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Geneva, Switzerland, UNICEF, Regional Office for CEE / CIS, Child Protection Unit, 2006. 89 p.This Report outlines some key findings and recommendations from an assessment of the efforts to prevent child trafficking in South Eastern Europe. Its main purpose is to increase understanding of the work prevention of child trafficking, by looking at the effectiveness of different approaches and their impacts. The assessment covered Albania, Republic of Moldova, Romania and the UN Administered Province of Kosovo. The Report is based on a review of relevant research and agency reports as well as interviews with organizations implementing prevention initiatives and with trafficked children from the region. The first part of the Report reviews key terms and definition related to child trafficking, as common understanding about what constitutes trafficking and who might be categorised as a victim is crucial to devising prevention initiatives and guaranteeing adequate protection for trafficked children. Furthermore, to intervene in any of the phases of the trafficking process it is essential to understand specific factors contributing to the situation and the key actors involved. Different approaches to understanding the causes of child trafficking and methods for developing prevention initiatives are also explored. The Report notes that all prevention efforts should incorporate the principles that have proved essential in designing and implementing other initiatives in the ares of child rights and protection. That is, good prevention initiatives should be rooted in child rights principles and provisions, use quality data and analysis, applying programme logic, forge essential partnerships, monitor and evaluate practice and measure the progress towards expected results. (excerpt)
USAID project profiles: children affected by HIV / AIDS. Fourth edition. [Perfiles del proyecto USAID: niños afectados por VIH/SIDA. Cuarta edición.]
Washington, D.C., Jorge Scientific Corporation, Population, Health and Nutrition Information (PHNI) Project, 2005 Jan. 264 p. (USAID Contract No. HRN-C-00-00-00004-00)No generation is spared the catastrophic consequences of the HIV/AIDS pandemic. From newborn babies of HIV-positive mothers to elderly caregivers, the disease does not discriminate. One of the most tragic consequences is the toll on children. In 2003, more than 15 million children under age 18 had lost one or both parents to AIDS. Along with grief and abandonment, children in affected families face the added burdens of responsibilities far beyond their capabilities - nursing a sick or dying parent, raising younger siblings, running the household or family farm, replacing a breadwinner, or struggling for survival on city streets. An estimated 5 percent of children affected by HIV/AIDS worldwide have no support and are living on the streets or in residential institutions. Globally, approximately 2.1 million children under age 15 have HIV/AIDS. (excerpt)
IDU. Injecting Drug User Intervention Impact Model. Version 2.0, May 2000. A tool to estimate the impact of HIV prevention activities focused on injecting drug users.
London, England, London School of Hygiene and Tropical Medicine, 2000 May. 53 p.IDU 2.0 is one of five simulation models within HIVTools. IDU 2.0 can be used, within a particular setting, to estimate the impact on HIV transmission of prevention activities focusing on the injecting drug users (IDU's). It can also be used to explore the likely impact of different policy options. The program simulates the transmission of HIV between injecting drug users, and the transmission of HIV and STDs between IDU's and their sexual partners, both in the presence and absence of an intervention. The extent to which an intervention may avert HIV infection is estimated using a range of context specific inputs. This includes epidemiological information describing the prevalence of HIV infection among the IDU's and their non-IDU sexual partners at the start of the intervention, and the probabilities of HIV and STD infection. Behavioural inputs are used to describe the patterns of needle sharing, sexual behaviour and condom use among the IDU's reached and not reached by the intervention. Demographic and intervention specific inputs are used to estimate the size of the total IDU population, the proportion of males and females in the IDU population, and the proportion of each reached by the intervention. These are then used to project the overall patterns of needle sharing, sexual behaviour and condom use among IDU's with and without the intervention. (excerpt)
School. School Intervention Impact Model. Version 2.0, December 1999. A tool to estimate the impact of HIV prevention activities focused on youth in school.
London, England, London School of Hygiene and Tropical Medicine, 1999 Dec. 48 p.A collaborative research project between the UNAIDS and the Health Economics and Financing Programme at the London School of Hygiene and Tropical Medicine has been working since 1994 to develop methodologies to determine the costs and likely impact of five HIV prevention strategies - the strengthening of blood transfusion services, condom social marketing projects, school education, the strengthening of sexually transmitted infections (STI) treatment services, and interventions working with sex workers and their clients. 'HIV Tools: a cost-effectiveness toolkit for HIV prevention' is currently being developed. HIV tools consists of: 1) a set of five simulation models that estimate the impact on HIV and STD transmission of different HIV prevention activities; and 2) guidelines for costing different HIV prevention activities. HIV Tools aims to be a flexible and easy to use product, designed for policy makers, programme managers and AIDS Service Organisations working to address HIV and ST1 transmission. It can be used to estimate the impact, cost and cost-effectiveness of different HIV prevention strategies in different settings. (excerpt)
Global Consultation on the Health Services Response to the Prevention and Care of HIV / AIDS among Young People. Achieving the Global Goals: Access to Services. Technical report of a WHO consultation, Montreux, Switzerland, 17-21 March 2003. A WHO technical consultation in collaboration with UNAIDS, UNFPA, and YouthNet.
Geneva, Switzerland, World Health Organization [WHO], Department of Child and Adolescent Health and Development, 2004.  p.Young people (10-24 years) are at the centre of the HIV epidemic in terms of transmission, impact, vulnerability and potential for change. The global goals on young people and HIV/AIDS that have now been endorsed in a wide range of fora reflect both the strong public health, human rights and economic reasons for focusing on young people, and also the concern and commitment of governments around the world to direct resources to the prevention and care of HIV/AIDS among adolescents and youth. In order to contribute to the growing clarity about what needs to be done to achieve these global goals, and to strengthen the collaboration between a range of UN and NGO partners committed to accelerated health sector action, WHO organized a technical consultation on the health services response to HIV/AIDS among young people, in collaboration with UNAIDS, UNFPA, UNICEF, and YouthNet, in Montreux, from 17 to 21 March 2003. The consultation sought to obtain consensus around evidence-based health service interventions for the prevention and care of HIV among young people; effective strategies for delivering these interventions, the essential characteristics of successful programmes; and the strategic partnerships and actions at global and regional levels that will be required to stimulate and support action in countries. It is now widely accepted that the prevention and care of HIV/AIDS among young people will require a range of interventions from a range of different sectors. The health sector itself will be responsible for a number of different interventions, through a range of health system partners. The consultation brought together UN, NGO and academic partners, and provided the opportunity for these diverse actors to review the evidence for action: what was understood by “evidence”, the available evidence about increasing young people’s access to priority services, and what could reasonably be inferred or extrapolated from the available evidence from other age groups. (excerpt)
HIV-infected women and their families: psychosocial support and related issues. A literature review.
Geneva, Switzerland, World Health Organization [WHO], Department of Reproductive Health and Research, 2003. vi, 57 p. (Occasional Paper; WHO/RHR/03.07; WHO/HIV/2003.07)This review is divided into three sections. Section one provides a synthesis of the reviewed literature on prevention of mother-to-child transmission (PMTCT) of HIV, voluntary HIV testing and counselling (VCT), and other issues that impact on the care, psychosocial support and counselling needs of HIV-infected women and their families in the perinatal period. Section two provides examples from around the world of projects that focus on the care and support of women and families, with a focus on MTCT. The fi nal section contains recommendations on psychosocial support and counselling for HIV-infected women and families. (excerpt)
Review and evaluation of national action taken to give effect to the International Code of Marketing of Breast-Milk Substitutes: report of a technical meeting, The Hague, 30 September - 3 October 1991.
[Unpublished] 1991. 24 p. (WHO/MCH/NUT/91.2)The report of the national actions in marketing breast-milk substitutes includes a review and evaluation summarized in the accompanying annex and the results of a meeting. Participants found the evaluation helpful, that progress had been made, and that the International Code of Marketing of Breast-milk Substitutes must be viewed in a broad context. Lessons learned and recommendations are given for the development and implementation of national measures, as well as the training and education in the health sector, the information to the general public and mothers, monitoring and enforcement, and manufacturers and distributors of products within the scope of the Code. Successful implementation depends on a clear international perspective, on all concerned parties' involvement in development and monitoring, and a continuing commitment to a complex process. Difficulties encountered were lack of 1) political commitment, 2) integration of sectors, and 3) recognition that the Code applied to all counties; there were also questions about the scope of products included in the Code. There is no limit to age group. Partial adoption is not sufficient and has a negative impact. The Code was being ignored in countries moving toward a market economy. Health professionals were unaware of new developments in infant feeding practices. The Code assumes a compatible relationship between manufacturers and health personnel, which is not the case. Manufacturers used mass media and formal and informal educational sectors to disseminate information about their products with the approval of authorities who considered the use consistent with the Code. The expanding international telecommunications systems have proved to be a crippling challenge to some countries without the tools to know how to regulate programming. The feeding bottle is an inappropriate child care symbol for breast feeding, which is frequently found in public places. Monitoring has been uneven. Enforcement is hampered by an absence of, inadequacy in, and inability to apply sanctions. Joint health and industry provisions are weaker than the Code, and marketing strategies do not conform to the Code. Manufacturers apply the Code differently in developed and developing countries. Not enough attention has been paid to feeding or pacifier products. Retail stores sell infant formula next to other infant food products which is misleading.
Geneva, Switzerland, World Health Organization, 1986. x, 424 p. (RPD/COM/86.)This compendium provides substantive, systematic coverage of all research-related activities of the World Health Organization (WHO) for 1984-1985. Coverage includes programs which do not have a special managerial framework for their research activities. The volume is structured according to the official program classification of WHO (1984-1985); its principal concern is to reflect adequately the fields of scientific investigation within individual programs and to suggest, wherever appropriate, existing or possible lines of convergence between them. Research activities within global programs described include such population-related fields of study as: (1) health manpower; (2) maternal and child health; (3) women, health, and development; and (4) family health. Also included are reports on research activities within regional programs in Africa, the Americas, the Eastern Mediterranean, Europe, South-east Asia, and the Western Pacific region. The report's final two sections are a List of Institutionally Based Research Related Activities and a Summary Budgetary Table and Graphs.
Report of the Expanded Programme on Immunization Global Advisory Group Meeting, 21-25 October 1984, Alexandria.
[Unpublished] 1985. 51 p. (EPI/GEN/85/1)This report of the Expanded Program on Immunization Global Advisory Group Meeting, held during October 1984, contains the following: conclusions and recommendations; a summary of the global and regional programs; a review of the Expanded Program on Immunization (EPI) in the Eastern Mediterranean Region; a review of country programs in Denmark, Brazil, and India; a report on the epidemiology and control of pertussis; and discussion of sentinel surveillance, surveillance of neonatal tetanus, polio, and measles, and research and development; and proposals for the 1985 meeting of the Global Advisory Group. The Global Advisory Group concluded that national immunization programs have made much progress, realizing some 30% coverage in developing countries with a 3rd dose of DPT. Yet, the lack of immunization services continues to extract a toll of 4 million preventable child deaths annually in the developing world. The Global Advisory Group indicated that the acceleration of existing programs is essential if immunization services are to be provided for all children of the world by 1990. Such acceleration calls for continued vigorous action to mobilize political support and financial resources at national and international levels. Considerable experience has been gained in most countries regarding implementation of immunization programs. The knowledge now exists to bring about major improvements in program achievement, yet gaps in knowledge exist in both technical and administrative areas. Action is needed in the following areas if programs are to accelerate sufficiently to meet the target: management of existing resources; use of intensified strategies; program evaluation; coordination with other components of primary health care; collaboration among international agencies; and regional and country meetings. To take maximum advantage of the benefits offered by vaccine, each country should take the necessary steps to include all relevant antigens in its national program. In particular, the universal use of measles vaccine should be encouraged. It also is of concern that some countries are not yet using polio vaccine and that others omit pertussis vaccine from their programs. Countries are urged to review their current practices about the anatomical site of intramuscular immunization. Taking into account the criteria of safety and ease of administration, thigh injection for DPT and arm injection for TT are recommended strongly. The Global Advisory Group reaffirmed its 1983 recommendation to use every opportunity to immunize eligible children.
[Unpublished] 1985. 114 p.This document is a practical guide to help those Planned Parenthood Associations which want to establish contraception and counseling services for young people. It draws its examples from the considerable experience of selected European countries in what can be controversial and difficult areas. In the section devoted to adolescent sexuality and contraception, contributors cover culture and subculture, health and sexuality, sexual behavior and contraceptive services, the adolescent experience, the question of opposition to services for adolescents, and statistical indices. 1 section is devoted to examples of contraceptive counseling services for adolescents in Sweden, Italy, France, the UK, and Poland. Another section summarizes service provision examples. The 5th section presents methodology for the establishment of adolescents services and the final section discusses methodology testing of new projects. This report contends that the case for the rapid development of contraceptive/counseling services, tailored to the needs and desires of young people, is justified on moral as well as on sociological, psychological, and health grounds. It rejects totally the argument that any measure which could facilitate the sexual debut of the unmarried or legally dependent adolescent should be resisted. It does recognize public concern about family breakdown and the potential health risks of sexual activity but considers the examples given as measures designed to combat rather than ignore these. Taking into account sociological, psychological, and medical evidence, the contributors to this report challenge the following presumptions: sexual activity among the young is always and necessarily morally unacceptable and socially destructive; adolescents will resort to promiscuous sexual activity in the absence of legal deterrents such as refusal of access to contraceptive/counseling services; the potential health risks of sexual activity and use of contraceptives during adolescence provide sufficient justification for deterrent measures, including refusal of contraceptive/counseling services; and the scale of sexual ignorance and prevalence of unplanned pregnancy among adolescents can only be reduced by disincentives and deterrents to sexual activity itself. The case for the provision of contraceptive/counseling services rests on their potential to help adolescents to recognize and resist repressive forms of sexual activity, which are destructive of humanmanships. Evidence suggests that it is not difficult to attract a large cross-section of an adolescent public to use contraceptive/counseling services, where established.
TDR NEWS. 1997 Oct; (54):8, 10.One of the partner agencies working with the UN Development Program/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases (TDR) is the French development research agency, ORSTOM. ORSTOM has been conducting research in intertropical regions for approximately 50 years with a particular focus on entomoparasitological aspects of vector-borne diseases. ORSTOM's close collaboration with TDR since the TDR Special Program was launched in 1975 has led to 1) improved knowledge about various aspects of trypanosomiasis that allowed identification of ways to control the epidemic; 2) reappraisal of the taxonomy of the parasitic protozoa responsible for Chagas disease and leishmaniasis; 3) improvements in the strategy to fight malaria; 4) assessment of the efficacy of ivermectin as a form of mass treatment for onchocerciasis; 5) improved knowledge about dracunculiasis that contributed to an eradication campaign; 6) expansion of the scope of biological control of bancroftian filariasis and other parasites; and 7) improved knowledge about ways to control two schistosome species. ORSTOM also participated in a training and structural enhancement initiative that resulted in creation of the Boake Medical and Veterinary Entomology Training Center. ORSTOM is currently undergoing a complete restructuring to respond to changes in international tropical disease research and to changing priorities that focus on vector-borne diseases, nutrition, AIDS, and health systems.
In: Assessment of research and service needs in reproductive health in Eastern Europe -- concerns and commitments. Proceedings of a workshop organized by the ICRR and the WHO Collaborating Centre on Research in Human Reproduction in Szeged, Hungary, 25-27 October 1993, edited by E. Johannisson, L. Kovacs, B.A. Resch, N.P. Bruyniks. New York, New York, Parthenon Publishing Group, 1997. 43-50.The European Region of the International Planned Parenthood Federation (IPPF) has associations in 24 countries and is active in 10 other countries. Since 1989 most of its work focused on the countries of Eastern Europe, Central Europe, and the former Soviet Union. The newly formed family planning organizations are the major service providers in these countries, although they struggle with funding shortages. In Romania the Society for Education on Contraception and Sexuality was formed in March 1990 and has trained more than 500 general practitioners, nurses, students, teachers, and gynecologists in family planning; organized national congresses and press conferences; and published articles. It uses the radio to promote its services and has 9 clinics in different cities. In Russia the Russian Family Planning Association was established in December 1991 and formed 17 branches in the country. It organized seminars on adolescent sex education and contraception, modern contraceptive methods, abortion prevention, and quality care in abortion. In Bulgaria the national association was restructured to collaborate with government departments and to develop training programs in family planning. Counseling centers are also scheduled to open. In the Czech Republic 2 new clinics are to open, collaboration with the Ministry if Education would result in introducing school-based sex education, and Norplant would also be offered in services. Hungary's Pro Familia was focusing on visiting nurses to provide advice on contraception and condoms; and a model clinic was opened in Budapest. In Slovakia the new association endorsed abortion legislation and sterilization and organized conferences for health professionals. In Albania the new association opened a clinic in Tirana and held sex education seminars for teachers. Problems relate to lack of contraceptives because of the severe economic situation, the attitudes of health professionals (low doctors' salaries and misinformation about contraception), the deteriorating status of women, and the over-medicalization of family planning services.
Washington, D.C., CEDPA, . 20 p.This 1996 annual report of the Centre for Development and Population Activities (CEDPA) opens with a message from CEDPA's board, which notes that the organization's activities have continued to expand through efforts to improve health, development, human rights, and gender equality in Africa, Asia, eastern Europe, and Latin America. In particular, CEDPA worked with nongovernmental organizations and funding agencies to achieve continued growth of women's advocacy, activism, and leadership. During 1996, CEDPA used participatory processes to provide technical assistance and training to 73 community organizations that acted as policy advocates, advanced women's rights, extended media impact, and mobilized interfaith action. Also during 1996, CEDPA's gender-focused family planning and reproductive health projects were expanded; CEDPA conducted a Democracy and Governance Initiative, which involved leading women's groups in an effort to build civil society in Nigeria; family planning, reproductive health, and maternal/child health were promoted in Nepal; and maternal health services were strengthened in Romania. In the area of youth and leadership, CEDPA provided training, funding, and technical assistance to 40 partners in 20 countries and sponsored conferences in the US and India. The Better Life Options for Girls and Young Women program flourished, and adolescent reproductive health was promoted in Africa and Latin America. Girls in Egypt received education and training, and youth rights were promoted in Africa and Asia. CEDPA's capacity-building training program reached 841 people representing 54 countries, and CEDPA partners moved to attain program sustainability and increase gender equity in programs, projects, and institutions. Regional networks strengthened training and advocacy efforts. In addition to describing these activities, this annual report lists CEDPA's training participants by region, sponsors of the global training program, training mentors, partners, supporters, board and staff members, publications, and offices and provides a financial statement for 1996.
The WHO Collaborating Center in Szeged; the history of successful international collaboration in complicated times.
ADVANCES IN CONTRACEPTION. 1996 Dec; 12(4):325-30.In the early 1970s, researchers at the Department of Obstetrics and Gynecology in Szeged, Hungary, had few opportunities to communicate with the international scientific community and few resources to purchase needed equipment and supplies. However, the Department was designated a World Health Organization (WHO) Collaborating Research Center of the Expanded Programme of Research, Development, and Research Training in Human Reproduction in 1972. This 23-year collaboration provided the Department with the equipment and training it needed to carry out more than 40 clinical and nonclinical research projects in collaboration with various WHO Task Forces. Thousands of Hungarian citizens benefitted from access to new and effective means of fertility regulation, and staff members contributed to almost 100 scientific publications. When political change came to Europe during the 1980s and 1990s, the Center was able to play a prominent role in promoting cooperation in reproductive health research. In 1990, the Center hosted a meeting of the directors of WHO Collaborating Centers in Europe to 1) exchange information, 2) identify common reproductive health research needs and priorities, 3) develop collaborative plans, 4) mobilize scientific expertise, and 5) explore ways to mobilize resources. This led to a workshop on reproductive health needs in eastern Europe in 1993 during which the 1994 "Szeged Declaration" was drafted. This declaration identifies the basic elements of reproductive health, assesses the regional reproductive health indicators, and contains 14 recommendations to further reproductive health. The regional problems identified were so serious that the WHO established a scientific working group to achieve regional improvement.
[Geneva, Switzerland], IAMANEH, 1995. 52 p.This 1995 annual report of the International Association for Maternal and Neonatal Health (IAMANEH) opens with the announcement that Professor Aldo Campana has assumed his duties as the new Secretary General of the Association. The president's message notes that IAMANEH is continuing to provide project and educational support to achieve maternal and child health in developing countries. The executive director reports that new national sections representing Argentina, South Africa, and Togo were added to IAMANEH in 1995. The report continues with a financial statement and summaries of the activities that took place in Argentina, Bangladesh, Brazil, Colombia, Costa Rica, Egypt, France, Ghana, Guatemala, Haiti, India, Italy, Japan, Malaysia, Mali, Pakistan, Philippines, Portugal, Romania, Sierra Leone, South Africa, Switzerland, Turkey, Togo, and the UK. The report provides lists of IAMANEH-related international conferences and meetings, the IAMANEH membership, the names and addresses of officers, the secretariat, the national sections, the members of the management committee, the technical advisory panel, and associated organizations.
SEXUALIDADE E PLANEAMENTO FAMILIAR. 1994 Jul-Sep; (3):19-20.The national directorate of Portugal's Family Planning Association (FPA) introduced a novel motion for the biennial period of 1994-96. 27 years after its foundation the association recommended a woman to be the president of its national directorate. This choice was proposed by the president of the International Planned Parenthood Federation at the time of the expiration of his mandate stating that the next president of IPPF should be a woman, and the idea caught on in international circles. Within different associations male perspectives and problems were also addressed in addition to the sexual and reproductive rights of women. The dominant areas of the FPA are health and education, which are intimately linked to psychology and sociology, as well as social assistance to people in need. The diverse training and educational activities at the national directorate are carried out by a staff consisting of a teacher, a psychologist, a sociologist, a nurse, and three physicians. Nowadays family planning has to be approached from a multidisciplinary point of view. For the coming two years, 1994 and 1995, the program of FPA in the area of education comprises new courses for motivators; organizing two major projects by producing materials and doing social communication field work: one for educated and uneducated young people and the other one for socially underprivileged women in poor areas; holding the 7th national meeting of voluntary workers; new interregional projects; and the formation of an interregional FPA delegation for the Azores. International work comprises the active participation in the program of the IPPF, especially with the southern European group. The Advanced School of Education also prepares teachers and motivators for sex education programs teaching basic sex education.
New York, New York, United Nations, 1992. xvii, 265 p.This directory of population centers in Europe, the US, and Canada was based on responses to a survey of 170 demographic research and/or training centers. Published information was available on 130 centers, due to deadlines. Countries providing information included Austria (3), belgium (5), Bulgaria (2), Canada (9), Cyprus (1), Czech and Slovak Federal Republic (2), Denmark (5), Finland (3), France (6), Germany (12), Greece (2), Hungary (1), Ireland (2), Italy (3), Luxembourg (1), Malta (2), Netherlands (6), Norway (2), Poland (5), Portugal (1), Rumania (2), Russian Federation (2), Spain (1), Switzerland (4), Turkey (3), Ukraine (1), UK (15), US (28), and the former Yugoslavia (3). The questionnaire distributed to the centers is included. Information requested included the following topics: name of institution, name of parent organization, name of director, postal address, telephone number, telex number, cable address, fax number, major functions (4 options indicated), status of institution (4 options), major areas of work in training and research and analysis (22 options), names of professional staff members, titles of major publications, titles of current major research projects of the institution, and titles of major surveys conducted since 1985.
In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988].  p.. (USAID Contract No. DPE-3040-A-00-5064-00)In 1986 the European Regional World Health Organization (WHO) Office convened a meeting of health workers' organizations to develop a strategy for implementing breastfeeding promotion. The elements in this strategy are outlined along with the reasons why some countries have seen increases in breastfeeding and a discussion of the possible ways international organizations can help. The "International Code of Marketing of Breast-Milk Substitutes" constitutes the clearest mandate for an "action program" in the field of breastfeeding. It provides a framework for action and for the formulation of a breastfeeding promotion strategy. Further, the "Code" identifies the obligations of both governments and health workers. According to the Resolution recommending the "Code," one of the obligations of governments is to report regularly to WHO on the progress in 5 areas of infant nutrition: encouragement and support of breastfeeding; promotion and support of appropriate weaning practices; strengthening of education, training, and information; promotion of health and social status of women in relation to infant and young child feeding; and appropriate marketing and distribution of breast milk substitutes. The WHO member states in the European Region have taken their reporting obligation seriously; 71 reports from 29 of the 32 members states have been received. The picture that emerges is one of large diversity with regard to breastfeeding both among and within countries. The European Strategy outlines 7 priority areas for action: the basic attitude of health workers; maternity ward routines; the formation of breastfeeding mothers' support groups; ways to support employed mothers who want to breastfeed; research in breastfeeding; commercial pressure on health workers; and the need for advocacy of breastfeeding. The promotion of breastfeeding is the cumulative effect of activities from several different disciplines that becomes evident in the statistics as an increase in breastfeeding. Factors that contribute to an increase in breastfeeding, based on the Scandinavian experience, are outlined. In regard to establishing a breastfeeding policy, the various activities that can encourage and support breastfeeding fall into 3 categories: making breast milk available to the baby by influencing the material conditions of breastfeeding; increasing knowledge either about human milk or about lactation management as well as about changing attitudes and behavior; and assuring the quality of the milk itself. Ideally, an organization with an advisory and to some degree an executive, decision-making function coordinates these activities.
TROPICAL AND GEOGRAPHICAL MEDICINE. 1985 Sep; 37(3 Suppl):S78-80.In the Netherlands the program of international cooperation focuses on the improvement of the socioeconomic situation of the poorest groups in societies as one of the major aims. Health is considered to be an important component of that situation and emphasis is laid on the complexity of the many different factors that determine the health status of individuals, groups, and populations. The ministry strongly advocates a community-based or community-oriented approach, popular participation, and a multisectoral approach by integration of activities such as health care, drinking water supply, agriculture, education, and poverty-reducing measures in general. Considering the above identified policy and the positive experiences the government had gained through bilateral, multilateral, and nongovernmental organization channels, the Netherlands wholeheartedly welcomed the results of the World Health Organization (WHO) UN International Children's Emergency Fund Conference of Alma Ata in 1978, endorsing the declaration of the conference. It was stated that the actual health situation of the world population was intolerably poor, that the majority of humankind had to live without possibilities to benefit from modern health technology, and that primary health care (PHC) had to be considered the key strategy in order to obtain the aim of "Health for All at the Year 2000." In the years that followed, PHC became a popular concept worldwide. Within the Netherlands itself, the Royal Tropical Institute in Amsterdam created a multidisciplinary group linked with other institutions in order to process and analyze the experience gained in different PHC projects in various 3rd world countries. These studies already have contributed to basic knowledge in the PHC field and the group assisted through direct or indirect training. Additionally, about 200 Dutch medical doctors working in developing countries and doctors from those countries have participated in the annual international Courses in Health Development, organized in 1963. In the context of a multilateral approach to help solve global problems, the Netherlands has built up a certain tradition, one that supports WHO in its efforts to elaborate the concept of PHC as well as to develop and to supply the means to implement the strategy. Support also is given to WHO's initiative to establish the Health Resources Group, which participates in making an inventory of national health problems and of available resources from national and international sources. Returning to the theme of this symposium, vaccination can function as a starter for PHC when it is implemented in accordance with the overall PHC philosophy, i.e., it supports the general development process of societies and individuals.
Report of a WHO Meeting on Adolescent Sexuality and Reproductive Health: Educational and Service Aspects, Mexico City, 28 April - 2 May 1980.
[Unpublished] 1981. 69 p. (MCH/RHA/81.1)In 1977, the Maternal and Child Health Unit of the World Health Organization (WHO) collaborated with the International Planned Parenthood Federation in the design and implementation of a cross-cultural survey in an effort to fill the gaps in available country-specific information on the reproductive health needs of adolescents and the information, education, and services available to them. The premise was that the use of a well-designed survey instrument would provide a global picture of the issues surrounding adolescent sexuality and reproductive health. The surveys were used as background information for the WHO Meeting on Adolescent Sexuality and Reproductive Health: Educational and Service Aspects, held in Mexico in May 1980. The objectives of the meeting were: to review the needs and problems related to sexuality and reproductive health of adolescents; to identify priority research issues related to these needs; to identify appropriate approaches including strategies and channels to meet these needs, including education, health, and social services; and to suggest specific follow-up activities to the recommendations of the meeting. To establish a working outline for the discussions which were to take place during the meeting, extensive background material was presented by some of the participants. These papers, included in an annex, focused on the health and social aspects of pregnancy in adolescents and on adolescents in a changing society, especially in the context of their sexuality and reproductive behavior. A system of plenary sessions and small group discussions took place during the meeting. Based on the background papers and the reports of the 4 working groups, the full meeting developed 4 issues for specific consideration: an adolescent overview; a conceptual model; strategies for action; and specific recommendations. These 4 issues are covered in detail in this report of the meeting. The meeting participants repeatedly emphasized the need to involve adolescents, policy makers, and potential service providers in a program which is not predetermined and sufficiently flexible to permit the participation of all concerned. Meeting participants recommended the development of a series of community-based pilot projects on educational and service programs in sexuality and reproductive health for and with adolescents, action research to support the development of the pilot projects, a focus on youth participation in programs addressed to meet the specific needs of adolescents, and attention directed to encouraging youth to assume responsibility in program development. Summary reports of the cross-cultural survey are included in this report.
Health planning and management--requirements for HFA2000 development: report on a working group, Athens, 26-29 September 1983.
[Unpublished] 1984. 18 p. (ICP/SPM 028(1))The purposes of the Working Group, composed of temporary advisers and consultants from 12 Member States of the European Region, were as follows: to examine how the existing health management and planning systems in the European Member States comply with the requirements of Health for All 2000 (HFA2000); and to identify critical areas in the development of health systems and ways of promoting change. In this context, the Group was asked to discuss: existing health planning structures and processes in European Member States, specifically with a view toward longterm outcome and strategic planning; levels of decisionmaking in planning and the balance between centralization and decentralization; the involvement of providers and consumers in the decisionmaking process of health planning; mechanisms for intersectoral involvement and leadership in health development issues; how existing financial mechanisms and budget availability meet the needs of problem-oriented issues and program budgeting; and the consequences of management and planning for health, taking the present economic situation into consideration. In the opinion of the Working Group, the broad policy basis, the strategic goals, and the majority of targets of the HFA2000 strategy for the European Region are widely accepted, but this general agreement does not exclude marked differences in emphasis placed on various aspects of the HFA2000 message in the countries represented at the meetings. A wide variety of steering, planning, and management approaches to the health sector exists in the European Region. Actual management practice varies according to the different balances between formal planning mechanisms and more informal steering and negotiating mechanisms. Issues of centralization and decentralization play an important role in the majority of health planning and management mechanisms and systems in the European Region. These issues contain an essential dilemma of value conflicts that are receiving more and more attention. Basic need orientation, innovative capacity, sufficient flexibility, and community as well as user and provider participation in health development require health planning and management to be closely related to the expressed needs of the population in local communities, in regions, or other "peripheral" levels. The involvement of users, providers, and decisionmakers as well as community participation can contribute considerably to the responsiveness of health planning and management to local needs. Health protection and health development are major objectives in all countries of the European Region. In the Eu ropean Region, the variety of financing mechanisms, budgetary processes, and pricing procedures reflects the various countries' general governmental features. The majority of Member States are at this time passing through a period of economic stringency with zero or even negativve growth tendencies some cases.
Implementation of action area four ("Meeting the Needs of Young People") of the IPPF three year plan 1985-87.
[Unpublished] 1984 Dec. 11,  p. (PC/3.85/4)The objective of this paper is to assist the Central Council of the International Planned Parenthood Federation (IPPF) in monitoring the implementation of the IPPF 1985-87 plan. Baseline information is provided on all 1985 youth projects proposed by grant receiving family planning associations (FPAs) in their 1985-87 Three Year Plans. Detailed analysis was confined to the 67 FPA 1985-87 Three Year Plans received at the International Office by September 1984. This number covers most of the Associations in the region; the exception is the Western Hemisphere where several of their plans arrived in London too late to be included in the analysis. For nongrant receiving Associations, summary information was extracted from regional bureau sources and a list of youth activities in these countries is shown in an appendix. A summary of 1985 youth activities supported by the IPPF Secretariat at both regional and international level is shown in a 2nd appendix. To provide the necessary background to an analysis of 1985 youth projects, all strategies proposed by FPAs in their 1985-87 Plans were examined. A total of 360 strategies were classified according to their main purpose. A further classification into 14 categories was then used to demonstrate their relationship to the IPPFs 1985-87 Action Areas. Information about the purpose of youth projects, the types of activity carried out, and whether the project was new or ongoing was also extracted from the FPA Plans. For the 67 FPAs whose Three Year Plans were reviewed, a total of 360 strategies were proposed for the 1985-87 period. The largest number of strategies were concerned with providing family planning services; male involvement was the least mentioned. A total of 34 FPAs specifically mentioned young people in their list of strategies. A further 17 FPAs proposed youth projects but did not as yet devote a special youth strategy for them. Taking into account all regions, a total of 51 Associations in 1985 intended to spend almost $2 million implementing 169 youth projects. The projects fell into 4 main types: family life and population education; training; increasing awareness of issues affecting young people; and family planning services. The number of new youth projects in 1985 varies from region to region, the highest number being in Africa. FPAs still have much to do to meet the new objective of involving parents and the community in preparing young people for responsible sexuality and family life.
New York, New York, Population Council, Center for Poplicy Studies, 1985 Aug. 42 p. (Center for Policy Studies Working Papers No. 113)This analysis of family planning program funding suggests that current funding levels may be inadequate to meet projected contraceptive and demographic goals. Expenditures on organized family planning in less developed countries (excluding China) totaled about US$1 billion in 1982--about $2/year/married woman of reproductive age. Cross-sectional analysis indicates that foreign support as a proportion of total expenditures decreases with program duration. Donor support to family planning in less developed countries has generally declined from levels in the late 1970s. This is attributable both to positive factors such as program success and increased domestic government support as well as requirements for better management of funds and the worldwide economic recession. Foreign assistance seems to have a catalytic effect on contraceptive use only when the absorptive capacity of family planning programs--their ability to make productive use of resources--is favorable. The lower the stage of economic development, the less visible is the impact of contraceptive use or fertility per investment dollar. On the other hand, resources that do not immediately yield returns in contraceptive use may be laying the foundation for later gains, making increased funding of family planning programs an economically justifiable investment. The World Bank has estimated that an additional US$1 billion in public spending would be required to fulfill the unmet need for contraception. To increase the contraceptive prevalence rate in developing countries to 58% (to achieve a total fertility rate of 3.3 children) in the year 2000 would require a public expenditure on population programs of US$5.6 billion, or an increase in real terms of 5%/year. Improved donor-host relations and coordination are important requirements for enhancing absorptive capacity and program performance. A growing willingness on the part of donors to allow countries to specify and run population projects has been noted.
Food and Nutrition Bulletin. 1982 Jan; 4(1):7-16.This study describes 3 nutrition intervention programs in Sri Lanka; Lanka Jathika Sarvodaya Samgamaya; Redd Barna, the Norwegian Save the Children Program; and the US Save the Children fund. The Sarvodaya Shramadana Sangamaya is a private, nonprofit organization that began in 1958 devoted to mobilizing voluntary labor for village reconstruction. It is now engaged in a series of development projects in over 2,000 villages. One of its main objectives is to mobilize community resources for development. The children's service now integrates pre-school, nutrition, and community health services. There are an estimated 86 day care centers. The main service available in these day care centers, apart from physical care, is the provision of nutrition. Pre-school nutrition programs are also administered. The program costs about Rs230/beneficiary per year. The International Council of Educational Development from the United States was invited to review the program. Recommendations are given. The Norwegian Save the Children (Redd Barna) program in Sri Lanka was started in 1974. Projects are of 2 types: 1) settlement projects; and 2) integrated community development projects which aim to improve the standard of living with particular attention to child welfare. The US Save the Children Fund (SCF), a private, nonprofit voluntary organization, began its 1st project in Sri Lanka in urban community development in a slum and squatter settlement within Colombo. It focused on housing, but also includes other programs such as health and nutrition. These activities are carried out through a pediatric clinic, a home visits register, a nutritional status survey, a supplementary feeding program, nutrition, education, and a day care center. The approximate cost of the nutrition program would be Rs7700/month for an average of Rs13/month, or Rs156/year/beneficiary.
London, Her Majesty's Stationary Office, June, 1980. 38 p. (Overseas Development Paper; No. 21)Recent trends in world population growth and in governments' attitudes towards population and development are generally discussed. A historical perspective of the British Ministry of Overseas Development (ODA) involvement in population activities is given. Support began in the 1960s and ODA's Population Bureau was established in 1968 to function in an advisory capacity, promote training and research in issues related to population. The scope of the Bureau's work has broadened from clinical aspects of family planning to include demographic, social and economic factors related to population. ODA's assistance for population is outlined. Details of ODA's support of the following types of programs are given: 1) multilateral; 2) bilateral (including data collection and analysis, regional demographic training, formulation of population policies and programs, maternal and child health/family planning, and communications and education); 3) institutional support; 4) voluntary agencies; 5) research. Meetings attended by members of the Population Bureau in 1977-1979 are listed. ODA expenditure on population activities in 1977, 1978 and 1979 are listed by country or institution.