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United Nations Educational, Scientific and Cultural Organization. Address by Mr Koichiro Matsuura, Director-General of the United Nations Educational, Scientific and Cultural Organization (UNESCO), on the occasion of the Information Meeting with Permanent Delegates on HIV / AIDS, UNESCO, 10 May 2005.
[Paris, France], UNESCO, 2005.  p. (DG/2005/074)It is a pleasure to welcome you to this information session on UNESCO's role, aims and programme in the fight against HIV and AIDS. We are very lucky to have with us Dr Peter Piot, whose excellent work and results as the Executive Director of UNAIDS have recently been underscored by his re-appointment for a new five-year mandate from this year. I am also delighted to welcome Mrs Cristina Owen-Jones, UNESCO Goodwill Ambassador with a special brief for the fight against HIV/AIDS, who will also address you this afternoon. In my introductory remarks to you today, I would like to briefly outline the process through which UNESCO has engaged with the HIV/AIDS challenge during the past few years. That engagement has taken place within an overall context marked by three main features: first, the continuing spread of the epidemic; second, its devastating impact on whole societies and their key institutions (such as education systems) as well as upon communities and families; and, third, the emphasis upon treatment as the major response to HIV and AIDS. (excerpt)
Psychoanalytic Review. 1998 Aug; 85(4):639-658.This article will explore some of the issues of resilience in the child population of Bosnia during the recent war there. It will also look at similar issues in the humanitarian aid workers who came from outside the country as representatives of relief agencies. I, myself, worked for UNICEF, and it was my job to train members of the local population to work with Bosnian children in an attempt to increase their resilience under intense wartime stress and to reduce the traumatic impact to those children already harmed. (author's)
In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar.  p. (KEN-13)For the past 20 years, Chogoria Hospital has run a steadily expanding clinic and community-based health service program in Meru District. This hospital, with its 32 satellite clinics and its catchment area, has been renowned for its high contraceptive prevalence and low fertility rate compared to the Kenyan national average and that of many sub-Saharan countries. Several factors have contributed to this success, including community-based distribution by family health educators (FHEs) and community health workers (CHWs). Through these community-based distributors, family planning (FP), child welfare, and antenatal clients who fail to turn up for appointments within a month after the default date are followed-up and encouraged to visit a clinic. Financial support for this default tracking system has been ensured through donor funds. Lately, however, the longterm sustainability and usefulness of the tracking system have been questioned. In response to this concern, the management at Chogoria Hospital asked The Population Council to evaluate the default tracking system. This study, which cost US $15,080, determined the extent to which the default tracking system is effective in identifying, tracking, and bringing defaulters back to the program. In addition, the cost of tracking down and bringing back a client was determined. A third component involved assessing the attitude of clients towards this activity and their consequent behavior when they visit Chogoria or other clinics. Data were collected from interviews with 654 defaulting clients using a general questionnaire and 3 other ones specific to FP, child welfare, and antenatal issues. 4 teams composed of local school teachers, with heads of schools acting as supervisors, identified and interviewed the defaulters over a period of 13 days. The teams, who had substantial previous experience in interviewing and data collection, received a week-long training session which included 2 days of fieldwork. A different questionnaire was used to collect information from CHWs. These data were supplemented by information received from field team observations. True defaulters were few, and the impact of CHWs and FHEs in bringing back these clients was low (11-17%). The benefits derived from bringing back a defaulter were negligible compared to the high cost of deploying the CHWs and FHEs. As a result, it was recommended that the default tracking system be discontinued. In addition, it was suggested that the CHWs and FHEs be supervised more effectively and that they concentrate their efforts on other community health activities such as primary health care counseling.
INTERNATIONAL JOURNAL OF HEALTH SERVICES. 1991; 21(3):505-10.This article asks the reader to carefully consider the personal implications of AIDS were either he or close friends and relatives afflicted with the syndrome. We are urged to acknowledge the limited capabilities of personal and social response to the epidemic, and recognize the associated degree of social inequity and knowledge deficiency which exists. Summaries of 3 articles are discussed as highly integrated in their common call for global solidarity in the fight against HIV infections and AIDS. Pros and cons of Cuba's evolving response to AIDS are considered, paying attention to the country's recent abandonment of health policy which isolated those infected with HIV, in favor of renewed social integration of these individuals. Brazil's inadequate, untimely, and erred response to AIDS is then strongly criticized in the 2nd article summary. Finally, the 3rd article by Dr. Jonathan Mann, former head of the World Health Organization's Global program on AIDS, on AIDS prevention in the 1990s is discussed. Covering behavioral change and the critical role of political factors in AIDS prevention, Mann asserts the need to apply current concepts and strategies, while developing new ones, and to reassess values and concepts guiding work in the field. AIDS and its associated crises threaten the survival of humanity. It is not just a disease to be solved by information, but is intimately linked to issues of sexuality, health, and human behavior which are in turn shaped by social, political, economic, and cultural factors. Strong, concerted political resolve is essential in developing, implementing, and sustaining an action agenda against AIDS set by people with AIDS and those at risk of infection. Vision, resources, and leadership are called for in this war closely linked to the struggle for worldwide social justice.
Arlington, Virginia, Management Sciences for Health, Technologies for Primary Health Care [PRITECH], 1991 Jun.  p. (Occasional Operations Papers; USAID Contract No. DPE-5969-Z-00-7064-00)The paper presents results from diarrheal disease control (CDD) activities in Kenya. A World Health Organization Diarrheal Diseases Household Case Management Survey of 23,884 children under 5 years of age indicates a high use of recommended fluids before and during episodes of diarrheal illness. ORT use was high, while ORS use and volume were low, with better diarrheal management practiced in Western Kenya. Children with diarrhea in districts with CDD communication program are more likely to receive proper care. For home treatment of diarrhea, the Kenyan Food and Fluids Panel recommends mothers to use uji, a locally available porridge, liberal quantities of plain water, fresh fruit juices, fermented milk, and coconut water; exclusive breastfeeding for the 1st 4 months of life; continued feeding of at least 5 times/day during diarrhea; and improved, targeted communication for behavior change especially among mothers of at-risk children. Additional research on food, feeding, communications, and marketing ORS was also recommended. Principal research findings of the survey are discussed in detail. Messages most effective in improving the management of diarrhea include emphasizing feeding during diarrhea, stressing the use of nutritional fluids, continued hesitation of ORS promotion until 1.2- liter packets become generally available through the health system, and emphasizing the rare need for drug therapy of diarrhea. Recognizing signs suggesting the need for health facility treatment should be reinforced.
ACTA PAEDIATRICA SCANDINAVICA. 1988 Mar; 77(2):183-90.The acceptance of the World Health Organization (WHO) International Code for Marketing of Breastmilk Substitutes has stimulated governments to design programs for the more energetic promotion of breastfeeding, but promotional efforts in developing nations may not be getting through to the mothers or may not be designed to meet their specific needs. In a prospective study in Istanbul, it was observed that all infants, whether delivered in a hospital or at home, received not only mixtures of sugar and water and other mixtures soon after birth and for about 1 week thereafter, but also complementary foods now and then until this became a regular practice. This pattern can be defined as regular complementary feeding or partial breastfeeding. Yet, the mothers described it as exclusive breastfeeding. The early and haphazard introduction of water and food in those environments where contamination is common exposes the infants to concentrated amounts of microorganisms which may overwhelm the immunological protection provided by breastmilk and also reduces the milk supply through insufficient stimulation of the breast. Exclusive breastfeeding should be encouraged, and irregular complementary feedings during the early weeks of life should be strongly discouraged, unless there is a medical indication. When exclusive breastfeeding is no longer sufficient, i.e., at the age of about 5 months, complementary feeding should be promoted. Programs for the promotion of breastfeeding have been criticized for devoting too much attention to the infant and little or no attention to the needs of the mother. In a given society, it may be difficult to promote breastfeeding if women regard it as a means of preventing them from improving their socioeconomic situation. Women who want to breastfeed their children should not be prevented from doing so by their working conditions.
CHILD SURVIVAL ACTION NEWS. 1988 Apr; (9):1-2.Present thinking regarding the control of neonatal tetanus (NT) suggests that the accepted protocol in the past, i.e., immunizing pregnant women with tetanus toxoid (TT) during antenatal care, is not sufficient in countries where antenatal care may be unavailable. Current control strategies, experts, and official World Health Organization (WHO) recommendations now indicate that efforts should reach beyond immunization of pregnant women and the training of traditional birth attendants in hygienic cord care practice to immunization of all women of childbearing age. Babies continue to die form NT because it is so difficult to reach women during pregnancy for immunization. Lack of commitment to expanding immunization programs as Who recommends stems in part from failure at both national and local levels to acknowledge the extent of the neonatal tetanus problem. NT is vastly underreported for several reasons: cultural practices often include the seclusion of women and their babies during the period after birth; people in developing countries have a fatalistic attitude because so many children die within the 1st year of life; newborns are rarely taken to health centers for treatment; health workers may fail to report NT for fear that their superiors will blame them for failure to immunize or for poor care of the umbilical cord; Western medicine and research has a curative rather than a preventive focus; and gathering information on NT by asking mothers to recall deaths of newborns with symptoms of NT is difficult because many women are ashamed or otherwise unwilling to report the event. The WHO believes that conventional reporting systems in developing countries identify only 2-4% of actual NT cases. Without sound documentation of the problem, it is difficult to gain financial and political commitment to eradicating NT. The VIII International Conference on Tetanus that occurred in Leningrad during 1987 outlined WHO's recommendation for a mixed strategy to control and eliminate tetanus: immunize all women of childbearing age, with special emphasis on pregnant women and women known to belong to high risk groups; assure hygienic delivery and umbilical care through training and supervision of birth attendants; and investigate cases to determine what action could have prevented them.
INTERNATIONAL HEALTH NEWS. 1988 Apr; 9(4):4-5.In the effort to realize Universal Child Immunization by 1990, an active search is underway to find ways to raise immunization coverage levels. The World Health Organization's (WHO) Expanded Program on Immunization (EPI) has developed excellent systems that develop such program components as supply management, equipment maintenance, disease surveillance, clinical practice, and supervision. Program performance has shown a steady improvement over the years in those countries which have adopted such systems, yet the trend has not been as marked as expected. Coverage levels in many countries have remained below 60%, and figures show a "dropout" with the multi-dose vaccines. The dropout figures suggest that parental acceptance of immunization is difficult to sustain throughout the entire series, which is spread over the first 9 months of life. To reduce dropout and boost coverage levels still further, recent program directions have emphasized social mobilization to increase the public response to immunization. It is tempting to conclude that with the implementation of improved management systems the final success will come from persuading parents to avail themselves of immunization services, but field reports suggest that this may not be the case. Health records show missed immunizations despite numerous visits to clinics, suggesting widespread problems in the implementation of the WHO systems. A combination of causes seem to ensure that children attending with their mothers do not get immunized, including errors and omissions on the part of field staff which reduce the chances for immunizations by families making return visits to the clinics. Few programs incorporate immunizations in daily practice. In a series of immunization coverage surveys conducted recently in 1 African country, the most striking fact was that the limitations of the data collected meant that the calculated contribution of clinical error could only be a gross underestimation of true clinical error contribution. This suggests that social mobilization to improve clinical attendance is likely to be ineffective until problems with the provision of services have been solved, but improving services has the potential to increase coverage levels as well as the potential to motivate parents to bring their children to the clinics.
POPULATION EDUCATION NEWS. 1987 May; 14(5):6-9.Population education incentives, voluntary action, community participation, and improved program management are 5 family planning areas recently redefined by the government of India. Population education, integrated with the educational system, is important in influencing fertility behavior. The Adult Education program, and the nonformal educational system will be strengthened, with aid from UNFPA. Incentives, which are presently available to government employees, will be increased. Economic incentives, rural development program incentives, and insurance, lottery, and bond incentive schemes are being considered. Voluntary organizations will be encouraged to work in the family welfare sphere, and organized sector units will be urged to provide family welfare services to their employees. Cooperatives, which cover 95% of villages, will be used as a means of educating, motivating, and communicating population control objectives on the local level. Tax incentives will be offered to the corporate sector for providing integrated family welfare services. Community participation, which is crucial to the success of the programs, will be addressed on several levels. Popular committees, youth and women's groups, and medical students will increase community involvement through various means. In addition, political and community leaders will be involved in motivational work, and a village Women's Volunteer Corps is planned. Social marketing of contraceptives, although fairly extensive for the last 15 years, leaves much to be desired in creating a large demand. A marketing board will be created to ensure aggressive marketing, advertising, and promotion, with expansion to include oral contraceptives. Reorganization and reorientation toward modern program management will be undertaken, so that policy, planning, implementation, review, and evaluation are carried out efficiently. At the state, district, and the block level, more effective coordination is the goal, as well as strengthening the District Family Welfare Bureau.
[The Church, the Family and Responsible Parenthood in Latin America: a Meeting of experts] Iglesia, Familia y Paternidad Responsable en America Latina: Encuentro de Expertos.
Bogota, Colombia, CELAM, 1977. (Documento CELAM No. 32.)This document is the result of a meeting organized by the Department of the Laity of the Latin American Episcopal Council on the theme of the Church, Family, and Responsible Parenthood. 18 Latin American experts in various disciplines were selected on the basis of professional competence and the correctness of their philosophical and theological positions in the eyes of the Catholic Church to study the problem of responsible parenthood in Latin America and to recommend lines of action for a true family ministry in this area. The work consists of 2 major parts: 12 presentations concerning the sociodemographic, philosophical-theological, psychophysiological, and educational aspects of responsible parenthood, and conclusions based on the work and the meetings. The 4 articles on sociodemographic aspects discuss the demographic problem in Latin America, Latin America and the demographic question in the Conference of Bucharest, maturity of faith in Christ expressed in responsible parenthood, and social conditions of responsible parenthood in Peruvian squatter settlements. The 3 articles on philosophical and theological aspects concern conceptual foundations of neomalthusian theory, pastoral attitudes in relation to responsible parenthood, and pastoral action regarding responsible parenthood. 2 articles on psychophysiological aspects discuss the couple and methods of fertility regulation and the gynecologist as an advisor on psychosexual problems of reproduction. Educational aspects are discussed in 3 articles on sexual pathology and education, education for responsible parenthood, and the Misereor-Carvajal Program of Family Action in Cali, Colombia. The conclusions are the result of an interdisciplinary effort to synthesize the major points of discussion and agreements on principles and actions arrived at in each of the 4 areas.
ECONOMIC AND POLITICAL WEEKLY. 1986 Apr 12; 21(15):670-2.Central to the position taken in "Case for Injectable Contraceptive," made by the World Health Organization (WHO), the International Planned Parenthood Federation (IPPF), by the Medical Association of Britain, Sweden, and other European countries, and by major research establishments, including the Johns Hopkins University, are 2 points: no contraceptive is perfect, but experience and research strongly indicate that the injectable is more effective than most means of contraception and safer than the oral contraceptive (OC); and compared with other contraceptives, the injectable can be more easily managed in a family planning program and in one's personal life. Das and Sarkar argued these points, supporting the position against the injectable contraceptive taken by Padma Prakash in "Retreat on Depo-provera?" Das and Sarkar challenged the use of the contraceptive and raised basic questions about the validity of family planning programs generally and the integrity of the Indian programs specifically. In regard to their statements on family planning programs, there is some uncertainty as to the meaning of much of what they write. In this writer's view, there needs to be differentiation between a family planning program and a population program. The former focuses on the family and planning the number and timing of children born to a couple. A population program sets as its goal the control of the population growth rate. More importantly, their arguments return to the questions about the injectable contraceptive. Das and Sarkar raise questions about its safety and its convenience. The WHO report "Facts about Injectable Contraceptives" supports the view of the Indian Council of Medical Research (ICMR) that the injectable has no life-threatening side effects. Years of research on medroxy-progesterone (DMPA) and norethindrone enanthate (NET-EN) have shown fewer, not more, health problems than with other types of hormonal contraceptives. Das and Sarkar maintain that providing the injectable to women is an inconvenient and complicated procedure. They base their claim on the ICMR Research Protocol which describes the actions to be taken by medical staff and recipients when research is to be conducted on the injectable contraceptive. The use of this document is puzzling, because the ICMR document is a set of directions for conducting research. The complicated procedures are those needed to obtain detailed data for statistical analysis. It is a research guide and not, as Das and Sarkar imply, a set of instructions for implementing a social service program. THe implementation of a family planning service program offering the injectable contraceptive would follow the steps recommended in the WHO publication "Injectable Contraceptives: Technical and Safety Aspects."
GOVERNANCE. HARVARD JOURNAL OF PUBLIC POLICY. 1987 Winter-Spring; 9-14.The future of international population assistance is threatened by the emergence of a New Right coalition composed of conservative Republicans, Protestant fundamentalists, elements of the Catholic Church, and other right-to-life advocates. This coalition has advanced 3 main arguments against population assistance: 1) rapid population growth in developing countries does not hinder social and economic development; 2) contributing to population assistance links the US with the promotion of abortion and threatens traditional family values; and 3) population assistance facilitates coercion in family planning programs in developing countries. As a result of the coalition's efforts, the US has suspended contributions to the International Planned Parenthood Federation (IPPF) and the United Nations Fund for Population Activities (UNFPA). In addition, the US Agency for International Development (AID) is under pressure to define the preferred content and clientele of its services in accordance with the views of the New Right. As the US Government reduces population assistance, it will lose opportunities to debate population issues with other donors. Moreover, in the absence of strong US support for multilateral programs, other donors may become uncertain about their commitments. Although the Reagan Administration is unlikely to change its position, advocates of a strong international population policy may be able to protect programs from further erosion. They can remind policy makers that reducing birth rates in developing countries will yield significant social benefits; they can support efforts to integrate family planning with other health and development programs. Finally, the resources of agencies such as IPPF and UNFPA can be augmented by support to affiliated agencies or specific projects.
Politics and population. U.S. assistance for international population programs in the Reagan Administration.
[Unpublished] .  p.US support for family planning programs in developing nations has become more and more controversial as the existing consensus on the rationale for these programs has been lost. This article discusses the major issues of the current debate on international family planning assistance and some of the reasons why bipartisan support for the program has eroded in recent years. During the 1960s, 2 factors contributed to the advent of the international family planning movement: the development of modern contraceptive technology in the form of the oral contraceptive (OC) and the IUD, technologies which, it was believed, could be made readily available and used easily, even in the poorest developing countries; and the growing realization that as mortality rates were declining rapidly due to improved health care in developing countries, the rate of population growth was increasing at a pace never before achieved. After some initial reluctance, efforts to stabilize population growth rates came to be accepted as in the US national interest, and by the 1970s both Republican and Democratic administrations and bipartisan congressional coalitions supported regular increases in funding for population programs as part of the foreign aid program. The US, together with several European countries, was instrumental in the development and early support for the UN Fund for Population Activities and the nongovernmental International Planned Parenthood Federation. In general, US support for international population programs was not a controversial issue in foreign aid debates until last year. Since President Reagan took office in January 1981, both the advocates and opponents of population programs have become more active and organized. Foreign aid in general and international family planning programs in particular are a favorite target for conservative groups, which include several antiabortion groups. Consequently, early in the Reagan administration efforts were made to slash the foreign aid budget. These efforts went so far as to propose eliminating all funding for international family planning programs. These efforts failed, and the US maintained its position as preeminent donor for family planning until 1984. In its final version, the US policy paper for the 1984 Mexico City Conference made 2 important revisions regarding US international population policy: the explanation of population growth as a "neutral phenomenon," caused by counterproductive, statist economic policies in poor countries, for which the suggested remedy is free market economic reform; and the assertion that the US does not consider abortion an acceptable element of family planning programs and will not contribute to nongovernmental organizations that perform or actively promote abortion as a family planning method in other nations. How this controversy over US International population policy is resolved depends largely on how Congress defines the issue.
Socio-economic development and fertility decline in Costa Rica. Background paper prepared for the project on socio-economic development and fertility decline.
New York, New York, United Nations, 1985. 118 p. (ST/ESA/SER.R/55)This summary of information on the development process in Costa Rica and its relation to fertility from 1950-70 is a revision of a study prepared for the Workshop on Socioeconomic Development and Fertility Decline held in Costa Rica in April 1982 as part of a UN comparative study of 5 developing countries. The report contains chapters on background information on fertility and the family, historical facts, and political organization of Costa Rica; the development strategy and its consequences vis a vis the composition of the gross domestic product, balance of trade, investment trends, the structure of the labor force, educational levels, and income; the allocation of public resources in public employment, public investment, credit, public expenditures, and the impact of resource allocation policies; changes in land tenure patterns; cultural factors affecting fertility, including education, women and their family roles, behavior in the home, women and politics, work and social security, and race and religion; changes in demographic variables, including nuptiality patterns, marital fertility, and natural fertility and birth control; characteristics and determining factors of the decline in fertility, including levels and trends, decline by age group, decline in terms of birth order, differences among population groups, how fertility declined, and history and role of family planning programs; and a discussion of the modernization process in Costa Rica and the relationship between demographic and socioeconomic variables. Beginning with the 1948 civil war, Costa Rica underwent drastic changes which were still reflected in national life as late as 1970. The industrial sector and the government bureaucracy have become decisive forces in development and the government has become the major employer. The state plays a key role in economic life, and state participation is a determining factor in extending medical and educational resources in the social field. The economically active population declined from 64% in 1960 to 55% in 1975 due to urbanization and migration from rural to urban areas, but there was an increase in economic participation of women, especially in urban areas. Increased educational level of the population in general and women in particular created changes in traditional attitudes and behavior. Although there is no specific explanation of why Costa Rica's fertility decline occurred, some observations about its determining factors and mechanisms can be made: the considerable economic development of the 1950s and 1960s brought about a rapid rise in per capita income and changes in the structure of production as well as substantial social development, increased opportunities for self-improvement for some social groups, and a rise in expectations. The size of the family became an aspect of conflict between rising expectations and increasing expenses. The National Family Planning Program helped accelerate the fertility decline.
London, England, Bodley Head, 1984. 286 p.This biography of the British family planning pioneer Helena Wright, who lived from 1887-1981, is based on her books, letters, and papers and on a series of personal interviews, as well as on the recollections and writings of her friends, colleagues, and critics. Considerable attention was given to her background and early life because of their strong influence on her later works and attitudes. Wright was the only physician among the small group of women who founded the British Family Planning Association, and was a founder and officeholder of the International Planned Parenthood Federation. She helped gain acceptance of the principle of contraception from the Anglican clergy and the medical establishment, and was an early worker in the field of sex education and sex therapy. Among Wright's books were works on sexual function in marriage, sex education for young people, contraceptive methods for lay persons and for medical practitioners, and sexual behavior and social mores. This biography also contains extensive material on the history of contraception and of the birth control movement, including the development of the British Family Planning Association and the International Planned Parenthood Federation, as well as important early figures in the movement.
[Needs of youth in family planning: the problem in Latin America. A equivocal policy: putting the cart before the horse] Necesidades de los jovenes en planificacion familiar: el problema en America Latina. Una politica equivocada: poner la carreta delante de los bueyes.
[Unpublished] May 1983. Presented at the Meeting of the Regional Council of the FIPF-RHO, Mexico City, May 14, 1983. 9 p.The increasingly young ages at which sexual activity begins and the rising rates of adolescent pregnancy with its severe physical, social, and economic problems are by now well known in Latin America. The explanation of the problem and the near impossibility of resolving it stem from the social unacceptability of contraceptive use by adolescents, a factor which foredooms to failure most programs to curb adolescent pregnancy. The unacceptability of contraceptive use by adolescents should, therefore, be defined as the problem and struggled against. The lack of acceptability of contraceptive use is the practical expression of a repressive ideology which condones sexual discrimination against women. Latin American society, which has always validated recreational sex for males of any age and is recently permitting recreational sex for adult women, roundly refuses to permit it for young women. Such a double standard shows how far discrimination against women has survived, despite all the rhetoric about equality of rights and opportunities. Young women will not use contraception until their social and cultural surroundings validate contraceptive usage. The required policy for dealing with adolescent pregnancy will move from recognizing the fact of early sexual experience, to acceptance of the fact, to social validation of the fact. Only when the undeniable and unchangeable fact of early sexual experience is recognized, accepted, and socially validated will contraceptive programs for adolescents become viable. The task of the International Planned Parenthood Federation should be to do everything possible to promote this decisive ideological change from repression of sexuality in young women to validation of it. The priority of programs to prevent adolescent pregnancy is part of a larger priority: that of struggling on all fronts for an effective liberation of women, questioning of traditional roles and achieving for women the same status and personal dignity enjoyed by males in their sexual and procreative lives.