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WHO healthy cities and the US family support movements: a marriage made in heaven or estranged bed fellows?
Health Promotion International. 1996; 11(2):137-142.The family support movement in the US emerged at about the same time that the WHO Healthy Cities project was gaining momentum in Europe, and the underlying principles and ecologic frameworks of the two have much in common. However, while many 'Healthy Cities' in Europe have included activities that benefit families, this has not been made a major focus. There seems to be little awareness of experience gained in the US in terms of establishing programs with limited or no government funding, using volunteers, and developing social marketing and advocacy strategies sustain long term viability. Similarly, cities and states in the US are struggling to develop networks of family support programs and they appear to be doing this without the benefit of experience gained in Healthy Cities projects on how to engage political leadership, develop public policies, establish intersectoral councils, fund a coordinator position, mobilize neighborhoods, and evaluate community wide health promotion programs. The purpose of this paper is to examine how these two movements might join forces and learn from each other. (author's)
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)
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.
AIDS WEEKLY PLUS. 1996 Dec 9; 7-8.The Female Health Co. (FHC), London, United Kingdom, has signed a three-year agreement with the Joint United Nations Program on HIV/AIDS (UNAIDS) to provide a global public sector price for the female condom to 193 affiliated countries. An adjunct education and social marketing program, supported by UNAIDS, will be launched. High rates of acceptance have been shown previously when the female condom has been introduced with an effective educational approach. Negotiations between FHC and UNAIDS began in September 1996; 80 of 193 countries, upon inquiry, have already identified a requirement for over 7 million female condoms in 1997. UNAIDS estimates that nearly 50% of new human immunodeficiency virus (HIV) infections are in women; the female condom is the only woman-controlled product providing protection against sexually transmitted diseases (STDs), including HIV and acquired immunodeficiency syndrome (AIDS). Studies have indicated that the number of unprotected sex acts decreases when the female condom is available. Dr. Peter Piot (UNAIDS) states that the female condom is important in those cultures and situations where women have limited control over sexual decisions. Dr. Mary Ann Leeper (FHC) states that the company is committed to making the female condom available in developing countries.
SOMARC III HIGHLIGHTS. 1994 Mar; (10):1-2.Morocco's Protex condom project was introduced in September, 1989, by Social Marketing for Change (SOMARC). Since September, 1993, when Protex became self-sufficient, the local distributor, Moussahama, has maintained strong sales, with 1993 fourth quarter sales 18 percent higher than they were the year before. Moussahama is purchasing the condoms directly through the International Planned Parenthood Federation. Moussahama continues to expand distribution to non-traditional outlets. Condom sales are projected to reach three million units in 1994, nearly 40 percent higher than in 1993. An important component of SOMARC's project was a media campaign designed to improve attitudes toward condom use. A recent study measuring the impact of the campaign documented that current condom use of any brand among married men has increase from 3% in 1989 to 20% in 1993; 93% of all married men interviewed were aware of Protex, and nine out of ten condom users said they use Protex most often. The Okey condom in Turkey became self-sufficient in December, 1993, attributed chiefly to SOMARC's having obtained from Eczacibasi, the Turkish distributor, a commitment to directly purchase all condoms to be sold in the social marketing project. Eczacibasi has covered all commodity as well as management and distribution costs of the product since its initial launch. During this time, USAID saved over US $700,000 which it would otherwise have spent providing condoms to the project. Sales of Okey have increased rapidly since the condom's introduction in June, 1991, and are expected to exceed seven million units 1994. Eczacibasi budgeted over US $450,000 in 1994 for advertising and promotion for the Okey brand. A recent study evaluating the impact of SOMARC's condom social marketing in Turkey has increased by a dramatic 124 percent. The success of the Okey condom has encouraged the London Rubber Co. to take a more active role in marketing condoms in Turkey.
New York, New York, AVSC, 1993 Mar 16. vi, 43, 108, 47, 15 p.The March 1993 Association for Voluntary Surgical Contraception (AVSC) workplan outlines strategic plans to expand services to USAID priority developing countries while reducing services in other countries and to add all contraceptive methods requiring a medical procedure to its services. AVSC plans on continuing to focus on voluntary sterilization. Its guiding principles still are expanding access to services, guaranteeing free and informed choice, and ensuring the safety and effectiveness of services. AVSC plans to develop comprehensive country programs and to take on special or global programs. Some anticipated special programs include medical quality assurance, voluntarism and well-informed clients, client-centered service systems, and vasectomy and male involvement. Managerial plans are country level planning and evaluation, continuous strategic planning, annual workplan development, decentralization, strengthening technical capacity, interagency collaboration and strategic alliances, and diversification of funding. AVSC's 1993 funding sources are dominated by USAID (57% from USAID central office and 27% from USAID missions). UNFPA and the World Bank together comprise 8% and private sources make up another 8%. AVSC plans to provide services in some countries for which USAID does not provide funding: Iran, Vietnam, the former Soviet Union, and the US. Specific issues that AVSC faces in fiscal year 1993 are insufficient USAID funding, resistance by other agencies to collaborate, addressing the highly competitive bidding game related to requests for proposals with the USAID Office of Population, assuring partners and supporters of its continued emphasis on voluntary sterilization, confronting the effect of adverse press coverage on vasectomy and prostate cancer, and remaining mindful of contraceptive choice issues.
Geneva, Switzerland, WHO, 1992 Jun 22. 4 p.After reviewing 15 HIV prevention projects in 13 countries, the WHO Global Programme on AIDS has concluded that several approaches are effective in changing sexual behavior. The various projects centered around condom marketing programs, mass media campaigns, and friends and co-workers. Mass media campaigns and commercial marketing techniques in Zaire (attractively packaged condoms with appealing names) have resulted in a dramatic increase in condom sales, from <100,000->18 million between 1987-91. The government in Thailand has been able to gain the support of brothel owners and the prostitutes in 66 of 73 provinces to work toward achieving 100% condom use. For example, it penalizes brothel owners who do not comply. In Samut Sakhon, client condom use has reached almost 100%. Mass media campaigns in Switzerland have encouraged people to increase condom use from 8% to 52% between 1987-90, and condom sales have increased almost 2-fold (7.6-13.8 million between 1986-91. The community-based program in Zimbabwe uses prostitutes, actors, and musicians to tell their peers about HIV transmission and infection and encourage them to use condoms. In Tanzania, truck drivers, their assistants, and prostitutes along the trans-African Tanduma highway inform others about AIDS and condoms. In <1 year, condom use among prostitutes along the highway increased from 50% to 91%. Other successful projects include a community-based project in Ciudad Juarez, Mexico where prostitutes serve as peer educators (>85% condom use) and a mass media campaign in the Philippines (96% of youth remembered the campaign). Political will and adequate resources in these efforts will save millions of lives.
San Francisco, San Francisco Press, 1974. 292 p.Despite its high effectiveness, lack of side effects, ease of use, and low cost, condom utilization has declined in the U.S. from 30% of contracepting couples in 1955 to 15% in 1970. The present status of the condom, actions needed to facilitate its increased availability and acceptance, and research required to improve understanding of factors affecting its use are reviewed in the proceedings of a conference on the condom sponsored by the Battelle Population Study Center in 1973. It is concluded that condom use in the U.S. is not meeting its potential. Factors affecting its underutilization include negative attitudes among the medical and family planning professions; state laws restricting sales outlets, display, and advertising; inapplicable testing standards; the National Association of Broadcasters' ban on contraceptive advertising; media's reluctance to carry condom ads; manufacturer's hesitancy to widen the range of products and use aggressive marketing techniques; and physical properties of the condom itself. Further, the condom has an image problem, tending to be associated with venereal disease and prostitution and regarded as a hassle to use and an impediment to sexual sensation. Innovative, broad-based marketing and sales through a variety of outlets have been key to effective widespread condom usage in England, Japan, and Sweden. Such campaigns could be directed toward couples who cannot or will not use other methods and teenagers whose unplanned, sporadic sexual activity lends itself to condom use. Other means of increasing U.S. condom utilization include repealing state and local laws restricting condom sales to pharmacies and limiting open display; removing the ban on contraceptive advertising and changing the attitude of the media; using educational programs to correct erroneous images; and developing support for condom distribution in family planning programs. Also possible is modifying the extreme stringency of condom standards. Thinner condoms could increase usage without significantly affecting failure rates. More research is needed on condom use-effectiveness in potential user populations and in preventing venereal disease transmission; the effects of condom shape, thickness, and lubrication on consumer acceptance; reactions to condom advertising; and the point at which an acceptable level of utilization has been achieved.