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Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.
Health Services Research. 2017 Oct 20;OBJECTIVE: To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. DATA SOURCES: Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. STUDY DESIGN: Interviews addressed organizational capacities to expand family planning and integrate services with primary care. DATA EXTRACTION: Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. PRINCIPAL FINDINGS: Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. CONCLUSIONS: Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. (c) Health Research and Educational Trust.
[Wellington, New Zealand], Family Planning International, 2006 Dec. 27 p.This report focuses on the relationship between policies implemented by the World Trade Organisation, World Bank, and the International Monetary Fund, and access to health, particularly sexual and reproductive health. .
Geneva, Switzerland, ILO, 2005. 60 p. (TMEHS/2005)These guidelines are the product of collaboration between the International Labour Organization and the World Health Organization. In view of their complementary mandates, long-standing and close cooperation in the area of occupational health, and their more recent partnership as co-sponsors of UNAIDS, the ILO and the WHO decided to join forces in order to assist health services in building their capacities to provide their workers with a safe, healthy and decent working environment, as the most effective way both to reduce transmission of HIV and other blood-borne viruses and to improve the delivery of care to patients. This is essential when health service workers have not only to deliver normal health-care services but also to provide HIV/AIDS services and manage the long-term administration and monitoring of anti-retroviral treatments (ART) at a time when, in many countries, they are themselves decimated by the epidemic. (excerpt)
Reproductive health strategy to accelerate progress towards the attainment of international development goals and targets.
Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2004.  p. (WHO/RHR/04.8)Reproductive and sexual health is fundamental to individuals, couples and families, and the social and economic development of communities and nations. Concerned about the slow progress made in improving reproductive and sexual health over the past decade, and knowing that the international development goals would not be achieved without renewed commitment by the international community, the Fifty-fifth World Health Assembly adopted resolution WHA55.19 requesting WHO to develop a strategy for accelerating progress towards attainment of international development goals and targets related to reproductive health. The resolution recalled and recognized the programmes and plans of action agreed by governments at the International Conference on Population and Development (Cairo, 1994) and the United Nations Fourth World Conference on Women (Beijing, 1995), and at their respective five-year follow-up review conferences. (excerpt)
Unintended consequences: drug policies fuel the HIV epidemic in Russia and Ukraine. A policy report prepared for the UN Commission on Narcotic Drugs and national governments.
New York, New York, Open Society Institute, International Harm Reduction Development program, 2003. 16 p.Taking action now to reduce HIV transmission rates and treat those already infected is critical. With the goal of avoiding adverse effects on social welfare and public health, the Russian and Ukrainian governments should reconsider how they interpret international treaties. Policy changes should be made in the following areas: Harm reduction. The governments should play an active role in establishing and supporting a large, strategically located network of harm reduction programs that provide services for IDUs, including needle exchange, HIV transmission education, condom distribution, and access to viable treatment programs such as methadone substitution. Similar services should be available in all prisons. Education. Simple, direct, and dear information about HIV transmission should be made available to all citizens-especially those most at risk. Similarly, society at large should be educated about the realities of drug use and addiction as part of an effort to reduce stigma. Discrimination and law enforcement abuse. Public health and law enforcement authorities should take the lead in eliminating discrimination, official and de facto, toward people with HIV and marginalized risk groups such as drug users. Authorities must no longer condone or ignore harassing and abusive behavior, including physical attacks, arrest quotas, arbitrary searches, detainment without charges, and other violations of due process. HIV-positive people, including IDUs, should be included in all policy discussions related to them in the public health and legal spheres. Legislation. Laws that violate the human rights of people with HIV and at-risk groups should be repealed or restructured to better reflect public health concerns. Moving forward with the above strategies may make it appear that the governments are backing away from the goals and guidelines of the UN drug conventions. They may be criti- cized severely by those who are unable or unwilling to understand that meeting the goals of the conventions, some of which were promulgated more than 40 years ago, is far too great a price to bear for countries in the midst of drug use and HIV epidemics. Governments ultimately have no choice, though, if they hope to maintain any semblance of moral legitimacy among their own people. (excerpt)
International Family Planning Perspectives. 1986 Jun; 12(2):49-53.The Convention on the Elimination of All Forms of Discrimination Against Women was adoptedin in 1979 by the UN Gereral Assembly and came into force in 1981. By May 1986, 87 countries had ratified and in so doing become states parties to it. The Forward looking Strategies for implementing the goals of the UN decade for women outline measures that countries must take by the year 2000 to achieve equality between men and women. The Strategies was adopted by over 150 countries in 1985 in Nairobi and endorsed subsequently by UN General. This article discussedes how the Convention and the strategies can be used to promote family planning (FP), reproductive rights, and maternal health. The covention requires states parties to ensure equal access of men and women to health and FP services. The article outlines the many practices and policies that enhigbit equal access to FP services. For example, in some nations, husbands but not wives are allowed to obtain contraceptives without spousal authorization; in others unmarried men but not unmarried women may obtain contraceptives. The strategies recognize that adolescent pregnancy has adverse effects on the morbidity and mortality of mothers and children and requires nations to provide contraceptives on an equal basis to adolescent men and women. The article concludes by explanining that states parties to the convention must report to the committee on the Elimination of Discrimination Against Women, established by the convention, on steps they have taken to eliminate discriminatory practices in health care and FP specifically and other fields generally, and outlines what FP organizations can do to assist in that reporting process. (author's modified)
Ippf Situation Report. 1974 Sep; 1-9.The current status of family planning in Sri Lanka was described, and relevant background information on population characteristics was supplied. Family planning services have been provided by the Family Planning Association of Sri Lanka since 1954. In 1958 the government initiated a family planning pilot project. In 1965 the government assumed full responsibility for providing family planning services, but the governemnt did not formulate or publicly endorse a family planning policy until 1972. Sri Lanka's population was 13,033,000 in 1972, and the annual average population growth rate was 2.3% between 1963-72. The crude birth and death rates were respectively 29.6 and 7.6 in 1971, and the infant mortality rate was 48 in 1973. 41% of the population was under the age of 15 in 1973. In 1972, per capita income was US 100. 71% of the population is Sinhalese, and 70% of the population is Buddhist. The country is primarily agricultural and derives 1/3 of its income from gorwing and processing tea. Education is compulsory for all children aged 5-14 and currently 89.7% of the males and 75.4% of the females are literate. Free medical care is provided, and in 1968 there were 310 hospitals and 3242 physicians. There are no laws restricting contraception in Sri Lanka. The Ministry of Health is responsible for operating the country's national program, and the goal of the program is to reduce the birth rate to 25 by 1975. The government provides family planning services through 496 family health bureaus, and oral contraceptives (OC) and condoms are distributed by midwives and through a variety of other channels at low cost. Service statistics for 1967-73 were provided. In 1973 the number of new acceptors was 27,528 for IUDs, 34,214 for OCs, 13,941 for traditional methods, and 20,248 for sterilizations. In 1973, 11 population and family planning projects, funded by the UN Fund for Population Activities were launched in collaboration with a number of government and UN agencies, labor and employer groups, and the University of Sri Lanka. A contraceptive knowledge, attitude, and practice survey was conducted in 1973, and a National Seminar on Law and Population was held in 1974. In 1973 an effort was launched to decentralize and intensify training for family planning personnel, and several new training courses for nurses, midwives, medical officers, health educators, and public health personnel were developed. The national program receives additional assistance from the International Planned Parenthood Federation, the UN Development Programme, the Swedish International Development Authority, the Canadian International Development Agency, the World Assembly of Youth, and the Population Council. During 1973, the Family Planning Association of Sri Lanka provided family planning services for 8174 new acceptors and 20,858 continuing acceptors at its 25 clinics, located primarily in Colombo. The Association conducts several industrial sector and rural programs which promote vasectomy and provide vasectomy services. Recently the Association conducted several mass mdeia educational campaigns, provided family training for 125 government physicians, and conducted several contraceptive studies, including a Depo-Provera study. In 1973, the Population Services International initiated a national social marketing project for distributing condoms.
General survey of the reports relating to conventions nos. 97 and 143 and recommendations nos. 86 and 151 concerning migrant workers. (International Labour Conference, 66th Session, 1980) Report III (Part 4B).
Geneva, Switzerland, ILO, 1980. 189 p.In accordance with article 19 of the International Labor Office (ILO) Constitution, the Governing Body decided at its 201st Session (November 1976) to request reports on the Migration for Employment Convention (Revised), 1949 (No. 97), and the Migrant Workers (Supplementary Provisions) Convention, 1975 (No 143) from governments which have not ratified them, as well as reports on the Migration for Employment Recommendation (Revised), 1949 (No. 86), and the Migrant Workers Recommendation, 1975 (No. 151). These reports, dealing with the state of law and practice in relation to the standards laid down by the instruments in question, and the reports supplied under article 22 of the Constitution by govenments that have ratified 1 or both of the Conventions, have enabled the Committee of Experts to make a general survey of the situation. Reports have been received from 109 countries either under article 19 of the Constitution of the ILO on Conventions Nos. 97 and 143 and Recommendations Nos. 86 and 151 or under article 22 on the 2 Conventions when they have ratified them. An appendix provides detailed information on the countries that have communicated reports. The plan adopted for this present survey is as follows: preliminary measures of protection--information and assistance and recruitment, introduction, and placement of migrant workers; protection against abusive conditions (migrations in abusive conditions, the illegal employment of migrant workers, and minimum standards of protection); equality of opportunity and treatment and social policy; and certain aspects of the employment, residence, and departure of migrant workers. The vast range of subjects covered illustrates the complexity of the subject of migration for employment. The measures needed for the protection of migrant workers extend beyond their period of actual employment and must cover the initial phase of information, recruitment, travel, and settlement into the country of employment and the regulation of rights arising out of the employment but continuing after its termination. During the period of employment, they go beyond measures dealing exclusively with conditions of work to cover various other aspects of conditions of life which affect the context in which the migrant worker has to work and form the broader framework of the conditions of work and life of migrant workers. Thus, it is possibly understandable that few governments have covered all the subjects dealt with in the instruments in their reports. Convention No. 97 has been ratified to date by 34 countries and Convention 143 has been ratified by 8 States. Problems exist in many member States in affording to migrant workers the guarantees provided for in the instruments.
Migrant workers: summary of reports on conventions nos. 97 and 143 and recommendations nos. 86 and 151 (Article 19 of the Constitution). (International Labour Conference, 66th Session, 1980) Report III, part 2.
Geneva, Switzerland, ILO, 1980. 151 p.Article 19 of the Constitution of the International Labor Organization (ILO) provides that Members shall report to the Director General at appropriate intervals on the position of their law and practice in regard to the matters dealt with in unratified Conventions and Recommendations. The reports summarized in this volume concern the Migration for Employment Convention (Revised) (No. 97) and Recommendation (Revised) (No. 86), 1949, Migrant Workers (Supplementary Provisions) Convention, 1975 (No. 143) and Migrant Workers Recommendation, 1975 (No. 151). The governments of member States were asked to send their reports to the ILO Office by July 1, 1979, and this summary covers country reports received by the Office up to November 1, 1979. Reports are included for the following countries: Argentina, Austria, Belgium, Benin, Bolivia, Botswana, Brazil, Cameroon, Colombia, Congo, Cuba, Cyprus, Czechoslovakia, Dominican Republic, Egypt, El Salvador, Fiji, Finland, France, Gabon, German Democratic Republic, Guyana, Hungary, India, Japan, Kuwait, Lebanon, Luxembourg, Madagascar, Malaysia, Mali, Malta, Mauritius, Mexico, Mongolia, Morocco, Netherlands, Niger, Nigeria, Norway, Pakistan, Panama, Peru, Philippines, Poland, Portugal, Romania, Rwanda, Senegal, Sierra Leone, Singapore, Spain, Sri Lanka, Sudan, Surinam, Swaziland, Sweden, Switzerland, Tanzania, Turkey, USSR, UK, Uruguay, Venezuela, and Zambia.
Geneva, Switzerland, WHO, 1980. 290 p.This Sixth Report on the World Health Situation tries to bring out the main ideas on health and health care issues and how to deal with them that arose during the 1973-1977 period. The primary sources of information used in the preparation of the report were the following: information routinely passed on by Member Governments to the World Health Organization (WHO); country reviews specially submitted by Member Governments for the Sixth Report; information routinely collected by other organizations of the United Nations system; and information for the reference period collected by WHO on an "ad hoc" basis to meet specific policy and program requirements. A background chapter focuses on general considerations, population, food and nutrition, education, social changes, economic trends, employment, poverty, health-related behavioral factors, evaluation of development progress and data needs, and policy issues. Subsequent chapters examine health status differentials, health action, research, and the outlook for the future in terms of demographic prospects, social and economic aspects, health status trends, health manpower supply and demand, and world health policies. Most significant during the 1973-1977 period was the explicit recognition of the view that health development is a reflection of conscious political, social, and economic policy and planning rather than merely an outcome (or by-product) of technology. The goal of "health for all by the year 2000" expresses the political commitment of health services and the agencies responsible for them to a "new Health order." Primary health care is the most important vehicle for achieving this new health order. The most important social trends during the report period are reflected in the still low and in some areas worsening nutritional level of the majority of the population. The overall picture with regard to mortality continues to be mixed, with a few notable cases of marked decline and many of continuing unspectacular decline. The data on morbidity are even less reliable than those on mortality, but it appears that there has been a significant increase or resurgence of certain communicable diseases. There is evidence of decreasing dependence on physicians in some parts of the world and a related strengthening of various paramedical and auxiliary groupings. Some of the important new health programs are to be found in the area of family health. The overall role and importance of primary health care are emphasized in many parts of the report. There are some specific indications of ways in which primary health care activities are being integrated with the more traditional activities of the health sector.
Geneva, Switzerland, WHO, 1980. 412 p.This report on the world health situation comes in 2 volumes, and this, the 2nd volume, reviews the health situation by country and area, with the additions and amendments submitted by the governments, and an addendum for later submissions. Information is presented for countries in the African Region, the Region of the Americas; the Southeast Asia Region, the European Region, the Eastern Mediterranean Region, and the Western Pacific Region. The information provided includes the following areas: the primary health problems, health policy; health legislation; health planning and programming; the organization of health services; biomedical and health services research; education and training of health manpower; health establishments; estimates of the main categories of health manpower; the production and sale of pharmaceuticals; health expenditures; appraisal of health services; demographic and health data; major public health problems; training establishments; actions taken; preventive medicine; and public health.
Washington, D.C., World Bank, 1980 Aug. 166 p.This report examines some of the difficulties and prospects faced by developing countries in continuing their social and economic development and tackling poverty for the next 5-10 years. The 1st part of the report is about the economic policy choices facing both developing and richer countries and about the implications of these choices for growth. The 2nd part of the report reviews other ways to reduce poverty such as focusing on human development (education and training, health and nutrition, and fertility reduction). Throughout the report economic projections for developing countries have been carried out, drawing on the World Bank's analysis of what determines country and regional growth. Oil-exporting countries will face greater economic growth; their average GNP per person could grow 3-3.5% in the 1980s. Oil-importing countries will develop slower or fall to 1.8%/year. Poverty in oil-importing developing countries could grow at about 2.4% GNP/person and by 1990 there would be 80 million fewer people in absolute poverty. Factors which will contribute to the economic problems of developing countries are trade (import/export), energy, and capital flow. The progress of developing countries depends on internal policies and initiatives concerning investment and production efficiency, human development and population. Not only can human development increase growth but it can help to reduce absolute poverty.
New York, UNFPA, 1978 Jun. 53 p. (Report No 3)The present report presents the findings of the Mission which visited Afghanistan from October 3-16, 1977 for the purpose of assessing the country's needs for population assistance. Report focus is on the following: the national setting (geographical, cultural, and administrative features; salient demographic, social, and economic characteristics of the population; and economic development and national planning); basic population data; population dynamics and policy formulation; implementing population policies (family health and family planning and education, communication, and information); and external assistance (multilateral and bilateral). The final section presents the recommendations of the Mission in detail. For the past 25 years Afghanistan has been working to inject new life into its economy. Per capita income, as estimated for 1975, was $U.S. 150, a relatively low figure and heavily skewed in favor of a very small proportion of the population. The country is still predominantly rural (85%) and agricultural (75%). In the absence of reliable data, population figures must be accepted tentatively. According to the 7-year plan, the population in 1975 was 16.7 million and the rate of growth around 2.5% per annum. The crude birth rate is near 50/1000 and the crude death rate possibly 25/1000. The Mission endorses the priority given by the government to the population census and recommends continued support on the part of the United Nations Fund for Population Activities (UNFPA) to help the Central Statistical Office in the present effort and in building up capacity for future work. The Mission recommends that efforts be concentrated on the reduction of infant, child, and maternal mortality levels and that assistance be continued to the family health services and to programs of population education. Emphasis should be on services to men and women in rural areas. The Mission also recommends a training program for traditional birth attendants.
Impact of population assistance to an African country: Department of State, Agency for International Development. Report to the Congress by the Comptroller General of the United States
U.S. General Accounting Office. Comptroller General, Washington, D.C., United States, 1977. (ID-77-3) v, 65 p.Add to my documents.
[Unpublished] . 26 p.The basis of reproductive control is a woman's ability to consider the matter as an integrated part of her life. Despite this reality, there exists a contradiction in the organization and provision of women's reproductive health care. Services are fragmented between a number of programs and providers, providing a piecemeal approach to care. This paper explains the causes of such fragmentation and argues the need for an integrated system around women's reproductive health services. The modern fragmentation is related to the definition of health care put forward by the medical profession in the 19th century and the continued response of advocacy groups to this definition. By reviewing this history and examining the relation of birth control to other reproductive services, it is possible to understand the current political stalemate which surrounds women's health services. The fragmentation of reproductive health care occurred in the 19th century. During that period, women-dominated networks of care gave way to a male-dominated system for treating disease. The medical profession most profoundly influenced this process. In its push to establish professional dominance, reproduction was transformed so that a distinction was made between birthing and pregnancy prevention. Male physicians controlled the former while the antiabortion and obscenity laws made the latter unlawful. Women's reproductive health services have never been an accepted part of medicine, and therefore never integrated into the health care delivery system. Current attacks are to a large extent similar to those experienced by those birth control advocates who organized in response to the Comstock law. Women who distributed birth control literature in the early 1900s were jailed. Clinics were closed in the 1920s and 1930s. Physicians working for Planned Parenthood affiliates were harassed by local medical societies in the 1950s. In the 1960s and early 1970s clinics were the site of pickets who charged them with practicing genocide. The form has changed, and clinics are now faced with federal cutbacks and regulations. The intent remains the same. These actions are designed to discourage clients from seeking and utilizing services because family planning is not considered an integral part of medical practice. This history also teaches that the strategies that were successful in the past may not be as effective in the future. The strategy needed now is one of intergration. Services are vulnerable because they are provided independently of each other. They could be better protected if the various reproductive health organizations formed alliances and coalitions. In this way it would become more difficult to single out a specific services because it would be an integral part of a comprehensive program. Administrative initiatives have failed because fragmentation is deeply entrenched in the history of medicine and health service delivery.