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  1. 1

    Innovations from the Integrated Family Planning and Parasite Control Project: PDA experience.

    Phawaphutanond P

    INTEGRATION. 1990 Apr; (23):4-11.

    Since 1976, the Integrated Family Planning and Parasite Control (IP) has been conducted by the Population and Community Development Association (PDA) through the financial support of the Japanese Organization for International Cooperation in Family Planning (JOICFP). Family planning was integrated with other activities starting with parasite control and then environmental sanitation. In 1976, PDAs activities were focused on a community-based delivery (CBD) system for contraception in rural Thailand. In the IPs first years, the PDA conducted mass treatment campaigns using both the local plant "maklua" and modern medicines. Various motivational activities were included, such as letting children see the parasites under a microscope. Many villagers showed up for treatment. Later, however, they were reinfected and failed to get further treatment. Since 1981, the major emphasis of the IP rural program has been to push building of latrines and improved water resources. PDA has started a major project for safe storage of rainwater. Some 11,300 liter bamboo-reinforced concrete rainwater storage tanks are being built in northeast Thailand. Giant water jars for rainwater catchment with a 2000-liter capacity are produced. The financing of PDAs environmental sanitation construction activities is unique. Villagers pay back the cost of the raw materials of the tank, latrine, or jar they received. Repayments go into a revolving fund which can be lent to other families. Peer pressure has made repayment levels approach or exceed 100% in target districts. Villagers are trained to produce the casings, bricks, and other things needed for building. Individuals from building crews are selected and given special training in construction techniques and are taught the potential health benefits of each activity. These people become village sanitation engineers. Villagers can engage in income-generating activities and receive technical assistance from the PDA. The IP has taken on a community participation approach. The PDAs Family Planning (FP) Health Checkup Program is the urban version of the IP. In 1989, the PDA sold 11,109 cycles of pills and 2100 packages of 3-piece condoms through FP volunteers based in 459 enterprises. These FP volunteers also tell their co-workers about parasite control and other issues that they learned from the annual refresher courses. The PDA also does school health checkup services. The PDA generated funds to keep the programs ongoing. The Thai government actively supports the work of the nongovernmental organizations.
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  2. 2

    A Philippine experiment in community development.

    Joicfp Review. 1986 Jun; 11:6-11.

    For years, villages in the towns of La Trinidad and Tuba in the Philippine province of Benguet suffered from several serious health problems. The use of "entry points" or projects which yield immediate tangible results within a short period of time was introduced in the municipalities of La Trinidat and Tuba in 1981. A year later, 9 additional pilot areas were selected. Today, these cities and municipalities form the nucleus of a new and promising experiment in community development, i.e., the Integrated Family Planning/Maternal Child Health Project, jointly sponsored by the Philippines' Commission on Population (POPCOM) and the Japan International Cooperating Agency (JICA). Generally, the project aims to strengththen and expand community-based family planning and maternal and child health services in the project areas that aim to improve the health of the residents. Specifically, it seeks to achieve several objectives: increase the rate of family planning acceptance and decrease the dropout rate in family planning participation within the community; decrease the incidence of malnutrition among preschool and school age children; and decrease the intestinal parasite infection rae in the community. In the field, these objectives are translated into concrete activities which people, especially in remote rural areas, can readily understand. Children, who are the center of love and attention in every home, are introduced to services which produce immediate results: growth monitoring, breastfeeding and nutrition, immunization, and cure of common childhood diseases. Deworming and its marked and immediate reslutls establish and increase the credibility of family planning, health, and other fieldworkers in the areas. The health development services break the barrier of resistance on the part of parents and adults. Once the population and health workers establish rapport with the community, they introduce family planning concepts and techniques, environmental sanitation projects, and income generating projects. In June 1985, POPCOM commissioned an independent research agency to evaluate the impact of the integrated project in the 2 model areas. The study, conducted from June 30 to July 31, 1985, consisted of a survey, an evaluation workshop, and library research. The main findings included: there was a marked increase in the number of breastfeeding mothers in both La Trinidad and Tuba; both municipalities showed a decrease in the number of postnatal care cases; maternal mortality went down to zero throughout the survey period; there was a consistent upward trend in the prevalence of family planning. Based on reports from the projects areas, 27,744 children aged 0-4 had undergone stool examination. Of these, 25,963 or 93% were treated. Other major accomplishments of the project are cited.
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  3. 3

    Parasites of all types must be controlled.

    Solon FS

    Joicfp Review. 1985 Oct; 10:44.

    The primary health care program in the Philippines today officially includes only the control of parasites which cause malaria and schistomiasis. Dr. Solon suggests that equal emphasis should be given to the control of all types of parasites. This paper presents excerpts from an interview with Dr. Solon. He expresses his opinion that in the past 20 years infant mortality has decreased markedly. In 1985, it was reduced to 58/1000 live births. He attributes this to a political will to support the health ministry in the implementation of its programs. The efforts to implement primary health care (PHC) has resulted in receiving the Kawaski Award given by Japan and the World Health Organization (WHO) to a country successfully implementing PHC. JOICFP has demonstrated the approaches used in the integration of family planning, nutrition and parasite control. Dr. Solon hopes that the integrated project would pave the way for the control of parasites other than schistostomiasis and malariasis. Less attention has been paid to the control of helminths such as ascaris, bookworm, trichuris t. and roundworm, which are common in the Philippines. Worms may cause deadly diseases such as pneumonia and bronchitis. JOICFP has shown that in several project areas in the country, use of the right personnel, equipment and anthelmintics can result in controlling these parasites.
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  4. 4

    Making primary health care a way of life.

    Mamuya SJ

    Joicfp Review. 1985 Oct; 10:28-31.

    Umati is a nongovernmental and nonprofit voluntary family planning organization which pioneered family planning activities in Tanzania in 1959. Umati was also assigned a role in the MCH program to ensure that the family planning component be given equal priority with the other components of the health program. Umati assists the Ministry of Health in its efforts to increase awareness of the advantages of family planning and responsible parenthood; gives advice on service delivery as well as assists the Ministry of Health in its task of training family planning service providers; and assists the Ministry of Health in the procurement and distribution of contraceptives and equipment. Umati is supported by the International Planned Parenthood Federation (IPPF). The integrated project aims to compensate for some of the deficiencies inherent in the MCH program. The project should respond to other community needs in order to attract and sustain the interest and active participation of community members. Parasite control and nutrition have been selected as priority health concerns. The integrated project must belong to the community. The following channels are being utilized on the local level: the local steering committee; the project volunteers; the Family Planning Association of Tanzania; MCH unit of the government; the government environmental sanitation unit; primary schools; religious institutions; the village government; and information, education and communication. The project should be evaluated and should be flexible.
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  5. 5

    IPPF in action 1980.

    International Planned Parenthood Federation [IPPF]

    London, Eng., International Planned Parenthood Federation, 1980. 43 p.

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  6. 6

    The philosophy and strategy of the integrated project.

    Kunii C

    In: Rodrigues W, ed. The Third American Conference on Integrated Programmes [Rio de Janeiro, Brazil, August 17-20, 1982] Capri III. [Unpublished] 1982. 21-7.

    The Integrated Project promoted by the Japanese Organization for International Cooperation in Family Planning (JOICFP) is based on the concept of humanistic family planning. The Project integrates family planning, nutrition and parasite control. If these components are arranged according to a parent's priorities, they would be in the following order: parasite control, nutrition, and finally, family planning. In developing countries, the Project controls the most commonly found parasites which are transmitted through soil, conducts nutrition education programs, and family planning. In order to implement and develop the Integrated Project, a pilot project should contain the following objectives: 1) to see the effect of the Integrated Project; 2) to use these projects as opportunities for training people to be family planning workers and parasite examination technicians; and 3) to demonstrate the effect of the Integrated Project to the central and local governments and try to encourage them to takeover the projects as their programs. In addition, a steering committee should be responsible for policy making, project design and support in other areas such as procurement and distribution of necessary materials, monitoring, training, research and coordination with the central government and the foreign donor agencies. Pilot areas should contain 20,000 to 30,000 people. More than 1 site with different living conditions should be selected simultaneously, so that different information and experiences from various regions can be obtained. For future evaluation, preliminary surveys are recommended before project implementation. Such surveys should study the acceptance rate of family planning, parasite infection rate, the status of various diseases, and environmental conditions. Deworming drugs, microscopes, and educational materials must be available. A work plan should be formed by holding discussions and clarifying the implementation of parasite control. As the Integrated Project is transformed from the original pilot projects of the experimental stage into expanded programs, it will obtain a higher reputation. Mass media and observations of people outside will help to expand the projects. As a result, the experiences gained in the Project can be incorporated into government controlled primary health care programs.
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  7. 7

    Reports of session 2.

    In: Rodrigues W, ed. The Third American Conference on Integrated Programmes [Rio de Janeiro, Brazil, August 17-20, 1982] Capri III. [Unpublished] 1982. 111-8.

    Group 1 analyzed the question: "How to organize the community and elicit people's participation?" The following items were identified as priorities: 1) previous diagnosis of the community; 2) leadership identification; 3) identification of opposition to the programs; 4) formation of a planned and systematic voluntary action; and 5) selection of human resources. In spite of considering sources at the community, municipal, state, federal, and foreign levels, the group recognizes and advises priority and emphasis to the community as the agent of its own development and therefore all efforts should be made in order to make the maximum use of all available resources. In order to increase the available sources, it is important to reach the highest potentials from all community resources, and elicit the interentity integration besides promoting campaigns for collecting resources. Group 2 developed the Community Development Methodology Pattern in response to the question: "How to organize community and elicit people's participation?" The survey, diagnosis, planning, implementation, and evaluation of the community and program should be included. Funding can be obtained from international or national agencies, or derive from the community itself. However, the ultimate goal should be the self-financing of the program. In response to the question: "How to organize and elicit people's participation," Group 3 concluded that knowledge of the community, and frankness toward the community was of paramount importance. In order to motivate and educate the community, the strategies of dissemination and motivation must be set up, including the use of popular literature, and audiovisual materials. The development of human resources is a factor essential to any program. Training must cover the working team as well as the leaders and volunteers of the community. A part of the training process is the information and experience exchange meetings held by the participants of the different programs. Coordination with agencies concerned avoids duplication of efforts, program performance efficiency is improved, and each agency's role is clearly delineated.
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  8. 8

    Recommendations of Capri III.

    In: Rodrigues W, ed. The Third American Conference on Integrated Programmes [Rio de Janeiro, Brazil, August 17-20, 1982] Capri III. [Unpublished] 1982. 129-36.

    The Third American Conference on Integrated Programmes--CAPRI III, was held in the City of Rio de Janeiro, from August 17-20, 1982. It was attended by representatives from Maylasia, Mexico, Colombia, Peru, Paraguay, Ecuador, and Brazil. CAPRI III approved and adopted CAPRI II recommendations, to which the following recommendations were added: 1) the humanitarian character of the parasite control and family planning programs be conducted independently from any political or religious implications; 2) support is given to the "Manila Declaration," (the achievement of more effective utilization of appropriate approaches to attain the social and economic well-being of the people, through the experiences gained in the Integrated Family Planning, Nutrition and Parasite Control Project; 3) the integrated programs should be considered as an important and positive strategy of primary health care; 4) there is a need for permanent training of human resources and, with a veiw to this, courses and other activities concerning their development should be carried out; 4) it is necessary to find ways to increase the availability of financial resources from governments as well as from active involvement of the various segments of the community itself; and 5) use every effective demonstration means with a view toward obtaining an ever increasing mobilization of all possible community resources to assure continuity and development to integrated programs. In addition, the Seventh Asian Parasite Control/Family Planning Conference urges that all governments recognize the experiences gained in the Integrated Family Planning, Nutrition and Parasite Control Project; that all governments recognize the role that the project has played; that all governments recognize the catalytic role played by the nongovernment/voluntary organizations and continue to support them; that all internatioal organizations/agencies take note of the experiences gained in the Project; that all governments and international agencies reaffirm their continuing commitments to ensuring the participation of the people in the planning and implementation of the Program; that all international agencies/organizations increase their support for the implementation of all policies and programs aimed at achieving a better quality of life for the people.
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  9. 9

    IPPF in action.

    International Planned Parenthood Federation [IPPF]

    London, Eng., International Planned Parenthood Federation, 1982. 44 p.

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  10. 10


    Grant JP

    In: The Tenth Asian Parasite Control/Family Planning Conference. Proceedings. Under the joint auspices of the Asian Parasite Control Organization, the Japanese Organization for International Cooperation in Family Planning, the Japan Association of Parasite Control and the International Planned Parenthood Federation. Tokyo, Asian Parasite Control Organization, [1983]. 63-70.

    Economic depression affects children in 3 major ways: disposable family incomes drop sharply, with the most severe consequences for poor people and their children; government budgets for social services, particularly those affecting young children and including nutrition, health, and education, are the first to be cut back; and national and international levels of development assistance stagnate as a consequence of the restrictive budgetary policies adopted by industrialized countries. Despite the first welcome signs of an economic recovery in some industrialized nations, most indications are that the worldwide recovery may be relatively shallow in the mid-1980s and that significant beneficial impacts on many low income countries and families will be long delayed. Thus, in the absence of special measures to accelerate health progress, millions more children and mothers are likely to die in the in low income areas than was thought likely at the beginning of the decade. Possibly the only hopeful sign is that the restrictions imposed by the world recession have stimulated the search for innovative and cost effective ways to protect and improve the health of children and mothers. Within a decade, low cost advances could be saving the lives of 20,000 children daily and preventing the crippling of another 20,000. What is in question is the priority of this kind of progress -- among governments, among international assistance sources and networks, and in developing countries. The strategy adopted by JOICFP in its Integrated Family Planning, Nutrition, and Parasite Control Projects offers one such way. The projects are based on the concept that family planning programs will be more acceptable if combined with related services, which the community readily perceives as beneficial and useful. What most contributes to making parasite control a good entry point is that the process of examination and the effects of treatment are immediately visible. Possibly more important that the biological and medical effects of parasite control is its effectiveness as a tool for community health and education motivation. The UN International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) and multilateral and bilateral agencies are promoting 4 simple and relatively inexpensive measures to reduce malnutrition, illness, and death among the world's children: the use of growth charts; oral rehydration therapy; breastfeeding and proper weaning practices; and immunization against major childhood diseases. Ways to achieve accelerated progress for the protection and survival of children are identified.
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