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Roll Back Malaria: advocacy for resource mobilization (ARM) guide

This guide is to provide malaria stakeholders in endemic countries with an advocacy implementation guide, case studies and tools to assist them with mobilizing resources for malaria control and elimination at the country level. The intended audience for this guide includes a variety of in-country stakeholders from government officials in national malaria control programs to implementing partners focusing on health and malaria who recognize the need for additional resources and more effective use of them to scale up malaria efforts at the national and local level.

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Trade and health: towards building a national strategy

Globalization and the rise of international trade of goods and services in terms of volume and speed influence human health. This influence can be both positive and negative. Our work on “trade and health” is all about harnessing and maximizing opportunities to promote public health and minimizing the risks and threats.

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Health systems and disaster preparedness and response

From the public health point of view, the objective of disaster preparedness and response, the major theme of this issue of the Monitor, is to reduce the health consequences of public health emergencies, natural disasters and conflict and minimize their social and economic impact.

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Special issue: immunization in the African region

There has been a steady rise in immunization coverage over the years and vaccines have become available to many communities and populations, especially deprived communities in the countries of the WHO African Region. There has also been significant progress in the introduction of several new vaccines, including pneumococcal conjugate vaccine (PCV), rotavirus and conjugate meningitis vaccines in the Region. These successes have been made possible with the commendable leadership and unwavering commitment of governments and people in the Region and of partners. However, several challenges remain to be addressed. The articles carefully chart the successes and challenges of immunization in the African Region. This special edition is a call to all stakeholders – governments and people of the African Region as well as partners – to increase efforts at making immunization a way of life across the Region. Governments should continue to make vaccination a top priority and commit adequate resources and communities should appreciate the value of immunization, and demand and protect immunization services as a basic right.

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Special issue: universal health coverage

Universal health coverage (UHC) aims to provide health care and financial protection to all people in a given country with three related objectives: equity in access – everyone who needs health services should get them, and not simply those who can pay for them; quality of health services – good enough to improve the health of those receiving the services; and financial-risk protection – ensuring that the cost of health care does not put people at risk of financial hardship. It is a powerful concept in public health, and one of the key areas of progress in health in the African Region. This special issue of the African Health Monitor has a dual objective: firstly, it offers an overview of research on the subject of UHC in Africa; and secondly, it provides wider dissemination of research results presented and discussed in African scientific meetings.

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Daily iron supplementation in postpartum women: guideline

This guideline provides a global, evidence-informed recommendation on iron supplementation in post-partum women, as a public health intervention for the purpose of improving maternal and infant health outcomes. The guideline aims to help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions to achieve the Sustainable Development Goals (SDGs), in particular, Goal 2: End hunger, achieve food security and improved nutrition and promote sustainable agriculture. It will also support Member States in their efforts to achieve the global targets of the Comprehensive implementation plan on maternal, infant and young child nutrition, as endorsed by the Sixty-fifth World Health Assembly in resolution WHA65.6 and the Global strategy for women’s, children’s and adolescents’ health (2016–2030). The recommendation in this guideline is intended for a wide audience, including policy-makers, their expert advisers, and technical and programme staff at organizations involved in the design, implementation and scaling-up of programmes for anaemia prevention and control, and in nutrition actions for public health. This guideline is intended to contribute to discussions among stakeholders when selecting or prioritizing interventions to be undertaken in their specific context. This document presents the key recommendations and a summary of the supporting evidence. Further details of the evidence base are provided in Annex 1 and other documents listed in the references.

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Ending preventable child deaths from pneumonia and diarrhoea by 2025

Stopping the loss of millions of young lives from pneumonia and diarrhoea is a goal within our grasp. This publication proposes a cohesive approach to ending preventable pneumonia and diarrhoea deaths. It brings together critical services and interventions to create healthy environments, promotes practices known to protect children from disease and ensures that every child has access to proven and appropriate preventive and treatment measures.

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The global strategy for women's, children's and adolescents' health (2016-2030)

Today we have both the knowledge and the opportunity to end preventable deaths among all women, children and adolescents, to greatly improve their health and well-being and to bring about the transformative change needed to shape a more prosperous and sustainable future. That is the ambition of this 'Global Strategy for Women’s, Children’s and Adolescents’ Health'. The previous Global Strategy achieved great things between 2010 and 2015. It galvanized political leadership, attracted billions of dollars in new financial commitments and created 'Every Woman Every Child', a powerful multi-stakeholder movement for health. However, far too many women, children and adolescents worldwide still have little or no access to essential, good-quality health services and education, clean air and water, adequate sanitation and good nutrition. This updated 'Global Strategy', spanning the 15 years of the SDGs, provides guidance to accelerate momentum for women’s, children’s and adolescents’ health.

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Medicines for maternal health

Expanding access to quality, affordable maternal health medicines is critical to making progress in reducing maternal mortality. However, significant challenges often impede such access. Chief among them is a lack of data on the needs, gaps, systems and financing for maternal health medicines. This report, prepared for the United Nations Commission on Commodities for Women and Children’s Health, provides a review of the current conditions and available evidence on maternal health medicines, specifically Oxytocin and Misoprostol to prevent post-partum haemorrhage and magnesium sulfate, considered the safest, most effective, and lowest-cost medication for treating pre-eclampsia and eclampsia. The report also includes 11 priority issues for actions.

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Population dynamics in the LDCs: challenges and opportunities for development and poverty reduction

This report, prepared for the 2011 UN Conference on Least Developed Countries, outlines major population dynamics in LDCs and addresses their implications for development and poverty reduction. It identifies five areas of intervention that can help countries anticipate, shape and plan for changes in their population. These areas include: focusing investments on adolescents and youth; increasing access to sexual and reproductive health care and empowering women; strengthening capacity to integrate population dynamics in the framework of sustainable development; linking population to climate change; and effectively utilizing data in public policy and development. According to the latest survey of the United Nations Population Division, about three-quarters of the governments of LDCs are concerned with major demographic shifts projected to impact them: high fertility, high population growth and rapid urbanization.

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Socio-cultural influences on the reproductive health of migrant women: A review of literature in Cambodia, Lao PDR, Thailand and Viet Nam

This paper is an overview of the analysis presented in a series of four literature reviews that the United Nations Population Fund (UNFPA) commissioned to identify sociocultural factors that affect the sexual and reproductive health of female migrants. The reviews encompassed looking at research, study reports and other available documents, mainly from the past decade, on internal migrants in Cambodia, Lao People’s Democratic Republic and Viet Nam, and international migrants from Myanmar in Thailand. The reviews were premised on the assumption that socio-cultural factors impact on the potential of female migrants to access sexual and reproductive health information and services and protection from violence. The consultants sought to identify factors enabling access to information and services, as well as examples of good intervention models that might be replicated or scaled up. Potential barriers to access of reproductive health services by female migrants were also described.

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Study on traditional beliefs and practices regarding maternal and child health in Yunnan, Guizhou, Qinghai and Tibet

The study was undertaken in the provinces of Guizhou, Yunnan, Qinghai and Tibet and considered the cultural beliefs and practices of selected representatives of six ethnic minority groups - Miao, Dong, Jingpo, Dai, Hui and Tibetans - in relation to key aspects of maternal and child health. It was designed to identify enabling factors that contribute to the uptake of MCH services, as well as any harmful traditional practices or other barriers that impede maternal and child health and utilization of related services. Information was gathered in relation to religious and traditional beliefs and practices in general, as well as attitudes, beliefs and practices in relation to health and nutrition of pregnant women and children. The research team was tasked to identify and highlight specific practices, beliefs or attitudes – from either demand or supply side - which could be targeted in MCH guidelines, policy and service delivery, in order to enhance access to and utilization of MCH services, thus contributing to improved health targets.

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Impacts of population dynamics reproductive health and gender on poverty

How do the many the different components of the UNFPA mandate contribute to poverty reduction? This publication analyses this question in detail, looking at both the micro level (impacts on individuals and households) and the larger picture. The document concludes that the strength of UNFPA's contribution to poverty reduction resides in the complementarity of different interventions and the synergies by which population dynamics, gender equality and reproductive health work together to reduce poverty.

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Implementing comprehensive HIV/STI programmes with sex workers: practical approaches from collaborative interventions

This tool offers practical advice on implementing HIV and STI programmes for and with sex workers. It is based on the recommendations in the guidance document on Prevention and treatment of HIV and other sexually transmitted infections for sex workers in low- and middle-income countries published in 2012 by the World Health Organization, the United Nations Population Fund, the Joint United Nations Programme on HIV/AIDS and the Global Network of Sex Work Projects. Topics covered in the tool include approaches and principles to building programmes that are led by the sex worker community such as community empowerment, addressing violence against sex workers, and community-led services; they include how to implement the recommended condom and lubricant programming, and other crucial health-care interventions for HIV prevention, treatment and care; and they include suggestions on how to manage programmes and build the capacity of sex worker organizations. The tool contains examples of good practice from around the world that may support efforts in planning programmes and services. The tool is designed for use by public-health officials and managers of HIV and STI programmes; NGOs, including community and civil-society organizations; and health workers. It may also be of interest to international funding agencies, health policy-makers and advocates.

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Implementing comprehensive HIV and STI programmes with transgender people: practical guidance for collaborative interventions

This tool contains practical advice on implementing HIV and sexually transmitted infection (STI) programmes with transgender people. Topics covered include community empowerment and human rights, addressing violence, stigma and discrimination and delivering trans-competent services, especially for HIV and STI prevention, diagnosis, treatment and care. The tool also covers community-led outreach, safe spaces and the use of information and communications technology in programming, and it offers strategies for managing programmes and building the capacity of trans-led organizations. It contains examples of good practices from around the world that can be used to support efforts to plan programmes and services with trans people. The tool is designed for use by public-health officials, managers of HIV and STI programmes, NGOs – including community and civil-society organizations – and health workers. It may also be of interest to international funding agencies, health policy-makers and advocates.

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Adolescent boys and young men: engaging them as supporters of gender equality and health and understanding their vulnerabilities

Achieving gender equality must, and has, involved efforts to understand the vulnerabilities and risks that adolescent girls and young women face every day – but how much do we know about the realities of adolescent boys and young men? This report takes a deeper look at the daily lives of adolescent boys and young men around the world and at how they can join the movement towards improved health and gender equality. Exploring global research, the report reveals boys’ and young men’s specific risks and realities in relation to health in general, sexual and reproductive health in particular, sexuality, media violence, sexual exploitation and other vulnerabilities. It analyses the implications of these risks and realities not only for boys, but also on the lives of women and girls. Adolescence is a key period where individuals of all gender identities form attitudes, opinions and beliefs – about themselves, about their sexuality and about their place in the world. It is a period when ideas about equality can become ingrained. The study emphasizes that a holistic approach to advancing gender equality and sexual and reproductive health must include both adolescent girls and boys. It highlights the need to engage adolescent boys and young men as allies to achieve gender equality and as supporters of women’s empowerment, as well as the importance of addressing the specific health and social development needs of boys themselves.

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Universal access to reproductive health: progress and challenges

Universal access to reproductive health affects and is affected by many aspects of life. It involves individuals’ most intimate relationships, including negotiation and decision-making within these relationships, and interactions with health providers regarding contraceptive methods and options. This report seeks to identify areas where reproductive health has advanced or not according to four main indicators: Adolescent birth rate, contraceptive prevalence rate, unmet need for family planning rate, proportion of demand for contraception satisfied.

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Religion, women's health and rights: points of contention and paths of opportunities

This report looks at the religious arguments around some of the most sensitive and contentious SRH-related issues, from the perspective of the major faith traditions of this world. These issues range from contraception to abortion to GBV to Child Marriage. Far from merely listing the 'religious objections' to be found in the 5 main religions of the world (Buddhism, Hinduism, Judaism, Christianity and Islam), this Report then goes on to elaborate the alternative, faith-based lived realities, interpretations and actions which support the sexual and reproductive rights in question.

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Trends in maternal mortality: 1990 to 2015

Accurate measurement of maternal mortality levels remains an immense challenge, but the overall message is clear: hundreds of thousands of women are still dying due to complications of pregnancy and/or childbirth each year. Many of these deaths go uncounted. Working towards SDG 3.1 and ultimately towards ending preventable maternal mortality requires amplifying the efforts and progress catalysed by MDG 5. Among countries where maternal deaths remain high, efforts to save lives must be accelerated and must also be paired with country-driven efforts to accurately register births and deaths, including cause of death certification. Strengthening civil registration and vital statistics will support measurement efforts and help track progress towards reaching SDG 3.1. Among those countries with low overall maternal mortality, the next challenge is measuring and amending inequities among sub-populations. The new Global Strategy for Women’s, Children’s and Adolescents’ Health will spearhead an enhanced global collaborative response aimed at ending all preventable maternal deaths.

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Adolescent girls in disaster & conflict: interventions for improving access to sexual and reproductive health services

Millions of adolescent girls are in need of humanitarian assistance. A crisis heightens their vulnerability to gender-based violence, unwanted pregnancy, HIV infection, maternal death and disability, early and forced marriage, rape, trafficking, and sexual exploitation and abuse. In emergencies, adolescent girls need tailored programming to increase their access to sexual and reproductive health services, including family planning, and to protect them from gender-based violence. From safe spaces to mobile clinics to youth participation, UNFPA uses different approaches to reach displaced, uprooted and crisis-affected adolescent girls at a critical time in their young lives. This publication features new case studies on reaching adolescent girls in humanitarian situations from programmes in Malawi, Myanmar, Nepal, Nigeria, Pakistan, the Philippines and Somalia.

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Ending the AIDS epidemic for adolescents, with adolescents

This publication provides guidance to programme designers, implementers, policymakers and decision-makers on how to meaningfully engage adolescents in the AIDS response and in broader health programming. It also demonstrates why adolescents and youth are critical in efforts to end the AIDS epidemic by 2030. The publication additionally highlights what steps should be taken to implement programmes and policies that improve adolescent health outcomes (including for HIV) at the national, regional and global levels.

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Establishing a workable follow-up and review process for the Sustainable Development Goals

The Open Working Group document proposes that governments will set its own national targets. They will be guided by the global level of ambition but taking into account national circumstances. To make the Post-2015 agenda actionable, much more thought needs to be given to the process of target-setting, different actors’ responsibilities, implementation and accountability.

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Mind the gap? A comparison of international and national targets for the SDG agenda

The stretch required for low-income countries (LICs) to achieve SDG targets is generally greater than for middle-income and high-income countries (MICs and HICs). The gaps identified indicate where most work is needed to alter political priorities in order to realise the SDGs. Most hard work will be needed in areas that are highly politically contentious (climate policy) or expensive (secondary education, electricity and sanitation). This has implications for how governments structure a review process and how resources are mobilised for the post-2015 sustainable development agenda. The report also found a great deal of variation in the approach to measuring targets at the national level. A standardised approach would make comparisons easier and hold governments more readily to account.

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How does Nepal’s Child Grant work for Dalit children and their families?

The Child Grant is targeted at all households with children aged up to five years in the Karnali Zone and at poor Dalit households in the rest of the country. Launched in 2009 and covering around 20% of Nepal's children, it is seen as a key mechanism to support children in the government's draft National Framework for Social Protection. This study focuses on two districts; Bajura and Saptari, using a mixed-method approach to identify implementation barriers and recommend ways to improve effectiveness of the Grant.

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Improving maternal and child health in Asia through innovative partnerships and approaches

To help respond to a shortage of 7 million health workers worldwide and a growing overall burden of disease, CARE International UK has entered into partnership with GlaxoSmithKline (GSK) as the implementing partner of GSK’s 20% Reinvestment Initiative in Asia. This corporate community investment initiative aims to reinvest 20% of the company’s profits into strengthening of community health systems in six of the least developed countries in which GSK operates. This strategic partnership between CARE and GSK focuses on improving maternal and neonatal child health by improving the quantity and quality of front-line community health workers in the most remote and marginalised communities in Afghanistan, Bangladesh, Cambodia, Laos, Myanmar and Nepal. Through a mix of programming, lesson-learning and advocacy efforts, the initiative hopes to galvanise further national and international action on the health workforce issue. The CARE-GSK partnership is about to complete its first phase (2011-2015) and plans to continue and scale up its projects in 2015-2020. This briefing provides highlights from the six country projects. First, it presents the key indicators and context for each of the countries, followed by the goals and objectives of each project, and then outlines their achievements and impact. The briefing ends with a discussion of the key approaches and models that the projects have developed also providing some broad conclusions and recommendations for strengthening community health systems with a particular focus on maternal and child health.

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