Logistics is the business of ensuring that high-quality commodities are available at the right place, at the right time, and in the right quantities. From past experiences in Kenya, it has been noted that a well-functioning logistics system is a critical factor to achieve and sustain high-quality care. The most common constraint in the improvement of logistics in the region remains the unawareness of distribution center staff about the needs of their clients. Two strategies were employed to help improve the logistics system and quality of care in Kenya: 1) the creation of service orientation; 2) distribution of commodities based on need. Under the creation of service orientation, activities consist of formal and informal logistics management training, and operationalize the link between reporting and re-supply. For distribution commodities based on need, the system requires private sector logistics techniques and technologies, reducing costs, improving product quality, and projecting national requirements. Moreover, it is noted that measuring the impact is a critical element towards sustaining donor support in the medium term and building policy support to increase government investment in logistics management in the longer term.
Newspaper articles on family life education / sex education in Kenya.
This document presents newspaper articles on family life education/sex education in Kenya. The first article, "Population and Family Life Education: The never ending debate," presents an argument on population and family life education and the morality of introducing it into the school curriculum. It presents research findings of the sex behavior of Kenyan adolescents and the protagonists' views of the matter. The article, "Population and Family Life Education (POP/FLE): What does the syllabus say?", discusses the POP/FLE curriculum and its contents, and presents the primary education syllabus. The article, "Population and Family Life Education: The Big Question", examines answers to the question whether sex education promotes promiscuity. In the article, "Sex and Sex Education", the cultural view of sex and its implication for sex education are discussed. Finally, the article, "How About Life Planning Education?", discusses the importance of implementing life planning education in the region.
Meru and Kakamega: collaborators in family planning.
Since Kenya's independence in 1963, it has witnessed high levels of population growth. Earlier efforts to promote family planning were ineffective in controlling the country's fertility level. Figures show that the population grew at a rate of 2.2% per annum despite Kenya's family planning program. In response to the alarm sounded by the Ministry of National Planning and Development concerning this issue, many governments and nongovernmental organizations made their move. The Japanese government, through the Japan International Cooperation Agency, provided technical assistance to a population education promotion project (PEPP) in Meru and Kakamega in Kenya. Since 1988 PEPP has employed a multimedia strategy by producing audiovisual and print materials that help in population education. In 1993 the project introduced folk media and community development. The presence of other organizations in these districts contributed much to the success of PEPP, as it voluntarily works hand in hand with both existing and new organizations. This paper describes which, where and how these organizations carry out their activities. It includes, among others, Marie Stopes Kenya, Family Planning Association of Kenya, District Public Health Nurse, Adult Education, District Public Health Officer, Maua Methodist Hospital, Child Clinic, Chuka District Hospital, Kibirichia Health Center, and Maendeleo ya Wanawake Organization.
Community determinants of demographic behavior in Kenya. First report.
This report presents the initial findings of the Kenya Community Survey (KCS) in several descriptive tables. The objectives of the survey were to test several hypotheses about the relationship of demographic phenomena to community characteristics and to develop community survey methodology. This paper describes the design and fielding of the KCS, and univariate analysis of data collected. The survey method used was a structured group interview with knowledgeable members of the community. Chapter 2 of this report details the design and fielding of the survey, while chapter 3 describes the physical and social contexts of the group interviews. The remaining chapters of the report correspond to sections of the questionnaire which collected data on the following: distance to various facilities and local road conditions, marriage characteristics and bridewealth, women's groups, and female land tenure and miscellaneous community characteristics. Overall, the experience of KCS shows that it is feasible to conduct a stand-alone community survey designed to be linked with a large-scale community survey.
A national competition to identify new approaches to AIDS prevention for World AIDS Day 1994.
Since its inception in 1991, the Nairobi Province AIDS Task Force has been involved in organizing AIDS Awareness sessions in Nairobi, Kenya. In an effort to involve members of the public by suggesting ways of controlling and preventing AIDS, the Task Force conducted a national competition, in conjunction with the World AIDS Day 1994, among the general population for the most creative yet practical ideas on how to prevent AIDS transmission. The emphasis was on how behavior change could be achieved. This paper presents the ideas presented by 965 entrants who participated in the competition. The entrants observed that education on AIDS using various avenues remains one of the most important strategies in AIDS prevention. Education, however, should be suited to individual groups depending on age, sex, social, and educational background. Other common ideas suggested were strengthening of the family unit, change in traditional practices, active government involvement, and continuing the search for a cure for AIDS.
Child sexual exploitation in Kenya.
This survey examined the issue of child exploitation in Kenya. Findings suggest that various forms of child sexual exploitation have various adverse effects on the growth and development of the child. Five forms of child sexual exploitation were identified: child prostitution, pornography, sex tourism, sex trafficking, and child marriage. These forms differ in severity and magnitude from region to region; however, some forms, such as child prostitution, tend to be rampant throughout Kenya. The following factors were found to be associated with child sexual exploitation: economic circumstances, social problems, tradition and culture, child labor, statutory provisions, and programs. Several recommendations were suggested to solve this unique problem of child sexual exploitation. One major recommendation is to conduct action-oriented research, which will go deeper into finding out the extent of this problem in the country and the number of children at risk. Two vital organizations were identified to collaborate, organize, and sponsor such action-oriented research. In addition, the report recommends further strengthening of existing programs, particularly with a view to re-designing or designing new appropriate programs that are tailored to solving the problem in a more integrated approach. Though child sexual exploitation is not yet an alarming problem in Kenya, the country should not remain complacent about the issue.
1996 IUCN red list of threatened animals.
This document presents taxonomic lists of threatened animals worldwide. List 1 includes all species categorized as either Critically Endangered, Endangered, or Vulnerable. List 2--Lower Risk: conservation dependent (LR:cd)--covers species that are subjects of a targeted conservation program. List 3 includes species in the near-threatened subcategory of the LR category. List 4 presents species categorized as Extinct or Extinct in the Wild. This list reflects some movement of species between extinct and threatened categories as a result of new information and interpretation. List 5 covers species that lack the data needed to make an assessment of possible risk. List 6 includes all subspecies that were listed in 1994 and which have been reassessed in 1996. List 7, which outlines the taxa that appeared in the 1996 Red Lists, is presented in two parts: the first part highlights the taxa that were formerly listed and were assessed; the second part presents the names of taxa previously listed, but not evaluated, and contains a number of species that are excluded from the main list. Each standard entry in lists 1, 4, and 6 follows this format: scientific name (where available), common name, category abbreviation, source of category assessment (for threatened categories only), and range countries. Lists 2, 3, and 5 contain species in a single category. Two classes of threatened taxa--birds and mammals--are assessed comprehensively and are discussed in relation to the countries in which a large number of these species is found.
1997 IUCN red list of threatened plants.
This document presents a comprehensive list of threatened plants on a global scale. A global catalog of vascular plant taxa that have been assessed, the 1997 International Union for the Conservation of Nature Red List of Threatened Plants provides a snap-shot of the state of global plant diversity at the end of the second millennium. The list is arranged by major taxa: fern allies (lycopodiopsida), true ferns (pteridopsida), gymnosperms (gnetophytes, conifers, Ginkgo, and cycads), and angiosperms (dicotyledons and monocotyledons). Within each of these major taxa, families and their respective genera and species are listed alphabetically. Following the list of taxonomic data is a list of all relevant data sources, arranged numerically. Finally, an index to the genera, families, and major taxa is included. Summary statistics are given in the list at the beginning of each family; these comprise an estimate of the total number of genera, species, and threatened taxa. Several tables showing the number of threatened species recorded for each country are also presented.
Dimensions of need: an atlas of food and agriculture.
Although food production is adequate throughout the world, some 800 million people still do not have access to enough food. The major problem is that increases in food production are spread unevenly across the globe and that the poor cannot afford to buy what is produced. The pressing issues of food production and distribution are explored in this book entitled “Dimensions of Need: An Atlas of Food and Agriculture.” Topics covered include: human nutrition, people and population at risk, availability of food, living conditions of the poor, and food security. The welfare of the world's natural resource base of agriculture, fisheries, and forestry is crucial to the future of food production. The book discusses current threats to natural resources and the need for sustainable development into the 21st century. Other related issues are economies in transition, world trade, technology transfer, and biotechnology. The UN system and its role in fighting world hunger is also discussed in detail. The volume contains 40 maps and over 100 illustrations that bring issues to life.
The people in between: Sri Lankans face long-term displacement as conflict escalates.
This report describes the findings of US Committee for Refugees (USCR) during their investigation on the long-term displacement of Sri Lankans amidst the escalating conflict. This dispute started in the 1970s, continued in the 1990s, and is attributed to the Liberation Tigers of Tamil Eelam (LTTE), a dominant militant group. As a result, civilians began leaving Jaffna town in large numbers in October 1995 during the start of the military offensive. These displaced civilians went initially to towns within the vicinity of Jaffna, while nongovernmental organizations (NGOs) provided relief operations to households. However, NGOs had to obtain permits from the government for any relief they provided. This paper also presents an analysis of the food distribution, health care, education, shelter, water and sanitation, economic situation, child recruitment, casualty counts, restrictions on freedom of movement, LTTE bombing, destabilization in the eastern part, threats on the security of Tamils in Colombo, impact of the offensive, re-capturing the space for peace, constitutional peace proposals, the censorship and slanted reporting of the media and other NGOs and government concerns. USCR believes that there would be no lasting solution to the problem short of an answer to the underlying civil conflict. This paper ends with several suggestions on how to restore peace in Sri Lanka.
Pipeline monitoring and procurement planning. Pipeline v 1.4 user's guide.
This PipeLine User's Guide presents a step-by-step procedure in the use of PipeLine products and product procurement plans as part of the Family Planning Logistics Management Project implemented by John Snow, Inc. Section 1 provides an overview of the PipeLine Monitoring and Procurement Planning System, a software tool designed to monitor the status of product pipelines and product procurement plans. Section 2 presents the procedure for installation and backup of PipeLine, systems requirements, restoration of databases, and upgrading of systems. The third section discusses the programs and supporting information: accessing, selecting, creating, editing, deleting, backing up and restoring of programs. Section 4 explains how to maintain PipeLine data, particularly program parameters and primary data. The fifth and last section lists PipeLine reports and graphs that can be created with PipeLine.
U.S. and international population non-governmental organizations.
This monograph, published by The Population Institute, offers a brief summary of the different organizations that aim to promote the basic human right of couples to determine the number and spacing of their children. Policies have been adopted by the government and programs were launched as a result of the efforts of the private sector in promoting awareness of global population issues. Presented here are the scope and purpose of the most active nongovernmental organizations (NGOs) in the international population field. Divided into sections, these organizations are classified under the categories of US and international population NGOs, international population NGOs, college and university affiliates, and co-sponsors of World Population Awareness Week. Likewise, included in the summaries are the contact numbers and addresses of these organizations.
This paper was prepared based on the field experience of the Operations Research Project of the International Centre for Diarrheal Disease Research, Bangladesh: Centre for Health and Population Research, in facilitating the process of site selection for Community Clinics at Abhoynagar of Jessore district and Mirsarai and Patiya of Chittagong district, between October 1998 and August 1999. The general objectives of the operations research component on site selection for Community Clinics were: 1) orientation of government managers and providers at the district level, thana level and below, and community leaders on the new program; 2) operationalization of Community Clinics with particular emphasis on site selection and other related issues of Community Clinic-based service delivery; and 3) documentation and dissemination of corresponding findings to suggest measures on further fine-tuning of related government guidelines and documents, as and when required. Activities related to site selection were conducted in collaboration with officials of the Ministry of Health and Family Welfare in accordance with government guidelines and the Programme Implementation Plan. Thana managers, union supervisors, and outreach field workers of the government health and family planning service delivery systems and community leaders were involved with facilitation activities to help them understand the issues and thereby expedite the process of site selection for Community Clinics. Overall, the set objectives were attained by organizing briefing meetings, planning workshops, field visits and personal contacts, stock-taking meetings, focus group discussions and technical assistance.
Clinical contraceptives: situation in rural Bangladesh.
This study assessed the knowledge and practice among currently married women in four rural areas of Bangladesh, namely, Abhoynagar, Keshobpur, Mirsarai, and Satkania. Data were collected from 9861 currently married women between November 1998 and May 1999. Surveillance system on a 3-monthly (previously 2-monthly) round were collected to estimate the discontinuation rates of pills, condoms, injectables, and IUDs. Results showed that 90% of the women could identify a clinical method of contraception, but knowledge regarding Norplant and male sterilization was low. More than half of the women who mentioned a clinical method had misconceptions about the disadvantages of the method. Misconceptions were highest for IUDs (66%) and lowest for injectables (57%). Religious prohibition of permanent methods and also fear of surgery related to permanent methods and Norplant were mentioned. The contraceptive prevalence rate was found to be 47% and was highest in Abhoynagar (63%) and lowest in Satkania (31%). The pill was the most widely used method, and only a few women used Norplant. It was further found that switches to clinical methods occurred mainly from pills to injectables, while intention to use contraceptives was positively associated with advice from the field workers, education and number of living children. These findings suggest that there is a need to remove barriers to clinical contraception with emphasis on the removal of misconceptions prevailing in the community.
This study examined the profiles of the medicine-sellers of pharmacies of an urban area of Bangladesh. It also assessed their knowledge of sexually transmitted diseases (STDs) and HIV/AIDS and their practices in managing STD cases. A total of 201 medicine-sellers from 157 pharmacies of Tongi Municipality were surveyed using a self-administered questionnaire. Also, mystery shopping events were conducted in 33 randomly selected pharmacies. Results showed that 93% of the medicine-sellers completed at least 10 years of schooling. Medicine-sellers defined an STD as only gonorrhea or syphilis, and 84% were able to mention the STD-related complications. About 43% could describe AIDS, and 65% could mention at least 1 preventive measure for AIDS. 99% reported that they received STD clients with complaints of urethral discharge, genital ulcer, and vaginal discharge. A gap between the reported and the observed practices of the medicine-sellers was also noted. Moreover, 72% reported that they referred their STD clients to physicians, and 43% reported that they provided treatment. During the mystery-shopping events it was observed that only 4 of the 33 medicine-sellers referred the STD clients (mystery-shoppers) and 27 provided treatments and counseling. The medicine-sellers maintained privacy but provided inadequate treatment to the STD clients (mystery-shoppers). This study implies that pharmacies provide services to STD clients in terms of medicines, advice, and referrals, but they lack the ability to provide adequate information and treatments.
The role of men and women in decision making about reproductive issues in Malawi.
This paper examines the roles of men and women in decision-making regarding childbearing and the use of traditional and modern methods of family planning, using quantitative and qualitative data collected in Malawi. Results show that men have traditionally played a limited role in making decisions relating to childbearing and contraception. However, when it comes to modern contraceptives, men are demanding to be consulted and give consent before their wives use the methods. This attitude of men seems to be motivated by several differences in their perception between traditional and modern methods. For instance, modern methods are provided in a modern institutional setting and are thus associated with modernity and progress. Also, the perceived greater effectiveness of modern methods influences men who are suspicious about their wives' faithfulness; therefore, they want to exert more control over these methods than over the traditional ones. These results suggest that the changes in the reproductive decision-making structure that are brought about by modern methods are bound to increase the role of the couple as a decision-making unit and reduce the influence of the elderly women's establishment on reproductive matters.
Strengthening reproductive health service delivery in Cambodia.
This paper highlights the efforts and accomplishments of the US Agency for International Development-supported Family Planning Service Expansion and Technical Support Project (SEATS) and three projects it has supported in Cambodia. The paper begins by introducing Cambodia's challenges and efforts in health-sector reform. The subsequent chapters then explore five technical interventions SEATS and its partner organizations have undertaken to improve access to and quality of sustainable family planning and reproductive health service delivery programs in Cambodia. These include: safe motherhood, service expansion and outreach, logistics management, quality improvement, and organizational development. The final chapter summarizes the experiences of, and lessons learned by, the country's leading health-sector organizations. Overall, it is noted that over the course of the 3 years of implementation of SEATS, the reproductive health situation has improved significantly in the public and private sectors. Some of the key lessons learned that apply across all SEATS program operations include 1) building collaboration; 2) extending project timelines; 3) overcoming cultural barriers; 4) ensuring accurate translation; 5) re-evaluating testing procedures; and 6) ensuring a well-trained health care workforce.
The Family Planning Service Expansion and Technical Support II Project (SEATS II) was implemented to expand the development of, access to, and use of quality family planning and reproductive health services in underserved populations. Accordingly, quality of care (QOC) was a major priority of the project and SEATS sought to mainstream quality improvement in the subprojects with which it worked. This publication shares the experiences in implementing the projects, the accomplishments, and the possible areas of improvement in the future. Some of the approaches applied by SEATS include the Continuous Quality Improvement and client exit interviews, and surveys measuring quality at the country, municipality, and nongovernmental organization levels and at the facility level were conducted. Case studies that describe how the quality improvement efforts supported under SEATS were realized in the field and the results that were achieved are presented. Overall, it is noted that over the project's 5 years the family planning/reproductive health field made important progress in defining what is meant by QOC and in implementing a wide variety of programs to make improvements and measure quality.
Population growth is one of the world's most pressing concerns. It is projected that in the next 25 years, the world's population will increase to nearly 8 billion people. The most growth is expected to occur in regions with the least resources, particularly Africa, Asia, and Latin America. If these predictions are accurate, the majority of the people in the world will be affected by the deterioration in quality of life, in life expectancy, and in environmental and economic stability. It is noted that providing access to contraceptives and high-quality reproductive health services could prevent some of the millions of unwanted pregnancies that occur each year and save the lives of millions of mothers and children. One program that seeks to increase access to family planning (FP) and reproductive health care (RHC) is the Midwifery Association Partnerships for Sustainability (MAPS). It promotes the development of midwives as a way to address unmet needs for FP/RHC. MAPS works with midwives in the private and public sectors, through professional associations. Overall, the MAPS experience illustrates that with adequate support midwives can successfully expand access to reproductive health care. They can reach underserved populations and provide high-quality, integrated reproductive health services, including family planning.
Population policy for South Africa.
This paper describes a population policy designed to provide a comprehensive and multisectoral framework for addressing population issues that are currently considered not commensurate with achieving sustainable socioeconomic and environmental development in South Africa. The policy emphasizes the shift to a sustainable human development paradigm that places population at the center of all development strategies and regards populations as the driving force and ultimate beneficiary of development. It has been designed and conceived as integral to development policies and strategies, not as a substitute for them. In addition, it clearly articulates the Government's position on the relationship between population and development. Sustainable human development is the central theme and organizing principle of this policy. It is based on a set of 12 guiding principles, which provide the ethical context for a human rights approach to integrating population concerns into development planning, implementation and monitoring. A number of strategies are outlined, which comply with the multisectoral nature of the population policy.
This document reports the preliminary assessment findings of the Government of Indonesia's family planning and health logistics systems carried out between September 27 and October 8, 1999. The purpose of the assessment was to begin the search for causes of the supply imbalances and to set out an initial plan for addressing logistic system design and performance issues. Two logistic systems were assessed: BKKBN and DEPKES. Results revealed that these systems have well-developed, institutionalized supply chains, with a long history of good performance and a strong infrastructure for procurement, storage, and distribution of goods. Until the monetary crisis of 1997, the nation was self-sufficient in contraceptives and essential health commodities. Since that time, both organizations have taken significant, concrete steps to ensure continuity of supplies to the poorest Indonesian families and to those who have been hardest hit by the crisis. The details of the existing systems and the steps taken in response to the crisis are contained in section II of this document. Sections III, IV, and V discuss technical issues and concerns that will provide the basis for a detailed plan of action to restore distribution system performance. Several concrete steps for BKKBN and DEPKES are cited.
Growing together: a guide for parents and youth.
"Growing Together" is a book that guides parents in helping their children develop into men and women of God. It provides vital information on becoming an adult and on sexuality. It contains five basic sections. The first section tells the stories of Rose and Steven, who are typical young people facing the normal adolescent questions, experiences, changes, and problems. The second section entitled 'A Closer Look for Youth' presents the questions young people are asking and provides answers in their language and context. These questions include understanding parents, physical changes, relating to authority, relating to the opposite sex, choosing friends, and being accepted by others. The third section relates a true story of a Kenyan family which modeled effective relationships, and the impact those relationships had even across generations. This section elaborates on the needed foundations to build a strong relationship between parents and children. The section on friendship discusses issues on how to help young people understand friendships and the importance of making good choices in friendships. Finally, the last section on confronting common concerns tackles many common issues and problems young people faces. These include sexually transmitted diseases (including HIV/AIDS), sexual abuse, pregnancy, drug abuse and depression.
Knowledge, attitudes and practices related to AIDS and HIV infection among adolescents in Kenya.
This study examined the knowledge, attitudes and practices related to AIDS and HIV infection, contraception, and reproductive health among adolescents in Kenya. Participants included 2303 secondary school students in 22 schools, within 5 different districts in the country. Data were collected by interview using a self-administered, partly-structured questionnaire. Findings revealed that 60.8% of the students were aged 15-17 years; male and female students were more or less equal in the study population. 39.9% of the study population was sexually experienced. The mean age at first coitus was 15 years. Boys started earlier and had more and more varied sexual partners than girls. A strong correlation was noted between having a friend of the opposite sex and being sexually experienced. A similar correlation between the age at menarche and age at first coitus for the girls was also observed. The adolescents' contraceptive knowledge was above average, but their use was low in spite of high sexual activity. 97% of the students had heard of HIV infection and AIDS. Their knowledge of the various modes of transmission, causative agent, risk behaviors, and preventive strategies was also quite good. However, more than one-third of them thought that AIDS/HIV infection could be cured with Kemron and Azidothymidine. Adolescents should be appropriately and adequately informed on AIDS/HIV infection and other related reproductive issues.
Contraceptives / family planning. Which is the best method for me?
This paper discusses in detail the different contraceptive methods available in Kenya, describing how each one is used and how it works. It also presents the advantages and disadvantages of the contraceptive methods, as well as their relative effectiveness. The first part of this paper provides background information on both the male and female reproductive organs. The main part focuses on the different types of contraceptive methods. The natural family planning methods discussed are the calendar method, the temperature method, and the cervical mucus or Billings method, while hormonal contraceptives discussed are pills and injectable contraceptives. Other methods of contraception discussed are IUDs, barrier contraception, sterilization or voluntary surgical methods, coitus interruptus (withdrawal), and douching. The last part of this paper offers suggestions in choosing a contraceptive method.
Helpers for a healing community: a pastoral counseling manual for AIDS.
This pastoral counseling manual is a reference guide that describes the skills and the issues that are important for AIDS counseling. It presents case studies that will help the counselor apply these issues to actual situations and help them sharpen their skills. The manual is composed of nine sections and aims to achieve the following goals: 1) help any willing person counsel those affected by HIV/AIDS; 2) help lay church counselors understand and deal with problems in light of the Bible; and 3) sharpen the skills in helping the healing process in people's lives. Lastly, this manual is designed to help one find answers to particular problems when confronted with difficulties during counseling.
Study on integration of family planning and essential drugs in Kenya.
This study aims to make recommendations for the integration of family planning delivery and essential drug delivery in Kenya. Data were collected by interviewing relevant staff at the Essential Drug Program (EDP) headquarters, at the Division of Family Health, and at the Mission for Essential Drug Supplies headquarters in Nairobi. Documents pertaining to the subject matter were also reviewed. It was found that major fundamental differences exist between the EDP and the Family Planning Program (FPP), which make it impossible to integrate any components of the two. The reasons for these differences are cited. In order to arrive at an integrated program, the following recommendations were presented: 1) establishment of a national kit packaging factory; 2) development of a national drug policy; 3) implementation of a 'Know Your Medicines' campaign; 4) acceleration of the implementation of the Bamako Initiative; and 5) evaluation of the logistics, transport, and storage of the EDP/FPP.
The influence of reproductive status on rural Kenyan women's time use.
This article determined the effects that pregnancy and infant care had on Embu women's productive work activities. Time use patterns were calculated for women at different stages of pregnancy and lactation, as well as for women who were neither pregnant nor lactating. Time allocation data were collected from 169 households, from March 1985 through February 1986, using a spot observations technique. Detailed reproductive data were collected monthly, and household socioeconomic status (SES) data, quarterly. Results demonstrated that when women become pregnant, considerable 'productive work' time spent for commercial activities, subsistence agriculture, housework, and tending animals gives way to a significant amount of time caring for children, and to a lesser extent, being inactive and socializing. Work activities were curtailed especially in the third trimester of pregnancy and the first period of lactation. Over the 2-year pregnancy and lactation cycle, the pregnant/lactating woman devotes about 53 fewer days to commercial, subsistence agricultural, and other 'productive work' activities than the nonpregnant/nonlactating woman. Low and medium-low SES women in their third trimester of pregnancy work less (50-52% of daily time) than high and medium-high SES women (61%). Rest during pregnancy and child care responsibilities during lactation were the major factors accounting for these time use patterns. Overall, these findings highlight the economic 'losses' due to continuous cycles of pregnancy and childbearing.
Reproductive rights among women in Kenya.
In response to high fertility rates in Kenya, the basic human right of women to contraceptive information and services is being emphasized. This paper examines direct as well as indirect legislation influencing women's reproductive rights. It discusses a woman's right to regulate her fertility and identify the existing legislation and cultural practices which directly impede this right by suggesting strategies for eliminating or minimizing their negative impacts. It is noted that there is no specific legislation on family planning information dissemination, on the manufacture and distribution of contraceptives, on the provisions for sterilization, on abortion, and on the health-legal aspect of fertility regulation in the country. Thus, other Acts are used as counteractions. However, these are found to be restrictive to some aspects of the issues. They also constrain women from exercising their rights of access to and use of contraception.
Women and health in Kenya: developing an action agenda (summary of research findings).
Kenya has a population of 25 million, half of whom are women. Existing anecdotal evidence suggest that the female fraction of this population is more often sick, attends health facilities more frequently and consumes more health resources than the male population. In an attempt to identify the root causes of this disparity, this paper looks into several issues influencing the poor health of Kenyan women. These issues include the sociocultural context of the woman's life, the health care facilities available, problems with sexuality, fertility control and cancers, carriage or miscarriage of pregnancy and associated stress, concerns about food security and nutrition, and a woman's fight against sexually transmitted diseases and HIV/AIDS. The paper ends by presenting the areas where interventions are needed, which include legislative, administrative and cultural and traditional practices affecting women's health.
Small family for better living.
This pamphlet contains information on family planning describing the importance as well as the advantages of using family planning. Presented in a comic design, it also enumerates the barriers to family planning. These include lack of information on the part of the couple, rumors surrounding family planning, and old habits and traditional ideas. In addition, this pamphlet discusses possible impacts of family planning dropouts on Kenya's population. Ways in preventing the effects of rapid population increase are also cited. Some of these include changing one's attitude towards family planning and obtaining knowledge regarding the access to family planning services and information.
Mombasa: situation analysis on women and children.
This paper presents a situation analysis on women and children in Mombasa, Kenya. Part A discusses population characteristics, economic conditions, social organizations, and services that exist in Mombasa. It shows that about 40% of the population lives on the Island of Mombasa, while the rest is distributed in the remaining areas. Changamwe has the highest number of low-income households and also the highest density per hectare. Women comprise 23% and under-five children constitute 16.5% of the total population. Mombasa has the largest port in East Africa and is considered an important center for trade and communication. Furthermore, Mombasa has 134 self-help groups that help members generate income. Facilities for health and education are also in existence. Part B of this paper discusses women's social role and position; incidence of poverty; education literacy and educational attainment; and survival, health, and nutritional status. It also includes infant and child mortality (0-5 years); morbidity cases; immunization and malnutrition status; disability among children; educational status; child labor; and children in difficult circumstances.
This article presents the findings of a comparative review which highlights the extent, levels, patterns, causes and consequences of adolescent sexual behavior. Available research shows that young people in Kenya engage in sexual activities at younger ages, with multiple partners and with little or no information and knowledge on sexuality and reproduction. These activities take place in the context of inadequate contraceptive information and service. Studies also indicate that these sexual activities are associated with a myriad of negative health consequences such as the risks and contraction of sexually transmitted diseases, cervical cancer, HIV/AIDS, and unwanted pregnancies. Most of these are prenatal pregnancies and are associated with chances of risky induced abortions conducted under unsanitary conditions, thus resulting in infections, infertility, and death. Other pregnancy-related health problems include malnutrition, anemia, pregnancy and delivery complications, high morbidity and mortality rates. Despite the extensive documentation highlighting the extent of these problems and the severity of their consequences, there exist very few opportunities for young people to receive the relevant information and services that can aid in the prevention, reduction, and management of these health problems. Recommendations for governmental action and policy development are listed.
The Global Knowledge Women's Forum: transcending the gender information divide.
This report summarizes the processes, presentations, discussions and recommendations of the Global Knowledge II Women's Forum. It is divided into three sections, with the first section being a summary of the Women's Forum Action Plan, in which crosscutting recommendations for action are made. In addition, specific recommendations for action, as they relate to access, empowerment, and governance, are presented. The second section provides a synthesis of the processes, discussions and context for the Action Plan. The history of the conference is traced in this section. It also notes the inputs and the recommendations given during the conference, and discusses future plans. Finally, the third section is a collation of presentations prepared by guest speakers at the Women's Forum. It is hoped that this report will be an important contribution to those who have an interest and mandate to support women in information and communication technologies.
This Manual on Field Practice in Internal Displacement describes activities undertaken in situations of internal displacement so as to strengthen the link between assistance and protection activities. The intent of this compilation is to provide field practitioners with examples from a variety of country contexts of interventions on behalf of the internally displaced in promoting standards for protection and assistance to internally displaced persons. It demonstrates that something can be done and is being done by international and local organizations to address the issue of internal displacement, as well as give support to efforts by governments and agencies to implement the Guiding Principles on Internal Displacement. These principles restate and consolidate in one document the relevant principles applicable to the internally displaced, providing practical guidance for use in responding to situations of internal displacement. Each principle is discussed and summarized in the manual, followed by examples of field practices geared toward the fulfillment of each. More than 60 concise examples of program initiatives undertaken by operational agencies, by governments, and by the displaced themselves are presented.
Communication network of women's NGOs in the Islamic Republic of Iran.
This document presents the Communication Network of Women's Nongovernmental Organizations (CNWN) in the Islamic Republic of Iran. CNWN is a non-profit and nongovernmental institution created as a unique foundation, which plays the role of a connective bridge between women issues and the government. Its aim is to achieve better communication and exchange of information of women between civil and international government and NGOs. The first extended women organization in Iran under the consultative status of the Economic and Social Council of UN (ECOSOC) has organized training workshops on minor credits, fertility hygiene, elimination of discrimination against women, girls' maturity health, and human rights. These activities emphasize the need to empower women to achieve gender equality in the region. In addition, forums and conferences have been conducted, and policies have been proposed concerning the activities of the ECOSOC. This document also provides a list of NGOs that are members of the CNWN.
This document presents Egypt's Presidential Decrees No. 90 and 93 for the year 2000, following the review of the constitution. Articles under Presidential Decree No. 90 call for the establishment of "The National Council for Women", to be affiliated to the President of the Republic. The Council shall consist of 30 members of public figures and experts in women's issues and social work. It will be entrusted with mandates presented in Article 3. The Council's purpose is to convene at least once every 2 months or whenever deemed necessary by its chairperson and to establish permanent committees to perform its functions. These committees are noted in Article 5 of this decree. Moreover, the Council is to be headed by a Secretary-General whose function is to represent the Council in its dealings and contacts with other bodies and before the Judiciary. State's agencies are to provide the Council with data and statistics as requested by the Council to perform its functions. Presidential Decree No. 93 is based on Presidential Decree No. 90. The articles present the members of the National Council for Women.
This report focuses on institutionalizing the use of Operations Research (OR) at universities and service providing institutions. The project aimed to disseminate the OR methodology among reproductive health/family planning (RH/FP) professionals and university professors in Peru. Specifically, it aimed to strengthen the institutional capacity of agencies providing RH/FP services to carry out OR projects and local universities to offer high quality OR courses for targeted audiences. The OR institutionalization model consisted of an OR Workshop in which multidisciplinary teams of health personnel and university professors are exposed to concepts and cases and design their own research proposals assisted by experts. The studies included an experiment that evaluated the use of an interactive pamphlet to increase the use of reproductive health services at a family planning clinic; a test focusing on the use of three models of home visits to reduce the unmet need for contraception; and an assessment of contraceptive continuation using life tables. Overall, an indicator of success of the project is accounted for in the request to replicate the workshop in priority regions of Peru's Ministry of Health.
The Latin America and the Caribbean Operations Research and Technical Assistance in Family Planning and Reproductive Health project (INOPAL III), "From Baby and Mother Friendly Hospital to Child and Woman Friendly Clinic," was designed to develop and test a family-friendly clinic (FFC) strategy to provide high-quality, comprehensive reproductive health care at the Mexican Social Security Institute. Overall, the main objectives of the project were met: the benchmark indicators were developed, an evaluation system was designed, and a test was conducted in six units. The test showed that the strategy was useful in improving the quality of the services, and this could be assessed by looking into the providers' knowledge and attitudes and client satisfaction. The FFC strategy includes all quality of care elements that are useful in engaging clinic staff in a quality improvement process. In addition, the experience indicated the need to develop materials such as manuals for external evaluators and the criteria for the evaluation and certification of clinics. Finally, it is suggested that more time be devoted to the implementation process.
Introduction. Executive summary.
As part of the overall National AIDS campaign and education in Kenya, the Ministry of Health, through the National AIDS Control Program, initiated an AIDS educational program via the radio. The radio program sought to create awareness on the existence of AIDS, educate communities on dangers of the disease, and thus influence sex behavior and practices of the people. This paper reports on the impact of the radio program on the control of AIDS in Kenya. Areas examined were radio program coverage and impact in terms of general, national, and vernacular languages used; level of awareness created; influence on attitudes and practices toward sex; and the effectiveness of radio as a channel for communicating AIDS information and education. Findings showed that in addition to creating awareness, the radio program has been effective in increasing knowledge on AIDS and influencing sex behavior. However, in terms of the adequacy of the radio coverage, 48.7% said the coverage was not adequate. Four areas need further coverage: origin of AIDS, transmission, cure, and symptoms of the disease. While 51.3% of the sample claimed taking precautionary measures against AIDS, 48.7% did nothing. The findings further showed that out of the 286 respondents using condoms, 59 (20%) said they were motivated by the radio program. Reasons for low levels of condom use were cited. Finally, recommendations for the improvement of the AIDS radio program in Kenya were made.
100 years of women revolution.
This booklet traces the history of the last 100 years of the women's revolution in the Republic of Bangladesh. At the start of the last century, Begum Rokeya gave a call to women to raise their voices in ascertaining their rights. In response to her call, Begum Sufia Kamal and many other Bengali women came forward to augment women issues in politics, social advancement, and in every sphere of life at the juncture of history when Bangladesh was going through changes. This document summarizes the major achievements of the women's movement during the period 1900-1999. Highlights of the UN Initiative for women's development are outlined at the last portion of the booklet.
Attitudes towards water quality and water use practices in low income areas in Lusaka.
This study examined perceptions of water quality, methods of water storage and water use, and awareness and practice of water purification in two low-income neighborhoods of Lusaka, Zambia. The analysis is based on reports from 825 randomly selected men and women who were administered a structured knowledge, attitude, practices questionnaire on water use. Cross tabulations are used to examine the relationships between age, gender education and household assets, and water storage practices and perception of water quality. Majority of the households (70%) use 20-liter containers for storing drinking water, with 53% of the respondents keep water containers completely covered. Although majority of the respondents are aware that poor water quality can result in diarrhea and cholera, perception of being at risk of these diseases, at least through drinking water, is low. While more than half (54%) of the respondents believe that water quality can be improved, a very small proportion of households (13%) are regularly taking measures to improve water quality. These outcomes are correlated with educational and socioeconomic status of respondents. Hygiene practices related to food preparation, eating, and toilet use exposed a large number of respondents to high risks of fecal-oral contamination. Exposure to environmental contaminants is also high in these neighborhoods. Based on these findings, areas for future intervention are discussed.
Tool kits for social marketing research: guidelines for contracting research.
This document gives an overview of the major steps to be observed in arranging research with consultant or research organizations based on the protocols provided by Population Service International. It provides general guidelines for the preparation of requests for proposals and research contracts, giving specific examples for survey research and for qualitative research. Contract specifications are discussed which include statements of the scope of work, roles and responsibilities of key personnel, deliverables, budget and payment, subcontractor's rights to use the data, and copyright of research report. Examples of a request for proposals, a research contract, and a research budget are appended.
The conflict in Sierra Leone, which started in 1990, displaced thousands of people from the eastern, southern and northern regions of the country. Estimates vary from 100,000 to 500,000 homeless displaced people at various sites around Freetown. It is noted that these people have placed untenable pressure on the already weak infrastructure and welfare services, including essential health care provision. Health workers in the camps have reported the prevalence of cholera, malaria, gastroenteritis, sexually transmitted infections, kwashiorkor, anemia, malnutrition, worms and skin complaints such as scabies. Women and children are especially vulnerable, and some women are also suffering trauma and physical injury due to rape. Marie Stopes International has been addressing these problems for years, using the existing program resources of the Marie Stopes Society of Sierra Leone. The project has been providing maternal and child preventive and curative health services, basic general health care, diagnosis and treatment of sexually transmitted infections, advice on personal and environmental hygiene and nutrition, and referral of emergency obstetric cases on a mobile basis to the displaced communities. The project will be undertaken in full cooperation with the Department of Health and other agencies.
Treatment of incomplete abortion.
This manual presents a sequential guide in the treatment of incomplete abortion. The first section focuses on the technique of manual vacuum aspiration (MVA). MVA is an effective method in treating first- and early second-trimester incomplete abortion by removing the contents of the uterus through suction. It is noted that this technique has been found to result in fewer complications than dilation and curettage (D&C) and causes less trauma to the patient. Precautions prior to performing MVA, preparation for the MVA procedure, and the 17 steps in performing MVA are delineated. The second section discusses the treatment of second-trimester incomplete abortions, which include the procedure of intravenous oxytocin, sharp curettage (D&C), or dilation and evacuation. The third section highlights postoperative care, in which monitoring patient's recovery, postoperative information and postabortion family planning are examined. Equipment and supplies needed for MVA is appended.
Haiti Family Planning and AIDS Prevention Survey, 1998.
This report describes the main findings from the 1998 Haiti Family Planning and AIDS Prevention Survey (HFAPS-98). Implemented in April 1998, the survey includes information on a random sample of 1298 sexually experienced women aged 15-45 living in the service areas of family planning service institutions in Port-au-Prince, St. Marc, and four rural areas. Overall, the survey revealed that, among all women in the HFAPS-98 sample, 9% became sexually active before 15 years of age. Fertility levels were also found to be fairly high, with 13% of women having 3 children and 19% having 4 or more children. In addition, knowledge of contraceptive methods was shown to be high and contraceptive use had increased, compared to data from a previous survey. In the context of sexually transmitted disease and AIDS prevention, a significant result indicated that condom use was reported by nearly 1 in 5 women (19%). These women also reported that condom use was either their own decision (44%) or a joint decision (40%). Finally, in terms of exposure in advertising and promotion, results indicated that women have much higher levels of exposure in advertising for social marketing brand oral contraceptives than for commercial brands.
Reproductive health, training and MISP kits needs assessment report.
In March 1997, the coordinator for the Refugee Reproductive Health (RH) project of the Great Lakes Region visited the refugee camps and the transit centers in Kigoma region. The visit was conducted in order to determine the extent to which RH needs of the refugees, especially in the areas of family planning (FP), sexually transmitted diseases (STDs), HIV/AIDS, and maternal health are being met. Moreover, adolescent health problems, prevalence of sexual violence, and complications arising from induced abortions due to unwanted pregnancies were assessed; and RH training needs and need for Minimum Initial Service Package kits were determined. This report presents the major findings of the field visits to the eight camps and three transit centers. It discusses the gaps found in RH services in the refugee camps and transit centers. These include areas in adolescent sexuality, sexual violence, interventions on miscarriage, STDs and HIV/AIDS, safe motherhood initiatives, FP and inadequate capacity to provide RH services. In addition, it highlights the issues raised concerning the situation in Nyarugusu Camp, services provided by the Federation and the Tanzanian Red Cross Society, as well as the Ministry of Health. Recommendations based on the findings are cited.
Role of UNFPA with populations affected by disasters.
This article discusses the role of the UN Population Fund (UNFPA) with populations affected by disasters. It is estimated that there are 50 million people affected by natural or man-made disasters worldwide, including refugees and returnees, internally displaced persons, and a less well-defined group of persons in refugee-like situations. These persons are in need of shelter, protection against violence and abuse, food and safe drinking water, and basic health services. In response, the UNFPA issued a policy framework, stating that in an emergency situation UNFPA assistance will focus on providing reproductive health (RH) and family planning counseling and services within the health care mechanisms available during relief operations. The agency also gives support to operational activities, collaborating with other international agencies to provide maximum services to this population. In terms of the future role of UNFPA, it is noted that the agency will support the documentation of the nature, incidence, and severity of RH rights abuses through project support. Improvements planned in the Fund's emergency-response mechanisms include a greater participation in needs assessment mission; increased resource mobilization at all levels; improved RH health kit; greater availability of information and equipment for service providers; accelerated project approval; and continued attention to oversight and accountability.
International Rescue Committee reproductive health programs, 1997.
This article presents the Reproductive Health Programs of the International Rescue Committee (IRC) for 1997. Its field programs include the provision of family planning, AIDS education, prevention and treatment of sexually transmitted diseases, gynecological care, and related services in refugee assistance programs in nine countries, namely Azerbaijan, Cote d'Ivoire, Ghana, Guinea, Kenya, Pakistan, Southern Sudan, Tanzania and Thailand. A Reproductive Health Program Officer monitors, evaluates, assists, and documents the field programs. The officer helps the different programs exchange information, works with the field to develop better evaluation practices, and help provide continuity in the field programs. A training workshop focused on collecting, interpreting and using basic health statistics to evaluate the impact of reproductive health programs on the health of the population served is being planned. This workshop will also enable program directors from different countries to share their experiences and learn from each other. Funding for the reproductive health program of IRC has been provided by international, governmental and private donors. Moreover, the IRC is collaborating with other agencies to promote reproductive health among the international organizations, government agencies, and voluntary organizations that work with refugees.
Survey on social marketing contraceptive availability in urban Zambia 1999.
This survey determined the availability of social marketing contraceptives in traditional and nontraditional outlets in urban Zambia following the introduction of the Family Planning Policy Guidelines, which has expanded the channels for the distribution of contraceptives. Data were collected through interviews with providers at 2486 randomly selected outlets. Overall, results indicate that expansion of contraceptive distribution to nontraditional outlets has greatly increased the availability of contraceptives in the country. Condom availability has reached significant levels; about 42% of all urban outlets sell condoms. Social marketing makes a very significant contribution to this increase in availability of condoms, as well on the availability of vaginal foaming tablets. However, it is noted that the supply of contraceptives through sales agents or detailers is extremely resource intensive. Hence, it may be useful to experiment with mechanisms of distribution that are more reliant on general and pharmaceutical wholesalers.
The Fourth World Conference on Women, also known as the Beijing Women's Conference, has had a positive impact on Chinese women. The most immediate result was the political participation of Chinese women. They are transforming themselves, striving to gain political power that is based on democracy. Also, the conference marked a turning point for the All China Women's Federation (ACWF), the largest women's nongovernmental organization in the world. The conference provided a big boost in status to the ACWF and gave new life to its long administrative arm. Overall, the Beijing women's conference clearly contributed to the country's political renaissance. It helped Chinese women see themselves as leaders in the forefront of China's modernization.
Mongolia: "Women still have a long way to go".
This article discusses the role of the Women's Federation in the social and economic development of women in Mongolia. The Women's Federation, a nongovernmental organization, was instrumental in getting women's development programs like microcredit made part of the national poverty alleviation programs. It also functions like a bank, issuing and collecting payments while monitoring the progress of the local women. The federation has branches in all the provinces of Mongolia. Aside from money lending, the federation also conducts classes on sewing and typing. Women in Mongolia have made a lot of progress, yet, when it comes to wages, politics and domestic issues, they still have a long way to go. The federation is doing its best to address all concerns of women, including domestic violence.
One day, one side of Hong Kong.
The 3861 square miles of Hong Kong, Kowloon, and the New Territories are crowded with 6 million residents and busy with enterprise. Employment agencies have brought in thousands of Filipino women, many of them college graduates, to meet the great demand for domestic workers. They work very hard and for long hours, with only one day off a week, in order to earn HK$4000 (about US$520) per month, which is much more money than they would earn at home. They send much of their money home, perhaps enduring abuse from their employers, and return home in a few years. Now that the Hong Kong government has changed, the fate of these women is uncertain.
Colombia: speaking up, speaking out.
This article discusses the role of various organizations working on the status and health of women in Colombia. Groups that work for reproductive health rights and services in this country have a multifaceted function. Organizations like Profamilia, the UN Population Fund (UNFPA), and La Liga Colombiana de Lucha Contra el SIDA (the Colombian League for the Fight Against AIDS) are not only family planning providers. They hold classes and have outreach programs to inform women of their legal rights, help them find counseling for abuse, and teach adolescents about pregnancy and sexually transmitted diseases, including AIDS. Profamilia sends social workers and consultants out to social security buildings to teach classes on birth control both for prevention of pregnancy and protection against AIDS and STDs. Colombia's Ministry of Health launched a media campaign directed at men and women, adolescents and adults, to promote the use of condoms. The public service announcements aggressively target teenagers. La Liga, a group that originated as advocates for AIDS patients and gay men's rights, has set up workshops in poor neighborhoods outside Bogota to educate people about the importance of condoms and to use the information they gather to further their research into common social practices.
For populations to enjoy any of the economic fruits of development, access to political and civil rights must be observed. However, the main international body charged with protecting political and civil rights has in itself been misguided. Political gamesmanship, structural problems, and misguided priorities continue to plague the UN Commission on Human Rights. The Commission's mandate to discuss "civil liberties, the status of women, freedom of information, the protection of minorities, the prevention of discrimination on the basis of race, sex, language, or religion" has not been adequately upheld at the Commission sessions held in Geneva, Switzerland. Each country has its own agenda, which destroys the main goal of the Commission. In order for the Commission to be the preeminent human right forum, countries must cease their political posturing, strengthen conditions for state membership in the Commission, and address the world's most pressing human rights concerns.
50 years after World War II, weapon manufacturers continue to produce and sell antipersonnel landmines, and today there are over 100 million hidden landmines in 68 countries. Every 22 minutes somewhere around the world, a man, a woman, or a child becomes the victim of antipersonnel landmines. Although one may cost as little as US$3-30 to produce, to remove it costs US$300-1000. Historically, the US has been one of the world's most influential exponents of landmine warfare doctrine, as well as one of the world's major landmine producers and exporters. From 1969 through 1992, the US exported 4.4 million antipersonnel mines. Military records show landmines caused 33% of all US casualties in Vietnam and 28% of US deaths were attributed to landmines. 90% of all mine and booby traps used by the Vietnamese National Liberation Front against US troops were made in the US. According to a Human Rights Watch report in April 1997, there are 47 US companies involved in the production of antipersonnel landmines. Nongovernmental organizations around the world, including the International Red Cross, have been instrumental in an advocacy campaign to convince governments to sign the International Treaty calling for an effective legally binding international agreement to ban the use, stockpiling, production, and transfer of antipersonnel mines. In April 1999, 135 countries had signed the treaty and 72 had ratified it, with the exception of the US.
Egypt: "the cornerstone for our economic reform".
The efforts of Egypt's President Hosni Mubarak for economic development have also impacted the country's population problem, adding to the effectiveness of the family planning program. After 13 years as president, Mubarak's national population program has made dramatic progress, decreasing the annual population growth rate from 3.1% to 2.2%. The family planning program is strictly voluntary and works by educating and advising the people, and leaving the decisions to each wife and husband. In his opening remarks during the International Conference on Population and Development in Cairo, he mentioned that the population problem can not be solved by addressing only its demographic dimensions; it should be dealt with as a problem tied to social, economic, and cultural development. He also said that the cornerstone of any successful population policy must include improving the condition of women, especially in developing countries.
In a formal ceremony witnessed by public health and family planning workers, Indonesia's President Soeharto signed the first issue of a new stamp commemorating the birth of Indonesia's 200 millionth child. The ceremony was a celebration of the success of the Ministry of Population's family planning program. Dr. R. Hasan Mohammad Hoesni, a member of the National Family Planning Coordinating Board, explained that the family planning program promotes the idea that each family should have two children, that girls are just as desirable as boys, and that the Indonesian government will help couples in their old age. There is also a policy of no free education for the third child. If not for education and the Ministry of Population's campaign, an estimated 80 million more children would have been born, many of them to die of neglect or starvation. According to a senior-level official of the family planning program, other nations, including China, have come to Indonesia to learn about its program. He added that smallpox, tuberculosis, polio, and malaria had been eliminated in Indonesia.
Nepal: new energy in age-old villages.
In the villages of Nepal, women have organized themselves and begun saving schemes through Amma Tolis (Mothers Groups). Over the past four years, the women in Amma Tolis built 250 resting places along the route that women travel; helped build two primary school buildings; conducted literacy classes for women; broadened village trails for easy access to villages; and helped maintain springs and wells for water supply. The labor was provided by the women themselves. Some of their activities received assistance from UNICEF, the UN Development Program, the UN Population Fund, and the local government. Eventually, Amma Tolis was able to render loans from the saving schemes to start income-generating activities. Development projects like these, which involve village participation, accomplish three important things: 1) they develop capacity at the grassroots level; 2) they provide and generate capital; and 3) they develop skills.
Jordan: what the children need.
In Jordan, infant and maternal mortality rates are far lower than those of many other Arab countries, according to UNICEF. Jordan's literacy rate, 85%, is one of the region's highest, and the country has launched specialized services for the handicapped. At the Prince Hassan Palestinian refugee camp, 90% of the children are immunized, and the mothers are taught lessons in basic health and hygiene. Yet Jordan's successes may prove a liability. Donors are reluctant to contribute aid to a country that seems not to need it. UNICEF reports that, despite its successes, Jordan has a great deal more to accomplish. Basic health care is widely available, but it remains underutilized. Girls are especially likely to drop out of school. Only 35% of women use any birth control, and many Jordanians have six or more children. Queen Noor has founded the National Task Force for Children to coordinate the efforts of various children's agencies in the country and to address a range of issues, from drug abuse and homelessness to basic health care, family planning, and children's rights. Queen Noor explains that children's rights can be improved in terms of legal protections, "but the family is the unit of authority, and not the state."
Guatemala: happy the war is over.
After 36 years of civil war that left 150,000 civilians dead, thousands "disappeared," and dozens of mass graves filled with bones of the unknown, Guatemala is making an effort to shift its focus away from immediate-survival concerns. With funding from the UN Development Programme (UNDP) and Fonpaz, Guatemala's Foundation for Peace, the Guatemalan government is offering civilian job training to its former soldiers and military personnel, many of whom never received their promised pensions. One project is the Feminine Technical Institute, which offers classes in sewing, baking, and hairdressing to women who had worked as cooks and laundresses for the military. One of its students is a man, a former explosives expert, who prefers hairdressing to working as one of the private security guards much in demand now that kidnapping is on the rise.
Costa Rica: even success can have problems.
Despite its success in achieving a fertility rate of 3.1 births per woman from the previous 7.3, Costa Rica is still concerned with its population growth rate. The fertility rate has declined sharply; however, many experts observed that it has stopped declining and is expected to double in less than 40 years. Costa Rica's high standards of health care and education have reduced poverty to the extent that, ironically, reducing family size is not a pressing concern to many Costa Ricans. 10% of Costa Rica's population is made up of immigrants, many of them illegal. The political and economic hardships of Nicaragua and El Salvador, and a five-year drought, have induced hundreds of thousands of people to flee into El Salvador. Of concern to government planners is increased urbanization. Approximately two-thirds of the country's population is crowded into the Central Region, which occupies only 20% the country's land area. The government has begin promoting the development of small, rural population centers and has decentralized some of its services to deal with the overcrowding problem. It has promoted family planning on radio and television, with emphasis on reducing the rate of teenage pregnancies. With the assistance of the UN Population Fund, the government is also trying to address regional differences in social conditions and access to family planning services.
Big Macs, Marlboros and color-coded contraceptives.
The paper focuses on the economic and social development of Vietnam after the civil war. Reborn as Ho Chi Minh City after the war, the city has prospered through more than 2 decades of Communist rule. Capitalism is alive and encouraged by the government. The signs of change are everywhere in Vietnam. The cities are teeming with small shops. More local branches of American fast-food chains are lining the streets, billboards displaying advertisements of foreign products tower over the streets. Aside from economic development, Vietnam has made some progress on the social front. It was able to lower its birth rate to 3.1 in 1995, increase life expectancy to 65 years, and lower the infant mortality rate to 46/1000 in 1994. Knowledge about modern contraceptives is remarkably high. 97% have heard of at least one method. Among couples of childbearing age, 63.8% were using contraceptives in 1995. Of these, 36.9% preferred IUDs, 4.5% used condoms, and 2.9% used the pill. Almost 80% of the contraceptives are supplied by the government through the health network. Despite this success, much remains to be done. The quality of health services offered needs improvement, but the government has no adequate funds. Yet the government is determined to improve the health care system, especially reproductive health care for women.
Cambodia: scavenging for survival.
In Cambodia economic backwardness, which is a product of decades of civil war and turmoil, has led to the growing population of street children. Children between the ages of 5 and 14 make up almost 30% of the country's population. At least 10% of them are believed to work as child laborers in harsh and unhygienic conditions for very little pay. According to estimates by the International Labor Organization, 60% of these working children do not attend school and seek employment only in order to supplement their households' income. In Phnom Penh, where almost 71% of Cambodia's urban population live, activities undertaken by street children include begging, cleaning cars, domestic work, scavenging, petty theft, and prostitution. In response, some nongovernmental organizations (NGOs) have taken up the task of directly targeting the problems of these street children. These NGOs include Japan International Volunteers Center and the US-based World Vision International.
Tanzania: a rocky road out of poverty.
Despite Tanzania's political stability and expanses of rich, arable land, the country has remained one of the five poorest countries in the world, with approximately 12 million people below the poverty line. Poor infrastructure and the misuse of resources hindered Tanzania's development, deterring investment. Another factor is its high population growth rate, which has adversely affected overall living standards. Uneducated women, male pride, and strong tribal customs are among the reasons for the country's high fertility rate. UMATI, a nongovernmental organization that promotes family planning programs, educates men and women concerning childcare, sexual, and reproductive health through peer counseling.
Zanzibar: restoring a crumbling beauty.
Decades after colonization, the 1963 coup, and socialism, Zanzibar, a small island off the coast of Tanzania, has been in a state of dilapidation. Officials and development workers are enforcing environmental and architectural improvements. The Aga Khan Foundation is integral in overseeing and helping to implement the changes needed in restoring Zanzibar. One of the first tasks undertaken by the foundation's Trust for Culture has been the renovation and reopening of the Old Dispensary. Moreover, the foundation financed the restoration of the 1700 buildings that have been declared by the government to be historical and protected structures. In addition, the foundation is working with local technical schools teaching building skills and styles.
According to some experts, overpopulation and poverty impede India's development prospects, despite foreign aid. 53% of Indians live below the poverty line, defined as $1 a day; one-third of Indians are illiterate, as are nearly two-thirds of the women; 90% of rural households have no access to any sanitary facilities and 60% have no electricity, while nationwide, more than 171 million people have no access to safe drinking water; 63% of all Indian children under the age of 5 suffer from malnutrition; and 25 million Indians are homeless, there are only 4.4 doctors for every 10,000 people, and Indian schools have only one teacher for every 64 students. Poverty and pollution are inextricably linked; worker absenteeism caused by environment-linked illness is estimated to reduce the country's productivity by more than $10 billion each year. Gender equity has not been reached. In India as a whole: girls 1-5 years old have a 43% higher mortality rate than boys; female workers earn 35% as much as male workers; women are only 2.3% of administrators and managers; 88% of pregnant women are anemic, and only 34% have a medical attendant at birth; and maternal mortality is 570 per 100,000 live births. The statistics are worse in rural areas. Development aid is needed. 30 million women are in need of family planning services that are not available. Investments in education would help. Poverty is a fundamental problem in India that limited economic programs alone will not fix. Human development must be the primary focus.
Chandigarh: stretching the limits.
For decades, Chandigarh has enjoyed a reputation as India's most perfectly planned settlement. However, over the years, the city's population growth and influx of urban migration has contributed to the increasing rates of homelessness and a permanent "street population" found mainly in markets. Moreover, inadequate public transport, coupled with rising middle-class incomes, has brought an overflow of new cars, scooters, and motorbikes into the streets. Some 35% of Chandigarh residents live in illegal settlements. During an international conference involving architects and urban planners from around the world, the city has been challenged to enforce strategies in alleviating population growth and dealing the issue of homelessness.
Should we change our financial architecture?
The 1944 Bretton Woods agreement, which set up the World Bank and the International Monetary Fund to launch reconstruction after World War II and fight off any renewal of the Great Depression, has achieved its purpose. The world's economy has multiplied, and international exchanges have reached an unimagined level, beyond the capacity of any government to manage. However, that very success and the technology of financial transactions have brought new problems. There are calls for a new international architecture, a new Bretton Woods to take account of what has changed and draw up new rules and procedures to accommodate changes. Nevertheless, several arguments opposing the change in financial architecture have been made, including the case that governments should have no mandate to interfere in the market. To reduce this dilemma, a conference needs to be held to study and discuss the possibilities.
As the Netherlands' new Minister for Development Cooperation, Eveline Herfkens wants the Netherlands aid program to be leaner and more efficient. The program will focus on fewer countries, fewer projects, and on quality and impact, rather than be dissipated over too many countries. The Netherlands is one of the biggest donors in the world, with 0.8% of its gross national product going toward official development assistance. However, every year more people seem to be convinced that development aid does not work. Herfkens aimed to change this view. This article focuses on a trip she made to the country of Yemen in search of a success story to promote Dutch aid that makes a difference. During the 20th anniversary of the start of Dutch aid to Yemen, she made a highly publicized whirlwind tour of the country, one of the poorest in the world. Herfkens emphasized that all projects have to build in a role for local authorities and community involvement, and the projects have to be self-sustaining, with a timetable for the aid to be withdrawn while the positive results continue. She found her success story in a potato-seed distribution project that was about to become privatized. An unscheduled stop at an emergency housing project, however, gave Herfkens an opportunity to prove her point through a failure. The houses were built, after the 1982 earthquake, without consulting the intended beneficiaries. Consequently, they were too small for the typical Yemeni family of six children and without the privacy of high compound walls that the culture requires. They remain unoccupied to this day.
Population and the politics of trade.
During a meeting on population held at the UN, the new trade politics of the 1990s were discussed and criticized by several delegates as "nouveau colonialism." Also called structural adjustment, protectionism, or tied aid, the policies often prevent diversification in developing nations, because they prevent capacity building. Recipients of tied aid criticized its wastefulness. For example, US foreign aid for a water treatment plant required a North African nation to buy only US equipment, which was too technologically sophisticated and required too much power, rather than more compatible equipment from the Netherlands. The plant shortly became useless. Trade protectionism benefits stronger countries and leaves weaker countries to be bullied. Structural adjustment policies destroy health and educational services, according to grassroots activist Peggy Antrobus, and have undone the gains of the 1970s.
The largest international conference ever.
During the closing session of the Plenary of the International Conference on Population and Development in Cairo, the Program of Action was adopted by acclamation. The Vatican's delegate announced that, for the first time in history, the Vatican was prepared to partially endorse the consensus of a population conference. Monsignor Renato Martino of the Holy See told the Plenary that his delegation wished to associate itself with the consensus on the Program of Action in a partial manner compatible with its own position. Nafis Sadik, secretary general of the Cairo Conference, told delegates that the Program of Action is detailed in its analysis, specific in its objectives, precise in its recommendations and transparent in its methodology. Delegates from Tunisia, Belize, Cameroon, and Australia also praised the Program of Action, particularly its elaboration of new concepts such as reproductive health and reproductive rights and its endorsement of women's empowerment. Delegations voicing reservations were from Iran, Libya, Yemen, El Salvador, Malta, Yemen, Peru, Ecuador, Argentina, the Dominican Republic, Nicaragua, Honduras, Guatemala, Paraguay, and Brunei. They felt some of the Program recommendations violated their laws, religion, or culture. The text of the Program clearly states that countries are not required to implement such recommendations. When the Plenary was called to adopt the Program, there were no objections. It will be presented to the General Assembly in New York in October 1994.
The meaning of the historic Cairo consensus.
This paper presents the major achievements of the International Conference on Population and Development in Cairo in the areas of reproductive health and reproductive rights. 1) A comprehensive definition of reproductive health was negotiated and approved by 179 UN member countries. 2) The Conference spelled out the linkage between family planning and other reproductive health activities. 3) It accepted a quantitative goal for delivery of reproductive health services to all individuals of appropriate ages no later than the year 2015. 4) It signaled the unequivocal acceptance by the international community of the notion that targets and quotas should not be used for delivery of family planning services and that coercion is unacceptable. 5) A new definition of reproductive rights was adopted. 6) The role and responsibilities of men in sexual and gender relations, use of contraceptives and parenting were strongly emphasized throughout the Program of Action. 7) It crystallized the international community's growing concern about the HIV/AIDS pandemic. 8) High priority was assigned to action on unsafe abortion as a major health concern. 9) It emphasized the need to give attention to adolescent sexual and reproductive health needs. 10) It linked maternal mortality to other issues relating to family planning, women's health, and safe motherhood.
In this statement, Bella Abzug praises the women from all over the world who came together to achieve a remarkable victory in transforming language, policies, and attitudes at the population conference and its Women's Caucus in Cairo. Women's empowerment is central to sustainable development. At the conference, these women overcome the narrow "population control" approach of rigid numerical demographics. In addition, the conference recognized the importance of eliminating political, economical, legal, and social discrimination against women. The conference produced a Program of Action that calls for promoting gender equity, including increased economic activity for women, wider educational opportunities for all, comprehensive and integrated primary health care, and broad access to sexual and reproductive health services, including the widest range of noncoercive family panning services. The strategies proposed by the Women's Caucus and Post-Cairo Task Force include monitoring UN General Assembly discussions on funding and resource allocations of the Cairo Program of Action. Close scrutiny will also be focused on how major multilateral, bilateral, and nongovernmental institutions dealing with population policies allocate their resources and the extent to which they integrate women's health and development needs into their programs.
What I saw from the chairman's seat.
This statement by Dr. Maher Mahran, who chaired the International Conference on Population and Development held in Cairo, Egypt, lists the positive developments he saw at the conference. These include: 1) meeting of different cultures as members of the global society; 2) dialogue between different religions and politics within the frame of ethics and mutual respect; 3) the world community's concern for morality and moral issues; 4) participants defending their views in a democratic way; 5) discussion on the future of the children in spite of political differences; and 6) flexibility of the Vatican (for the first time) in accepting the conference's Program of Action.
The International Conference on Population and Development held in Cairo, Egypt, was successful because it avoided two common conflicts. First, there was no specifically "Southern" or "Northern" approach; because of the size and urgency of the problem, participants efficiently identified what needed to be done and how costs should be shared. Second, the controversy between population-control ecologists and reproductive-rights feminists was resolved by focusing on the world-wide, unmet need for family planning. Meeting this need would be more effective than coercive top-down family planning programs. It was decided that this need could best be met within a framework of improved reproductive health services, and that the status of the women must be enhanced, especially through education. It remains to be seen if the conference's Program of Action will receive sufficient funding and support. The UN may be overextending itself with its many major conferences and summits.
A United Nations success story.
Over the last 50 years, the UN has held global discussions, debate, and action concerning how to make a better future by eliminating war or daily violence. However, the most important issue discussed was population. The UN recognizes that health, education, and the equality and empowerment of women are bases for any successful and peaceful society. In 1945, discussion of population issues resulted in the formation of the UN Population Fund (UNFPA). The role of UNFPA is to help developing countries find solutions for their population problems. Since 1974 there has been a series of international population conferences. Of particular importance was the International Conference on Population and Development (ICPD) held in Cairo, Egypt. ICPD was considered a landmark in the history of international discussion and action in the field of social development. It has successfully integrated population with parallel discussions on poverty, the environment, human rights, health, education, and the status of women. The Program of Action agreed on at ICPD has guided countries in issuing issue their own versions, so that the message conveyed at Cairo is made widely available. In the end, all the meetings have paved the way for national commitment and action. More than that, they have made a start in changing the lives of women and men around the world.
This paper reports developments 5 years after governments adopted the landmark Program of Action agreed to at the International Conference on Population and Development (ICPD) held in Cairo, Egypt. For 5 years, governments have been struggling to meet the ICPD goals because of economic, religious, and environmental reasons. For example, the Asian financial crisis has led to drastic cuts in social sector spending among countries that have long invested in health and education. Religious and other conservative forces worldwide represent key obstacles to the advancement of Cairo's goals. The drive for increased productivity has led to more and more women filling jobs in labor-intensive industries. Industrial chemicals and toxins in the environment take their toll on women's health, through both occupational and residential exposure. Yet, reproductive health is a recognized priority of policies and programs. New partnerships between governments, nongovernmental organizations, and the private sector have enabled creative collaborations and rights-based approaches. It is now recognized that structural adjustment and other economic reforms must be responsive to gender and environmental issues.
Despite the US$2.2 billion donation to be made by Bill and Melinda Gates for population and health-related projects worldwide, the UN Population Fund has projected that at least 120 million additional unwanted pregnancies, 49 million abortions, 5 million deaths of infants and children, and 65 maternal deaths will occur over the period 1995-2000 because of shortfalls in promised assistance to developing countries. Delegates to the International Conference on Population and Development in Cairo, Egypt, agreed that the conference's Program of Action would cost US$17 billion a year by the year 2000. Delegates further agreed that one-third of the price tag was to be borne by the donor countries and two-thirds by the developing countries. However, donor country contributions have been declining and stand at less than half the target figure. Although the Gates Foundation has an enormous amount of money available for grants, it can not substitute for governments' living up to their Cairo commitments.
Behind the doors: the five-year review.
Five years after the 1994 International Conference on Population and Development (ICPD) held in Cairo, Egypt, the UN met again to review how nations were implementing the ICPD Program of Action in the field of population and development. This process included an International Forum held in The Hague in February 1999, followed by a preparatory committee of the Commission on Population and Development (PrepCom) in March 1999. The process to review the implementation of the ICPD Program of Action was to culminate in a special session of the UN General Assembly in June 1999. Anwarul K. Chowdhury, Bangladesh's Permanent Representative to the UN, who chaired the PrepCom, prepared a draft document, which will serve as a basis for negotiation during the special session. The draft calls on countries to achieve specific benchmarks that were not part of the ICPD Program of Action. These include targets for access to and choice of family planning and contraceptive methods; a decrease in maternal mortality; and a decrease in the prevalence of HIV/AIDS. The working document also stresses the needs of adolescents and proposes that 20% of reproductive health programs be allocated for adolescents.
At the same time delegates to the International Conference on Population and Development (ICPD) ratified their Program of Action, 10 countries formed Partners in Population and Development (Partners) to facilitate greater cooperation between developing countries. Partners is a response to the call for intensified South-to-South collaboration as a key modality for implementing the ICPD Program of Action. Partner's founding countries were Bangladesh, Colombia, Egypt, Indonesia, Kenya, Mexico, Morocco, Thailand, Tunisia, and Zimbabwe, and they were since joined by China, India, Pakistan, and Uganda. The objective of Partners is to work in the expansion and improvement of reproductive health services and family planning in a self-initiated and sustained manner through a climate of mutual trust, respect, and openness. Moreover, Partners pursues strategies for integrating governmental and nongovernmental structures in the reproductive health field. It strives to engage the whole spectrum of civil society, from research and training institutions to the private sector, in forming partnerships to impact on the reproductive health of the poor. Partners' member countries have made significant investments to improve the quality of life of their citizens with the collaboration of several donor agencies. These agencies include the European Commission, the UK, the World Bank, the UN Population Fund, The Rockefeller Foundation, the David and Lucille Packard Foundation, the William and Flora Hewlett Foundation, and the William H. Gates Foundation.
This paper describes the emotional responses of the author to his experiences as a foreign correspondent based in India. Although caste, filth, poverty, stench, disease, riot, and death exist in the country, there is still a sense of national glory and splendor in the place. Visiting the cities of New Delhi and Calcutta, the author explored the areas of Chandni Chowk, Gulmarg, the ancient Varanasi, Kashmir, and Bombay. In his descriptions of the places, the author emphasizes that each day was a gift of life. Millions of individuals hungrily seek their fortunes, and the resulting riot of sounds, smells, and sights is rich and meaningful. One farmer firmly denounced the government and was confident enough to spell out his name for the reporter. Free politics and a free society in a poverty-stricken country struggling upward should be considered a great adventure.
This paper details the personal experiences of the author as a New York Times foreign correspondent based in Iran. The author visited the country in 1979, when the Islamic revolution was just starting. Economic chaos and political terror prevailed in the country. Islamic militants seized control over the region and dismantled the Western-style development projects. Aside from the Islamic revolution, the author observed the `social revolution' in the region, one that promoted family planning, literacy, and health care. Shortly before his death, Ayatollah Khomeini authorized a national dialogue on population, because he had been persuaded that the population rate was growing too rapidly and causing economic and social stress. In the years since Khomeini's death, Iran's theocracy has promoted family planning so extensively that the country's population growth rate has been almost halved to less than 2% annually. Contraceptive methods are freely available. Infant and maternal mortality rates have also fallen dramatically because of the availability and accessibility of basic health care services. In addition, the Literacy Movement Organization has been successful in raising Iran's literacy rate to almost 90%. Overall, the author viewed the country as an intriguing place, with its 17 different nationalities and ethnic groups, its 66,000 villages, its mix of social gentility and political volatility, its traditions of hospitality, and deep-rooted tribal feuds.
This paper reports the plans for an innovative new park in the heart of Cairo. The Aga Khan, the spiritual leader and Imam of Ismaili Muslims, proposed the park to the First Lady of Egypt, Suzanne Mubarak, as a gift for the people of Cairo. The park is expected to provide much-needed greenery and beauty to the over-crowded and polluted metropolis. It is to be known as the al-Azhar Park, and in 1984, the Aga Khan Cultural Services-Egypt (AKCS) was established to implement the construction of the 70-acre park on the barren Darassa site, contributed by the Governate of Cairo. The site is between the eastern edge of the Fatimid city and the Mamluk "City of the Dead," which is filled with tombs and living squatter families. On days when smog and pollution levels are low, the view spans the city, with its monuments and mosques, and even the pyramids in the distance. The park is intended to have a children's play area, game fields, gardens, a coffee shop, and cultural and educational facilities. The AKCS has started an on-site nursery and a desert nursery for landscaping the park with trees, plants, and flowers. A number of income-producing activities are also planned to be introduced into the neighborhood to provide furnishing and services for the park. It is hoped that once the park is finished, the local people will help run and maintain it.
The Aga Khan: venture capitalist to the poor.
This article reports the new philanthropic project of Prince Karim, Aga Khan IV, one of the world's wealthiest men, through the Aga Khan Development Network, which consists of institutions fostering economic, social and cultural development. The Aga Khan's approach to development is to encourage self-reliance and lessen aid dependence. Grassroots groups should generate profits and use money for promoting social good. The Network disburses large amounts of money for small but appropriate and highly effective grassroots projects. Through the economic development agencies of the Network--financial institutions, insurance companies, manufacturing companies, and tourist organizations, the Aga Khan seeks to establish working partnerships with local groups and encourages third-world societies to move on from the culture of dependency that has long been fostered by the postwar international development movement.
Minorities and cultural identity.
This article focuses on the religion and traditions of Sikhs, a minority in India. Sikhism is their form of religion and way of life. Although they number just 16 million out of an Indian population of close to a billion (1.6% of the population), Sikhs have made an enormous contribution to India's economic, political and cultural history. They are distinctive in their appearance because the men are required not to cut their hair (which they cover with turbans) or shave their beards. The religion was founded in 1469 by Nanak Chand, or Guru Nanak. At the time, the two major religions in India were Hinduism and Islam. Nanak attempted to combine the best of both religions and discard the worst, including meaningless rituals. The founding principle was "There is no Hindu, there is no Muslim." He preached love and tolerance. The word "sikh" is the Punjabi form of the Sanskrit word for "disciple." Despite problems caused by separatists in the Punjab state, Sikhs have coexisted harmoniously with India's Hindu majority over centuries. Such coexistence offers valuable lessons in pluralism to developing societies everywhere.
This article discusses two programs of the International Organization for Migration (IOM) to provide assistance to qualified professionals from war-torn countries who live as refugees in other countries. One, operational since 1996, is the Return of Qualified Nationals Program (RQN). It targets highly qualified Bosnian professionals whose skills are vital for the reconstruction and development of the country. By September 1998 it had placed 500 people by putting them in touch with prospective employers and providing a travel allowance and limited housing assistance. Employers are also given incentives to hire qualified refugees in the form of a 1-year limited subsidy per candidate hired. The employer can consult with the candidate about equipment needed, for which the IOM will pay. The second IOM program is the Economic Revitalization and Employment Generation Program, funded by the European Union. Similar to the RQN, this program combines the placement of qualified professionals with the physical rehabilitation of such places as schools, hospitals, and health centers. When the fighting in Bosnia-Herzegovina ended in 1995, there were more than 1.3 million refugees and 1 million internally displaced people. By mid-1997 only about 250,000 had returned home -- almost exclusively to areas where they belonged to the majority group. Ethnic cleansing and population shifts have given displaced people the unhappy choice of returning to their homes as minorities or giving up all claims to their homes to remain with their ethnic group as a majority.
The UN, the Organization of Economic Cooperation and Development (OECD), the World Bank, and other nongovernmental organizations (NGOs) are responding to public pressure for good governance. Although the issues are complex, these organizations have taken on the challenge of eliminating corruption in both private and public sectors. NGOs and international organizations are rapidly evolving programs and initiatives, yet the challenge is to mobilize political leadership and public support behind national integrity programs. These would require clean and fair elections, public statements of personal assets by government leaders, and decent pay for public officials. In addition, the OECD has drafted the Principles of Corporate Governance as an initiative to correct the inadequacies of regulation of publicly traded corporations. The international organizations have recognized that the lack of decent governance by government and business have undermined the full potential of the economies of many developing countries and the productive skills of the people of these countries. Within the coming years, they intend to change and improve this situation.
This paper traces the history of the Hung Wen Middle School in China. The author based her history on letters by her grandfather, Reverend Halvor N. Ronning, who founded the school, to his family in Iowa. Built in 1894, but founded in 1897, the school was established by the Ronning, his wife, and his sister, because they believed that all children should have the opportunity to be enlightened intellectually as well as spiritually. The Chinese custom had been to educate one boy per family or one boy per village. The school was a two-room brick schoolhouse: one room for boys, whom Ronning would teach himself, and one for girls, to be supervised by his wife and his sister. While the Reverend soon made progress in encouraging parents to send their boys to school, the girls' school was slower to gain pupils. This was because of the culture of China, in which educating females was a revolutionary and frightening idea. In that time, women were viewed as only necessary for proliferation of the species but inferior by nature. The sages stressed the danger of educating women or letting them go about freely. The school refused to allow its female students to bind their feet, a crippling tradition required of girls of the privileged class. (Peasant or servant girls were exempt because they needed their feet to work.) A century after the founding of the school, it has grown into the largest school of the province. It has become the Number One Middle School in Xiangfan, with 3000 students, half of them girls.
Gaza: the other side of politics.
In the West Bank and the Gaza Strip of Jerusalem, efforts are being made to renovate the areas after the long struggle over boundaries and mutual recognition. Although the plans are there and the work has started, the territory controlled by the Palestinian National Authority is still a long way from the prosperity of neighboring Israel. Towns in the West Bank, such as Hebron, Jericho, and Nablus, are the centers of intensive development programs. In the past two years, the United Nations Development Programme funneled $155 million in international aid to develop infrastructure in the West Bank and Gaza. Sewage systems, irrigation, water storage and distribution systems, schools, farming cooperatives, and markets to help sustain small business owners are all works in progress. Developers are focusing their efforts on architectural renovations, sewage, and water distribution systems in almost every area of the region.
Population: what can we expect in the new millennium?
In the 1990s, UN conferences have been organized around major substantive themes, including the environment, population, poverty alleviation, and empowerment of women. All of the themes received worldwide public and media attention because of the global conferences. The plans and programs they agreed upon have generated a considerable amount of action and follow-up by governments, nongovernmental organizations, and the international community. 5-year reviews of these conferences are also being conducted. In 1997, the Rio+5 review of the 1992 Earth summit was conducted, and a special session of the UN assembly was scheduled to review the Program of Action of the 1994 International Conference on Population and Development. In the year 2000, two more special sessions are scheduled: the Beijing+5 review and the Copenhagen+5 review. These reviews are expected to refocus public awareness on the themes of the earlier global conferences, to underline their interconnectedness and to generate extensive media coverage. They should help to focus attention on newly emerging issues as well as those issues that have gained urgency in the interim.
What to do about climate change.
This paper presents recommendations on how the business community can address the issues of climate change. The forecast of the Intergovernmental Panel on Climate Change is that over the next century temperatures might rise from 1 to 3.5 degrees Celsius, and that sea levels might rise by between 15 and 95 cm. The challenge is to achieve growth and a continuing rise in the living standards of all the people of the world in a non-destructive way. Since there is an existing target for an overall reduction of carbon emissions by 2005 or 2010, the next step will be to develop the means through which any target can be achieved. Through practical incentives, much can be achieved through means of: using combined heat and power plants to increase energy efficiency use; supporting scientific research and joint implementation initiatives in such areas as solar and other renewable energies; exploring for future oil, coal, and gas reserves. There is a great scope for practical constructive action across the whole agenda, and business has a role and a responsibility in that, including working with governments and nongovernmental organizations.
According to the 1998 State of the World Population report, the fasted growing segment of the world's population are youth 15-24 years old and people older than 60. These groups of young and old people are the new generations challenging society. The momentum of population growth has slowed, is slowing, and could slow still further in coming decades. The challenge that youth present to society is the need to find jobs in the next 15-20 years. A "workforce bulge" of young people coming into the workforce while fewer children are being born could effect more investment, greater labor productivity, and rapid development. This "bulge" could generate revenues for such social investments as health, education, and social security to meet the needs of both young and old and secure future development. As for aging, the growth of populations over age 65 will severely test the ability of families and societies to provide the financial, medical and social support older people will need. In some regions, however, these older people will be healthier, better educated, and more productive than their predecessors.
Water and the relevance of technology.
The water crisis is a very complicated issue. Roughly 1 billion people on Earth still have no access to drinkable water; almost 4 billion have no access to sanitation or sewage services. According to WHO, almost half of the people of the world suffer from water-borne or water-related diseases, which together account for roughly 5 million deaths a year. Moreover, the World Resources Institute has estimated that by 2050, 13-20% of the world's people will be living in water-scarce countries, mostly in the Middle East and Africa, but all countries face pockets of scarcity due to drought and various factors. Daily per capita use of water in Africa is about 30 liters--for those with access to it. In the US daily per capita use is 600 liters. This paper discusses the efforts of different international organizations and governments to secure potable water supply in the coming years. It quotes statements issuing from several conferences on the water crisis and follows an argument concerning private- versus public-sector investment in such technologies as community pipes and rain harvesting structures.
It is estimated that as the year 2000 approaches, the world population will surpass 6 billion. This projection is because either economic stagnation or social disintegration affects rapid demographic growth. Curtailing population growth alone can not solve the world's social and environmental ills; however, it requires a substantial reduction of human fertility in order to have a meaningful improvement of the human condition. To achieve this, organizations have implemented population and family planning programs in less developed countries. Although most of these efforts were not initiated until the 1960s and 1970s, there have been a number of notable successes. Contraceptive prevalence among married women of reproductive age has increased over the past 30 years from 25% to 56%. The annual rate of world population growth has declined from 2.06% to 1.4%. Within the past decade, the annual increase in human numbers has slowed from almost 90 million to less than 80 million. While these demographic trends are both important and encouraging, they do not signal victory in the world's continuing struggle to contain its human growth. This paper traces the changes in international public opinion concerning the importance of population stabilization, as long as it is based on human rights and voluntary acceptance of family planning.
From a history of negative economic growth, 33 African nations are now achieving new levels of positive economic growth. At the political level, more and more African countries are democratizing. Multi-party elections are being held and increasing focus is put on transparency and government. However, even in the midst of progress, Africa remains a continent in great need. The 1998 Human Development Report commissioned by the UN Development Program reveals that Africa must still call on the international community for support to reach its development goals. Out of the 174 countries covered by the report, the bottom-ranked 15 were from Africa. Across the continent, there is an extreme lack of basic social services such as safe water, health services, and sanitation. Regarding nutrition, Africa's per capita daily intake of calories falls below the required minimum of 2300. While the average protein consumption is 115 g per day in France, it is 32 g in Mozambique. Globalization has created greater marginalization in Africa, especially given the HIV/AIDS epidemic. The fact that African countries have been able to improve their economies should encourage the international community to give greater assistance to the social development of the continent.
Doing good: Steven Rattner's philanthropy.
This article profiles Steven Rattner, an investment banker who is the deputy chief executive of Lazard Freres & Co. LLC. Rattner is described not only as a financial wizard but also as a concerned citizen. He plays a role in environmental issues and those affecting the society in general. A former correspondent for The New York Times, Rattner has donated millions to philanthropic causes in such areas as environment and population. He has done work for the Nature Conservancy. Rattner is also an enthusiastic alumnus and trustee of Brown University. In his time, there was less direction towards such philanthropic after-hours activity. However, he finds time for philanthropy and engagement with social issues. His wife, Maureen White, left investment banking and focuses on humanitarian and refugee issues. She is a US representative to UNICEF. Rattner believes that the recent prosperity has encouraged successful people to want to give something back.
Ted Turner, conservation, and our collective future.
This paper discusses the contribution of media mogul Ted Turner to the conservation of natural resources through private land ownership. His efforts at restoring ecosystems bears special significance to the reorientation of conservation to private lands after a long time of government control. This emphasizes the need for the government to create conservation laws that would interface with the private lands. Although they are a positive development, government-owned protected areas do not work well enough, because they can not be separated from the rest of a threatened ecosystem. Private landowners could help preserve the remaining 96% of land that remains unprotected by the government. Therefore, Ted Turner's private ownership of a great ranch in New Mexico makes a lot of difference in the conservation of nature. Each individual must become a steward of the land.
This speech by Fields Wicker-Miurin, during the February 1998 Annual Meeting of the World Economic Forum at Davos, Switzerland, discusses the importance of nourishing the human soul. She elaborates her three beliefs regarding the soul: 1) the soul is important, it differentiates us from other forms of life and makes us humans; 2) as surely as the body must be nourished, the soul must be nourished and nurtured as well; and 3) we need to have the courage of our convictions and of our values, especially as the boundaries and comfort zones of our known physical and intellectual worlds vanish and disappear. The first belief is enhanced by the African concept of ubuntu, which is that we are made human through our interconnectedness. The second belief leads to the idea that the separations of heart and head, emotions and logic, art and enterprise are false ones. The human soul embraces and needs all forms of beauty. The third belief is illustrated by the anecdote of a top British company that appointed an American woman as its chief executive officer. She drew derision with her first public statement, that her primary concern was in nurturing her employees, but within a year she had been rated as the most effective manager of a company's performance in the city.
The ailing Alps and the future of mountains.
This paper comments on the impact of mass tourism on the Alps, which stretch from the French Mediterranean coast by way of Switzerland, Italy, and Austria to Vienna and to points near the Adriatic Sea in Slovenia. They are crowded with visitors both summer and winter, and mass tourism has brought severe transportation problems and air and noise pollution. Trans-Alpine commercial traffic has increased 10-fold during the last 25 years, a result of increased economic exchanges within the 15-nation European Union. In addition, the heavy motor traffic peaks with car jams, often several miles long, on the motorways during the main vacation periods. Consequently, atmospheric pollution and traffic noises are major complaints from the 13 million residents in the Alps and from a rising number of seasonal visitors. The establishment of several recreational and hotel amenities for Alpine vacations pose a threat to ecology. Consequently, in 1996 all states sharing in the mountain system agreed to safeguard the regional biosphere at the Alpine Convention. Moreover, the International Commission for the Protection of the Alps is lobbying for the extension of national parks, which today cover only one-eighth of Alpine territory.
Challenges for the 21st century.
This paper focuses on the role of entrepreneurship in meeting the challenges of globalization in the 21st Century. In this age of globalization, entrepreneurs have to embrace values that show a true commitment to improving the quality of life of all people. Unlike the 20th century prototype which is primarily the provision of social safety nets and other material measures to limit the damage done to the victims of the industrial revolution, 21st century's social responsibility has adapted the "soft issues" that characterize the ongoing revolution of globalization. 21st century entrepreneurship means to foster social development, sustainable development, and human development. In those areas, business leaders can make a real difference both individually and through partnerships with all sectors of society. At the dawn of this new century, new international regulatory systems and new standards are necessary to protect societies, individuals, and the environment.
Unreliability of PAP smears to diagnose female genital schistosomiasis.
Female genital schistosomiasis (FGS) is a common condition of infection with Schistosoma haematobium. Schistosome eggs of different species have been found in Papanicolaou-stained (Pap) smears either accidentally by the examination of cytological material obtained during screening for cervical malignancy, or in patients suspected of having FGS. To assess whether Pap smears may substitute for the examination of cervical tissue, a study was conducted with 51 women aged 15-47 years who excreted S. haematobium eggs in urine and presented with various symptoms at Mangochi District Hospital near Lake Malawi, Malawi. The biopsy was examined using the quantitative fresh compressed biopsy technique (QCBT), which is derived from a procedure developed for the assessment of cure in intestinal schistosomiasis and which has been successfully applied to biopsies taken from the cervix, the vagina, and the vulva. Overall, results demonstrated that endo/ectocervical smears, especially Pap smears, cannot substitute for the QCBT in diagnosing FGS. However, considering the epithelial atypias frequently associated with genital schistosomiasis, endo/exocervical Pap smears are a useful complementary examination in women suspected of having schistosomiasis of the lower reproductive tract.
Costs of tuberculosis for households and health care providers in Dar es Salaam, Tanzania.