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New York, New York, UNICEF, 2005 Mar.  p.The Multiple Indicator Cluster Survey (MICS) is a household survey programme developed by UNICEF to assist countries in filling data gaps for monitoring human development in general and the situation of children and women in particular. MICS is capable of producing statistically sound, internationally comparable estimates of social indicators such as the Millennium Development Goal (MDG) indicators. It is a flexible tool that is reasonably inexpensive and relatively quick to implement. (excerpt)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S5-S14.The rationale for developing a new international growth reference derived principally from a Working Group on infant growth established by the World Health Organization (WHO) in 1990. It recommended an approach that described how children should grow rather than describing how children grow; that an international sampling frame be used to highlight the similarity in early childhood growth among diverse ethnic groups; that modern analytical methods be exploited; and that links among anthropometric assessments and functional outcomes be included to the fullest possible extent. Upgrading international growth references to resemble standards more closely will assist in monitoring and attaining a wide variety of international goals related to health and other aspects of social equity. In addition to providing scientifically robust tools, a new reference based on a global sample of children whose health needs are met will provide a useful advocacy tool to health-care providers and others with interests in promoting child health. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S37-S45.The objective of the Motor Development Study was to describe the acquisition of selected gross motor milestones among affluent children growing up in different cultural settings. This study was conducted in Ghana, India, Norway, Oman, and the United States as part of the longitudinal component of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS). Infants were followed from the age of four months until they could walk independently. Six milestones that are fundamental to acquiring self-sufficient erect locomotion and are simple to evaluate were assessed: sitting without support, hands-and-knees crawling, standing with assistance, walking with assistance, standing alone, and walking alone. The information was collected by both the children's caregivers and trained MGRS fieldworkers. The caregivers assessed and recorded the dates when the milestones were achieved for the first time according to established criteria. Using standardized procedures, the fieldworkers independently assessed the motor performance of the children and checked parental recording at home visits. To ensure standardized data collection, the sites conducted regular standardization sessions. Data collection and data quality control took place simultaneously. Data verification and cleaning were performed until all queries had been satisfactorily resolved. (author's)
Measurement and standardization protocols for anthropometry used in the construction of a new international growth reference.
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S27-S36.Thorough training, continuous standardization, and close monitoring of the adherence to measurement procedures during data collection are essential for minimizing random error and bias in multicenter studies. Rigorous anthropometry and data collection protocols were used in the WHO Multicentre Growth Reference Study to ensure high data quality. After the initial training and standardization, study teams participated in standardization sessions every two months for a continuous assessment of the precision and accuracy of their measurements. Once a year the teams were restandardized against the WHO lead anthropometrist, who observed their measurement techniques and retrained any deviating observers. Robust and precise equipment was selected and adapted for field use. The anthropometrists worked in pairs, taking measurements independently, and repeating measurements that exceeded preset maximum allowable differences. Ongoing central and local monitoring identified anthropometrists deviating from standard procedures, and immediate corrective action was taken. The procedures described in this paper are a model for research settings. (author's)
Implementing the new recommendations on the clinical management of diarrhoea: guidelines for policy makers and programme managers.
Geneva, Switzerland, WHO, 2006. 34 p.WHO and UNICEF have released revised recommendations aimed at dramatically cutting the number of deaths due to diarrhoea. These new recommendations take into account two significant recent advances: demonstration of the increased efficacy of a new formulation for ORS containing lower concentrations of glucose and salt, and success in using zinc supplementation in addition to rehydration therapy in the management of diarrhoeal diseases. Prevention and treatment of dehydration with ORS and fluid commonly available at home, breastfeeding, continued feeding, selective use of antibiotics, and providing zinc supplementation for 10 to 14 days are the critical therapies that will help us achieve these goals. This manual provides policy makers and programme managers with the information they need to introduce and/or scale up a national decision to introduce the new ORS formulation and zinc supplementation as part of the clinical management of diarrhoeal diseases. (excerpt)
[Implementation of World Health Organization guidelines for management of severe malnutrition in a hospital in Northeast Brazil] Implementacao do protocolo da Organizacao Mundial da Saude para manejo da desnutricao grave em hospital no Nordeste do Brasil.
Cadernos de Saude Publica. 2006 Mar; 22(3):561-570.To assess the implementation of WHO guidelines for managing severely malnourished hospitalized children, a case-series study was performed with 117 children from 1 to 60 months of age. A checklist was prepared according to steps in the guidelines and applied to each patient at discharge, thus assessing the procedures adopted during hospitalization. Daily spreadsheets on food and liquid intake, clinical data, prescribed treatment, and laboratory results were also used. 36 steps were evaluated, 24 of which were followed correctly in more than 80% of cases; the proportion was 50 to 80% for seven steps and less than 50% for five steps. Monitoring that required frequent physician and nursing staff bedside presence was associated with difficulties. With some minor adjustments, the guidelines can be followed without great difficulty and without compromising the more important objective of reducing case-fatality. (author's)
Bulletin of the World Health Organization. 2007 Dec; 85(12):904.Each year, despite the availability of low-cost interventions such as vaccines that could prevent millions of deaths, nearly 11 million children worldwide die before the age of five. Failure to reach the Millennium Development Goal 4 (MDG 4) for child survival will result in an estimated 40 million children's lives lost by 2015. As nearly a quarter of global under-five mortality is attributable to vaccine-preventable diseases (VPD), vaccination can contribute significantly to attaining the MDG 4. An unprecedented array of life-saving vaccines is now available or in late stages of development. However, the decision to invest in vaccine introduction must be evidence-based and requires reliable data. Vaccine-preventable disease surveillance and programme monitoring provide the scientific and factual database essential for informed decision-making and appropriate public health action. In 2005, WHO and UNICEF published the Global Immunization Vision and Strategy 2006-2015 (GIVS), which defines the strategies and goals that will maximize the impact of immunization. One of the key components of achieving the GIVS goals is the need for strong systems for disease surveillance and programme monitoring. Recent developments, such as the availability and accessibility of new vaccines for the world's poorest countries, the need to achieve and sustain the global polio eradication goal, the new goal of reducing measles mortality by 90% by 2010, the new International Health Regulations and the threat of emerging or pandemic diseases, make a renewed and more comprehensive approach to surveillance and programme monitoring a necessity. To address this need, WHO, together with its global immunization partners, developed a Global Framework for Immunization Monitoring and Surveillance (GFIMS). (excerpt)
Morbidity and Mortality Weekly Report. 2014 Jul 25; 63(29):634-637.Since 2008, the World Health Organization (WHO) has coordinated the Global Rotavirus Surveillance Network, a network of sentinel surveillance hospitals and laboratories that report to ministries of health (MoHs) and WHO clinical features and rotavirus testing data for children aged <5 years hospitalized with acute gastroenteritis. In 2013, WHO conducted a strategic review to assess surveillance network performance, provide recommendations for strengthening the network, and assess the network’s utility as a platform for other vaccine-preventable disease surveillance. The strategic review team determined that during 2011 and 2012, a total of 79 sites in 37 countries met reporting and testing inclusion criteria for data analysis. Of the 37 countries with sites meeting inclusion criteria, 13 (35%) had introduced rotavirus vaccine nationwide. All 79 sites included in the analysis were meeting 2008 network objectives of documenting presence of disease and describing disease epidemiology, and all countries were using the rotavirus surveillance data for vaccine introduction decisions, disease burden estimates, and advocacy; countries were in the process of assessing the use of this surveillance platform for other vaccine-preventable diseases. However, the review also indicated that the network would benefit from enhanced management, standardized data formats, linkage of clinical data with laboratory data, and additional resources to support network functions. In November 2013, WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) endorsed the findings and recommendations made by the review team and noted potential opportunities for using the network as a platform for other vaccine-preventable disease surveillance. WHO will work to implement the recommendations to improve the network’s functions and to provide higher quality surveillance data for use in decisions related to vaccine introduction and vaccination program sustainability.