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Guideline

WHO recommendations on adolescent health: guidelines approved by the WHO guidelines review committee

Year of Publication
2017
Issuing Institution
World Health Organization
Links
WHO IRIS

Recommendations

176 included recommendations

Implement interventions to enhance adolescent girls’ abilities to resist coerced sex and obtain support if they experience coerced sex by: • building their self-esteem; • developing their life skills in areas such as communication and negotiation; and • improving their links to social networks and their ability to obtain social support. The above interventions should be combined with interventions to create supportive social norms that do not condone coerced sex

Status
New

Recommended in favor

Strong

WHO recommends that countries with high (>10 cases/100 000 population/year) or intermediate endemic rates (2–10 cases/100 000 population/year) of invasive meningococcal disease and countries with frequent epidemics should introduce appropriate large scale meningococcal vaccination programmes. Conjugate vaccines are preferred over polysaccharide vaccines due to their potential for herd protection and their increased immunogenicity, particularly in children <2 years of age. Both conjugate and polysaccharide vaccines are efficacious and safe when used in pregnant women.

Status
New

Context specific recommendation

Only in specific contexts

(Male involvement interventions for MNH Maternal and newborn health) Interventions to promote the involvement of men during pregnancy, childbirth and after birth are recommended to facilitate and support improved self-care of women, improved home care practices for women and newborns, improved use of skilled care during pregnancy, childbirth and the postnatal period for women and newborns, and increase the timely use of facility care for obstetric and newborn complications. These interventions are recommended provided that they are implemented in a way that respects, promotes and facilitates women’s choices and their autonomy in decision-making and supports women in taking care of themselves and their newborns. In order to ensure this, rigorous monitoring and evaluation of implementation is recommended.

Status
New

Recommended in favor

Strong

The use of lay health workers including trained TBAs to deliver the following interventions is recommended, with targeted monitoring and evaluation: distribution of some oral supplementtype interventions to pregnant women (calcium supplementation for women living in areas with known low levels of calcium intake, routine iron and folate supplementation for pregnant women, intermittent presumptive therapy for malaria for pregnant women living in endemic areas and vitamin A supplementation for pregnant women living in areas where severe vitamin A deficiency is a serious public health problem); and initiation and maintenance of injectable contraceptives using a standard syringe

Status
New

The GDG endorsed the recommendation from an existing guideline, WHO recommendation on community mobilization through facilitated participatory learning and action cycles with women’s groups for maternal and newborn health. c The implementation of community mobilization through facilitated participatory learning and action cycles with women’s groups is recommended to improve maternal and newborn health, particularly in rural settings with low access to health services. The implementation of facilitated participatory learning and action cycles with women’s groups should focus on creating a space for discussion where women are able to identify priority problems and advocate for local solutions for maternal and newborn health.

Status
New

Recommended in favor

Strong

Oropharyngeal candidiasis. In children: • Oral fluconazole 3 mg/kg for children for seven to 14 days is recommended as the preferred treatment. • When fluconazole is not available or contraindicated, alternatives include topical therapy with nystatin suspension or pastilles, or clotrimazole troches. • In children with mild oropharyngeal candidiasis, topical therapy with nystatin suspension or pastilles (alternatively clotrimazole troches) is recommended.

Status
New

Recommended in favor

Strong

Children with severe acute malnutrition who are HIV infected and who qualify for lifelong antiretroviral therapy should be started on antiretroviral drug treatment as soon as possible after stabilization of metabolic complications and sepsis. This would be indicated by return of appetite and resolution of severe oedema. HIV-infected children with severe acute malnutrition should be given the same antiretroviral drug treatment regimens, in the same doses, as children with HIV who do not have severe acute malnutrition. HIVinfected children with severe acute malnutrition who are started on antiretroviral drug treatment should be monitored closely (inpatient and outpatient) in the first 6–8 weeks following initiation of antiretroviral therapy, to identify early metabolic complications and opportunistic infections

Status
New

Recommended in favor

Strong

Treating cases of suspected severe malaria pending transfer to a higherlevel facility (pre-referral treatment): Where complete treatment of severe malaria is not possible but injections are available, give adults and children a single intramuscular dose of artesunate, and refer to an appropriate facility for further care. Where intramuscular artesunate is not available use intramuscular artemether or, if that is not available, use intramuscular quinine.

Status
New

Recommended in favor

Strong

School-age children and adolescents (5 to 19 years), and adults, including lactating women, with active TB and moderate undernutrition, who fail to regain normal body mass index after 2 months’ TB treatment, as well as those who are losing weight during TB treatment, should be evaluated for adherence and comorbid conditions. They should also receive nutrition assessment and counselling and, if indicated, be provided with locally available nutrient-rich or fortified supplementary foods, as necessary to restore normal nutritional status

Status
New

Recommended in favor

Conditional

Women who disclose any form of violence by an intimate partner (or other family member) or sexual assault by any perpetrator should be offered immediate support. Health-care providers should, as a minimum, offer firstline support when women disclose violence. First-line support includes: • being non-judgemental and supportive and validating what the woman is saying • providing practical care and support that responds to her concerns, but does not intrude • asking about her history of violence, listening carefully, but not pressuring her to talk (care should be taken when discussing sensitive topics when interpreters are involved) • helping her access information about resources, including legal and other services that she might think helpful • assisting her to increase safety for herself and her children, where needed • providing or mobilizing social support. Providers should ensure: • that the consultation is conducted in private • confidentiality, while informing women of the limits of confidentiality (e.g. when there is mandatory reporting) f health-care providers are unable to provide firstline support, they should ensure that someone else (within their health-care setting or another that is easily accessible) is immediately available to do so

Status
New

Recommended in favor

Strong

(Interventions during the first 5 days after the assault) Offer first-line support to women survivors of sexual assault by any perpetrator which includes: • providing practical care and support, which responds to her concerns, but does not intrude on her autonomy • listening without pressuring her to respond or disclose information • offering comfort and help to alleviate or reduce her anxiety • offering information, and helping her to connect to services and social supports

Status
New

Recommended in favor

Strong

(Women survivors of sexual assault, Interventions during the first 5 days after the assault) Health-care providers should offer levonorgestrel, if available. A single dose of 1.5 mg is recommended, since it is as effective as two doses of 0.75 mg given 12–24 hours apart. If levonorgestrel is NOT available, the combined oestrogen–progestogen regimen may be offered, along with anti-emetics if available. If oral emergency contraception is not available and it is feasible, copper-bearing intrauterine devices (IUDs) may be offered to women seeking ongoing pregnancy prevention. Taking into account the risk of sexually transmitted infections (STIs), the IUD may be inserted up to 5 days after sexual assault for those who are medically eligible

Status
New

Recommended in favor

Strong

(Women survivors of sexual assault, Interventions during the first 5 days after the assault) Discuss HIV risk to determine use of HIV post-exposure prophylaxis (PEP) with the survivor, including: • HIV prevalence in the geographic area • limitations of PEP • the HIV status and characteristics of the perpetrator if known • assault characteristics, including the number of perpetrators • side-effects of the antiretroviral drugs used in the PEP regimen • the likelihood of HIV transmission.

Status
New

Recommended in favor

Strong

(Women survivors of sexual assault, Interventions during the first 5 days after the assault) If HIV post-exposure prophylaxis (PEP) is used: • start the regimen as soon as possible and before 72 hours • provide HIV testing and counselling at the initial consultation • ensure patient follow-up at regular intervals • two-drug regimens (using a fixed dose combination) are generally preferred over three-drug regimens, prioritizing drugs with fewer side-effects • the choice of drug and regimens should follow national guidance

Status
New

Recommended in favor

Strong