hyperendemic settings. Our aim was to predict the short-term impact of various single and combined interventions on HIV spreading in the adult population of Ndhiwa subcounty (Nyanza Province, Kenya). METHODS: A mathematical model was used with data on adults (15-59 years) from the Ndhiwa HIV Impact in Population Survey to compare the impacts on HIV prevalence, HIV incidence rate, and population viral load suppression of various interventions. These interventions included: improving the cascade of care (use of three guidelines), increasing voluntary medical male circumcision (VMMC), and implementing pre-exposure prophylaxis (PrEP) use among HIV-uninfected women. RESULTS: After four years, improving separately the cascade of care under the WHO 2013 guidelines and under the treat-all strategy would reduce the overall HIV incidence rate by 46 and 58 %, respectively, vs. the baseline rate, and by 35 and 49 %, respectively, vs. the implementation of the current Kenyan guidelines. With conservative and optimistic scenarios, VMMC and PrEP would reduce the HIV incidence rate by 15-25 % and 22-28 % vs. the baseline, respectively. Combining the WHO 2013 guidelines with VMMC would reduce the HIV incidence rate by 35-56 % and combining the treat-all strategy with VMMC would reduce it by 49-65 %. Combining the WHO 2013 guidelines, VMMC, and PrEP would reduce the HIV incidence rate by 46-67 %. CONCLUSIONS: The impacts of the WHO 2013 guidelines and the treat-all strategy were relatively close; their implementation is desirable to reduce HIV spread. Combining several strategies is promising in adult populations of hyperendemic areas but requires regular, reliable, and costly monitoring.
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  11. 211
    377434

    Validation of maternal and neonatal tetanus elimination in Equatorial Guinea, 2016. alidation de l'elimination du tetanos maternel et neonatal en Guinee equatoriale, 2016.

    Releve Epidemiologique Hebdomadaire. 2017 Jun 16; 92(24):333-44.

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  12. 212
    377423
    Peer Reviewed

    Population-level impact of an accelerated HIV response plan to reach the UNAIDS 90-90-90 target in Cote d'Ivoire: Insights from mathematical modeling.

    Maheu-Giroux M; Vesga JF; Diabate S; Alary M; Baral S; Diouf D; Abo K; Boily MC

    PLoS Medicine. 2017 Jun; 14(6):e1002321.

    BACKGROUND: National responses will need to be markedly accelerated to achieve the ambitious target of the Joint United Nations Programme on HIV/AIDS (UNAIDS). This target aims for 90% of HIV-positive individuals to be aware of their status, for 90% of those aware to receive antiretroviral therapy (ART), and for 90% of those on treatment to have a suppressed viral load by 2020, with each individual target reaching 95% by 2030. We aimed to estimate the impact of various treatment-as-prevention scenarios in Cote d'Ivoire, one of the countries with the highest HIV incidence in West Africa, with unmet HIV prevention and treatment needs, and where key populations are important to the broader HIV epidemic. METHODS AND FINDINGS: An age-stratified dynamic model was developed and calibrated to epidemiological and programmatic data using a Bayesian framework. The model represents sexual and vertical HIV transmission in the general population, female sex workers (FSW), and men who have sex with men (MSM). We estimated the impact of scaling up interventions to reach the UNAIDS targets, as well as the impact of 8 other scenarios, on HIV transmission in adults and children, compared to our baseline scenario that maintains 2015 rates of testing, ART initiation, ART discontinuation, treatment failure, and levels of condom use. In 2015, we estimated that 52% (95% credible intervals: 46%-58%) of HIV-positive individuals were aware of their status, 72% (57%-82%) of those aware were on ART, and 77% (74%-79%) of those on ART were virologically suppressed. Reaching the UNAIDS targets on time would avert 50% (42%-60%) of new HIV infections over 2015-2030 compared to 30% (25%-36%) if the 90-90-90 target is reached in 2025. Attaining the UNAIDS targets in FSW, their clients, and MSM (but not in the rest of the population) would avert a similar fraction of new infections (30%; 21%-39%). A 25-percentage-point drop in condom use from the 2015 levels among FSW and MSM would reduce the impact of reaching the UNAIDS targets, with 38% (26%-51%) of infections averted. The study's main limitation is that homogenous spatial coverage of interventions was assumed, and future lines of inquiry should examine how geographical prioritization could affect HIV transmission. CONCLUSIONS: Maximizing the impact of the UNAIDS targets will require rapid scale-up of interventions, particularly testing, ART initiation, and limiting ART discontinuation. Reaching clients of FSW, as well as key populations, can efficiently reduce transmission. Sustaining the high condom-use levels among key populations should remain an important prevention pillar.
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  13. 213
    377411
    Peer Reviewed

    Severe injection site reactions after subcutaneous administration of Sayana(c).

    Jodicke AM; Dahmke H; Damke B; Schaublin M; Kullak-Ublick GA; Weiler S

    Swiss Medical Weekly. 2017 Jun 21; 147:w14432.

    PURPOSE: Sayana(R) was introduced as the first depot medroxyprogesterone acetate-containing contraceptive that is administered via subcutaneous injection. Within 10 months, the Regional Pharmacovigilance Centre (RPVC) Zurich received several anonymous reports of serious local reactions after Sayana(R) administration. In this retrospective study, individual case safety reports (ICSRs) on local adverse drug reactions (ADRs) related to Sayana(R) were analysed from the WHO pharmacovigilance database. METHODS: International, national and regional ICSRs during Sayana(R) administration up to 1 January 2016 were examined. Data on ADRs were retrieved from the WHO Global Database VigiBase. Demographic data, drug administration information, duration of Sayana(R) treatment, latency time of the ADR, and its course, severity and outcomes were analysed. RESULTS: Worldwide, 398 ICSRs after Sayana(R) use were registered in the database. We identified 20 reported terms that were potentially used to describe a persistent lipodystrophy. When only cases containing one or more of these 20 reported terms were selected, 323 (81.2%) international ICSRs remained for analysis. Of those, 91.6% (n = 296) were categorised as serious. The majority of the reactions (n = 193, 54.4%) did not recover. In the 67 Swiss ICSRs, 77 ADRs were reported using 10 different terms including severe or persistent local reactions like lipodystrophy, atrophy or fat necrosis. Thirty-two patients (47.7%) did not recover. All 11 regional cases reported to the RPVC Zurich were categorised as serious ADRs. For the majority of the patients (n = 7, 63.6%) the interval between the application of Sayana(R) and development of the lipodystrophy was between 2 and 4 months. Most of the reactions were irreversible (n = 9, 81.8%). One patient underwent plastic surgery for artificial infill of the dent. CONCLUSIONS: Persistent local injection site reactions such as lipodystrophy, fat tissue necrosis or atrophy occur frequently after subcutaneous Sayana(R) use. These adverse drug reactions were recently integrated in the Swiss product information. Physicians and patients should be informed and advised about these potentially irreversible effects.
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  14. 214
    375600

    UNICEF annual report 2016.

    UNICEF

    New York, New York, UNICEF, 2017 Jun. 84 p.

    This report details the results achieved by UNICEF for and with children worldwide in 2016. It covers the organization’s programme work, humanitarian action, partnerships and advocacy efforts in all strategic sectors, with an emphasis on reaching every child and accelerating progress for the most vulnerable and disadvantaged girls and boys. The report also highlights UNICEF’s innovations, its efforts to improve efficiency and effectiveness, and the stories of individual children and families directly affected by UNICEF’s work in the course of its 70th anniversary year.
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  15. 215
    374327

    10 essentials for services provision to survivors of violence against women.

    United Nations. UN Women

    2016 Nov; New York, New York, UN Women, 2016 Nov. 2 p.

    Violence against women and girls is one of the most universal and pervasive human rights violations in the world, of pandemic proportions, with country data showing that about one third of women in the world report experiencing physical or sexual violence at some point in their lifetime, mainly by their partners. UN Women provides knowledge-based policy and programming guidance to a diverse array of stakeholders at international, regional and country levels often partnering with other UN agencies and stakeholders. UN Women’s work is broadly focused on a comprehensive approach to ending violence against women and girls that addresses legislation and policies, prevention, services for survivors, research and data. The briefs included in this package aim to summarize in a concise and friendly way, for advocates, programmers and policy makers, the essential strategies for addressing violence against women in general, for preventing violence and providing services to survivors in particular.
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  16. 216
    374326

    10 essentials for prevention of violence against women.

    United Nations. UN Women

    2016 Nov; New York, New York, UN Women, 2016 Nov. 2 p.

    Violence against women and girls is one of the most universal and pervasive human rights violations in the world, of pandemic proportions, with country data showing that about one third of women in the world report experiencing physical or sexual violence at some point in their lifetime, mainly by their partners. UN Women provides knowledge-based policy and programming guidance to a diverse array of stakeholders at international, regional and country levels often partnering with other UN agencies and stakeholders. UN Women’s work is broadly focused on a comprehensive approach to ending violence against women and girls that addresses legislation and policies, prevention, services for survivors, research and data. The briefs included in this package aim to summarize in a concise and friendly way, for advocates, programmers and policy makers, the essential strategies for addressing violence against women in general, for preventing violence and providing services to survivors in particular.
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  17. 217
    374325

    10 essentials for addressing violence against women.

    United Nations. UN Women

    2016 Nov; New York, New York, UN Women, 2016 Nov. 2 p.

    Violence against women and girls is one of the most universal and pervasive human rights violations in the world, of pandemic proportions, with country data showing that about one third of women in the world report experiencing physical or sexual violence at some point in their lifetime, mainly by their partners. UN Women provides knowledge-based policy and programming guidance to a diverse array of stakeholders at international, regional and country levels often partnering with other UN agencies and stakeholders. UN Women’s work is broadly focused on a comprehensive approach to ending violence against women and girls that addresses legislation and policies, prevention, services for survivors, research and data. The briefs included in this package aim to summarize in a concise and friendly way, for advocates, programmers and policy makers, the essential strategies for addressing violence against women in general, for preventing violence and providing services to survivors in particular.
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  18. 218
    374323

    Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) for Youth.

    Khanna P; Kimmel Z; Karkara R

    2016 Dec; New York, New York, UN Women, 2016 Dec. 20 p.

    The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) is an international legal instrument that requires countries to eliminate discrimination against women and girls in all areas and promotes women’s and girls’ equal rights. CEDAW is often described as the international bill of rights for women, and is one of the key international agreements that guides the work of UN Women in achieving gender equality and empowering all women and girls. CEDAW for Youth is a youth-friendly version of CEDAW, that was authored by a young woman and young man. This resource explains why CEDAW is important to youth, describes CEDAW’s impact in advancing gender equality and human rights for women and girls around the world, and summarizes the articles of CEDAW, including the specific forms of discrimination that must be ended and how CEDAW is implemented and monitored.
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  19. 219
    374322

    Female genital mutilation/cutting and violence against women and girls strengthening the policy linkages between different forms of violence.

    United Nations. UN Women; United Nations Population Fund [UNFPA]; UNICEF

    2017 Feb; New York, New York, UN Women, 2017 Feb. 20 p.

    Violence against women and girls (VAWG) manifests in different forms. These include intimate partner violence, non-partner sexual violence, sexual exploitation and trafficking, and harmful practices such as female genital mutilation/cutting (FGM/C) and child, early and forced marriage, among others. Programmes to end harmful practices and programmes to end intimate partner violence and non-partner sexual violence are often planned and implemented separately, despite all being rooted in gender inequality and gender-based discrimination against women and girls. While this is intended so that programmes can be tailored accordingly, it can result in isolation of initiatives that would otherwise benefit from sharing of knowledge and good practices and from strategic, coordinated efforts. This policy note explores policy and programming interlinkages and considers entry points in the areas of (i) national legislation, (ii) prevention strategies, (iii) response for survivors, and (iv) data and evidence, for increased coordination and collaboration to advance the objectives of ending FGM/C and other forms of VAWG, in particular intimate partner violence and non-partner sexual violence. The note builds on the background paper “Finding convergence in policy frameworks: A background paper on the policy links between gender, violence against women and girls, and female genital mutilation/cutting” (available below). This policy note is intended for multiple audiences, including those directly involved in policy development, planning and implementing initiatives, those providing technical support, and advocates for ending all forms of VAWG, including FGM/C. This work is the result of a collaboration of UN Women with the UNFPA–UNICEF Joint Programme on FGM/C.
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  20. 220
    374316

    Corporate evaluation on strategic partnerships for gender equality and the empowerment of women: final synthesis report.

    United Nations. UN Women. Independent Evaluation Office

    2017 Jan.; New York, New York, UN Women, 2017 Jan. 118 p.

    In its Corporate Evaluation Plan 2014-2017, the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women) Independent Evaluation Office (IEO) committed to conduct a corporate evaluation of UN Women’s work on fostering strategic partnerships. This Synthesis Report is the final product of the Corporate Evaluation on Strategic Partnerships for Gender Equality and the Empowerment of Women (GEEW). The evaluation was conducted by an external independent team between September 2015 and September 2016 and managed by the UN Women IEO. The evaluation is intended to enhance UN Women’s approach to strategic partnerships for the implementation of the 2014-2017 Strategic Plan with the aim of ensuring that gender equality is reached by 2030. It is also expected to contribute to an understanding of how UN Women’s strategic partnerships can facilitate a strong position for gender equality and women’s empowerment within the current global development context and the 2030 Agenda for Sustainable Development (Agenda 2030). The objectives of this formative evaluation were to: a. Assess the relevance of UN Women’s approaches to strategic partnerships given the changing global development landscape. b. Assess effectiveness and organizational efficiency in progressing towards the achievement of organizational results within the broader dynamic international context (e.g., Sustainable Development Goals [SDGs], etc.), with attention to achievement of specific organizational effectiveness and efficiency framework (OEEF) results. c. Determine whether or not the human rights approach and gender equality principles are integrated adequately in UN Women’s approach to its strategic partnerships. d. Identify and validate lessons learned, good practice examples and innovations of partnership strategies supported by UN Women. e. Provide actionable recommendations with respect to UN Women strategies and approaches to strategic partnerships.
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  21. 221
    374315

    Youth leap into gender equality: UN Women’s youth and gender equality strategy: empowered young women and young men as partners in achieving gender equality.

    United Nations. UN Women

    New York, New York, UN Women, 2017 Apr. 28 p.

    UN Women’s Youth and Gender Equality Strategy is a pivotal response for increased youth engagement to strengthen gender equality and womens empowerment. Young people across the world have asserted their presence and raised their voices to demand a greater role in shaping their societies’ future that have challenged the status quo. The global youth population—an unprecedented 1.8 billion—only adds to the urgency of the youth agenda. The youth upsurge represents a tremendous strategic opportunity to tap into the talents and skills of young people to advance global and national development goals. UN Women’s Youth and Gender Equality Strategy is grounded in the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), the Beijing Platform for Action, the United Nations Millennium Declaration, the World Programme of Action for Youth, a host of resolutions and outcomes of the United Nations General Assembly on youth, gender equality and the empowerment of women, and the recently agreed, “Transforming our world: the 2030 Agenda for Sustainable Development” document. Moreover, the global review and commemoration of Beijing+20 and the adoption of a dedicated, comprehensive, and transformative Sustainable Development Goal (SDG) 5 on achieving Gender Equality and Women’s Empowerment for all women and girls coincides with the 20th anniversary of the World Programme of Action for Youth. This is a critical moment for action. UN Women aims to reinvigorate its work on youth issues against this larger global and institutional backdrop, especially the adoption of SDG 5. UN Women recognizes that both young men and women today possess extraordinary potential to positively transform their communities. UN Women has put in place a multi-faceted strategy that takes into consideration not only traditional forms of advocacy and engagement, but also new technologies and approaches in engaging young men and young women. Key elements of UN Women’s strategy include reinvigorated partnerships with a wider spectrum of entities, resource mobilization, and active monitoring and evaluation.
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  22. 222
    377140
    Peer Reviewed

    Projected Uptake of New Antiretroviral (ARV) Medicines in Adults in Low- and Middle-Income Countries: A Forecast Analysis 2015-2025.

    Gupta A; Juneja S; Vitoria M; Habiyambere V; Nguimfack BD; Doherty M; Low-Beer D

    PloS One. 2016; 11(10):e0164619.

    With anti-retroviral treatment (ART) scale-up set to continue over the next few years it is of key importance that manufacturers and planners in low- and middle-income countries (LMICs) hardest hit by the HIV/AIDS pandemic are able to anticipate and respond to future changes to treatment regimens, generics pipeline and demand, in order to secure continued access to all ARV medicines required. We did a forecast analysis, using secondary WHO and UNAIDS data sources, to estimate the number of people living with HIV (PLHIV) and the market share and demand for a range of new and existing ARV drugs in LMICs up to 2025. UNAIDS estimates 24.7 million person-years of ART in 2020 and 28.5 million person-years of ART in 2025 (24.3 million on first-line treatment, 3.5 million on second-line treatment, and 0.6 million on third-line treatment). Our analysis showed that TAF and DTG will be major players in the ART regimen by 2025, with 8 million and 15 million patients using these ARVs respectively. However, as safety and efficacy of dolutegravir (DTG) and tenofovir alafenamide (TAF) during pregnancy and among TB/HIV co-infected patients using rifampicin is still under debate, and ART scale-up is predicted to increase considerably, there also remains a clear need for continuous supplies of existing ARVs including TDF and EFV, which 16 million and 10 million patients-respectively-are predicted to be using in 2025. It will be important to ensure that the existing capacities of generics manufacturers, which are geared towards ARVs of higher doses (such as TDF 300mg and EFV 600mg), will not be adversely impacted due to the introduction of lower dose ARVs such as TAF 25mg and DTG 50mg. With increased access to viral load testing, more patients would be using protease inhibitors containing regimens in second-line, with 1 million patients on LPV/r and 2.3 million on ATV/r by 2025. However, it will remain important to continue monitoring the evolution of ARV market in LMICs to guarantee the availability of these medicines.
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  23. 223
    377112
    Peer Reviewed

    Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants.

    Eriksen KG; Johnson W; Sonko B; Prentice AM; Darboe MK; Moore SE

    Journal of Nutrition. 2017 Feb; 147(2):248-255.

    BACKGROUND: The WHO recommends exclusive breastfeeding (EBF) for the first 6 mo of life. OBJECTIVE: The objective of this study was to assess the benefit of EBF to age 6 mo on growth in a large sample of rural Gambian infants at high risk of undernutrition. METHODS: Infants with growth monitoring from birth to 2 y of age (n = 756) from the ENID (Early Nutrition and Immune Development) trial were categorized as exclusively breastfed if only breast milk and no other liquids or foods were given. EBF status was entered into confounder-adjusted multilevel models to test associations with growth trajectories by using >11,000 weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) z score observations. RESULTS: Thirty-two percent of infants were exclusively breastfed to age 6 mo. The mean age of discontinuation of EBF was 5.2 mo, and growth faltering started at approximately 3.5 mo of age. Some evidence for a difference in WAZ and WHZ was found between infants who were exclusively breastfed to age 6 mo (EBF-6) and those who were not (nEBF-6), at 6 and 12 mo of age, with EBF-6 children having a higher mean z score. The differences in z scores between the 2 groups were small in magnitude (at 6 mo of age: 0.147 WAZ; 95% CI: -0.001, 0.293 WAZ; 0.189 WHZ; 95% CI: 0.038, 0.341 WHZ). No evidence for a difference between EBF-6 and nEBF-6 infants was observed for LAZ at any time point (6, 12, and 24 mo of age). Furthermore, a higher mean WLZ at 3 mo of age was associated with a subsequent higher mean age at discontinuation of EBF, which implied reverse causality in this setting (coefficient: 0.060; 95% CI: 0.008, 0.120). CONCLUSION: This study suggests that EBF to age 6 mo has limited benefit to the growth of rural Gambian infants. This trial was registered at http://www.isrctn.com as ISRCTN49285450.
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  24. 224
    377105

    Progress towards measles elimination - African Region, 2013-2016. Progres realises en vue d'eliminer la rougeole - Region africaine, 2013-2016.

    Releve Epidemiologique Hebdomadaire. 2017 May 05; 92(18):229-39.

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  25. 225
    377078
    Peer Reviewed

    Assessing the availability of LLINs for continuous distribution through routine antenatal care and the Expanded Programme on Immunizations in sub-Saharan Africa.

    Theiss-Nyland K; Lynch M; Lines J

    Malaria Journal. 2016 May 04; 15(1):255.

    BACKGROUND: In addition to mass distribution campaigns, the World Health Organization (WHO) recommends the continuous distribution of long-lasting insecticidal nets (LLINs) to all pregnant women attending antenatal care (ANC) and all infants attending the Expanded Programme on Immunization (EPI) services in countries implementing mosquito nets for malaria control. Countries report LLIN distribution data to the WHO annually. For this analysis, these data were used to assess policy and practice in implementing these recommendations and to compare the numbers of LLINs available through ANC and EPI services with the numbers of women and children attending these services. METHODS: For each reporting country in sub-Saharan Africa, the presence of a reported policy for LLIN distribution through ANC and EPI was reviewed. Prior to inclusion in the analysis the completeness of data was assessed in terms of the numbers of LLINs distributed through all channels (campaigns, EPI, ANC, other). For each country with adequate data, the numbers of LLINs reportedly distributed by national programmes to ANC was compared to the number of women reportedly attending ANC at least once; the ratio between these two numbers was used as an indicator of LLIN availability at ANC services. The same calculations were repeated for LLINs distributed through EPI to produce the corresponding LLIN availability through this distribution channel. RESULTS: Among 48 malaria-endemic countries in Africa, 33 malaria programmes reported adopting policies of ANC-based continuous distribution of LLINs, and 25 reported adopting policies of EPI-based distribution. Over a 3-year period through 2012, distribution through ANC accounted for 9 % of LLINs distributed, and LLINs distributed through EPI accounted for 4 %. The LLIN availability ratios achieved were 55 % through ANC and 34 % through EPI. For 38 country programmes reporting on LLIN distribution, data to calculate LLIN availability through ANC and EPI was available for 17 and 16, respectively. CONCLUSIONS: These continuous LLIN distribution channels appear to be under-utilized, especially EPI-based distribution. However, quality data from more countries are needed for consistent and reliable programme performance monitoring. A greater focus on routine data collection, monitoring and reporting on LLINs distributed through both ANC and EPI can provide insight into both strengths and weaknesses of continuous distribution, and improve the effectiveness of these delivery channels.
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