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  1. 1
    046689

    A perspective on controlling vaccine-preventable diseases among children in Liberia.

    Weeks RM

    INFECTION CONTROL. 1984 Nov; 5(11):538-41.

    In 1978 the Ministry of Health and Social Welfare (MHSW) of Liberia launched the Expanded Program on Immunization (EPI) with the 5-year objective of establishing an 80% reduction in child mortality and morbidity from measles, polio, diphtheria, neonatal tetanus, pertussis, and tuberculosis. The program at first adopted a strategy of using 15 mobile units in 11 operational zones to deliver vaccinations throughout the country. However, by 1980, despite support from the Baptist World Alliance, the UN International Children's Emergency Fund (UNICEF), and the World Health Organization (WHO), it became evident that the mobile strategy was neither economically feasible nor practical. Therefore, with support from the US Agency for International Development (USAID), the EPI shifted to a strategy of integrating immunization activities into the existing network of state health facilities. After 5 years, in 1982, the Program was evaluated by a team from the MHSW, WHO, USAID, and the Centers for Disease Control. The evaluating team felt that the EPI's strategy was good, but its goals were not being achieved due to deficiencies in funding, clinic supervision, and rural community outreach, as well as shortages of kerosene and spare parts needs to keep the essential refrigerators in operating condition. Measles remains endemic; in the capital, Monrovia, only 9% of the children have been vaccinated against it. Immunization coverage is particularly low in the capital the countries. Other reasons for low vaccination coverage in Liberia are lack of community awareness of existing facilities and the importance of vaccination and lack of coordination at the community level to use the existing facilities efficiently. International assistance is still needed, especially to develop heat-stable vaccines, so that maintenance of refrigerators will not be necessary.
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  2. 2
    040875

    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    [Unpublished] 1984. 15 p.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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  3. 3
    038176

    Growing up in a changing world. Part two: youth organizations and family life education: ideas into action.

    Fordham J

    London, England, International Planned Parenthood Federation, Programme Development Dept., 1985. 107 p.

    This publication, Part 2 of "Growing up in a Changing World," was produced by the International Planned Parenthood Federation at the request of the Informal Working Group on Family Life Education. It provides practical guidelines for organizations that want to incorporate family life education into their program. Whereas Part 1 focused on the concept of family life education, Part 2 provides concrete material on training and project activities. A basic training program for youth leaders should include specific content areas in family life education and the use of participatory learning methods so leaders can organize educational activities for other young people in the community. The training should cover the communication process and give youth leaders practice in organizing group discussions. Project planning, management, and evaluation are also important aspects of leadership training. The activities suggested in this publication are all participatory in approach and based on the belief that people learn best through activities in which their own knowledge and experience are valued. The descriptions of activities include the following components: introduction, objectives, materials, time, preparation, and procedure. Of importance is assessment of the suitability of these sample activities for use with specific groups of young people. In considering suitability, 3 factors should be kept in mind: 1) there may be opposition by parents or religious leaders to subjects concerned with sex education and family planning, and ways should be sought to overcome this resistance; 2) activities must be appropriate to the learning abilities, characteristics, and circumstances of the target population; and 3) speical care is needed when developing or adapting activities for use with young people who are illiterate.
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