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  1. 1

    EPI in the Americas. Report to the Global Advisory Group Meeting, Alexandria, Egypt, 22-26 October 1984.

    Pan American Health Organization [PAHO]

    [Unpublished] 1984. 15 p.

    This discussion of the Expanded Program on Immunization (EPI) in the Americas covers training, the cold chain, the Pan American Health Organization's (PAHO) Revolving Fund for the purchase of vaccines and related supplies, evaluation, subregional meetings and setting of 1985 targets, progress to date and 1984-85 activities, and information dissemination. All countries in the Region of the Americas are committed to the implementation of the EPI as an essential strategy to achieve health for all by 2000. During 1983, over 2000 health workers were trained in program formulation, implementation, and evaluation through workshops held in Argentina, Brazil, Cuba, El Salvador, and Uruguay. From the time EPI training activities were launched in early 1979 through 3rd quarter 1984, it is estimated that at least 15,000 health workers have attended these workshops. Over 12,000 EPI modules have been distributed in the Region, either directly by the EPI or through the PAHO Textbooks Program. The Regional Focal Point for the EPI cold chain in Cali, Colombia, continues to provide testing services for the identification of suitable equipment for the storage and transport of vaccines. The evaluation of solar refrigeration equipment is being emphasized increasingly. PAHO's Revolving Fund for the purchase of vaccines and related supplies received strong support from the UN International Children's Emergency Fund (UNICEF), which contributed US $500,000, and the government of the US, which contributed $1,686,000 to the fund's capitalization. These contributions raise the capitalization level to US $4,531,112. Most countries are gearing their activities toward the increase of immunization coverage, particularly to the high-risk groups of children under 1 year of age and pregnant women. To evaluate these programs, PAHO has developed and tested a comprehensive multidisciplinary methodology for this purpose. Since November 1980, 18 countries have conducted comprehensive EPI evaluations. 6 countries also have had followup evaluations to assess the extent to which the recommendations from the 1st evaluation were implemented. At each subregional meeting, participants met in small discussion groups to review each other's work plans and discuss appropriate targets for the next 2 years. Immunization coverage has improved considerably in the Americas over the last several years. Figure 2 plots the incidence rates of polio, tetanus, diphtheria, whooping cough, and measles from 1970-83 in the 20 countries which make up the Latin American subregion. If all countries meet their 1985 targets, immunization coverages for DPT and polio will range from 60-100%, with most countries attaining coverages of over 80%. For measles, 1985 targets range from 50-95%, and from 70-99% for BCG. The main vehicle for dissemination of information is the "EPI Newsletter," which publishes information on program development and epidemiology of the EPI diseases.
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  2. 2

    China: long-term development issues and options. The report of a mission sent to China by the World Bank.

    Lim E; Wood A; Porter I; Taylor RP; Byrd W; Tidrick G; King T; Tims W; Pohl G

    Baltimore, Maryland, Johns Hopkins University Press, 1985. xiii, 183 p. (World Bank Country Economic Report)

    This report summarizes the conclusions of a World Bank study undertaken in 1984 to identify the key development issues China is expected to face in the next 20 years. Among the areas addressed by chapters in this monograph are agricultural prospects, energy development, spatial issues, international economic strategy, managing industrial technology, human development, mobilizing financial resources, and development management. China's economic prospects are viewed as dependinding upon success in mobilizing and effectively using all available resources, especially people. This in turn will depend on sucess in reforming the system of economic management, including progress in 3 areas: 1) greater use of market regulation to stimulate innovation and efficiency; 2) stronger planning, combining indirect with direct economic control; and 3) modification and extension of social institutions and policies to maintain the fairness in distribution that is basic to socialism in the face of the greater inequality and instability that may result from market regulation and indirect controls. Over the next 2 decades, China can be expected to become a middle-income country. The government has set the goal of quadrupling the gross value of industrial and agricultural output between 1980 and 2000 and increasing per capita income from US$300 to $800. China's size and past emphasis on local self-sufficiency offer opportunities for enormous economic gains through increased specialization and trade among localities. Increased rural-urban migration seems probable and desirable, although an increase in urban services and infrastructure will be required. The expected slow rate of population increase is an important foundation for China's favorable economic growth prospects. On the other hand, it may not be desirable to hold fertility below the replacement level for very long, given the effects this would have on the population's age structure. The increase in the proportion of elderly people will be a serious social issue in the next century, and reforms of the social security system need to be considered.
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  3. 3

    Report of the Task Force II on research inventory and analysis of family planning communication research in Bangladesh.

    Waliullah S; Mia A; Rahman M

    [Dacca, Bangladesh, Ministry of Information and Broadcasting] Oct. 1976. 85 p.

    Topics relevant to family planning such as interpersonal relationships, communication patterns, local personnel, mass media, and educational aids, have been studied for this report. The central theme is the dissemination of family planning knowledge. The methodology of education and communication are major factors and are emphasized in the studies. While the object was to raise the effectiveness of approaches, the direct concern of some studies was to examine a few basic aspects of communication dynamics and different human relationship structures. Interspouse communication assumes an important place in the family planning program and a couple's concurrence is an essential precondition of family planning practice. Communication between husband and wife varies with the given social system. A study of couple concurrence and empathy on family planning motivation was undertaken; there was virtually no empathy between the spouses. A probable conclusion is that there was no interspouse communication on contraception and that some village women tend to practice birth control without their husband's knowledge. Communication and personal influence in the village community provide a leverage for the diffusion of innovative ideas and practices, including family planning. Influence pattern and flow of communication were empirically studied in a village which was situated 10 miles away from the nearest district town. The village was found to have linkage with outside systems (towns, other villages, extra village communication network) through an influence mechanism operative in the form of receiving or delivering some information. Local agents--midwives, "dais," and female village organizers are in a position to use interpersonal relations in information motivation work if such agents are systematically involved in the family planning program and are given proper orientation and support by program authorities. These people usually have to be trained. 7 findings are worth noting in regard to the use of radio for family planning: folksongs are effective and popular; evening hours draw more listeners; the broadcast can stimulate interspouse communication; the younger groups can be stimulated by group discussions; a high correlation exists between radio listening and newspaper reading; most people listen to the radio if it is accessible to them; approximately 60% of the population is reached by radio. A positive relationship was found to exist between exposure to printed family planning publicity materials and respondents' opinions toward contraception and family planning. The use of the educational aid is construed as an essential element to educating and motivating people's actions.
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