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  1. 1
    322015

    Strengthening the capacity of the public health workforce in support of the essential public health functions and the Millennium Development Goals. Consultation with experts, San Jose, Costa Rica, 16-18 August 2005.

    Pan American Health Organization [PAHO]. Health Systems Strengthening Area. Human Resources for Health Unit

    Washington, D.C., PAHO, Health Systems Strengthening Area, Human Resources for Health Unit, 2006 Dec. 50 p. (HR Series No. 45; USAID Award No. LAC-G-00-04-00002-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ADJ-697)

    The main objective of this Consultation is to generate social recognition for the improvement and protection of human resources and the development of the health systems and well being of the populations of the Region of the Americas. There is no clear guiding principle in the conceptualization of human resources in health, or about its relationship to the PHWF. Human resources in health are currently facing a serious crisis, and public health should play a leading role in strengthening the capacities of this key resource in the Region. The causes and the magnitude of the problem are reflected in the lack of certain categories of personnel, the inequitable distribution of resources within countries, and institutional planning, management and education of these resources that are de-contextualized and focused on technical aspects. These considerations call for this presentation of the objectives of the Consultation to be accompanied by a recognition that learning to work together is not easy, but that this is precisely what is needed, i.e. the creation of strong partnerships, and the fact that public health work should be conceived in terms of cooperation in this area. (excerpt)
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  2. 2
    307220
    Peer Reviewed

    Regional immunization programs as a model for strengthening cooperation among nations.

    Tambini G; Andrus JK; Fitzsimmons JW; Roses Periago M

    Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2006; 20(1):54-59.

    The Pan American Health Organization traces its origin back to the First General International Sanitary Convention of the American Republics, which was held in Washington, D. C., in December 1902. At the top of the agenda of the meeting were the complex public health issues involved in fighting yellow fever and other epidemic infectious diseases. The final resolution of the first convention stated, "It shall be the duty of the International Sanitary Bureau to lend its best aid and experience toward the widest possible protection of the public health of each of the said Republics, in order that disease may be eliminated and that commerce between said Republics may be facilitated." In the 19th century, efforts at inter-American cooperation had been limited almost exclusively to assisting commerce, and had had almost nothing to do with health. In 1923 the International Sanitary Bureau changed its name to the Pan American Sanitary Bureau, which would eventually become known as the Pan American Health Organization (PAHO) (1). Pan-Americanism is the guiding principle upon which PAHO was founded. That principle is expressed in the PAHO Member States' commitment to working together to improve the health of their citizens and to support the countries facing the greatest need. This principle recognizes that many health problems require a collective effort. The PAHO Member States acknowledge that the health and public health of one's neighbors is a shared responsibility of all. Pan-Americanism is grounded in values aimed at breaking down the barriers of health inequities. This principle is perhaps even more relevant today in a world of free trade and vast movements of people. (excerpt)
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  3. 3
    181173

    Initial steps in rebuilding the health sector in East Timor.

    Tulloch J; Saadah F; de Araujo RM; de Jesus RP; Lobo S

    Washington, D.C., National Academies Press, 2003. xii, 57 p.

    The present monograph--on rebuilding the health sector in East Timor following the nation's struggle for independence--is the second in this series. It provides an overview of the state of the health system before, during, and after reconstruction and discusses achievements and failures in the rebuilding process, using an informative case study to draw conclusions for potential improvements to the process in other post-conflict settings. Other topics under consideration in the series include reviews of current knowledge on psychosocial issues, reproductive health, malnutrition, and diarrheal diseases, as well as other case studies. (excerpt)
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  4. 4
    184637
    Peer Reviewed

    Norms in tension: democracy and efficiency in Bangladeshi health and population sector reform.

    Shiffman J; Wu Y

    Social Science and Medicine. 2003 Nov; 57(9):1547-1557.

    Spurred on by donors, a number of developing countries are in the midst of fundamental health and population sector reform. Focused on the performance-oriented norms of efficiency and effectiveness, reformers have paid insufficient attention to the process-oriented norms of sovereignty and democracy. As a result, citizens of sovereign states have been largely excluded from the deliberative process. This paper draws on political science and public administration theory to evaluate the Bangladeshi reform experience. It does so with reference to the norms of efficiency, effectiveness, sovereignty and democracy as a means of making explicit the values that need to be considered in order to make health and population sector reform a fair process. (author's)
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  5. 5
    080677

    Latin American and Caribbean Region health care financing activities, 1982-1988. An annotated compilation. Draft.

    John Snow [JSI]. Resources for Child Health [REACH]

    [Unpublished] 1989 Mar. [2], 87 p. (USAID Contract No. DPE-5927-C-00-5068-00)

    The Resources for Child Health Project (REACH) presents an overview of health care financing (HCF) activities in the Latin American and Caribbean regions for the period 1982-88. REACH is compiling regional health care financing initiatives, preparing detailed case studies of USAID health financing experiences in 3 countries, and developing a set of general guidelines to be used by health officers to identify opportunities for HCF activities. A draft version of the first of these components is presented and includes an updated annotated list of health finance activities, studies, and projects conducted in the region since 1982. The USAID approach to HCF as put forth in policy statements and other official documents is summarized; World Bank, Inter-American Development Bank, and Pan American Health Organization viewpoints are reviewed as well as social security issues and their relationships to HCF; and country overviews are provided under Caribbean, Central America, South America, and North America subheadings. Brief overviews of HCF activities for each country are given followed by summaries of individual activities funded by USAID and other organizations. Summaries indicate whether activities are public or private sector, main areas of emphasis, and describe content. Activity costs are also given for USAID-funded initiatives.
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  6. 6
    273192

    Final reports, 98th and 99th meetings of the Executive Committee of the Pan American Health Organization, Washington, D.C., 27 September 1986 and 22-26 June 1987. XXXII meeting of the Directing Council of PAHO, XXXIX meeting, WHO Regional Committee for the Americas, Washington, D.C., 21-25 September 1987.

    Pan American Health Organization [PAHO]. Pan American Sanitary Bureau, Regional Office of the World Health Organization

    Washington, D.C., 1987. 136 p. (Official Document No. 219)

    The 98th and 99th Meetings of the Executive Committee of the Pan American Health Organization, the XXXII Meeting of the Directing Council of the Pan American Health Organization, and the XXXIX Meeting of the World Health Organization (WHO) Committee for the Americas were all held in Washington, D.C., between 9/86 and 9/87. This document contains the final reports of these conferences, including lists of all participants, and complete texts of all resolutions. The 99th Meeting resulted in Resolution VI, urging member countries to implement plans to control Aedes albopictus implicated in dengue, yellow fever, and california encephalitis. Resolution VII on Women, Health and Development, urging member nations to improve public and private comprehensive health care for women, and calling for increased participation of women in professional posts and representative roles within the organization; Resolution VIII, on Emergency Preparedness and Disaster Relief Coordination; and Resolution XII on AIDS Prevention and Control, which called for a WHO Special Program on AIDS and urged member countries to increase efforts at prevention and control, to provide information to WHO, and to permit free international travel for infected people. The XXXII Meeting contained Resolution IX on Women, Health and Development; Resolution X on Emergency Preparedness and Disaster Relief Coordination; Resolution XI on the Coordination of Social Security and Public Health Institutions; and Resolution XII on Acquired Immunodeficiency Syndrome (AIDS) in the Americas.
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  7. 7
    200951

    Toward the well-being of the elderly.

    Pan American Health Organization

    Washington, D.C., Pan American Health Organization, 1985. 172 p. (PAHO Scientific Publication 492.)

    At present, aging is the most salient change affecting global population structure, mainly due to a marked decline in fertility rates. The Pan American Health Organization Secretariat organized a Briefing on Health Care for the Elderly in October 1984. Its purpose was to enable planners and decision-makers from health and planning ministries to exchange information on their health care programs for the elderly. This volume publishes some of the most relevant papers delivered at that meeting. The papers are organized into the following sections: 1) the present situation, 2) services for the elderly, 3) psychosocial and economic implications of aging, 4) training issues, 5) research and planning issues, and 6) governmental and nongovernmental policies and programs.
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  8. 8
    022708

    Report of the second advisory group meeting held in Kuala Lumpur at the Hotel Majestic on the 18-19 September 1972.

    Inter Governmental Coordinating Commitee. Southeast Asia Regional Cooperation in Family and Population Planning. Secretariat

    [Unpublished] 1972. 67 p.

    This report of the proceedings of the 2nd Advisory Group Meeting covers the following: the workshop sessions; the progress report; the role and functions of the Intergovernmental Coordinating Committee (IGCC); and the speech of Encik Mohd. Khir Johardi. The progress report reviews all the projects and programs that will be initially implemented by the Secretariat IGCC: the regional program for observation and exchange of information; the regional program for exchange of experience through workshop in the various activities of family and population planning; clearinghouse activity; regional research project on thromboembolic disease; the special project to assist member countries without a national family planning program (Laotian Seminar, consultants for Khmer Republic, training 12 Khmers in the Philippines, the contraceptive supplies for the Khmer Republic); population and development planning workshop; joint ECAFE/IGCC/Government of Malaysia Training Course for Statisticians and Demographers; workshop on adult education and family planning; regional incentive program; Second Ministerial Conference and Third IGCC Meeting; and first obstetrician and gynecological meeting within the IGCC Member Countries. Member of the senior government officials who met at the 1st and 2nd Meeting were keen on the idea of exchange of professional staff among member countries for a short period of time. Some of the participants particularly at the 2nd Senior Government Officials Meeting felt that it is necessary to set up IGCC Regional Training Center to be utilized for the training of all facets of family planning program within the IGCC Region. Appendixes review backgrounds and objectives of the visits to Singapore, Indonesia, and the Philippines; report on the 1st Regional Training Workshop in Jakarta during December 1972, progress to date on clearinghouse activities, the ECAFE trip during August 1972, and the First National Seminar on Population and Family Well Being during August 1972; and discuss the population and development planning workshop proposal, the proposed workshop by IGCC on adult education and family life planning, and the proposed meeting of panel of regional advisers on sexual sterilization.
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  9. 9
    145345

    The immunisation programme in the Caribbean.

    Irons B; Smith HC; Carrasco PA; de Quadros C

    CARIBBEAN HEALTH. 1999 Oct; 2(3):9-11.

    The Directing Council of Pan American Health Organization approved a resolution concerning the formal inauguration of the Expanded Programme on Immunization (EPI) in the Americas in October 1977. Subsequently, the EPI entered full implementation in those countries that were members of the Caribbean Epidemiology Center (CAREC) during 1978-80. All 19 CAREC Member Countries (CMC) were conducting routine immunization with diphtheria, pertussis, tetanus, poliomyelitis, measles and BCG vaccines by 1980. The establishment of the program in these countries resulted in focused activities, including training and the development of operational guidelines. Health education has been primarily used to encourage mothers to have their children vaccinated at optimum age, and to advise parents and guardians about adverse reaction to vaccines. Great efforts have been made in immunization coverage in all the CMCs for the six vaccine preventable diseases. The eradication of poliomyelitis, the interruption of measles transmission (8 years measles-free), and the implementation of strategies for the elimination of rubella and CRS have presented many challenges to public health practitioners in the region. The success of all these initiatives is a reflection of the deep commitment and strong partnerships, which have been developed between the governments, health practitioners, and people of the region. Moreover, technical and financial support from both international agencies and service clubs played a major role in the success of the program.
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  10. 10
    142511

    NGO contributions to sexual and reproductive health and rights in Latin America. Recommendations from civil society for improved follow-up of the Cairo and Beijing commitments.

    de Schutter M; Alcala MJ

    New York, New York, United Nations Population Fund [UNFPA], 1998. [6], 27 p.

    This is a report on a regional meeting sponsored by the UN Population Fund (UNFPA) in collaboration with the Latin American and Caribbean Women's Health Network (LACWHN) and PAHO. The meeting was convened in order to draft recommendations to facilitate implementation of the agreements made at the Cairo and Beijing world conferences. This can be done, it was concluded at the meeting, by implementing or strengthening mechanisms for coordination and /or collaboration between government bodies, NGOs, and international cooperation agencies in the area of sexual and reproductive health and rights. Discussion and analysis focused mainly on the following areas: promoting sexual/reproductive rights, adolescent sexual/ reproductive health, promoting shared responsibilities/ male participation, and incorporating a gender perspective into reproductive health services. The observations and recommendations of the 50 participants are summarized.
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  11. 11
    117793

    Quality assurance guides health reform in Jordan.

    Abubaker W; Abdulrahman M

    QA Brief. 1996 Summer; 5(1):19-21.

    In November 1995, a World Bank mission went to Jordan to conduct a study of the health sector. The study recommended three strategies to reform the health sector: decentralization of Ministry of Health (MOH) management; improvement of clinical practices, quality of care, and consumer satisfaction; and adoption of treatment protocols and standards. The MOH chose quality assurance (QA) methods and quality management (QM) techniques to accomplish these reforms. The Monitoring and QA Directorate oversees QA applications within MOH. It also institutes and develops the capacity of local QA units in the 12 governorates. The QA units implement and monitor day-to-day QA activities. The QM approach encompasses quality principles: establish objectives; use a systematic approach; teach lessons learned and applicable research; use QA training to teach quality care, quality improvement, and patient satisfaction; educate health personnel about QM approaches; use assessment tools and interviews; measure the needs and expectations of local health providers and patients; ensure feedback on QA improvement projects; ensure valid and reliable data; monitor quality improvement efforts; standardize systemic data collection and outcomes; and establish and disseminate QA standards and performance improvement efforts. The Jordan QA Project has helped with the successful institutionalization of a QA system at both the central and local levels. The bylaws of the QA councils and committees require team participation in the decision-making process. Over the last two years, the M&QA Project has adopted 21 standards for nursing, maternal and child health care centers, pharmacies, and medications. The Balqa pilot project has developed 44 such protocols. Quality improvement (COUGH) studies have examined hyper-allergy, analysis of patient flow rate, redistribution of nurses, vaccine waste, and anemic pregnant women. There are a considerable number of on-going clinical and non-clinical COUGH studies. Four epidemiological studies are examining maternal mortality, causes of death, morbidity, and perinatal mortality.
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  12. 12
    070129

    Maternal and child health and catastrophe.

    Drake JW

    [Unpublished] 1991. Presented at the 119th Annual Meeting of the American Public Health Association [APHA], Atlanta, Georgia, November 11-14, 1991. 46, [1] p.

    The effects of the aftermath of the August 2nd, 1990 Iraqi invasion of Kuwait, the UN Security Council imposed sanctions, and the UN military offensive against Iraq on Iraq's maternal and child health sector and its public health infrastructure are examined. A review of the UN sanctions and dates of implementation are provided. A series of international responses ensued and are described. By February 1991, Baghdad had <5% of a normal water supply and the system was in collapse. Families, particularly women and children, suffered food shortages including infant formula, burns from makeshift cooking devices, e.g., epidemiologic and disease reporting ceased, drugs and vaccines were in short supply or absent, and sanitation and sewage systems were dysfunctional. It is concluded that OAS and US action against Haiti in the form of sanctions and military action would place a tremendous burden on the poor, and it is suggested that careful consideration be given before steps are taken. Also, discussed is the modern method of conflict resolution which is fueled by weapons technology and the profit incentive. There is a called to action for developing a realistic conception framework for the study and conduct of relationships with nations. There is a need to guide change peacefully and to resolve conflict without threat to life and the public's health, human environment, and ecosystem. The modern weapons technology and the protocols allowable under the UN Charter did not accomplish this in Iraq.
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  13. 13
    271242

    World wide report on A.I.D. and IPPF funded population activities, FY 1987-FY 1988.

    United States. Agency for International Development [USAID]. Office of Population; John Snow [JSI]. Family Planning Logistics Management Project

    Boston, Massachusetts, John Snow, Inc., 1989 Jan. 222 p. (Population Projects Database)

    This issue of the semi-annual Population Project Database Report contains short narrative summaries describing AID-funded population and family planning subprojects primarily as a management toil for the Office of Population; however, it may be useful for the entire international population community. The introduction begins with a discussion of AID population assistance -- how the funds are administered, where the support for activities comes from, and what types of projects are supported by AID's grants and contracts. The 1987 expenditures and 1988 commitments by cooperating agencies for in-country subproject activities are presented followed by a summary of AID subproject activities. This FY1987-FY1988 report includes information on 2,070 AID subproject activities in 94 countries. Of these, 30% concentrate on family planning service delivery, 24% on training-oriented activities, and 17% emphasize research to develop improved contraceptive methods. An additional 8% focus on education, information and communications with regard to family planning, and 7% are primarily concerned with operations research aimed at developing improved ways to deliver family planning services in developing countries. The data in this report were assembled from the Population Projects Database (PPD), a computer-based information system for the Agency for international Development. The bulk of the report is presented in tables which detail AID and IPPF funded population activities in FY1987 and FY1988 by cooperating agency, country and the following regions: Africa, Asia/Near East, Latin America/Caribbean, US/Canada, Europe/Australia, and inter regional. New charts showing the number and types of subproject activities in each region are also include.
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  14. 14
    051416

    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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  15. 15
    055654

    Breastfeeding promotion in family planning programs.

    Jennings VH

    In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988]. 7 p.. (USAID Contract No. DPE-3040-A-00-5064-00)

    The US Agency for International Development (USAID) and the Institute for International Studies in Natural Family Planning are at work to find ways to remove barriers to family planning breastfeeding promotion efforts. Barriers include lack of or conflicting measures of program success along with lack of information on the breastfeeding/fertility relationship. The 2 organizations have taken the following steps to assist family planning organizations to increase their promotion and support of breastfeeding: identify current activities and potential barriers to breastfeeding promotion; develop guidelines for breastfeeding support and promotion; assess feasibility and impact of the guidelines; and disseminate the guidelines. Much remains to be done to integrate family planning and breastfeeding. The keys to success are: generating and communicating information which can be used readily by both the population and health policymakers in family planning programs; developing and disseminating guidelines and prototype materials which can be adapted to program needs; identifying, implementing, and evaluating programmatic ways to promote breastfeeding in community and clinical settings; and involving the population community -- at the local, national, and international levels, and in research, service delivery, policy, and training -- in an ongoing dialogue about the relationship of family planning and breastfeeding.
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  16. 16
    201466

    Health for all by the year 2000: realistic target or utopian illusion?

    Hansluwka H

    In: Mortality and health issues in Asia and the Pacific: report of a seminar held at Beijing in collaboration with the Institute of Population Research, People's University of China from 22 to 27 October 1986. New York, New York, United Nations, 1987. 133-50. (Asian Population Studies Series No. 78.; ST/ESCAP/485.)

    This paper draws up a tentative balance sheet of the attainability of the global Health For All By The Year 2000 targets in the Economic and Social Commission for Asia and the Pacific (ESCAP) region. Given a continuation of unflinching government commitments, the specific global health status and health care provision targets set for the year 2000 seem to be within reach for most countries in the ESCAP region. Exceptions are the targets for water supply and sanitation where the supply of the rural population in several countries is likely to create substantial difficulties. The attainment of equity in the distribution of health resources constitutes a serious challenge. There are some encouraging signs that throughout the ESCAP region health policies and resources are being reoriented towards the provision of health care to the vulnerable and disadvantaged. This optimistic assessment of the prospects owes a good deal to the "conservative" targets set by the World Health Organization as well as to the impressive advances made by the majority of countries on a broad range of economic and social development activities such as food production, industrial output, education, family planning, and welfare. The global strategy does not purport to portray a health scenario for the year 2000 from which to deduce regional or national priorities and tasks. The targets set are not a substitute for national analysis and health trend projection. Seen from a regional perspective, the value and relevance of the Health For All strategy lies in the political field with its emphasis on national and international equity. Basing itself on the moral authority of the world health community, the great social policy issues of health as a fundamental human right are set out and the health sector assigned its proper place in national development efforts for a better and more human life.
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  17. 17
    201463

    Mortality and health issues in Asia and the Pacific: report of a seminar held at Beijing in collaboration with the Institute of Population Research, People's University of China from 22 to 27 October 1986.

    United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]

    New York, New York, United Nations, 1987. vi, 169 p. (Asian Population Studies Series No. 78.; ST/ESCAP/485.)

    The Seminar on Mortality and Health Issues was held at Beijing from 22 to 27 October 1986 as a cooperative venture between the UN Economic and Social Commission for Asia and the Pacific (ESCAP) and the Institute of Population Research, People's University of China, as part of the project, "Analysis of Trends and Patterns of Mortality in the ESCAP Region." Part 1 of the report includes a summary of the Beijing recommendations on health and mortality and the report of the seminar. Part 2 contains papers on a comparative analysis on trends and patterns of mortality in the ESCAP region, an overview of the epidemiological situation in the region, health for all by the year 2000, and inequalities in health.
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  18. 18
    049261
    Peer Reviewed

    Preliminary report of an identification mission for safe motherhood, Senegal: putting the M back in M.C.H.

    Kimball AM; Cisse S; Fayemi G; Ericcson S; Helfenbein S; Nakoulima A; Sene NT; Papiernik E

    INTERNATIONAL JOURNAL OF GYNAECOLOGY AND OBSTETRICS. 1988 Apr; 26(2):181-7.

    The government of Senegal, in March of 1986, requested assistance from the UN Development Program (UNDP) to formulate and execute a program for safe motherhood. Senegal, with an estimated maternal mortality rate of 580-760/100,000, was the 1st country to initiate a concrete national program to address the problem of maternal mortality. Despite the existence of a well-developed health infrastructure, data showed that the majority of Senegalese women deliver at home and that only 20% of maternal mortality is reported. Causes of mortality include endemic diseases (malaria and hepatitis), and abrupted placenta as a complication of hypertension. To identify the target areas of intervention, a "Mission of Identification" was organized by the UNDP in collaboration with the government of Senegal. 4 levels of the health infrastructure--village or rural maternity, the health post, the health center, and regional and national hospitals--were assessed as to existing and potential capacity to prevent maternal deaths. Epidemiology, social barriers to care, service delivery problems, and management issues were addressed. Results revealed a minimal knowledge of family planning, an expressed desire to solve the problems, and the strong influence of traditional beliefs in health care intervention, all of which contribute to maternal mortality. Interventions to reduce mortality were outlined based on identified causes of death and capabilities to address a specific problem. Over 50% of maternal deaths could be prevented by improved access and optimization of health care delivery and timely medical/surgical intervention. Adequate prenatal coverage and reducing pregnancy rates at the extremes of maternal age and parity were also cited as methods to reduce mortality. Estimates of the efficacy of these interventions were based on universal access, which does not now exist. A significant investment must be made to assure such access and to emphasize the priority given to maternal/child health by the government of Senegal.
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  19. 19
    049219

    Yellow fever vaccination in the Americas.

    BULLETIN OF THE PAN AMERICAN HEALTH ORGANIZATION. 1984; 18(2):188-92.

    Outbreaks of yellow fever in recent years in the Americas have prompted concern about the possible urbanization of jungle fever. Vaccination, using the 17D strain of yellow fever virus, provides an effective, practical method of large scale protection against the disease. Because yellow fever can reappear in certain areas after a 2-year dormancy period, some countries maintain routine vaccination programs in areas where jungle yellow fever is endemic. The size of the endemic area (approximately half of South America), transportation and communication difficulties, and the inability to ensure a reliable cold chain are problems facing these programs. In addition, the problem of reaching dispersed and isolated populations has been addressed by the use of mobile teams, radio monitoring, and educational methods. During yellow fever outbreaks, many countries institute massive vaccination campaigns, targeted at temporary workers and migrants. Because epidemics in South America may involve extensive areas, these campaigns may not effectively address the problem. The ped-o-jet injector method, used in Brazil and Colombia, should be used in outbreak situations, as it is effective for large-scale vaccination. Vaccine by needle, suggested for maintenance programs, should be administered to those above 1 year of age. An efficient monitoring method to avoid revaccination, and to assess immunity, should be developed. The 17D strain produces seroconversion in 95% of recipients, and most is prepared in Brazil and Colombia. But, problems with storage methods, instability in seed lots, and difficulties in large-scale production were identified in 1981 by the Pan American Health Organization and WHO. The group recommended modernization of current production techniques and further research to develop a vaccine that could be produced in cell cultures. Brazil and Colombia have acted on these recommendations, modernizing vaccine production and researching thermostabilizing media for yellow fever vaccine.
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  20. 20
    049313

    [Social mobilization and information, education, communication (IEC) in the area of population] Mobilisation social et information--education--communication (I.E.C) en matire de population.

    Zigirumugabe S

    FAMILLE, SANTE, DEVELOPPEMENT / IMBONEZAMURYANGO. 1988 Apr; (11):23-8.

    Despite efforts by Rwanda's National Office of Population (ONAPO) to increase awareness of Rwanda's population problems, there has been little change in the reproductive behavior of the rural population. ONAPO plans to formulate an overall information, education, and communication (IEC) campaign in the area of maternal-child health and family planning to inform the population about Rwanda's sociodemographic problems and the solution offered by family planning. The campaign will have 3 main components: 1) provision of information to the general population through the informal educational system 2) training and school-based population information and 3) production of educational materials to support the training and communication programs. IEC programs for maternal-child health and family planning will be integrated into more widely accepted activities having some degree of permanence, such as the school system, health centers, and religious institutions. The communal centers for development and permanent training will play an especially strong role in the integrated IEC plans for rural areas. Center personnel will help the population understand the connection between family planning and the socioeconomic and health status of families and will motivate couples to use family planning. The overall IEC plan will receive support from the National Revolutionary Movement for Development, the Association of Rwandan Women for Development, the Ministry of the Interior and of Communal Development, and the Ministry of Public Health and Social Affairs. Various other ministries, religious organizations, international organizations, and nongovernmental organizations should also support the IEC effort.
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  21. 21
    046471

    Report on the evaluation of the UNFPA funded project on labour and family welfare education in organized sector in Zambia (September-October 1986).

    Valdivia LA; Friedman M

    Arlington, Virgina, Development Associates, 1986. iii, 71 p.

    This report evaluates the UNFPA-funded Labor and Family Welfare project in the Organized Sector of Zambia, Africa. The project targeted 3 key elements of the Organized Sector--motivation of leaders, training of educators, and in-plant workers' education. The project laid the groundwork for a major expansion of education and services at the workers' level. It has also led to a National Population Policy formulation. 18 recommendations are suggested with priority given to factory-level education and family planning service delivery. Additional funding for companies to motivate and educate workers regarding acceptance of family planning services is suggested, as well as increased training for economics, teachers, psychology teachers, and social workers to enable them to incorporate population education into their curriculums. Training activities were a major focus of the project. Increased training and educational materials about family planning, in the form of posters and handouts, should be produced and disseminated at the factory level, as well as to medical personnel. UNFPA, in accord with the Ministry of Health of Zambia, should ensure an adequate supply of contraceptives to the factories. Existing record keeping, reporting and scheduling practices should be improved, as well as the International Labor Organization (ILO) disbursement system. Short-term ILO consultants should be recruited to improve the project and its management, and 2 additional staff members, provided by the government, could help to implement the program at the plant level. 2 new vehicles should be purchased for full-time field staff to ensure availability to carry out project activities. In addition, the present accounting and recordkeeping of the ILO Lusaka office should be restructured to achieve more accurate monitoring of the use of project funds.
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  22. 22
    040610

    Population/family health overview: Madagascar.

    Ferguson-Bisson D; Lecomte J

    Washington, D.C., International Science and Technology Institute, Population Technical Assistance Project, 1985 Aug 8. v, 7, [4] p. (Report No. 85-48-018; Contract No. DPE-3024-C-00-4063-00)

    The objectives of the consultation in Madagascar were to review existing policies and programs in population and family health, to assess government and nongovernment plans and capabilities to program implementation, to review other donor activities, to identify constraints impeding population and family planning activities, and to prepare recommendations for the US Agency for International Development (USAID) assistance to Madagascar. Although the government has no officially proclaimed population policy, there is increasing direct support of family planning. The private family planning association, Fianakaviana Sambatra (FISA) was officially recognized in 1967 and is permitted to import and distribute contraceptives. Sale of contraceptives in private pharmacies also is permitted. The major organization providing family planning services is FISA. The Ministry of Health (MOH) system does not include contraceptive services as part of its health care services, but at the request of MOH physicians, FISA provides services in 40 MOH facilities. Private pharmacies account for most of the contraceptive distribution, with oral contraceptives (OCs) being sold by prescriptions written by private physicians or, on occasion, by public health physicians. Contraceptive services also are provided in the medical centers of at least 3 organizations: JIRAMA, the water and electricity parastatal; SOLIMA, the petroleum parastatal; and OSTIE, a group of private enterprises that has its own health care system. A Catholic organization, FTK (Natural Family Planning Association) provides education and training in natural family planning. Demographic research has not been accorded a high priority in Madagascar. Consequently, the country's capabilities in the area are relatively limited. At this time, demographic research is carried out within several institutional structures. The major donor in the area of population/family planning is UN Fund for Population Activities (UNFPA). Activities of the UN International Children's Emergency Fund (UNICEF) in the area of health are relevant to the planned USAID assistance. For several years, USAID has provided population assistance to Madagascar through its centrally funded projects. Recommendations are presented in order of descending importance according to priorities determined by the consultation team: population policy; training/sensitization of the medical community; support to existing private voluntary organizations; demographic statistics and research; information, education, and communication; and collection and reinforcement of health statistics. In regard to population policy, assistance should be directed to 2 general objectives: providing guidance to the government in deciding which stance it ultimately wishes to adopt officially with regard to population; and encouraging the systematic incorporation of demographic factors into sectoral development planning.
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  23. 23
    039142

    Basis for the definition of the organization's action policy with respect to population matters.

    Pan American Health Organization [PAHO]

    [Unpublished] 1984 May 8. 31 p. (CE 92/12)

    This report shows how demographic information can be analyzed and used to identify and characterize the groups assigned priority in the Regional Plan of Action and that it is necessary for the improvement of the planning and allocation of health resources so that national health plans can be adapted to encompass the entire population. In discussing the connections between health and population characteristics in the countries of the region, the report covers mortality, fertility and health, and fertility and population increase; spatial distribution and migration; and the structure of the population. Focus then moves on to health, development, and population policies and family planning. The final section of the report considers the response of the health sector to population trends and characteristics and to development-related factors. The operations of the health sector must be revised in keeping with the observed demographic situation and the projections thereof so that the goal of health for all by the year 2000 may be realized. In several countries of the region mortality remains high. In 1/3 of them, infant mortality during the period 1980-85 exceeds 60/1000 live births. If measures are not taken to reduce mortality 55% of the population of Latin America in the year 2000 will still be living in countries with life expectancies at birth of under 70 years. According to the projections, in the year 2000 the birthrate will stand at around 29/1000, with wide differences between the countries of the region, within each of them, and between socioeconomic strata. High fertility will remain a factor hostile to the health of women and children and a determinant of rapid population growth. Some governments view the present or predicted growth rates as excessive; others want to increase them; and some take no explicit position on the matter. The countries would be well advised to assign values to their birthrate, natural increase, and periods for doubling their populations in relation to their development plans and to the prospects for improving the standard of living and health of their populations. An important factor in urban growth is internal migration. These migrants, like some of those who move to other countries, may have health problems requiring special care. Regardless of a country's demographic situation, the health sector has certain responsibilities, including: the need to promote the framing and adoption of population and development policies, in whose implementation the importance of health measures is not open to question; and the need to favor the intersector coordination and articulation required to ensure that population aspects are considered in national development planning.
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  24. 24
    035703

    AID reprograms UNFPA $10 million (USAID news release, 25 September 1985).

    POPULATION AND DEVELOPMENT REVIEW. 1986 Mar; 12(1):160-1.

    On September 25, 1985 M. Peter McPherson, administrator of the US Agency for International Development (USAID), announced that AID will reprogram $10 million originally earmarked for the UN Fund for Population Activities (UNFPA) to other family planning activities. Under recently enacted legislation, AID was required to withhold funding if UNFPA was found to "support or participate in the management of a program of coercive abortion or involuntary sterilization." McPherson concluded that sufficient evidence exists to indicate that UNFPA participates in the management of the China family planning program and also that implementation of China's 1-child per family policy has resulted in these abuses. The $10 million will be redirected to other voluntary bilateral population and family planning programs in Africa, Latin America and the Caribbean, Near East, and to US organizations that provide a variety of family planning services in developing countries. Reprogramming these funds reflects the Administration's policy to provide substantial support for voluntary family planning but firm opposition to abortion and coercive population control practices. AID's strategic plan includes providing 80% of the people in developing countries with access to a comprehensive range of family planning methods. AID currently spends $290 million on voluntary family planning programs in the developing world.
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  25. 25
    046588

    Vaccination coverage rates for 1986.

    Pan American Health Organization [PAHO]

    EPI NEWSLETTER. 1987 Oct; 9(5):3-5.

    This article sets forth data on vaccination coverage rates in children under 1 year of age in the individual countries of Latin America and the Caribbean in 1986. In the Region of the Americas as a whole, the 1986 coverage rate was 80% for oral poliovaccine, 54% for DPT, 55% for measles, and 63% for BCG. Vaccination coverage rates increased over 1985 levels for all but measles, which showed a 5% decline due to decreases in Brazil and Mexico. In the Caribbean subregion, the majority of country coverage rates for DPT and oral poliovirus vaccine are equal to or above 80%, while measles coverage rates are generally below 50%. In Central America, vaccine coverage rates with all antigens except BCG showed significant increases between 1985 and 1986. In Central America, coverage ranged from above 80% for oral poliovirus vaccine and DPT in Belize, Costa Rica, and Nicaragua, to below 40% in Guatemala. In general, countries in the region are improving vaccination performance as a result of establishment of vaccination days or campaigns and acceleration of the Expanded Program on Immunization. However, much work remains to be done if the goal of 100% immunization of children and women of childbearing age by 1990 is to be met.
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