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London, United Kingdom, Girls Not Brides, 2018 Nov. 4 p.In sub-Saharan Africa and countries like Ethiopia, levels of child marriage have declined at a modest rate in recent years through concerted efforts from government and civil society. Political will has been demonstrated with national launches of the African Union Campaign to end child marriage taking place in 24 countries. However, rapidly growing populations combined with declines in child marriage prevalence in South Asia mean that unless progress is significantly accelerated, sub-Saharan Africa will become the region with the highest absolute numbers of child brides in future.
Washington, D.C., MCSP, 2018 Dec. 2 p.This point-of-care postnatal care (PNC) pre-discharge checklist and wall poster is intended for use by healthcare providers, educators, and other PNC stakeholders. Originally published in 2016, the PNC checklist and poster have been updated to include recent clinical recommendations. These job aids are intended to support high-quality, evidence-based pre-discharge postnatal care, to help providers recognize danger signs in mothers and newborns, and to remind providers of key health interventions to promote best practices for mothers and families.
Paediatric and Perinatal Epidemiology. 2018 Oct 22;Add to my documents.
Geneva, Switzerland, World Health Organization [WHO], 2018. 116 p.The guideline uses state-of-the-art evidence to identify effective policy options to strengthen community health worker (CHW) programme performance through their proper integration in health systems and communities. The development of this guideline followed the standardized WHO approach. This entailed a critical analysis of the available evidence, including 16 systematic reviews of the evidence, a stakeholder perception survey to assess feasibility and acceptability of the policy options under consideration, and the deliberations of a Guideline Development Group which comprised representation from policy makers and planners from Member States, experts, labour unions, professional associations and CHWs. Critical to the success of these efforts will be ensuring appropriate labour conditions and opportunities for professional development, as well as creating a health ecosystem in which workers at different levels collaborate to meet health needs. Adapted to context, the guideline is a tool that supports optimizing health policies and systems to achieve significant gains to meet the ambition of universal access to primary health care services.
A strategic action framework for multipurpose prevention technologies combining contraceptive hormones and antiretroviral drugs to prevent pregnancy and HIV.
European Journal of Contraception and Reproductive Health Care. 2018 Oct; 23(5):326-334.OBJECTIVE: Multipurpose prevention technologies (MPTs) are an innovative class of products that deliver varied combinations of human immunodeficiency virus (HIV) prevention, other sexually transmitted infection (STI) prevention, and contraception. Combining separate strategies for different indications into singular prevention products can reduce the stigma around HIV and STI prevention, improve acceptability of and adherence to more convenient products, and be more cost-effective by addressing overlapping risks. METHODS: This article outlines a strategic action framework developed as an outcome of a series of expert meetings held between 2014 and 2016. The meetings focused on identifying opportunities and challenges for MPTs that combine hormonal contraception (HC) with antiretroviral drugs into single products. The framework aims to present an actionable strategy, by addressing key research gaps and outlining the key areas for progress, to guide current and future HC MPT development. RESULTS: We identified eight primary action areas for the development of impactful HC MPTs, and includes aspects from epidemiology, pharmacology, clinical trial design, regulatory requirements, manufacturing and commercialisation, behavioural science, and investment needs for research and development. CONCLUSION: Overall, the challenges involved with reconciling the critical social-behavioural context that will drive MPT product use and uptake with the complexities of research and development and regulatory approval are of paramount importance. To realise the potential of MPTs given their complexity and finite resources, researchers in the MPT field must be strategic about the way forward; increased support among policy-makers, advocates, funders and the pharmaceutical industry is critical.
Engaging young people for health and sustainable development. Strategic opportunities for the World Health Organization and partners.
Geneva, Switzerland, WHO, 2018. 72 p. (WHO/CDS/TB/2018.22)This report builds on WHO’s long-standing work on young people’s health and rights, including the Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030), the Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance, and contribution to the new UN Youth Strategy. It was developed as part of the roadmap towards the development of a WHO strategy for engaging young people and young professionals. The world today has the largest generation of young people in history with 1.8 billion between the ages of 10 and 24 years. Many of them already are driving transformative change, and many more are poised to do so, but lack the opportunity and means. This cohort represents a powerhouse of human potential that could transform health and sustainable development. A priority is to ensure that no young person is left behind and all can realize their right to health equitably and without discrimination or hindrance. This force for change represents an unparalleled opportunity for the WHO and partners to transform the way they engage with young people, including to achieve the 2030 Agenda for Sustainable Development. This report describes strategic opportunities to meaningfully engage young people in transforming health and sustainable development. This will mean providing opportunities for young people’s leadership and for their engagement with national, regional and global programmes.
Geneva, Switzerland, WHO, 2018. 32 p. (WHO/CDS/TB/2018.22)The 2018 United Nations General Assembly High-Level Meeting (HLM) on Tuberculosis and the current revision of the Roadmap for childhood tuberculosis together present an important moment to consolidate and advance advocacy, commitment, resource mobilization and joint efforts by all stakeholders to provide health care and address the burden of TB among children The first Roadmap, published five years ago, helped to draw the childhood TB epidemic into the global spotlight after decades of neglect. Today, we are closer to a generation of children free from TB. Armed with new knowledge about how 10% of all TB affects and manifests in children under 15 years of age, we have a clearer vision of what is needed, how to deliver it -and the priority actions and enhanced investments that are urgently required. The 2018 Roadmap incorporates an additional critical population: adolescents. Despite making up 1 in 6 of the world’s people, adolescents have been largely overlooked as global momentum to address TB has grown. Spanning the ages of 10-19 years, adolescents are both at risk of TB and represent an important population for TB control. They often present with infectious TB and frequently have multiple contacts in congregate settings, such as schools and other educational institutions. Nevertheless, few countries capture TB data in suitably age-disaggregated ways to allow full understanding of its impact in this group and even fewer provide the adolescent-friendly services our young people need to access diagnosis and care.
Private sector: Who is accountable? for women’s, children’s and adolescents’ health. 2018 report. Summary of recommendations.
Geneva, Switzerland, World Health Organization [WHO], 2018. 12 p.This report presents five recommendations, which are addressed to governments, parliaments, the judiciary, the United Nations (UN) system, the UN Global Compact, the Every Woman Every Child (EWEC) partners, donors, civil society and the private sector itself. Recommendations include: 1) Access to services and the right to health. To achieve universal access to services and protect the health and related rights of women, children and adolescents, governments should regulate private as well as public sector providers. Parliaments should strengthen legislation and ensure oversight for its enforcement. The UHC2030 partnership should drive political leadership at the highest level to address private sector transparency and accountability. 2) The pharmaceutical industry and equitable access to medicines. To ensure equitable, affordable access to quality essential medicines and related health products for all women, children and adolescents, governments and parliaments should strengthen policies and regulation governing the pharmaceutical industry. 3) The food industry, obesity and NCDs. To tackle rising obesity and NCDs among women, children and adolescents, governments and parliaments should regulate the food and beverage industry, and adopt a binding global convention. Ministries of education and health should educate students and the public at large about diet and exercise, and set standards in school-based programmes. Related commitments should be included in the next G20 Summit agenda. 4) The UN Global Compact and the EWEC partners. The UN Global Compact and the EWEC partners should strengthen their monitoring and accountability standards for engagement of the business sector, with an emphasis on women’s, children’s and adolescents’ health. They should advocate for accountability of the for-profit sector to be put on the global agenda for achieving UHC and the SDGs, including at the 2019 High-Level Political Forum on Sustainable Development and the Health Summit. The UN H6 Partnership entities and the GFF should raise accountability standards in the country programmes they support. 5) Donors and business engagement in the SDGs. Development cooperation partners should ensure that transparency and accountability standards aligned with public health are applied throughout their engagement with the for-profit sector. They should invest in national regulatory and oversight capacities, and also regulate private sector actors headquartered in their countries.
Benchmark assessment of orphaned and vulnerable children in areas of the Zambia Family (ZAMFAM) Project.
Washington, D.C., Population Council, Project SOAR, 2018 Jan. 139 p. (Project SOAR Final Report; USAID Agreement No. AID-OAA-A-14-00060)This benchmark assessment was a cross-sectional survey of 2,034 ZAMFAM beneficiary OVC households in project target communities conducted in the Lusaka and Copperbelt Provinces between May and July of 2016 (about a year after roll-out) and in the Central and Southern Provinces between September and October of 2016 (around the time of program initiation). Interviews were conducted with caregivers about themselves and any OVC in the household between the ages of zero and nine years. OVC in the household between the ages of 10 and 17 years were interviewed directly by the survey team. The study instrument was based on MEASURE Evaluation’s “Child, Caregiver & Household Well-being Survey Tools for Orphans & Vulnerable Children Programs,” and captured PEPFAR Core OVC Indicators. The analysis is descriptive, reviewing the PEPFAR essential and additional core OVC indicators. The study findings were disaggregated by province, age, sex, and residential status where appropriate.The findings provide a deeper understanding of the needs of OVC families and the gaps in service provision, as well as suggestions for strengthening care and support strategies for OVC in Zambia.
Characterizing male sexual partners of adolescent girls and young women in Mozambique: Key findings.
Chapel Hill, North Carolina, University of North Carolina, MEASURE Evaluation, 2018 Aug. 42 p. (USAID Cooperative Agreement AID-OAA-L-14-00004)Adolescent girls and young women (AGYW) ages 15–24 have been identified as a population vulnerable to HIV. Less than half of AGYW living with HIV know their HIV status, and treatment uptake and viral suppression rates among adolescents and young people, especially females, are extremely low globally. AGYW are at risk of acquiring HIV predominantly through sexual transmission from HIV-positive male partners. To stop AGYW from acquiring HIV, one strategy is to prevent HIV among their male sexual partners and reduce the infectiousness of those partners who are HIV-positive. However, little is known globally about the characteristics of AGYW’s sexual partners, which constrains efforts to reach them with HIV services and thus limits efforts to ultimately reduce HIV prevalence among them. The United States President’s Emergency Fund for AIDS Relief (PEPFAR), through the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe Initiative, has called on U.S. Government missions overseas to address this knowledge gap, through studies to characterize male sexual partners. USAID/Mozambique asked MEASURE Evaluation to undertake a study that would provide insights into the characteristics of men who have recently engaged in sexual activity with AGYW, the relationship dynamics, and factors that influence men’s engagement with HIV and AIDS prevention and care services. This study had three research questions: 1) Who are the sexual partners of AGYW? 2) Is sexual risk-taking behavior (i.e., multiple recent sexual partners and unprotected sex) among AGYW and their male partners associated with certain sexual partner characteristics (e.g., age, education, employment, income, or other factors)? 3) To what extent are male sexual partners of AGYW using/willing to use different types of HIV and AIDS services?
Guidance on ethical considerations in planning and reviewing research studies on sexual and reproductive health in adolescents.
Geneva, Switzerland, World Health Organization, 2018. 52 p.This document is intended to address commonly occurring situations and challenges that one faces in carrying out research with adolescents (people aged 10–19 years), the majority of whom are deemed not to have reached the recognized age of majority in their respective settings. To this end, adolescents aged 18 and 19 years are classified as adults in many settings and have the legal capacity to make autonomous decisions regarding their participation in research. In this document, the term “children” refers to people below the age of 18 years, and the term “minor adolescents” refers specifically to people aged 10-18 years.
Pretoria, South Africa, MEASURE Evaluation-Strategic Information for South Africa (MEval-SIFSA) Project, May 2018. 4 p.MomConnect is a national-scale ministerial mHealth initiative that employs cell phone technology to register pregnant women in South Africa and deliver to them stage-based maternal messages during pregnancy and after delivery. The effort aligns with the global health goal of the United States Agency for International Development (USAID) and the United States President’s Emergency Plan for AIDS Relief to prevent child and maternal deaths. USAID supported early implementation and rollout of the initiative through the MEASURE Evaluation-Strategic Information for South Africa (MEval-SIFSA) project. MomConnect has a helpdesk feature that allows mothers to ask maternal and child health-related questions and to provide feedback on services they receive at antenatal care (ANC) clinics. The MomConnect helpdesk has responded to almost 250,000 messages since the initiative’s launch, in August 2014. According to quantitative analysis conducted on helpdesk messages received through March 2017, feedback on health services comprised about 4 percent of all helpdesk messages. Approximately 8,100 messages were compliments and 1,800 were complaints about services received at ANC clinics. Compliments and complaints received through the helpdesk at the national office are forwarded to a MomConnect focal person at the relevant province or district department of health (DOH) office for follow-up action. Standard operating procedures (SOPs) were developed to outline steps for communicating and investigating complaints at national, provincial, district, and facility levels. The SOP document also includes requirements for documentation, monitoring, and reporting at each level to track the progress of complaints.
Human papillomavirus vaccine for cancer cervix prevention: Rationale & recommendations for implementation in India.
Indian Journal of Medical Research. 2017 Aug; 146(2):153-157.Add to my documents.
VASA. Zeitschrift Fur Gefasskrankheiten. 2018 Oct; 47(6):441-450.The use of sex hormones such as combined oral contraceptives (COC) or hormone replacement therapy (HRT) increases the risk for venous thromboembolism (VTE) considerably, especially in patients with an increased intrinsic risk for thromboembolic complications. Despite public and media attention and increasing scientific evidence, prescription patterns seem to be hard to change. It is well recognized that the patient's baseline risk is the most relevant factor in the absolute risk for developing VTE. The relative risk increase associated with sex hormones, depends on the type and dosage of hormones, the route of application (oral, vaginal, transdermal), and for COC, on the specific combination of oestrogen and gestagen components. Consequently, a careful decision for or against any specific type of hormone treatment needs to be based on an assessment of the patient's risk profile (disposition) as well as on the treatment-associated risks and benefits (exposition). This review discusses the most common sex hormone treatments in contraception and HRT, the relevance for VTE risk patients, and strategies to counsel patients with regard to hormone use according to their risk profiles. Keywords: Oral contraceptives, hormonal contraception, hormone replacement therapy, venous thromboembolism.
NewsCAP: The WHO releases Consolidated Guideline on Sexual and Reproductive Health and Rights of Women Living with HIV.
American Journal of Nursing. 2018 Jul; 118(7):17.Add to my documents.
Journal of Women's Health. 2017 Feb; 26(2):195-196.Add to my documents.
British Journal of Radiology. 2018 Oct; 91(1090):20170686.Tubal sterilization with Essure inserts has become a prevalent alternative to laparoscopic sterilization because of its minimal invasiveness. It is a well-tolerated ambulatory procedure that provides reliable permanent contraception without the risks associated with laparoscopic surgery and general anesthesia. Correct positioning of the Essure device is necessary to achieve the fibrotic reaction induced by the polyethylene terephthalate fibers, subsequently resulting in tubal occlusion usually within 3 months. After uneventful procedures with satisfactory bilateral placement, only the correct position of the devices needs to be confirmed at follow-up. The imaging techniques used to asses Essure devices may vary depending on the country and its recommendations. The gold-standard test to ascertain tubal occlusion remains the hysterosalpingography but after uneventful procedures, vaginal-ultrasound proved to be a reliable alternative to confirm the proper position of the inserts. Radiologists have been increasingly confronted to post-procedural evaluations and despite the efficiency rate of the Essure device, its use still exposes to a low risk of complications and malfunctions such as unwanted pregnancies, device misplacement, tubal or uterine perforation, and chronic pelvic pain. Unintended pregnancies are mostly due to patient or physician non-compliance and misinterpretation of post-procedural examinations by radiologists which emphasizes the importance of their training in Essure device assessment. This pictorial review discusses the imaging methods used to asses Essure implants and illustrates the possible complications related to them.
AIDS Research and Human Retroviruses. 2017 Oct; 33(10):985-992.Human immunodeficiency virus type 1 (HIV-1) is the major cause of acquired immunodeficiency syndrome (AIDS) in humans, where the immune system totally succumbs to the virus. A large proportion of the AIDS infected belong to developing countries and AIDS prevalence is intensified by severe poverty, malnutrition, and famine; fatal illnesses with a scorn shortage of medical amenities complemented with the lack of education and development. Current Pakistani health system setting is in a dire need of improvement. Low literacy rates, high birth rates, and associated maternal mortality plus a lack of clean drinking water and appropriate sanitation system have a serious impact on general living conditions contributing to a relatively short lifespan. HIV is, therefore, becoming a growing health concern in Pakistan with a rapid rise in the reported cases. AIDS is most prevalent among injection drug users (IDUs), male/female sex workers, and unchecked deported migrant workforce. To combat this virus, the Pakistan Government has been working hard over the past few years with local bodies and international organizations in an effort to combat this menace. This review aims to discuss the risk factors for the rise of this epidemic in the country and the recommendations, efforts to be done to address this alarming issue.
The Reproductive, Maternal, and Neonatal Health Innovation Fund Project: Lessons learned from technical assistance.
Addis Ababa, Ethiopia, Reproductive, Maternal, and Neonatal Health Innovation Fund Project, 2018. 24 p.In 2015, the Federal Ministry of Health and UK’s Department for International Development established a Reproductive, Maternal, and Neonatal Health Innovation Fund, and committed £19 million (amount after the closure decision) over four project years (2014 to 2018). Pathfinder International, as the Technical Assistance Supplier, embedded its team members to provide technical support to the different directorates within the Federal Ministry of Health. As the project is approaching its end after three years of implementation, Pathfinder International Ethiopia has documented feedback, reflections, and analysis of what worked well over the course of the project and identified areas of improvement under four major themes: achieving program outputs and management; coordination and learning platforms; capacity building; and promoting reproductive, maternal, and neonatal health innovations by involving the different stakeholders in the project--including Federal Ministry of Health Officials, regional health bureau representatives, Department for International Development, Pathfinder, and grant subrecipients.
[Washington, D.C.], MCSP, 2018 May. 6 p. (USAID Cooperative Agreement No. AID-OAA-A-14-00028)This brief reviews scaling up chlorhexidine cord care for newborns in Liberia.
A Reference Guide: Six Practical Tips for Understanding Data on Female Genital Mutilation/Cutting (FGM/C).
Washington, D.C., Population Council, 2018 Jun. 4 p.This guide aims to help researchers, advocates, program managers, and policymakers understand, interpret, and use the latest FGM/C data. It includes tips on: 1. Using the FGM/C module regularly; 2. Establishing trends through comparable data; 3. Being realistic about self-reported data; 4. Recognizing that data on daughters have changed; 5. Assessing changes in FGM/C rates over time by comparing youngest and oldest cohorts; and 6. Understanding how the best estimates of girls and women affected by and at risk of FGM/C are derived.
Geneva, Switzerland, WHO, 2017. 12 p. (Summary Brief WHO/RHR/17.20)Contraception is an inexpensive and cost-effective intervention, but health workforce shortages and restrictive policies on the roles of mid- and lower-level cadres limit access to effective contraceptive methods in many settings. Expanding the provision of contraceptive methods to other health worker cadres can significantly improve access to contraception for all individuals and couples. Many countries have already enabled mid- and lower-level cadres of health workers to deliver a range of contraceptive methods, utilizing these cadres either alone or as part of teams within communities and/or health care facilities. The WHO recognizes task sharing as a promising strategy for addressing the critical lack of health care workers to provide reproductive, maternal and newborn care in low-income countries. Task sharing is envisioned to create a more rational distribution of tasks and responsibilities among cadres of health workers to improve access and cost-effectiveness.
Improving care for women with obstetric fistula: new WHO recommendation on duration of bladder catheterisation after the surgical repair of a simple obstetric urinary fistula.
BJOG. 2018 Nov; 125(12):1502-1503.Under the Sustainable Development Goals (SDGs) and universal health coverage, the "survive, thrive, transform" agenda moves beyond reducing mortality and focuses on the importance of maternal morbidity.((1) ) An obstetric fistula, one of the most devastating types of maternal morbidity, is usually caused by injury during childbirth from prolonged or obstructed labour. The prolonged compression of the fetal head against the pelvic bones can cause ischaemic necrosis of parts of the bladder, urethra or vagina, resulting in an abnormal opening between a woman's genital tract and her urinary tract that leads to the continuous flow of urine through the vagina.((2)) Women with obstetric urinary fistula are often faced with serious social problems including abandonment by their partners, families and communities mainly due to persistent odour of urine as they are constantly wet and unable to control their urinary function.((3)) While these fistulae are almost non-existent in high-income countries, it remains a public health problem that affects over one million women, their families and communities in Sub-Saharan Africa and South Asia with poorly-resourced health systems and inadequate intrapartum care services. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Washington, D.C., Population Reference Bureau [PRB], 2018 Apr. 8 p. (Policy Brief; USAID Project No. AID-I-0304)This policy brief explores wealth-based disparities in the modern contraceptive prevalence rate, total fertility rate, and demand satisfied for modern methods of family planning in Ethiopia, Ghana, Malawi, and Tanzania.
Arlington, Virginia, JSI Research and Training Institute, Strengthening High Impact Interventions for an AIDS-free Generation [AIDSFree], 2018 May. 70 p. (USAID Cooperative Agreement No. AID-OAA-A-14-00046)To effectively address maternal and under-five mortality rates, health facilities must have ready access to key maternal, neonatal, and child health (MNCH) commodities such as oral rehydration salts and antibiotics. In response to this need, USAID’s AIDSFree Project and Ethiopia’s Federal Ministry of Health conducted a national assessment of the national Integrated Pharmaceutical Logistics System to identify gaps and set goals and strategies to strengthen the national MNCH commodities supply chain.