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  1. 1

    Status of family planning activities and involvement of international agencies in the Caribbean region [chart].

    Pan American Health Organization

    [Unpublished] 1970. 1 p.

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  2. 2

    Haiti. Project paper. Family planning outreach.

    United States. Agency for International Development [USAID]. International Development Cooperation Agency

    [Unpublished] 1981 Aug 28. 222 p. (AID/LAC/P-085)

    The background, goals, projected activities and beneficiaries, financial requirements, and implementation plans for a Family Planning Outreach Project in Haiti are detailed. The project is intended to assist the Government of Haiti to establish a cost-effective national family planning program. Population growth continues to accelerate in Haiti, despite high infant and child mortality, significant emigration, and declining fertility. The government does not have an articulated population policy. Although family planning and maternal and child health services have been in existence since 1971, there is no effective access to these services. This project is viewed as a means of achieving a substantial and sustained reduction in family size and improving health status. It is also a means of strengthening the Haitian family so it can participate more directly in the national development process. The purpose of the project will be accomplished through the following activities: 1) improvement of the organization and management of the national family planning program; 2) improvement of the quality and quantity of maternal and child health and family planning services; 3) expansion of the participation of private and voluntary organizations, other governmental, and local community groups in service provision; 4) increase in the availability of contraceptives at reasonable prices through rural and urban commercial channels; and 5) formulation of appropriate population and family planning policies. By the end of the project, all government health facilities and 75% of private facilities will actively counsel and provide family planning services; integrated models of community health and family planning services will have been developed to serve 60% of the population; basic drugs and contraceptives will be available at reasonable subsidized prices throughout the country; and 25% of women ages 15-45 at risk of pregnancy will be continuing users of effective contraceptive methods. The project will be implemented by the existing infrastructure of private and public organizations, primarily by the Department of Public Health and Population and its Division of Family Hygiene. The US Agency for International Development (USAID) is providing US$9.615 million (54%) toward the estimated US$17.980 million cost of the 5-year project. An additional US$6.555 million (36%) will be provided by the Government of Haiti.
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  3. 3

    Bilateral population assistance.

    Harrington J

    In: Population policies and programmes. Proceedings of the United Nations Expert Group Meeting on Population Policies and Programmes, Cairo, Egypt, 12-16 April 1992. New York, New York, United Nations, 1993. 165-80. (ST/ESA/SER.R/128)

    The International Forum on Population held at Amsterdam in 1989 called for a doubling of support to the population sector by the year 2000, which was endorsed by a United National General Assembly resolution in 1989 and by a meeting of the Development Assistance Committee of OECD in June 1990. In 1992 the United States provided 56.4% of all population funding and 78.3% of all bilateral funds. By 1990, the percentage had dropped to 42.1%. Donors other than the United States have delivered their bilateral assistance through 1) multilateral-bilateral arrangements channeling bilateral funds through United Nations bodies; 2) international nongovernmental organizations, such as the International Statistical Institute (ISI); 3) regional institutions such as CELADE in the Economic Commission for Latin America and the Caribbean (ECLAC), the International Centre for Diarrhoeal Disease Research, Bangladesh, and the University of the West Indies; 4) local nongovernmental organizations; 5) national nongovernmental organizations, such as the Danish Red Cross or the World University Service (Canada), the World Bank, or the Asian Development Bank. As of 1989/90 only a few countries had many bilateral donors: Bangladesh, 10; Kenya, 9; Tanzania and Zimbabwe, 5 each; while 4 others had 4 donors and 8 had 3 donors. A total of 59 countries are receiving bilateral assistance. The recently proposed Priority Country Strategy of the United States would focus bilateral population funding on 17 countries, while phasing down the others. To maintain current levels of contraceptive prevalence, donor funding will have to double by the year 2000. So far, Germany, the Netherlands, and the United Kingdom have committed themselves publicly. There will be further pressure to reduce population growth rates in developing countries, as they are the root causes of international migration. In the past 25 years most countries have established population policies which they are implementing. All developed countries have a responsibility to assist with population programs.
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  4. 4

    Final report: First Caribbean Health-Communication Roundtable, St. Philip, Barbados, 16-18 November 1987.

    Pan American Health Organization [PAHO]; Caribbean Community [CARICOM]

    [Unpublished] 1987. [4], 30, [49] p.

    To create a mechanism from which to mobilize communications media as a force for health in the Caribbean, the 1st Caribbean Health Communication Roundtable was held in 1987. Organized and initiated by the Pan American Health Organization (PAHO) and cosponsored by UNESCO and the Caribbean Community (CARICOM), the summary of the objectives discussed at the roundtable are presented in this report. Objectives include sensitizing the media to the health concerns of AIDS, disaster preparedness, nutrition and chronic diseases, and the examination of different types of health communication methodologies. Roundtable participants drafted a series of recommendations for submission to all relevant national, regional, and international agencies. 6 major recommendations covered various aspects of health communication. Workshops at the national and sub-regional level to train media and communications specialists were a suggested means of improving information techniques for health educators. Improvements in coordination and cooperation between Ministries of Health and Ministries of Information, requested by CARICOM, was recommended to strengthen health communication. The addition of an information specialist to the staff of the PAHO office was recommended, as well as the promotion of alternative communication methods and practices. Establishing a regional center for the identification, collection, cataloging, and dissemination of communication ideas, experiences and other resources was another major recommendation. In addition, evaluation of regional communication projects was suggested. Pre- and post-Roundtable questionnaires are reproduced in the Appendices, as are the program schedule, rationale, and list of participants.
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  5. 5

    Fellowship evaluation--by whom?

    Strombom M

    WORLD HEALTH FORUM. 1989; 10(3-4):397-402.

    Persons who line in developing countries are awarded fellowships for study abroad. They are given by many donors, the UN and the World Health Organization among them. It is important to know whether the money is used effectively. Many donor agencies have done evaluations, but difficulties arise. The recipient governments should evaluate the fellowships. The current selection process may be politicized, and fellowships are not officially advertised. There may also be irregularities in employing the returned fellows. It is hard to see what changes could be brought about by a donor's evaluation that hinted at a country's misuse of fellowships. Recipient countries have the right to run their own affairs. However, they should understand the advantages and responsibilities of this. Many donor's evaluations are not of much worth to recipients. Some criteria used by donors are not meaningful to recipients. There may be conflicting opinions about needs and technologies. Attempts may be made to get fellows from third world countries even if the courses are not terribly suitable. The influences that the fellows may be exposed to are very important. Many governments provide awards to their citizens for overseas training. It would be very useful for countries to analyze all fellowship activity. This could give information about overlapping. In Lesotho, too much emphasis was put on rural development. Recipient countries are in a better position to find former fellows. Donor studies tend to be bureaucratized, evaluated from habit rather than need. Occasionally reports have not come to the attention of authorities, which does no one any good. Oversimplified attempts may take place. Research should be adapted to standard methods. If recipient countries do not have the experience required to evaluate fellowships, it could be done jointly by donors and recipients.
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  6. 6

    Annual report of the Director 1987.

    Pan American Health Organization [PAHO]

    Washington, D.C., PAHO, 1988 Jul. v, 117 p. (Official Document No. 221)

    The global economy continued to adversely affect member countries' health programs and activities in 1987. For example, Latin American and Caribbean countries lost >$US28 billion in 1987 and from 1982-1987 they lost $US130 billion. At the same time, the percentage of adolescents and elderly in the total population increased tremendously, the numbers of people experiencing chronic and disabling diseases also increased while infectious and parasitic diseases still posed challenges for the health community, and the number of urban poor continued to grow. In 1987, to help member countries deal with the everchanging health needs of their populations, PAHO focused on population groups and geographic regions and within these defined areas concentrated on specific diseases. For example, PAHO worked with member governments to formulate, implement, and evaluate policies and programs on the health of adults. Specifically, diseases and conditions emphasized in adult health included cardiovascular diseases, cancer, diabetes mellitus, accident prevention, and the prevention, treatment, and rehabilitation of alcoholism and drug abuse. Other emphases were maternal and child health and family planning and those diseases and conditions associated with the population. Additionally, PAHO continued with special programs and initiatives to maximize its role as a catalyst and to mobilize national and international resources in support of activities aimed at selected health priorities. Some of these initiatives included the Expanded Program on Immunization, the Emergency Preparedness and Disaster Relief Coordination, and the Caribbean Cooperation in Health. In addition, each country's PAHO activities have been summarized.
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  7. 7

    Guide to sources of international population assistance 1988, fifth edition.

    United Nations Population Fund [UNFPA]

    New York, New York, United Nations Population Fund, 1988. xi, 477 p. (Population Programmes and Projects Vol. 1.)

    This is the 5th edition of the GUIDE to be published. A new edition is issued every 3 years. The GUIDE was mandated by the World Population Plan of Action, adopted by consensus at the World Population Conference held in Bucharest, Romania, in August 1974. Each entry for an organization describes its mandates, fields of special interest, program areas in which assistance is provided, types of support activities which can be provided, restrictions on types of assistance, channels of assistance, how to apply for assistance, monitoring and evaluation of programs, reporting requirements, and address, of organization. International population assistance is broadly construed as 1) direct financial grants or loans to governments or national and non-governmental organizations within developing countries; 2) indirect grants for commodities, equipment, or vehicles; and 3) technical assistance training programs, expert and advisory services, and information programs. To gather information for this edition of the GUIDE, a questionnaire was sent to more than 350 multilateral, regional, bilateral, non-governmental, university, research agencies, organizations, and institutions throughout the world.
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  8. 8

    Evaluation of the Resources for Awareness of Population in Development (RAPID II) Project.

    McGreevey WP; Bergman E; Godwin K; Sanderson W

    [Unpublished] 1986 Aug. 71, [45] p. (AID Contract No. DPE-3024-C-00-4063-00)

    The evaluation of the Resources for Awareness of Population in Development (RAPID II) Project was initiated on June 18, 1985, 25 months into the project operation, to determine if the results of actions undertaken thus far have been adequate to justify the time and money spent on them and to find ways to improve the efficiency and effectiveness of the program efforts. The objective of the 5-year RAPIDS II project is to assist those involved in development planning to better understand the relationship between population growth and socioeconomic development and thereby increase the less developed country (LDC) commitment to efforts designed to reduce rapid rates of population increase. This evaluation report discusses the development assistance context and then focuses on the following: RAPID II operations over the 1984-85 period; policy analyses and LDC subcontracting; the RAPID model and its presentation; visits by the evaluation team to the countries of the Dominican Republic, Ecuador, Cameroon, and Liberia; what works in terms of population policy development; some major problems and potential resolutions; and RAPID II activities over the 1985-88 period. US Agency for International Development (USAID) officials in Washington as well as in the field described RAPID II as being of continuing utility in helping to create a climate favorable to more effective population policies. The review of RAPID II activities was generally positive. The project was identified as useful in several countries of sub-Saharan Africa and Latin America. Due to the evidence of satisfactory performance in the field, the evaluation focused on differences between plan and midterm results with a view toward suggesting course corrections that can improve project performance. As population policy development is an inherently ambiguous field of activity, it has not been possible to draw clear lines between specific policy development activities and policy change in particular countries. Yet, there has been an improvement in the environment for population programs in LDCs. There were significant differences between planned and actual expenditures under the several subcategories of project expenditure. RAPID II total expenditures in the first 2 years of the project equalled budgeted expenditures when the contract was signed, but the distribution of expenditures by category was substantially different from what had been anticipated. It is recommended that emphasis in the project must shift predominantly to policy analyses (80% of remaining funds) and that that RAPID-style presentation resources (20%) be used carefully for only the highest priority requests. In regard to development of LDC subcontracts for policy analysis, efficiency has been low.
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  9. 9

    [Vaccination, the right of each child, World Day of Health 1987] Vacunacion: derecho de cada nino, Dia Mundial de la Salud 1987.

    Guerra de Macedo C; Mahler HT


    In the 10 years since the Panamerican Health Organization (PAHO) and the World Health Organization initiated the Extended Immunization Program in the Americas (PAI), coverage has increased from less than 1/3 to over 1/2 of children immunized in their first year against 6 major childhood diseases. Due mainly to the PAI, the incidence of measles, tetanus, and diptheria has been reduced by 1/2, that of whooping cough by 75%, and that of tuberculosis by about 5% annually. About 75% of children are immunized against polio, which has 1/10 as many victims today as 10 years ago. PAHO and several other organizations have targeted 1990 for eradication of polio from the South American continent. Since the PAI was established in 1977, more than 15,000 health workers have been trained, cold chains have been established to preserve vaccines, and more than 250 technicians have been trained to maintain and repair the needed equipment. The cost of the campaign to eradicate polio is estimated at US $ 24 million per year for the entire region--a low total compared to the costs of hospitalization and rehabilitation of the victims in the absence of such a program. The goal of immunizing all the world's children by 1990 proposed by the World Health Assembly in 1977 is achievable, but much remains to be done. The number of children immunized in the largest Third World countries ranges from 20-90% owing in part to national immunization days but also to assumption by local communities of the goal of universal immunization by 1990. All deaths produced by these 6 killer diseases are not registered, but the World Health Organization estimates that measles takes 2.1 million lives annually, neonatal tetanus 800,000, and whooping cough 600,000. Governmental and nongovernmental international organizations have made financial help available to countries needing it for their immunization programs. Most developing countries are expected to achieve the goal of universal immunization by 1990, but the 10 poorst countries of Africa and the Eastern Mediterranean may not be able to do so. At the worldwide level, 41% of the 118 million children who survive their first year have been vaccinated against measles and 46% against tuberculosis. 47% have received the full course of vaccine against diptheria, whooping cough, tetanus, and polio. The cost of these immunization is $5-15 per child and 80% is assumed by local countries. The World Health Organization recommends that all children, even the undernourished or slightly ill, be vaccinated, and that all health services vaccinate. Parents should be urged to return for the 2nd and 3rd doses of polio and DPT vaccines. Vaccination programs should pay more attention to impoverished urban populations. Several countries of the region have added innovations such as vaccination against other illnesses, house to house searches for unvaccinated children, or use of mass media to publicize national vaccination programs.
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  10. 10

    The challenges ahead.

    Guerra de Macedo C

    WORLD HEALTH. 1987 Oct; 26-9.

    In the next 13 years, health services must be created that will double present coverage. Preparations must be made for a population in which the proportion of elderly persons is increasing each year, and which is becoming increasingly urbanized, both geographically and culturally. The approval in 1986 by the Pan American Sanitary Conference--the highest policy organization of the Pan American Health Organization/World Health Organization (PAHO/WHO) in the Western Hemisphere--of program priorities for the 1987-1990 quadrennium has provided the tools to confront these challenges in a systematic and pragmatic way. This political decision established the quadrennial frame of reference for the Organization's cooperation in transforming health systems, with its activities now underway in 3 related areas of priority: the development of the health infrastructure, with emphasis on primary health care; specific programs for priority health problems among the most vulnerable groups; and the information management needed to carry out these programs. By targeting these 3 areas, the member countries have given the Organization a mandate to move effectively against the potential catastrophe of 300 million people lacking health services by century's end. This is a regional approach, developed on the basis of the particular socioeconomic and health conditions of the Western Hemisphere. But it is also an approach fitting perfectly within the principles which the Member States of the WHO accepted when they approved in 1977 the universal call for Health for All by the Year 2000.
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  11. 11

    Health services for all.

    Osuna J

    WORLD HEALTH. 1987 Oct; 23-5.

    The World Health Assembly of 1977 determined that all member governments should have as their primary goal--to achieve by the year 2000--a level of health that would allow their citizens to enjoy an economically and socially productive life. The goal is now known as "Health for All by the Year 2000" (HFA/2000). Problems directly related to health, grouped under personal health services, can be differentiated from infrastructure development, including methods and proceedures to improve health. The former encompasses maternal and child health, nutrition, treating infectious and chronic diseases, and environmental factors. The latter covers human, technical, and auxiliary resources, administration, planning, evaluation, information, legislation and regulation, basic and applied research, and financing. Almost all Latin American and Carribean countries are looking at 3 main strategies. The 1st is finding new ways to interconnect health sector institutions and to mesh goals and operations of institutions with overall policy and national objectives. Here, health ministries take on the broad task of guiding, leading, and mobilizing national and international resources and analyzing progress. 2nd, all the countries have tried hard to offer better alternatives for service financing for better and fuller health coverage, including equitable access by all people to the care level required by each case, and to eliminate unnecessary proceedures that raise costs without helping to solve real health problems. A 3rd route is implementing efficacious methods of planning, administration, and health service evaluation.
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  12. 12

    Health as a bridge for peace.

    Schneider ML

    WORLD HEALTH. 1987 Oct; 4-6.

    3 years ago, the Central American countries of Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama began a subregional initiative with PAHO/AMRO named "Health as a Bridge to Peace." Formally called "Priority Health Needs in Central America and Panama," this initiative has included: 1) A temporary cease-fire in El Salvador each year between government and guerrillas, permitting a 3-day nationwide immunization campaign throughout the country; 2) Belize's inclusion for the 1st time in an annual meeting of the Ministers of Health in Central America and Panama. The directors of the Social Security Institutions also participated. Although recent conflicts had strained international dialog, the initiative spurred cooperation between all countries of the region, including formal agreement between the Ministers of Health of Honduras and Nicaragua to conduct joint border monitoring to prevent the spread of malaria and other tropical diseases, mutual spraying in malaria endemic areas by Nicaragua and Costa Rica, and training and technical cooperation exchanges between the countries and their neighbors. Last year, in the 1st joint purchase from a revolving fund for essential drugs, the countries obtained some 17 drugs more than 300% cheaper than each had purchased them seperately the previous year. Priorities of the initiative are health services, human resources, essential drugs, food and nutrition, tropical diseases, and child survival. It concentrates on mothers and on children under 5, on refugees and displaced persons, and on the urban and rural poor.
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  13. 13

    Annual report of the director, 1986.

    Guerra de Macedo C

    Washington, D.C., Pan American Health Organization [PAHO], 1987. v, 105 p. (Official Document No. 215)

    During 1986, major factors in the delivery of PAHO technical cooperation have been both the ongoing economic crisis and the consequent deterioration of social conditions in many Latin American and Caribbean countries. PAHO has had to delineate its work to effectively support the countries' efforts to overcome the severe limitations imposed on them by these conditions, and so that greater gains can be made toward the goal of health for all by the year 2000. PAHO/WHO concentrated on mobilizing resources to address health priorities as determined by the member countries. This approach is critical to cooperation among the countries themselves. The XXII Pan American Sanitary Conference approved "Orientation and program priorities and PAHO during the quadrennium 1987-1990," a document setting the framework for PAHO's activities for a time that includes a new administrative period and the final period of WHO's 7th General Program of work.
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  14. 14

    Population funding: is it adequate?

    Nortman D

    International Family Planning Perspectives. 1987 Mar; 13(1):25-6.

    <2% of development aid for developing countries is designated for population assistance. The best information source regarding population funding is the UN Fund for Population Activities. 1981 estimates place the total figure at US $400 million annually, distributed by a combination of multilateral agencies (49%) bilateral aid from developed country donors to developing country governments (29%) and nongovernmental organizations (NGOs, 22%). 84% of the NGO funds also originated from developed country governments. Preliminary estimates for 1985 place the developed country government contribution at US $466 million. The US provided 62% of this Japan 10% and Norway 5%. 8 countries accounted for 95% of the aid. Tabulated data showing individual countries' contributions relative to their gross domestic products (GDPs) indicate a different order of contributors: Norway and Sweden far outdistance the rest (Norway's contribution relative to its GDP is 5 times greater than that of the US). The US contribution relative to its GDP has declined since 1972, with a slight upturn in 1985. According to the World Bank, funding would have to be double what it is now to meet demand; achieving a total fertility rate of 3.3 children/woman by the year 2,000 would mean an outlay of US $5.6 billion. For fertility to fall rapidly, spending would have to be US $7.6 billion.
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  15. 15

    Family planning program funds: sources, levels, and trends.

    Nortman DL

    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.
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  16. 16

    Annual report of the director, 1984.

    Pan American Health Organization [PAHO]

    Washington, D.C., PAHO, Pan American Sanitary Bureau/Regional Office of the World Health Organization, 1985. xix, 265 p. (Official Document No. 201)

    Efforts to meet the goal of health for all by the year 2000 have been hampered by the internal and external problems faced by many countries of the Americas. The pressures of external debt have been accompanied by a reduction in the resources allocated to social sector programs, including health programs. In addition, the conflict in Central America has constrained solutions to subregional problems. The health sector suffers from uncoordinated services, lack of trained personnel, and waste. Thus 30-40% of the population do not have access to basic health services. In 1984, the governments in the region, together with the Pan American Health Organization (PAHO), undertook projects in 5 action areas: new approaches and technology, development, intra- and intersectoral linkages, joint activities by groups of countries, mobilization of national resources and external financing, and preparation of PAHO to meet the needs of these processes. New approaches include the expansion of epidemiological capabilities and practices, the use of low-cost infant survival strategies, the improvement of rural water supplies, and the development of domestic technology. Interorganizational linkages are aimed at eliminating duplication and filling in gaps. Ministers of health and directors of social security programs are working together to rationalize the health sector and extend coverage of services. Similarly, countries have grouped to deal with common problems and offer coordinated solutions. The mobilization of national resources involves shifting resources into the health field and increasing their efficiency and effectiveness by setting priorities. External resources are recommended if they supplement national efforts and are short-term in nature. In order to enhance these strategies, PAHO has increased the managerial and operating capacity of its central and field offices. This has required consolidating programs, retraining staff, and instituting information systems to monitor activities and budgets. The report summarizes health indicators and activities by country, for all nations under PAHO.
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  17. 17

    Breastfeeding: growth of exclusively breastfed infants.

    Huffman SL

    Mothers and Children. 1985 Nov-Dec; 5(1):5, 7.

    Currently standards from industrialized countries are used to assess the growth patterns of breastfed infants in developing countries. Infant growth faltering is interpreted as an indicator of insufficient lactational capacity on the mother's part. 2 recent articles suggest the need for a critical reappraisal of current growth standards and their use for evaluating the adequacy of infant feeding practices. The most commonly used standards to evaluate infant growth are derived from the US National Center for Health Statistics based on anthropometric data collected in the US population 3-month intervals up to the age of 3. During this period, infant feeding practices varied greatly. Many babies were bottle-fed and given supplemental feedings early in life. No large sample of exclusively breastfed infants has been studied from birth on, and thus a standard for breastfed infants is not available. A study of fully breastfed infants was done in England and suggests that there are differences in growth rates. Among a population of 48 exclusively breastfed boys and girls, for the 1st 3 to 4 months of life, growth of breastfed infants was greater than National Center for Health Statistics Standards, while after 4 months growth velocity decelerated more quickly than the standard. The growth of infants studied in Kenya, New Guinea and the Gambia appears to falter at 2-3 months of age using the NCHS standard. Findings suggest that current FAO/WHO recommended energy intakes may be excessive. Recent studies in the US support this assertion. The adequacy of the milk production for the infants in this US study done in Texas was illustrated by their growth rates. Length for age percentiles were higher than the NCHS standards throughout the study though at birth they did not differ significantly. 1 reason these breastfed infants were able to maintain growth despite less than recommended energy intakes is that the ratio of weight gain/100 calories of milk consumed was 10-30% higher among the breastfed infants compared to formula fed infants, suggesting a more efficient use of breastmilk than formula. There is a need for studies of exclusively breastfed infants with larger samples to determine what growth pattern should be considered the norm.
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  18. 18

    POPIN Working Group on Dissemination of Population Information: Report on the meeting held from 2 to 4 April 1984.

    United Nations. Department of International Economic and Social Affairs. Population Division. International Population Information Network [POPIN]

    Popin Bulletin. 1984 Dec; (6-7):69-79.

    The objectives of this meeting were: to analyze the general dissemination strategy and functions of POPIN member organizations and assess the methods currently employed to identify users; to select publications or other information output and evaluate how they are being distributed and how procedures for the selective dissemination of information are developed; to develop guidelines for determining the potential audience and reader's interests; to discuss the methodology for maintaining a register of readers' interest; to develop guidelines for establishing linds with key press and broadcasting agencies to ensure rapid dissemination of information; to dientify media and organizations currently involved in the dissemination of population information; to document experience and provide recommendations for the utilization of innovative approaches to serve audiences; and to explore ways and means to meet the special needs of policy makers. Problem areas in population information dissemination were identified at the meeting as well as priority areas in meeting speical information needs of policy makers. Collection of information for dissemination is difficult, costly and time-consuming; there is a shortage of staff trained in the repackaging and dissemination of population information; the direct use of the mass media for information dissemination is still very limited; and financial resources are limited. Priority areas include: compilation of a calendar of events or meetings; conducting media surveys and inventories of population infromation centers and their services and compilation of results; resource development through product marketing and preparation of resource catalogues; and preparation of executive summaries highlighting policy implications to facilitate policy making. Recommendations include: promotion of training and technical assistance in population information activities by the POPIN Coordinating Unit; encouraging member organizations with relevant data bases to develop subsets for distribution to other institutions and, where feasible, to provide technical assistance and support for their wider use; the POPIN Coordinating Unit should alert its members regularly of new technological facilities and innovations in the field of information; organizations conducting population information activities at the national and/or regional levels should be encouraged to provide the POPIN Coordinating Unit with yearly calendars of meetings for publication in the POPIN Bulletin; and the members of POPIN are urged to emphasize the need to incorporate specific plans and budgets for population information activities.
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  19. 19

    Guide to sources of international population assistance 1985 (Fourth Edition).

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, United Nations Fund for Population Activities, [1985]. xi, 428 p. (Population Programmes and Projects, v. 1.)

    The fourth edition of the guide to international population assistance lists multilateral, regional, bilateral, nongovernmental, university, research, and training agencies and organizations that offer financial or technical assistance to population programs in developing countries. The guide is organized by type of agency. Each agency listing includes a description of the mandate of the agency, its population activities, fields of special interest, program areas in which assistance is offered, types of support provided, restrictions, channels and procedures, how to apply for assistances, how programs are evaluated, reports required, and the agency's address. Appendices include a bibliography of current newsletters and journals and index.
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  20. 20

    FPIA: 1984-1986. A strategic plan.

    Planned Parenthood Federation of America [PPFA]. Family Planning International Assistance [FPIA]

    New York, New York, FPIA, 1984 Mar. [5], 113 p.

    Family Planning International Assistance (FPIA) initiated strategic planning in 1983, including mission statement, objectives, means, and tactics commonly used to reach the objectives and considerations for strategy development. This document contains background information, FPIA's rationale for developing a 3-year strategic plan, the plan's method, a strategic plan summary, and country plans for countries in the Caribbean, Central America, South America, Asia, and Africa. FPIA's rationale for developing a 3-year strategic plan is as follows: to address AID/W's ongoing need for a clear rationale for continued funding in a time of limited resources; to increase FPIA's capability to make decisions systematically; to organize efforts to carry out decisions and to measure decisions through systematic feedback; to increase FPIA's capability to monitor progress in reaching objectives; to increase FPIA's control over its environment; to continue to address 1981 evaluation findings; and to decrease time involved in plan preparation by planning over a longer time period. FPIA's tactic statements describe the basic approaches to be used in carrying out a predetermined strategy by: extending existing family planning services of government and nongovernment institutions to new geographic areas or to new populations; initiating family planning service in institutions not currently involved in service provision; providing parallel or complementary services; transferring management technology; training staff; working with resistant populations, adolescents, utilizing local resources; and supplying family planning commodities to projects and nonproject institutions. Once objectives were set, the regions were ready to write a strategy for each country. To facilitate writing the strategies, each region received the following series of strategic considerations: state of development of the family planning program in each country; government plans, AID, and USAID mission strategies; type of program FPIA, AID/W, and USAID currently is funding; and rationale for continued private voluntary organization/FPIA support to the country. The strategic plan summary (1984-86) includes FPIA's goals, policy, and philosophy and FPIA's mission, goals, and objectives.
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  21. 21
    Peer Reviewed

    Latin American health policy and additive reform: the case of Guatemala.

    Fiedler JL

    International Journal of Health Services. 1985; 15(2):275-99.

    Until the mid 1960s, Latin American health system reflected the skewed distribution of wealth in the region: most health resources were found in curative care medicine and were concentrated in the capital cities, where they primarily served the needs of the elite. For many countries, however, the 1964 Pan American Health Organization's (PAHO) efforts to introduce health planning, intended as a 1st step in rationalizing the health sector, marked a fundamental turning point in the structural development of their delivery systems. Guatemala, however, was and remains an exception. Its technocrats have proven unable to plan effectively; no single entity is responsible for health sector planning, and the 5-year plans have come to consist of disjointed mini-plans, each reflecting the aims, desires and goals of a particular vested interest group or institution. The Guatemalan oligarchy has proven unwilling to appropriate the resources necessary to effect change. The reforms that have been made have been the products of bilateral and multilateral agencies such as the InterAmerican Development Bank, USAID, UNICEF, Kreditanstaldt and PAHO, which have conceptualized, promoted, designed, built and underwritten them. Those changes have not altered the fundamental structure of the system, but instead have been tacked onto it, and exemplify what may be termed additive reform. The government of Guatemala's own commitment to these outside agency funded projects is reflected in the recurrent shortfall of current or operating funds, and in the rapid depreciation of facilities. Evidence suggests that without the continued sponsorship, support, and guidance of the bilateral and multilateral agencies, even these additive reforms will not last.
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  22. 22

    US is key player in Salvador's controversial birth control plan.

    Hedges C

    CHRISTIAN SCIENCE MONITOR. 1984 Jan 13; 78(34):8, 23.

    The US Agency for International Development (USAID) has played a key role in El Salvador's family planning program and has identified population control as among its main objectives in the country. In addition to helping to start the Salvadorean Health Ministry's Family Planning Coordination Office, USAID has provided over $4 million to the Salvadorean Demographic Association (ADS). These organizations distribute contraceptives nationwide and perform surgical sterilizations on women. USAID estimates that 25% of women of childbearing age in El Salvador are now using some form of contraception. However, the program has been criticized by many local physicians and health workers. It is argued that the US has ignored the really pressing health needs of the Salvadorean people and is attempting to limit the number of poor people. The most controversial aspect of the population program concerns the surgical sterilizations performed on 21,000 women each year. Relief workers have charged that food has been offered to women in displaced persons camps if they agree to be sterilized, and that some procedures are performed against the will of patients. ADS teams make home visits to explain the advantages of sterilization, and each field nurse is expected to sign up an average of 1 woman/day for the procedure. USAID officials have indicated they will conduct an investigation into the alleged abuses of sterilization. The agency has also initiated a US$25 million program in El Salvador intended to reduce shortages of pharmaceutical supplies and replace some medical equipment.
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  23. 23

    Socio-economic planning: legislative measures for improvement of the nutritional status of the mother/child dyad.

    Manciaux M; Pechevis M

    In: Hambraeus L, Sjolin S, eds. The mother/child dyad: nutritional aspects. Stockholm, Almqvist and Wiksell, 1979. 143-9. (Symposia of the Swedish Nutrition Foundation 15)

    Many legislative measures aimed at improving maternal and child nutrition were adopted by developed countries during the 20th century and some of these measures were also adopted by developing countries. These measures were reviewed and recent efforts by international, national, and institutional bodies to formulate policies to deal with nutritional problems were discussed. Measures adopted during the: 1900s with varying degrees of success included: 1) the introduction of nutritional programs into the school curriculum; 2) programs to reduce maternal nutritional deficiencies during the pregnancy; 3) measures to delay the age at marriage; 4) improvements in prenatal care; 5) hospital based programs to educate postpartum women in child nutrition; 6) programs aimed at promoting breastfeeding; 4) programs to provide low cost supplementary weaning foods; and 8) efforts to regulate the manufacture and sale of baby food products. At the international level various bodies have recommended the adoption of measures to improve working conditions for lactating and pregnant women and to reduce abusive marketing practices. At the national level, Algeria adopted policies aimed at promoting breastfeeding and improving nutritional standards through a variety of programs. China successfully promoted breastfeeding by adopting measures which make it easier for working women to breastfeed. France recently adopted policies aimed at regulating the sale of infant food products. In the future more efforts should be directed toward designing nutritional programs which take into account the needs of the local community and which provide nutritional services as an integral part of maternal and child health and community health services. Attention should also be directed toward improving the nutritional knowledge of the public and of the health professional.
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  24. 24

    Report of the Technical Work Group on the Participation of Organizations Related to Women in Primary Health Care Activities, 26-28 April, 1983, Washington, D.C., Volume I. Final report.

    Pan American Health Organization [PAHO]. Technical Work Group on the Participation of Organizations Related to Women in Primary Health Care Activities

    Washington, D.C., Pan American Health Organization, 1983. 30 p.

    Women from Colombia, Honduras, and Peru met with Pan American Health Organization (PAHO) advisors April 26-28, 1983, to discuss how women's organizations can participate more effectively in primary health care. Specific objectives of the meeting were to define the current and potential roles of women as promoters and beneficiaries of primary care; to define ways women's groups can collaborate with ministries of health in the planning, implementation, and evaluation of primary health care services; and to determine how PAHO can facilitate such collaboration. The obstacles to women's fuller utilization of primary health care were noted. These barriers include a lack of information on health problems and availability of services, cultural beliefs, real or perceived negative attitudes of health care providers, and the fragmentation of services. Other areas of discussion concerned the need to raise women's awareness of their responsibilities and rights as individuals, employment of women in key positions within the Ministry of Health, enhancement of women's influence on the health care system, and the lack of interagency coordination. As a hypothetical exercise, conference participants from each country drafted proposals for specific primary health care projects involving women. The Honduran and Peruvian projects, based on real experiences, concerned local construction of latrines and cancer screening, respectively. The Colombian project was aimed at sex and self-awareness education for teenage girls. Recommendations emerging from the meeting focused on 4 broad areas: 1) increasing awareness and concern for women's health issues among health personnel and policy makers, 2) establishing improved communication and coordination between the Ministry of Health and women's groups, 3) improving women's health care to more effectively meet women's needs, and 4) increasing the influence of women's groups on health activities. Specific tasks outlined for PAHO include the development and dissemination of educational materials, funding of research on women's health, technical assistance, definition of specific areas of primary health care (e.g., oral rehydration, breastfeeding, family planning, and immunization) in which women's groups are especially qualified to work effectively, and the promotion of communication about and coordination of health activities between the Ministry of Health and nongovernmental women's organizations.
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  25. 25

    Role of the pharmaceutical industry of the developing countries in research on fertility regulation.

    Anand N; Kamboj VP

    In: Diczfalusy E, Diczfalusy A, ed. Research on the regulation of human fertility: needs of developing countries and priorities for the future, Vol. 2. Background documents. Copenhagen, Denmark, Scriptor, 1983. 975-86.

    The pharmaceutical industry of the developing countries is at present not equipped for and unlikely to contribute much to the discovery and development of new fertility regulating agents, but could play an effective role in process development, and in the organization of clinical trials. In view of the crucial role of the pharmaceutical industry to bring the research effort on a new contraceptive to fruition, and because of the waning interest of the industries of the developed countries in this field, the pharmaceutical companies of the developing countries should be encouraged to get involved in research by special incentives from their national governments, such as tax exemption for investment made for inhouse research of for sponsored research. The subsidiaries of multinational corporations, which dominate the pharmaceutical industry in the developing world, must establish research centers in these countries with efforts focussed on local priority health problems, such as contraceptive development; such research conducted in some of the developing countries would be more cost effective. It would be necessary to establish government or public sector research institutes to supplement the research facilities of the private industries, particularly for animal toxicology studies; these institutions could even serve as regional centers, supported by international agencies, since some of the smaller countries may not be able to develop their own centers. The collaboration between industrial, academic and public secotr institutions should be encouraged and formalized to establish partnership in research on contraceptive development; the exact mode and form would depend upon the scientific and technical institutional structure and industrial development status of each country. (author's modified)
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