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Women and young persons with disabilities: Guidelines for providing rights-based and gender-responsive services to address gender-based violence and sexual and reproductive health and rights

HOLOBOFF RADFORD, Anastasia
et al
November 2018

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This publications aims to provide practical and concrete guidelines for making Gender-Based Violence (GBV) and Sexual and Reproductive Health and Rights (SRHR) services more inclusive of and accessible to women and young persons with disabilities and for targeting interventions to meet their disability-specific needs.
 
Critical services for all victims and survivors of GBV include health services (e.g. first-line support, sexual assault examination and care, mental health assessment and care), justice and policing services (e.g. assessment and investigation, perpetrator accountability and reparations, safety and protection, justice sector coordination), social services (e.g. crisis counselling; help lines; legal and rights information, advice, and representation; psychosocial support and counselling), and coordination at both the national and local level.

 

Fundamental SRHR services for women and young persons—with and without disabilities— include comprehensive sexuality education; information, goods, and services for the full range of modern contraceptive methods, including emergency contraception; maternal/newborn healthcare (including antenatal care, skilled attendance at delivery, emergency obstetric care, post-partum care, and newborn care); prevention, diagnosis, and treatment for sexual and reproductive health issues (e.g. sexually transmitted infections, including HIV, syphilis, and HPV, cancers of the reproductive system and breast cancer, and infertility); safe and accessible abortion, where it is not against the law; and post-abortion care to treat complications from unsafe abortion.

 

While the primary audience of these Guidelines is GBV and SRHR service providers and support staff, these Guidelines are also intended as a valuable resource for all stakeholders—including those in government, international organizations, and non-governmental organizations—involved in designing, developing, implementing, or advocating for GBV or SRHR services for women and young persons with disabilities. 

Integration of childhood tuberculosis into maternal and child health, HIV and nutrition services: A case study from Uganda

VERKUIJL, Sabine
et al
September 2016

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"Country case studies were conducted in Uganda and Malawi to document and analyse experiences and perspectives on childhood TB integration into other programmes at country level and related health system requirements. The aim was to inform the broader thinking about integration of childhood TB services. The Uganda case study identified and described different approaches to integration and unpacked the integration process. The perspective on TB integration of different relevant health actors at national and district level are described. The case study used a health systems approach and focused on the community and primary levels of the health system, paying attention to factors related to children of different ages in a lifecycle approach. The methodology for the case study included document review, consultations with key health actors at national and district level, a facility visit and a participatory workshop at national level. An analytical framework approach was used to investigate the extent of integration of childhood TB interventions in multiple dimensions. An assessment tool for the case studies was developed, summarising the assessment questions by theme, combining a number of existing tools and frameworks on health care integration in general and childhood TB and iCCM benchmarks"

Integration of childhood TB into maternal and child health, HIV and nutrition services. A case study from Malawi.

VERKUIJL, Sabine
et al
September 2016

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"Country case studies were conducted in Uganda and Malawi in order to document and analyse experiences and perspectives on childhood TB integration into other programmes at country level and related health system requirements. The aim was to inform the broader thinking about integration of childhood TB services. The Malawi case study identified and described different approaches to integration and unpacked the integration process. The perspective on TB integration of different relevant health actors at national and district level are described. The case study used a health systems approach and focused on the community and primary levels of the health system, paying attention to factors related to children of different ages in a lifecycle approach. The method for the case study included document review, consultations with key health actors at national and district level, a facility visit and a participatory workshop at national level. An analytical framework approach was used to investigate the extent of integration of childhood TB interventions in multiple dimensions. An assessment tool for the case studies was developed, summarising the assessment questions by theme, combining a number of existing tools and frameworks on health care integration in general and childhood TB and benchmarks for integrated community case management (iCCM)"

UNICEF’S STRATEGY FOR HEALTH (2016-2030) (full version)

UNICEF
2015

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For the five year period 2016-2020, UNICEF’s Strategy for Health sets two overarching goals: 1. End preventable maternal, newborn and child deaths 2. Promote the health and development of all children. To achieve these goals, the Strategy considers the health needs of the child at all life stages. It highlights the need for intensified efforts to address growing inequities in health outcomes, including a particular focus on addressing gender-specific needs and barriers that may determine whether boys and girls are able to reach their full potential in health and well-being. Working together with global and local partners, UNICEF will promote three approaches to contribute to these goals: addressing inequities in health outcomes; strengthening health systems including emergency preparedness, response and resilience; and promoting integrated, multisectoral policies and programmes. The three approaches described underpin a "menu of actions” from which country offices can select, based on their situation analysis, country programme focus, and context. 

Maternal and new-born care practices among disabled women, and their attendance in community groups in rural Makwanpur, Nepal

LEONARD CHESHIRE DISABILITY AND INCLUSIVE DEVELOPMENT CENTRE
2013

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This paper presents qualitative and quantitative research that describes the type and severity of disability of married women in the study area, describes their participation in community groups and analyses associations between maternal and new-born care behaviours and disability. Health workers and field researchers were also interviewed about their experience with disabled women in rural Makwanpur
Cross-cutting Disability Research Programme, Background Paper: 01

Access to health care, reproductive health and disability: A large scale survey in Sierra Leone

GROCE, Nora
TRANI, Jean-Francois
BROWN, Joyce Brown
KETT, Maria
BAH, Osman
MORLAI, Teddy
BAILEY, Nicki
2011

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This is the first study to compare health status and access to health care services between disabled and non-disabled men and women in urban and peri-urban areas of Sierra Leone. It pays particular attention to access to reproductive health care services and maternal health care for disabled women. A cross-sectional study was conducted in 2009 in 5 districts of Sierra Leone, randomly selecting 17 clusters for a total sample of 425 households. All adults who were identified as being disabled, as well as a control group of randomly selected non-disabled adults, were interviewed about health and reproductive health. As expected, we showed that people with severe disabilities had less access to public health care services than non-disabled people after adjustment for other socioeconomic characteristics (bivariate modelling). However, there were no significant differences in reporting use of contraception between disabled and non-disabled people; contrary to expectations, women with disabilities were as likely to report access to maternal health care services as did non-disabled women. Rather than disability, it is socioeconomic inequality that governs access to such services. We also found that disabled women were as likely as non-disabled women to report having children and to desiring another child: they are not only sexually active, but also need access to reproductive health services.

Analysing commitments to advance the global strategy for women's and children's health|The PMNCH 2011 report

THE PARTNERSHIP FOR MATERNAL, NEWBORN & CHILD HEALTH (PMNCH)
2011

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"This report seeks to further our collective understanding of the current Global Strategy commitments, facilitating more effective advocacy to advance the Every Woman, Every Child effort, as well as greater accountability in line with the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health. This 2011 report is based on structured interviews with those who made commitments, supplemented by reviews of related documentation. This report analyses the specific nature of each commitment recorded through May 2011 to produce a preliminary picture of the achievements of the Global Strategy commitments to date, as well as to identify opportunities and challenges for advancement"

Taking critical services to the home : scaling-up home-based maternal and postnatal care, including family planning, through community midwifery in Kenya

MWANGI, Annie
WARREN, Charlotte
2008

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This publication is the report of a project to scale-up a community-based model, in Kenya, that enabled women to give birth safely at home or be referred to a hospital when attended by a self-employed skilled midwife living in the community. The findings of the project were that community midwifery contributed to increasing the proportion of women assisted by skilled attendants during birth in the four districts in which the scheme was trialed, amounting to just under half of all skilled attended births in the districts. Although the skilled birth attendant rate in these districts was well below the national average of 42 percent, there was a steady increase in the proportion of attended deliveries since CMs were introduced in 2005. The districts also reported an increase in postnatal assessments in the first 48 hours and increase in immunization coverage

State of the world’s children 2008 : child survival

United Nations Children's Fund (UNICEF)
2008

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This publication provides a wide-ranging assessment of the current state of child survival and primary health care for mothers, newborns and children. It examines lessons learned in child health during the past few decades and outlines the most important emerging precepts and strategies for reducing deaths among children under age five and for providing a continuum of care for mothers, newborns and children

Integrated management of pregnancy and childbirth : WHO recommended interventions for improving maternal and newborn health

WORLD HEALTH ORGANIZATION (WHO), DEPARTMENT OF MAKING PREGNANCY SAFER
2007

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This paper contains five tables listing recommendations to improve maternal and newborn health and survival, through health services, family and community. Table 1. Care in pregnancy, childbirth and postpartum period for mother and newborn infant; Table 2. Place of care, providers, interventions and commodities; Table 3. Home care, family, community and workplace support for the woman during pregnancy and childbirth and for the newborn infant; Table 4. Care for the woman before and between pregancies; Table 5. Pregnant women not wanting child

Obstetric care in poor settings

MILLS, Samuel
et al
2007

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This report explores why maternal mortality continues to be so high in developing countries, and why emergency obstetric services are little utilized, through research carried out in poor areas in Ghana (Kassena-Nankana district), India (Uttar Pradesh state), and Kenya (Nairobi slums)

Key steps for maternal and newborn health care in humanitarian crisis

WORLD HEALTH ORGANIZATION (WHO), DEPARTMENT OF MAKING PREGNANCY SAFER
2007

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This document has been prepared for maternal and newborn health experts as well as reproductive health experts coordinating and assisting with emergency care during the humanitarian crisis. It describes the ways to estimate the number of pregnant women and those who are about to deliver, highlights some important aspects of emergency care related to pregnancy, childbirth and newborn care, and describes the content of UN kits for such care in three different scenarios

Maternal survival : improving access to skilled care. A behavior change approach

CHANGE
February 2005

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This summary is based on the CHANGE Maternal Survival Toolkit, available online at: www.changeproject.org and on CD-ROM. It explores ways of influencing behaviours and encouraging use of health services and health professionals during childbirth and the postpartum period. A number of factors can prevent pregnant women from accessing skilled care, often putting themselves and the child at risk. They include availability of health services and high costs but also, and crucially, local culture, family and community behaviours and traditional practices. The CHANGE Project's approach and this document stress locally appropriate, behaviour-based interventions that integrate what is happening in homes, communities and health facilities. This tool is aimed at organisations and individuals working in the field of mother and child health, and willing to look at maternal and child survival issues from a behaviour change perspective

HIV risk exposure in young children : a study of 2-9 year olds served by public health facilities in the Free State, South Africa

SHISANA, Olive
MEHTAR, Shaheen
2005

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South Africa has, until now, focused its HIV prevention efforts on youth and adults, and now needs to expand its focus to include children. Much is already known about mother to child transmission, which is the dominant mode of HIV transmission among children. However, little investigation has been done into the potential for horizontal transmission of HIV on the population below reproductive age. This report focuses on children aged 2-9 years and, using a combination of qualitative and quantitative methods, presents evidence on the potential for HIV transmission in dental, maternity and paediatric service in public health facilities. A new finding concerns the practice of shared breastfeeding

Maternal health care among adolescents

REYNOLDS, Heidi
et al
March 2004

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The use of maternal health care services by pregnant adolescents could reduce death and disability during pregnancy and childbirth. Youth are less likely to access maternal health services, which explains some of the increased risk they face. This issue of YouthLens argues that the development of appropriate services could help overcome this problem

HIV prevention in maternal health services : programming guide

PERCHAL, Paul
et al
2004

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This guide helps Ministries of Health, policy makers, programme managers, trainers, and nongovernmental organisations to plan, implement, monitor, and evaluate HIV and STI prevention programmes in maternal health services.The purpose of this guide is to address programming gaps in the prevention of HIV and other STIs in maternal health services; and to increase the capacity of maternal health providers and community based providers through training and facilitative supervision to provide pregnant and post-partum women with HIV and STI prevention services and referrals. It looks at programme planning; the different types of prevention programmes that are possible (eg information and communciation programmes and counselling programmes); and the different types of training that can be considered for staff involved in delivering maternal health services

HIV prevention in maternal health services : training guide

PERCHAL, Paul
et al
2004

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This training pack has been developed using participatory training approaches, which means that the exercises require the active involovement of all participants. It has been developed for use by skilled and experienced trainers who are familiar with the content and objectives of each exercise. The guide consists of a detailed curriculum with session guides, and a series of appendices containing additional materials

Health and social wellbeing : women and disability

DEPARTMENT OF HEALTH, SOCIAL SERVICES AND PUBLIC SAFETY NORTHERN IRELAND
2004

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Research by the Equality Commission for Northern Ireland highlights that many disabled women have particular difficulty in accessing key services such as reproductive health care and screening. This overview decribes issues faced by disabled women, especially in the areas of sexual and reproductive health ,and provides government solutions to solve these issues
Inequalities and Unfair Access Issues Emerging from the DHSSPS (2004) "Equality and Inequalities in Health and Social Care: A Statistical Overview" Report

Reducing maternal mortality : learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica, and Zimbabwe

KOBLINSKY, Marjorie
2003

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"To assist countries in their efforts to improve maternal health and reduce maternal mortality, the World Bank is publishing two volumes: Investing in Maternal Health: Learning from Malaysia and Sri Lanka, and Reducing Maternal Mortality: Learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica, and Zimbabwe. These two books offer success stories in improving health and reducing maternal mortality in a range of developing countries. The first book is based on the experiences of Malaysia and Sri Lanka during the past five to six decades. The second book discusses the more recent experiences of Bolivia, China (Yunnan), Egypt, Honduras, Indonesia, Jamaica, and Zimbabwe. These nine countries have made important strides in improving maternal health, and these two books outline what worked and what did not"

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