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International Family Planning Perspectives. 2008 Jun; 34(2):101-102.At the midpoint of the 15-year timetable for achieving the Millennium Development Goals, the majority of countries with high levels of maternal and child mortality are not on track to meet the targets for reductions in these outcomes by 2015, according to a recent analysis.1 Among the 68 countries that account for the vast majority of maternal and child deaths, only 16 are on track to reduce mortality among children younger than five to one-third of its 1990 level (Goal 4). Progress toward reducing maternal mortality by three-quarters (Goal 5) has been slow as well: In all 41 Sub-Saharan African countries included in the analysis, at least 300 maternal deaths occur per 100,000 live births. The research was conducted by Countdown to 2015, a collaboration of researchers, policymakers and other stakeholders that has been tracking progress toward the Millennium Development Goals in the 68 countries in which 97% of deaths among women of childbearing age and children younger than five occur. Researchers focused on determining coverage rates (the proportion of individuals in each country who need a service and are able to obtain it) for interventions that have been proven to avert maternal, newborn and child deaths, that can be widely implemented in resource-poor countries, and whose levels can be reliably estimated across countries and over time; these interventions include provision of contraceptive and STI services, skilled care during childbirth, and pre- and postnatal care. Most of the data were obtained through nationally representative household surveys. (excerpt)
MEASURE Evaluation Bulletin. 2001; (2):1-27.This issue of the MEASURE Evaluation Bulletin includes articles in a number of areas of monitoring and evaluation of AIDS programs. The first four articles are based on a field test of indicators on knowledge, sexual behavior and stigma that was carried out as part of a large international effort to improve monitoring and evaluation of national programs. The field test resulted in revisions of standard indicators for AIDS programs, which were eventually published by UNAIDS, and revisions of the survey tools that are now used to collect AIDS information in many countries. Three subsequent articles deal with different aspects of monitoring and evaluation. The first of these explores estimation of the size of core groups, such as commercial sex workers or bar workers, which is essential but difficult. Capture-recapture techniques can be used to make such estimates, although there are multiple pitfalls. The next article focuses on monitoring trends in HIV prevalence among young antenatal women, which is the most feasible method of monitoring HIV incidence. Modelling shows that using prevalence trends to extrapolate incidence trends has to be done very carefully, but can be done if one takes measures to minimize the various biases. The last article of the Bulletin discusses the use of newspaper clippings as a source of indicators on political will and commitment and stigma. Although newspaper clippings have been cited as an easily accessible source for these indicators, the analysis suggests that an analysis of newspaper clippings may be more suitable for a cross-sectional situation analysis or in-depth qualitative research than for monitoring purposes. (excerpt)
Putting young people into national poverty reduction strategies: a guide to statistics on young people in poverty.
New York, New York, United Nations Population Fund [UNFPA], . 35 p.Many national poverty reduction strategies overlook the needs of young people. Even where national strategies do have a youth focus, the analysis of their situation is limited because little or no reference is made to readily available data. For those advocating on behalf of young people in poverty, considerable scope exists to make use of simple but reputable statistics to mount a strong case for Governments and civil society to allocate more resources in addressing poverty among this major population group. The purpose of this guide is to show how relevant statistics on young people in poverty can be easily sourced for use in developing national poverty reduction strategies. The guide shows how to use accessible databases on the Internet to provide individual countries with sophisticated statistical profile of young people in poverty. (excerpt)
Bulletin of the World Health Organization. 2007 Oct; 85(10):734.posited that the process of development entails changes in incomes over time. Larger income levels achieved via positive economic growth, appropriately discounted for population growth, would constitute higher levels of development. As many have noted, however, the income measure fails to adequately reflect development in that per-capita income, in terms of its levels or changes to it, does not sufficiently correlate with measures of (human) development, such as life expectancy, child/infant mortality and literacy. The United Nations Development Programme's (UNDP) human development index (HDI) constitutes an improved measure for development. HDI has been modified to be gender-sensitive with variants that reflect gender inequality. Various measures reflecting Sen's "capability" concept, such as civil and political rights, have also been incorporated. Countries where the level of poverty is relatively large tend also to exhibit low values of human development, thus lowering the mean values of the development measures. Where inequalities of development indicators are very large, however, the average values may not sufficiently reflect the conditions of the poor, requiring the need to concentrate on poverty per se. (excerpt)
Investing in people - eliminating poverty - includes related articles on Preparatory Committee's progress report and social development - World Summit for Social Development.
UN Chronicle. 1994 Dec; 31(4): p..A fifth of the world's population live in absolute poverty, earning scarcely 2 per cent of the world's income. The ill-effects of this economic deprivation are often compounded by ethnic tensions and warfare, which can lead to the local displacement of people and large refugee movements. There are some 17 million refugees and 20 million displaced persons in the world today, deprived of home, health and education, their lives and livelihoods destroyed. These people add not to their nations' productivity but to their overall economic burdens. "In the worst of instances, the survival of an entire society or nation is threatened because the essentials of life are beyond the reach of its people", concluded participants in the 46th Annual DPI/NGO Conference. (excerpt)
Studies in Family Planning. 2005 Dec; 36(4):311-315.Women in many countries are often denied vital family planning services if they are not menstruating when they present at clinics, for fear that they might be pregnant. A simple checklist based on criteria approved by the World Health Organization has been developed to help providers rule out pregnancy among such clients, but its use is not yet widespread. Researchers in Guatemala, Mali, and Senegal conducted operations research to determine whether a simple, replicable introduction of this checklist improved access to contraceptive services by reducing the proportion of clients denied services. From 2001 to 2003, sociodemographic and service data were collected from 4,823 women from 16 clinics in three countries. In each clinic, data were collected prior to introduction of the checklist and again three to six weeks after the intervention. Among new family planning clients, denial of the desired method due to menstrual status decreased significantly from 16 percent to 2 percent in Guatemala and from 11 percent to 6 percent in Senegal. Multivariate analyses and bivariate analyses of changes within subgroups of nonmenstruating clients confirmed and reinforced these statistically significant findings. In Mali, denial rates were essentially unchanged, but they were low from the start. Where denial of services to nonmenstruating family planning clients was a problem, introduction of the pregnancy checklist significantly reduced denial rates. This simple, inexpensive job aid improves women's access to essential family planning services. (author's)
The level of effort in the national response to HIV / AIDS: the AIDS Program Effort Index (API), 2003 round.
Washington, D.C., USAID, 2003 Dec.  p.The success of HIV/AIDS programs can be affected by many factors, including political commitment, program effort, socio-cultural context, political systems, economic development, extent and duration of the epidemic , and resources available. Many programs track low-level inputs (e.g., training workshops conducted, condoms distributed) or outcomes (e.g., percentage of acts protected by condom use). Measures of program effort are generally confined to the existence or lack of major program elements (e.g., condom social marketing, counseling and testing). To assist countries in such evaluation efforts, several guides have been developed by the Joint United Nations Program on HIV/AIDS (UNAIDS), the World Health Organization (WHO), the United States Agency for International Development (USAID) and other organizations (see, for example, “Meeting the Behavioural Data Collection Needs of National HIV/AIDS and STD Programmes” and “National AIDS Programs: A Guide to Monitoring and Evaluation of HIV/AIDS Programs”). However, information about the policy environment, level of political support, and other contextual issues affecting the success and failure of national AIDS programs has not been addressed previously. (excerpt)
Indicators for monitoring the Millennium Development Goals: definitions, rationale, concepts and sources.
New York, New York, United Nations, 2003 Oct.  p.This handbook contains basic metadata on the agreed list of quantitative indicators for monitoring progress towards the 8 goals and 18 targets derived from the Millennium Declaration. The list of indicators, developed using several criteria, is not intended to be prescriptive but to take into account the country setting and the views of various stakeholders in preparing country-level reports. Five main criteria guided the selection of indicators. They should: Provide relevant and robust measures of progress towards the targets of the Millennium Development Goals. Be clear and straightforward to interpret and provide a basis for international comparison. Be broadly consistent with other global lists and avoid imposing an unnecessary burden on country teams, governments and other partners. Be based to the greatest extent possible on international standards, recommendations and best practices. Be constructed from well-established data sources, be quantifiable and be consistent to enable measurement over time. The handbook is designed to provide the United Nations country teams and national and international stakeholders with guidance on the definitions, rationale, concepts and sources of the data for the indicators that are being used to monitor the Millennium Development Goals. Just as the indicator list is dynamic and will necessarily evolve in response to changing national situations, so will the metadata change over time as concepts, definitions and methodologies change. (excerpt)
Measuring the level of effort in the national and international response to HIV / AIDS: The AIDS Programme Effort Index (API). Summary report.
Geneva, Switzerland, UNAIDS, . 24 p.UNAIDS, USAID and the POLICY Project have developed the AIDS Programme Effort Index (API) to measure programme effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that programme effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programmes scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programmes received relatively high rating in all categories except care. The results presented here will be supplemented later in 2001 with a new component on human rights. (excerpt)
Measuring the level of effort in the national and international response to HIV / AIDS: The AIDS Program Effort Index (API).
Geneva, Switzerland, UNAIDS, 2001 Feb. 31 p.UNAIDS, USAID and the POLICY Project have developed the AIDS Program Effort Index (API) to measure program effort in the response to the HIV/AIDS epidemic. The index is designed to provide a profile that describes national effort and the international contribution to that effort. The API was applied to 40 countries in 2000. The results show that program effort is relatively high in the areas of legal and regulatory environment, policy formulation and organizational structure. Political support was somewhat lower but increased the most from 1998. Monitoring and evaluation and prevention programs scored in the middle range, about 50 out of 100 possible points. The lowest rated components were resources and care. The API also measured the availability of key prevention and care services. Overall, essential services are available to about half of the people living in urban areas but to only about one-quarter of the entire population. International efforts to assist country programs received relatively high rating in all categories except care. The results presented here will be supplemented later this year with a new component on human rights and a score that compares countries on program effort. (excerpt)
AIDS. 1998; 12 Suppl 2:S57-65.The World Health Organization's Global Program on AIDS (WHO/GPA) has developed a protocol for conducting facility-based assessments of sexually transmitted disease (STD) case management strategies. The WHO/GPA methodology measures two composite prevention indicators (PIs): PI16--the proportion of patients presenting with STD symptoms who are diagnosed and treated appropriately, and PI17--the proportion who receive basic counseling about condoms and partner notification. The protocol calls for direct observation of provider-client interactions and provider interviews. This article reviews the research literature on the evaluation of STD case management in developing countries. Several studies adapted the WHO/GPA protocol for resource-poor settings and utilized techniques such as record review, patient encounter forms, patient exit interviews, and simulated patients and pharmacy shoppers. Overall, experience indicates that it is difficult to implement the protocol as intended in all field situations. Although nonstandardized alternative methods of data collection do not provide a composite PI16 score, they do generate rich data for monitoring the quality of STD case management and contribute to managerial and supervisory aspects of intervention programs. A widespread observation was that providers have the knowledge to provide better quality STD care than they do in actual practice.
In: Family planning. Meeting challenges: promoting choices. The proceedings of the IPPF Family Planning Congress, New Delhi, October 1992, edited by Pramilla Senanayake and Ronald L. Kleinman. Carnforth, England, Parthenon Publishing Group, 1993. 163-71.The costs of family planning programs was discussed by the International Planned Parenthood Federation in 1991-92 highlighting demand and resources. They proposed a strategy to review methodologies used by the World Bank, USAID, and UNFPA; and to develop cost analysis methodologies. Expenditures in 25 family planning associations (FPAs) worldwide were also reviewed in this presentation. The results showed that worldwide the average IPPF commodity grant represented only 5.7% of all grants and income. Most FPAs had personnel costs that were 30-50% of total expenditure, although Korea and Malaysia had personnel costs of about 60%. Lebanon, Indonesia, Nepal, Sri Lanka, and Mexico had lower personnel costs because they relied heavily on volunteer labor. The variation in average cost per couple year of protection (CYP) could be explained by the differences in programs in terms of clinic and nonclinic service delivery; information, education, and communication (IEC), and other development projects. Therefore, FPA expenditures by type consisted of these categories. The IEC category included males, youth, and women-in-development projects. Tanzania reported very low cost per CYP (less than $5), but a very high cost per visit (more than $14) because a large proportion of its commodities were distributed through non-FPA channels. In contrast, Madagascar had a lower clinic service delivery cost ($1.29), compared with a cost per CYP of $18 because it distributed all the contraceptives through clinics. The cost per CYP was high in Liberia (about $32), followed by Kenya (about $20), Madagascar (about $19), Ethiopia (about $16), and Tanzania (about $4). Most of these CYP costs were derived from grants. In the future FPA might investigate some other issues: the measurement of demand and need, the projecting of future costs, and the role of FPAs in filling the gap between public expenditures and community needs.
WORLD HEALTH. 1988 Jan-Feb; 10-11.In 1979 WHO invited its member states to participate in a global strategy for health and to monitor and evaluate its effectiveness using a minimum of 12 indicators. Members' 1982 implementation reports and 1985 evaluation reports form the basis for evaluating each measure. Indicators 1-6 have strong political and economic components in both developed and developing countries and are not complete. Indicator 7, for which rates of reply are satisfactory, asks whether at least 5 elements of primary health care are available to the whole population. The 8th gauge seeks information on the nutritional status of children, considering birth weight (a possible indicator of risk) and weight for age (a monitor of growth). Infant mortality rate and life expectancy at birth, indicators 9 and 10, are difficult to estimate in developing countries, and health services are not always kept informed of current estimates. Indicator 11 asks whether the literacy rate exceeds 70%; it can provide information on level of development and should emphasize literacy for women, for whom health information is critical. The last global measure yields information about the gross national product, which is not always the most recent, despite the trend of countries to publish their gross domestic product. Failure to make use of the best national sources, such as this, is one of several problems encountered by WHO's member states in collecting accurate data. Other problems include lack of universally acceptable definitions, different national accounting systems, disinterest of health authorities in economic matters, lack of staff, lack of financial resources in developing countries, and inadequately structured health system management. Each country must choose the most appropriate methods for collection of data. If an indicator cannot be calculated, the country is encouraged to seek and devise a substitute. WHO must produce more precise and reliable indicators. It must respond to requests for ways of improving or strengthening national systems.