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Notes from the Field. 2002 Jul; (14): p..Alejandra, senior program officer, and Rebecca, evaluation officer, traveled to Ecuador in June 2002 to monitor the implementation of two adolescent projects funded by the Hewlett and Turner foundations. We spent the first two days of our trip in Guayaquil, where IPPF/WHR's affiliate, APROFE, has its main offices and clinics. This organization has begun providing services tailored to the needs of youth for the first time. Their idea was to build a separate space for youth with funds from the Hewlett Foundation to allow the clients to have access to health care providers who are specially trained to meet their needs as young people. It will also provide them with greater privacy. Unfortunately, there have been some construction delays for the new youth center. APROFE is therefore providing youth services in a section of the main clinic's office which has been refurbished as a youth clinic. I was struck by how friendly and colorful the office looked. There were lots of posters and signs painted by the youth. We also saw the blueprints for the youth center, which APROFE hopes to have completed by December. (excerpt)
Improving family planning, health, and nutrition in India: experience from some World Bank-assisted programs.
Washington, D.C., The World Bank, 1989. , 45 p. (World Bank Discussion Papers No. 59)This paper looks at the experience of 3 large-scale, World Bank- assisted, outreach programs in India, and attempts to distill some lessons for the design and management of the National Family Welfare and Integrated Child Development Services programs. The 3 programs reviewed are 1) the Tamil Nadu Integrated Nutrition Project, which has halved the rate of severe malnutrition in about 9000 villages in Tamil Nadu; 2) the training and visit system of agricultural extension, being implemented in most of the major states of India and in about 40 other countries; and 3) the health component of the Calcutta Urban Development Project, which has sharply increased immunization and contraceptive prevalence rates among slum dwellers in that city. In spite of these programs being in different sectors, they have a number of design and management features in common: 1) field workers focus on a manageable number of priority tasks; 2) the ratio of clients to workers is reasonable; 3) workers are trained to follow a defined daily routine concentrating on clients most in need of services; 4) workers receive regular, in-service training complemented by regular, supportive supervision; 5) 2 of the 3 programs recruit local workers; and 6) clients are involved in implementation. Design and management improvements could be made in 1) increasing field worker productivity by concentrating on priority tasks, 2) making services more responsive to community needs and therefore increasing demand, 3) developing a national-level family planning in- service training program, and 4) initiating operations research programs in service delivery.
Draft team member contributions to mid-term evaluation of the Population and Family Planning Project (608-0171) in Morocco.
[Unpublished] 1988 Mar. 13 p.The draft team member contributions to the mid-term evaluation of the population and family planning project in Morocco examine current progress and address future needs. Increased awareness of at least 1 method of family planning was attributed to a USAID-funded project. But, problems of access, religious constraints, and lack of method-specific media campaigns need to be addressed. An increased effort to direct promotion efforts toward men is needed, as a prior immunization program showed that the husband was a key factor in encouraging mothers to bring their children to be vaccinated. Because the local health worker plays a critical role at the community level, training and support for these workers should be emphasized. Media-specific and audience-specific campaigns, by the government and private sector, should focus on the most cost-effective means of reaching the provincial level population. Donor organizations (such as UNICEF, UNFPA and USAID) should address the IEC needs identified by the central health education office, whose role and supporting functions need to be strengthened. Content of family planning materials must be method-specific, using a systematic methodology to address problems of inappropriateness, inadequate contraceptive mix, and lack of field worker training materials. Improved distribution methods for existing materials, as well as increased use of television and mass media are viable options. Using the community more effectively by encouraging leader motivation and instituting incentives could help to improve promotional and distributional activities at the provincial level. An evaluation of training needs revealed that the workshop method of training may be overemphasized, and most health workers expressed a desire for lengthened training. The private sector could be sensitized to public health issues and needs and, in conjunction with out of country technical assistance, produce effective social marketing of contraceptives within the Moroccan context. Coordination with other donors would be beneficial, with the exchange of documents and meetings between the groups.
PUBLIC HEALTH REPORTS. 1980 Sep-Oct; 95(5):422-6.The implications of the eradication of smallpox in the context of epidemiology are presented. Eradication of disease has been conceived since the 1st smallpox vaccination was developed in the 18th century. Since then, attempts to eradicate yellow fever, malaria, yaws and smallpox have been instituted. Most public health professionals have been rightfully skeptical. Indeed, the success with smallpox was fortuitous and achieved only by a narrow margin. It is unlikely that any other disease will be eradicated, lacking the perfect epidemiological characteristics and affordable technology. The key to success with smallpox was the principle of surveillance. This concept has a vigorous developmental history in the discipline of epidemiology, derived from the work of Langmuir and Farr. It involves meticulous data collection, analysis, appropriate action and evaluation. In the case of smallpox, only these techniques permitted the key observations that smallpox vaccination was remarkably durable, and that effective reporting was fundamental for success. The currently popular goal of health for all, through horizontal programs, is contrary to the methods of epidemiology because its objective is vague and meaningless, no specific management structure is envisioned, and no system of surveillance and assessment is in place.