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UNDP/UNFPA/WHO/World Bank Special Programme of Research HRP Biennial Technical Report 2009–2010 WHO Library Cataloguing-in-Publication Data Biennial technical report 2009–2010 / Department of Reproductive Health and Research, including UNDP/UNFPA/ WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. 1.Reproductive medicine. 2.Reproduction. 3.Family planning services. 4.Contraception. 5.Research. I.UNDP/UNFPA// World Bank Special Programme of Research, Development and Research Training in Human Reproduction. II.World Health Organization. Dept. of Reproductive Health and Research. ISBN 978 92 4 150174 3 (NLM classification: WP 630) Acknowledgements We are grateful to all those who contributed to the work detailed in this report including our collaborating centres, details of which can be found on our web site at www.who.int/reproductivehealth/topics/countries/centers © World Health Organization 2011 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial dis- tribution – should be addressed to WHO Press through the WHO web site (http://www.who.int/about/licensing/copy- right_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Printed by the WHO Document Production Services, Geneva, Switzerland. Contents Preface . 2 Chapter 1 Promoting family planning . 3 Chapter 2 Improving maternal and perinatal health . 22 Chapter 3 Controlling sexually transmitted and reproductive tract infections . 42 Chapter 4 Preventing unsafe abortion . 55 Chapter 5 Gender, reproductive rights, sexual health and adolescence . 65 Chapter 6 Research capacity strengthening and programme development: interregional activities . 82 Chapter 7 Research capacity strengthening and programme development: African and Eastern Mediterranean Regions . 87 Chapter 8 Research capacity strengthening and programme development: Region of the Americas . 98 Chapter 9 Research capacity strengthening and programme development: South-East Asia and Western Pacific Regions . .105 Chapter 10 Research capacity strengthening and programme development: Eastern Europe and Central Asian Republics . .113 Chapter 11 Technical cooperation with countries: policy and programmatic issues . .116 Chapter 12 Mapping best reproductive health practices . .126 Chapter 13 Implementing best practices in reproductive health . .133 Chapter 14 Monitoring and evaluation . .137 Chapter 15 Communication, advocacy and information . .143 Chapter 16 Statistics and informatics services . .148 Chapter 17 Primary health care . .156 Chapter 18 Linkages between sexual and reproductive health and HIV interventions . .160 Chapter 19 Universal access . .166 Acronyms and abbreviations . .169 Biennial Technical Report 2007–2008 Technical Biennial 1 Preface This biennial technical report of the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), presents HRP’s work in the context of the World Health Organization’s work in sexual and reproductive health. In odd numbered years, HRP produces a Biennial Technical Report, which is drawn from work pre- sented to HRP’s Scientific and Technical Advisory Group (STAG); this complements the Biennial Report, which is produced in even numbered years, and targeted at a wider audience, including policy-makers, programme managers and donors. The Department of Reproductive Health and Research (RHR), including HRP, has continued to address the various areas of sexual and reproductive health as elaborated within the WHO Global Reproductive Health Strategy. It is taking into account the contribution of sexual and reproduc- tive health to the achievement of the Millennium Development Goals (MDGs). Its global research and programme development work, including national research and technical capacity strength- ening, aim to accelerate progress towards universal access to sexual and reproductive health. The United Nations Secretary-General’s Global Strategy for Women’s and Children’s Health has provided additional impetus to our collective efforts to improve sexual and reproductive health. An external evaluation of HRP for the period 2003–2007 concluded that HRP remains a global leader in sexual and reproductive health research and research capacity strengthening, with par- ticular relevance to the needs of populations in resource-poor settings. It is with pleasure that I introduce this HRP Biennial Technical Report, 2009–2010, which provides scientific and technical details on the full range of activities undertaken by HRP in 2009 and 2010. This report is intended to be a key tool for disseminating information on sexual and reproductive health to scientists, researchers, programme managers and other partners. Highlights of HRP’s work for 2010 are available as a standalone, printed document. To conserve resources we have limited the number of printed copies of this document, but an electronic version is available from: www.who.int/reproductivehealth. Details of collaborating researchers and the departmental staff list are available in the online version. Dr Mike Mbizvo Director Department of Reproductive Health and Research June 2011 Biennial Technical Report 2007–2008 Technical Biennial 2 Chapter 1 Promoting family planning 1 . INTRODUCTION prevent or reduce risk factors for health conditions associ- ated with … unsafe sex” (SO6). Over the past few decades, family planning (FP) programmes have had increasing success in reaching couples to improve Within SO4, the Team’s guidelines and research achieve- contraceptive prevalence rates globally. However, levels of ments have contributed to the achievement of two WHO unmet need for FP remain high, especially in specific popula- Organization-wide expected results (OWERs). The guide- tions, and demand for infertility services is increasing world- lines work is targeted to OWER 7, which highlights the impor- wide. The RHR Promoting Family Planning Team (PFP) tance of making available “guidelines, approaches and tools seeks to contribute to a substantial reduction in the unmet … with provision of technical support to Member States … need for contraception and improved access to infertility pre- towards the attainment of international development goals vention and care services, allowing people to achieve their and targets related to reproductive health.” In 2009–2010, fertility goals. Its programme of work aims at improving the the Team focused on developing, updating, translating and quality of FP within sexual and reproductive health care glob- disseminating appropriate, evidence-based guidelines in ally. The Team focuses on the development and dissemina- order to support countries to meet the needs of their popula- tion of evidence-based FP and infertility guidelines and tools, tions and ensure universal access to contraception and fertil- research into users’ and providers’ perspectives on FP and ity services. Collaborative activities to provide direct support sexual and reproductive health services and technologies, to countries in adapting and implementing the PFP tools and the development of new or improved methods of fertility reg- guidelines have been of paramount importance, despite lim- ulation, the evaluation of the long-term safety and efficacy ited funding for this work. OWER 2 within SO4 specifically of existing methods, and technical assistance to country FP calls for national research capacity to be strengthened and and sexual and reproductive health programmes in the adap- “New evidence, products, technologies, interventions and tation and implementation of technical and programmatic delivery approaches of global and/or national relevance” to guidance. Research results and significant accomplishments be developed. The research supported by PFP in 2009–2010 from 2009 and 2010 are presented here. served both to strengthen research capacity and provide new evidence regarding contraceptive and reproductive health products and technologies. Some of the research portfolio is 2 . CONTRIBUTION TO WHO’S MEDIUM-TERM targeted towards the development of new methods of family STRATEGIC PLAN
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