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Journal of the College of Physicians and Surgeons Pakistan. 2014 Jul; 24(7):493-7.OBJECTIVE: To evaluate the efficacy of adopting WHO feeding guidelines on weight gain and case fatality rate in malnourished children. STUDY DESIGN: Cross-sectional, observational study. PLACE AND DURATION OF STUDY: Department of Pediatrics, Dow University of Health Sciences, Karachi, from 2009 to 2010. METHODOLOGY: Patients above 6 months and less than 5 years of age with severe malnutrition were included during the study period, acute complications were treated and nutritional rehabilitation by WHO feeding formulae was done. Demographic details, clinical features, reasons for weight gain and risk factors of mortality were analyzed. RESULTS: A total of 131 children were included. Mean age of children was 22 +/- 18 months. There were 78% marasmic, 4% kwashiorkor and marasmic kwashiorkor 18% children. Resolution of edema took 8 +/- 4 days, dermatosis cleared in 11 +/- 3 days. Mean hospital stay was 10 +/- 8 days. Case fatality rate was 13%. Mean weight gain was 5.25 +/- 4.57 g/kg/day. Weight gain of > 5 gm/kg/day was associated with hospital stay of more than 7 days, acceptability and palatability of feed by the children and mothers and early clearance of infections. CONCLUSION: Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however, adequate healthcare services are available at the therapeutic feeding centers.
Communities of practice: The missing link for knowledge management on implementation issues in low-income countries?
Tropical Medicine and International Health. 2011 Aug; 16(8):1007-1014. [The implementation of policies remains a huge challenge in many low-income countries. Several factors play a role in this, but improper management of existing knowledge is no doubt a major issue. In this article, we argue that new platforms should be created that gather all stakeholders who hold pieces of relevant knowledge for successful policies. To build our case, we capitalize on our experience in our domain of practice, health care financing in sub-Saharan Africa. We recently adopted a community of practice strategy in the region. More in general, we consider these platforms as the way forward for knowledge management of implementation issues.
Coordination, management and utilization of foreign assistance for HIV / AIDS prevention in Vietnam. Assessment report.
Ha Noi, Vietnam, CCRD, 2006 Oct. 82 p. (CCRD Assesssment Report)International assistance for HIV / AIDS prevention and control in Vietnam has significantly contributed to combating this epidemic. However, while current resources have not yet fully met the needs, the management and utilization of resources still had many limitations which affect the effectiveness of foreign assistance and investments. The independent assessment was prepared for the Conference on “the Coordination of Foreign Assistance for HIV / AIDS Prevention and Control”. Analytical assessment and comments on the management and coordination of foreign aid were made on the basis of Government’s official procedures and regulations on those issues. This research was carried out in October, 2006.
European Journal of Public Health. 2007 Oct; 17(5):409.In public health teaching, tuberculosis (TB) has been a traditional example of how disease occurrence is determined by the triad agent, environment, host. And it has since long been standard textbook knowledge that there are strong socioeconomic determinants behind all three components: The agent is more prevalent and is spread more easily in conditions of crowding and poor hygienic conditions, and under these conditions several host factors are also more prevalent, such as malnutrition and alcoholism. In recent years another dimension has been added to the socioeconomic patterning of TB: An already very solid mass of research has highlighted the social and economic aspects of care and follow-up of patients with TB. A recent example of this research is the paper by Wang et al. in this issue of the journal, on differences in both patient's delay and doctor's delay in the diagnosis of TB, when comparing residents and non-residents (rural immigrants) in Shanghai. (excerpt)
International Journal of Health Planning and Management. 1997; 12:149-157.This note seeks to sharpen our understanding of co-ordination and its significance in healthcare management by offering a picture of an activity where information, incentives and the mixing of various (professional and other) cultures are key. The research design was policy driven, and concentrated on incentives, decision-making and information gathering/ dissemination activities particularly between individuals working across different types of organizations. Data are drawn from 40 primary interviews with mostly senior staff from organizations in two countries, USA and Thailand, internal and external corporate documents, over 1000 items from a Reuters database of news items, newspaper articles and press releases, as well as secondary academic articles. The interviews, which lasted from between 20 min to more than 3 h over two visits, constitute the main source of evidence for the issues discussed below. (excerpt)
Significance of foreign funding in developing health programmes in India - the case study of RNTCP in the overall context of North-South co-operation.
Health Administrator. 2003; 15(1-2):52-60.External assistance on disease containment and health policy has been a global phenomenon ever since the advent of modern medicine. The technically and resource advanced countries have been contributing to health programs of the resource constrained nations particularly with an objective of disease containment and eradication. India has its own history of receiving external assistance for its health programs since 1950s. Eradication of Small Pox, control of Malaria in 1970s, Family Planning Program, Universal Immunization Program (UIP), Pulse Polio and more recently campaigns against Human Immune-deficiency Virus (HIV) and Tuberculosis Programme had been supported by bilateral or multilateral aids. External assistance in India is small in terms of its proportion to the Gross Domestic Product (GDP). In health, it has never been more than 1-3 % of the total public health spending in any given year. Yet external assistance has had a profound impact on health, as technical support obtained from such assistance has made a significant contribution to hastening India’s demographic and epidemiological transition. The present paper reviews the issue of foreign funding in health programmes and specifically highlights its impact of TB Programme development in India. (excerpt)
Geneva, Switzerland, WHO, Department of Child and Adolescent Health and Development, 1999. 4 p. (IMCI Information. Integrated Management of Childhood Illness (IMCI); WHO/CHS/CAH/98.1H)The WHO Department of Child and Adolescent Health and Development (CAH) has developed and made available a range of tools and materials to support the implementation of Integrated Management of Childhood Illness (IMCI). Many continue to be modified and expanded in the light of country experience and research findings. The materials include: clinical guidelines and training materials for first-level heath facilities, a guide to support the adaptation of IMCI clinical guidelines and training materials to specific country needs, guidelines for conducting follow-up visits to recently trained health workers, a breastfeeding counselling course, and a course to train health workers from first-level health facilities in managing drug supplies. In addition, the Department currently supports a range of initiatives, described below, to strengthen the implementation of the IMCI strategy. These focus on general management issues and the three components of the strategy – improving health workers’ skills, improving the health system to support IMCI and improving family and community practices. (excerpt)
South Africa. Improving access and choice in reproductive health education and services: PPASA in the South African urban slums.
Ampang, Malaysia, International Council on Management of Population Programmes [ICOMP], 2000 Sep.  p. (Series on Upscaling Innovations in Reproductive Health No. 12)South Africa has what is often described as the most progressive constitution in the world, guaranteeing sexual and reproductive health (SRH) to all regardless of race, religion, sex, disability or sexual orientation. Since the new, democratically elected government came to power, numerous legal obstacles, which would have slowed down progress in improving reproductive health (RH), have been reformed. Despite these significant achievements in the field of RH, South Africa still has numerous and difficult obstacles to overcome. The government is in the process of transforming a previously fragmented health system into an integrated, unitary health system. The country is also facing the enormous task of dealing with a rapidly rising Human Immuno-deficiency Virus/Acquired Immuno-Deficiency Syndrome (HIV/AIDS) epidemic, unwanted adolescent pregnancy, high maternal mortality rate, and increased sexual violence against women and children. Resources and other limitations related to the past legacy of apartheid have also slowed down the pace of bringing genuine equity and opportunity to all South Africa’s people, especially for women and youths. South Africa may be fairly described as the “potential engine for development in East and Southern Africa”, with growth accelerating to almost 3% and inflation falling to less than 10%. The high unemployment rate, however (25-30% overall, with almost double this rate for coloured people in South Africa), continues to undermine these economic achievements. An estimated 25% of South Africans (mostly black) subsist on less than $1.00 per day in the shadow of opulence and privilege. (excerpt)
Bulletin of the World Health Organization. 2003 Nov; 81(11):777.During the last quarter-century or so there has been a revolution in both health and information technology. For the globe as a whole we have seen tremendous strides made in life expectancy and disease control, together with an explosion of information technology and techniques. Humanity now has the potential to make all existing health knowledge available simultaneously to the entire population of the planet. By no means everyone has benefited from the overall trend of increased life expectancy, however, or from that of increased knowledge and its communicability. This gap goes beyond the notion of the “digital divide”. It is a “knowledge divide”, in which large sections of humanity are cut off not just from the information that could help them but from any learning system or community that fosters problem-solving. (excerpt)
[Unpublished] 1993 Dec. xii, 217,  p. (Report No. 12577-AFR)The World Bank has recommended a blueprint for health improvement in sub-Saharan Africa. African countries and their external partners need to reconsider current health strategies. The underlying message is that many African countries can achieve great improvements in health despite financial pressure. The document focuses on the significance of enhancing the ability of households and communities to identify and respond to health problems. Promotion of poverty-centered development strategies, more educational opportunities for females, strengthening of community monitoring and supervision of health services, and provision of information on health conditions and services to the public are also important. Community-based action is vital. The report greatly encourages African governments to reform their health care systems. It advocates basic packages of health services available to everyone through health centers and first referral hospitals. Health care system reform also includes improving management of health care inputs (e.g., drugs) and new partnerships between public agencies and nongovernmental health care providers. Ministries of Health should concentrate more on policy formulation and public health activities, encourage private voluntary organizations, and establish an environment conducive to the private sector. African countries need more efficient allocation and management of public financial resources for health to boost their effect on critical health indicators (e.g., child mortality). Public resources should also be reallocated from less productive activities to health activities. More commitment from governments and domestic sources and an increase of external assistance are needed for low income African countries. The first action step should be a national agenda for health followed by action planning and setting goals to measure progress.
Report of the European Region on Immunization Activities. (Global Advisory Group EPI, Alexandria, October 1984). WHO/Expanded Immunization Programme and the European Immunization Targets in the Framework of HFA 2000.
[Unpublished] 1984. Presented at the EPI Global Advisory Group Meeting, Alexandria, Egypt, 21-25 October 1984. 3 p. (EPI/GAG/84/WP.4)Current reported levels of morbidity and mortality from measles, poliomyelitis, diphtheria, tetanus, and tuberculosis in most countries in the European Region are at or near record low levels. However, several factors threaten successful achievement of the Expanded Program on Immunization (EPI) goal of making immunization services available to all the world's children by the year 2000, including changes in public attitudes as diseases pose less of a visible threat, declining acceptance rates for certain immunizations, variations in vaccines included in the EPI, and incomplete information on the incidence of diseases preventable by immunization and on vaccination coverage rates. To launch a more coordinated approach to the EPI goals, a 2nd Conference on Immunization Policies in Europe is scheduled to be held in Czechoslovakia. Its objectives are: 1) to review and analyze the current situation, including achievements and gaps, in immunization programs in individual countries and the European Region as a whole; 2) to determine the necessary actions to eliminate indigenous measles, poliomyelitis, neonatal tetanus, congenital rubella, and diphtheria; 3) to consider appropriate policies regarding the control by immunization of other diseases of public health importance; 4) to strengthen existing or establish additional systems for effective monitoring and surveillance; 5) to formulate actions necessary to improve national vaccine programs in order to achieve national and regional targets; 6) to reinforce the commitment of Member Countries to the goals and activities of the EPI; and 7) to define appropriate activities for the Regional Office for Europe of the World Health Organization to achieve coordinated action.
[Unpublished] 1985. 114 p.This document is a practical guide to help those Planned Parenthood Associations which want to establish contraception and counseling services for young people. It draws its examples from the considerable experience of selected European countries in what can be controversial and difficult areas. In the section devoted to adolescent sexuality and contraception, contributors cover culture and subculture, health and sexuality, sexual behavior and contraceptive services, the adolescent experience, the question of opposition to services for adolescents, and statistical indices. 1 section is devoted to examples of contraceptive counseling services for adolescents in Sweden, Italy, France, the UK, and Poland. Another section summarizes service provision examples. The 5th section presents methodology for the establishment of adolescents services and the final section discusses methodology testing of new projects. This report contends that the case for the rapid development of contraceptive/counseling services, tailored to the needs and desires of young people, is justified on moral as well as on sociological, psychological, and health grounds. It rejects totally the argument that any measure which could facilitate the sexual debut of the unmarried or legally dependent adolescent should be resisted. It does recognize public concern about family breakdown and the potential health risks of sexual activity but considers the examples given as measures designed to combat rather than ignore these. Taking into account sociological, psychological, and medical evidence, the contributors to this report challenge the following presumptions: sexual activity among the young is always and necessarily morally unacceptable and socially destructive; adolescents will resort to promiscuous sexual activity in the absence of legal deterrents such as refusal of access to contraceptive/counseling services; the potential health risks of sexual activity and use of contraceptives during adolescence provide sufficient justification for deterrent measures, including refusal of contraceptive/counseling services; and the scale of sexual ignorance and prevalence of unplanned pregnancy among adolescents can only be reduced by disincentives and deterrents to sexual activity itself. The case for the provision of contraceptive/counseling services rests on their potential to help adolescents to recognize and resist repressive forms of sexual activity, which are destructive of humanmanships. Evidence suggests that it is not difficult to attract a large cross-section of an adolescent public to use contraceptive/counseling services, where established.
Health and health services in Judaea, Samaria and Gaza 1983-1984: a report by the Ministry of Health of Israel to the Thirty-Seventh world Health Assembly, Geneva, May 1984.
Jerusalem, Israel, Ministry of Health, 1984 Mar. 195 p.Health conditions and health services in Judea, Samaria, and Gaza during the 1967-83 period are discussed. Health-related activities and changes in the social and economic environment are assessed and their impact on health is evaluated. Specific activities performed during the current year are outlined. The following are specific facets of the health care system that are the focus of many current projects in these districts; the development of a comprehensive network of primary care programs and centers for preventive and curative services has been given high priority and is continuing; renovation and expansion of hospital facilities, along with improved staffing, equipment, and supplies for basic and specialty health services increase local capabilities for increasingly sophisticated health care, and consequently there is a decreasing need to send patients requiring specialized care to supraregional referral hospitals, except for highly specialized services; inadequacies in the preexisting reporting system have necessitated a continuting process of development for the gathering and publication of general and specific statistical and demographic data; stress has been placed on provision of safe drinking water, development of sewage and solid waste collection and disposal systems, as well as food control and other environmental sanitation activities; major progress has been made in the establishment of a funding system that elicits the participation and financial support of the health care consumer through volunary health insurance, covering large proportions of the population in the few years since its inception; the continuing building room in residential housing along with the continuous development of essential community sanitation infrastructure services are important factors in improved living and health conditions for the people; and the health system's growth must continue to be accompanied by planning, evaluation, and research atall levels. Specific topics covered include: demography and vital statistics; socioeconomic conditions; morbidity and mortality; hospital services; maternal and child health; nutrition; health education; expanded program immunization; environmental health; mental health; problems of special groups; health insurance; community and voluntary agency participation; international agencies; manpower and training; and planning and evaluation. Over the past 17 years, Judea, Samaria, and Gaza have been areas of rapid population growth and atthe same time of rapid socioeconomic development. In addition there have been basic changes in the social and health environment. As measured by socioeconomic indicators, much progress has been achieved for and by the people. As measured by health status evaluation indicators, the people benefit from an incresing quantity and quality of primary care and specialty services. The expansion of the public health infrastructure, combined with growing access to and utilization of personal preventive services, has been a key contributor to this process.
Boston, Massachusetts, MSH, 2001. 26 p.This 2001 annual report summarizes the efforts of Management Sciences for Health (MSH) at the global, national, and local levels to fight HIV/AIDS and other preventable diseases. It is noted that MSH seeks to increase the effectiveness and sustainability of health services by improving management systems, promoting access to services, and influencing public policy. Its activities focus on educating those concerned in health care; applying practical management skills to public health problems in the public and private sectors; strengthening capabilities through collaborative work and training programs; and applying and replicating innovations in health management. Case studies from Malawi and Brazil are included.
Kuala Lumpur, Malaysia, ICOMP, 1988 Jan. vi, 68 p.1987 has proven to be a most successful year for the International Council on Management of Population Programs (ICOMP). Membership expanded to 61 -- program managers 34, heads of management institutes 12, associate members 9, and honorary members 6. 6 workshops were held in 1987, 4 devoted to population program management and 2 in the area of women's programs. The UN Fund for Population Activities (UNFPA), South Asian Management Program (SAMP) is being executed in a timely manner. ICOMP also executed a management training program for Vietnam at the request of the UNFPA. Training activities were conducted in Vietnam, and study tours of the ASEAN region were conducted. Other activities in 1987 included the study tour of China, the ongoing research activities under the community participation project, and various international activities. The 1987 Financial Report and Accounts shows that ICOMP has reached its financial target of US$1,000,000. The actual income for 1987 was US$1,014,602. The various activities of the year are detailed.
Workshop for Managers of the Expanded Programme on Immunization. Convened by the Regional Office for the Western Pacific of the World Health Organization, Manila, Philippines, 28 July - 1 August 1986. Report.
Manila, Philippines, WHO, Regional Office for the Western Pacific, 1987 Jan. 39 p. (ICP/EPI/001)The Workshop of Managers of the Expanded Program on Immunization (EPI), held in the Philippines in August 1986, sought to review the progress of the EPI on a country-by-country basis, identify barriers to program implementation, identify the strategies likely to accelerate the EPI, and propose national EPI plans of action to meet the goal of providing immunization of all children of the world by 1990. The workshop was attended by 26 participants from 19 countries of the World Health Organization's Western Pacific Region. Participants concluded that program acceleration can be achieved by adopting national immunization schedules that protect children as early in the 1st year of life as possible, promote immunization at every contact point, and mobilize consumer demand through community participation. Strategies to improve the management of immunization programs include reduced clinic waiting times, information on side effects of immunization, use of the growth chart as the immunization record, use of sterile needles and syringes for each injection, and promotion of record systems that identify children who have not appeared for scheduled immunizations. All national programs should set specific immunization coverage and disease reduction targets, with particular priority given to measles, poliomyelitis, and neonatal tetanus. National program reviews remain an effective means of identifying problems, suggesting solutions, and obtaining commitment from decision makers.
In: High risk mothers and newborns: detection, management and prevention, edited by Abdel R. Omran, Jean Martin and Bechir Hamza. Thun, Switzerland, Ott Verlag, 1987. 355-60.Today the UN Fund for Population Activities (UNFPA) is working in 8 main areas: 1) basic data collection, 2) population dynamics, 3) formulation of population policies and programs, 4) implementation of policies and programs, 5) family planning, 6) communication and education, 7) special programs, and 8) multisector activities. UNFPA has always been convinced of the health benefits of family planning or of the negative effects of unregulated fertility on maternal, perinatal, neonatal, infant, and child health. In countries which remain unconvinced of the need for family planning, UNFPA has provided assistance for conducting studies which tend to demonstrate the negative health effects of unregulated fertility. In countries convinced of the need for providing family planning services, on the basis of studies of the type just mentioned or of demographic or socioeconomic evidence, a shift typically occurs in UNFPA assistance patterns toward greater support for family planning service-related activities. Such services may take a variety of forms in accordance with national desires and still be eligible for UNFPA support, so long as all couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children. UNFPA will support both high-risk-only family planning programs and those open to all comers, but movement toward wider availability is always welcomed. Regarding modes of service delivery, UNFPA is willing to support 1) specialized free-standing, nonintegrated family planning programs; 2) family planning integrated with maternal and child health in the context of primary health care; 3) family planning integrated in socioeconomic development programs; 4) community based distribution programs, and 5) commercial marketing programs.
POPULATION MANAGER: ICOMP REVIEW. 1987 Jun; 1(1):19-22.Communication plays an essential role in creating the necessary social climate for the development and adoption of population policies and in supporting actions undertaken to implement these policies. To be effective, however, there must be integrated communication for population and development programs. In addition to knowledge of the mass media and community organizations, communicators in the field of population must have the ability to collaborate with other development programs in an intersectoral effort, Toward this end, UNESCO, in collaboration with the Asia-Pacific Institute for broadcasting Development, has organized specialized courses in the management of population communication programs. A review of the situation at the time this program was initiated revealed that IEC directors had minimal knowledge and understanding of the role of IEC in family planning programs, little practical experience in planning and managing multimedia, community-based, interpersonal communication activities, and these programs had no scientifically established data base. As result, a pilot 2-week course comprised of o modules was held in India in 1983. Module 1 focused on a systematic problem-solving approach to IEC program situations, Module ii emphasized human resource management, and Module III was designed to impart specific communication skills. The course was subsequently expanded to 3 weeks, and has in the past 3 years involved 54 persons from 20 countries. Unesco has also developed a population communication course in collaboration with the Arab States Broadcasting Union.
HEALTH POLICY AND PLANNING. 1986 Mar; 1(1):37-47.This economic analysis assesses the probable costs of implementing various activities of the World Health Organization's (WHO's) global strategy of "health for all by the year 2000" and the likelihood that developing countries will be able to afford these costs, either on their own or with the assistance of developed countries. If this policy is to be transformed into concrete results, there must be a plan complete with budgetary requirements, planned activities, and expected results specified in adequate detail. The overall costs of the activities proposed by the global strategy would amount to approximately 5% of the gross national product of most developing countries, with water supplies and primary health care comprising the most expensive activities. Although there is a good match between estimated resource requirements and planned activities, the desired outcomes are often unlikely to result from the activities proposed. At present, all 25 industrial market and nonmarket industrial developed countries have already achieved the outcome goals of the global strategy; however, these countries account for only 25% of the world's population. Of the 63 middle-income countries, 54 have already achieved a gross national product per capita of over US$500, but only 22 have an infant mortality rate better than 50/1000. Very few low-income countries are close to reaching their targets for income, infant mortality, life expectancy, or literacy. On the basis of current trends, 25-33% of countries are considered unlikely to achieve the outcome goals by the year 2000. In general, it appears that expenditure targets are too low to cover the needed health services activities. Further research on the costs of health promoting activities such as immunization and primary health care should be given high priority.
New York, New York, United Nations Fund for Population Activities, 1985. viii, 41 p. (Report Number 71.)This report contains the findings of the United Nations Fund for Population Activities' 2nd Basic Needs Assessment Mission to Pakistan (March 24-April 9, 1984). Pakistan, the world's 8th most populous country is projected to have over 200 million people by 2020. The current growth rate is 3.1%, total fertility is 5.84/woman, and urban growth is 4.4%. Governmental efforts emphasize and fund education, manpower, and health improvements, but much research on 1) family planning program cost effectiveness, 2) expected demographic effects of the 6th Plan, 3) relationships of nuptiality, fertility, and mortality rates and trends, 4) population projections, and 5) internal and international migration is needed. Population programs suffer from lack of trained manpower. The Government's 6th 5 Year Plan (1983-1988) strives to 1) raise the current family planning practice level from 9.5% to 18.6%; 2) raise the continuous family planning practice level from 6.8% to 13%, and 3) provide reproductive care and child health services. Mission recommendations include expanding outreach services, studying the use of traditional medical practioners (hakeems), and motivating younger couples to seek sterilization. Mission recommendations for improving population education include 1) greater primary school teacher training, 2) adding population education to only 2 or 3 subjects at each grade level, 3) introducing population education into the non-formal sector and into literacy programs, and 4) introducing a population component into projects for women and youth. The report also describes programs in Pakistan and external, multilateral assistance.
Washington, D.C., PAHO, Pan American Sanitary Bureau/Regional Office of the World Health Organization, 1985. xix, 265 p. (Official Document No. 201)Efforts to meet the goal of health for all by the year 2000 have been hampered by the internal and external problems faced by many countries of the Americas. The pressures of external debt have been accompanied by a reduction in the resources allocated to social sector programs, including health programs. In addition, the conflict in Central America has constrained solutions to subregional problems. The health sector suffers from uncoordinated services, lack of trained personnel, and waste. Thus 30-40% of the population do not have access to basic health services. In 1984, the governments in the region, together with the Pan American Health Organization (PAHO), undertook projects in 5 action areas: new approaches and technology, development, intra- and intersectoral linkages, joint activities by groups of countries, mobilization of national resources and external financing, and preparation of PAHO to meet the needs of these processes. New approaches include the expansion of epidemiological capabilities and practices, the use of low-cost infant survival strategies, the improvement of rural water supplies, and the development of domestic technology. Interorganizational linkages are aimed at eliminating duplication and filling in gaps. Ministers of health and directors of social security programs are working together to rationalize the health sector and extend coverage of services. Similarly, countries have grouped to deal with common problems and offer coordinated solutions. The mobilization of national resources involves shifting resources into the health field and increasing their efficiency and effectiveness by setting priorities. External resources are recommended if they supplement national efforts and are short-term in nature. In order to enhance these strategies, PAHO has increased the managerial and operating capacity of its central and field offices. This has required consolidating programs, retraining staff, and instituting information systems to monitor activities and budgets. The report summarizes health indicators and activities by country, for all nations under PAHO.
Washington, D.C., SOMARC, .  p.This document contains briefing materials for the participants of an upcoming meeting of the advisory council and working groups of Social Marketing for Change (SOMARC), an organizational network, funded by the US Agency for International Development (USAID) and composed of 5 firms which work together in helping agencies, organizations, and governments develop contraceptive social marketing programs. Social marketing is the use of commercial marketing techniques and management procedures to promote social change. The briefing materials include 3 background and 18 issue papers. The background papers provide brief summaries of USAID's population activities and of the history of social marketing programs, an overview of USAID sponsored contraceptive social marketing programs in 14 countries and of 3 major non-USAID programs, and a listing of the skills and resources needed to develop effective contraceptive social marketing programs. The issue papers provide a focus for the discussion sessions which are scheduled for SOMARC's working groups on marketing communication, management, and research. USAID's objective is to promote the development of family planning programs which are completely voluntary and which increase the reproductive freedom of couples. Contraceptive social marketing programs are consistent with this objective. USAID provides direct funding for family planning programs as well as commodity, technical, and training support. USAID's involvement in social marketing began in 1971, and USAID is currently sponsoring programs in Jamaica, Bangladesh, Nepal, El Salvador, Egypt, Honduras, Ecuador, the Caribbean Region, Costa Rica, Guatemala, and Peru. In the past, USAID provided support for programs in Mexico, Tunisia, and Ghana. The Mexican project is now functioning without USAID support, and the projects in Tunisia and Ghana are no longer operating. Major non-USAID contraceptive social marketing programs operate in India, Sri Lanka, and Colombia. These programs received only limited technical support from USAID. To ensure the success of social marketing programs, social marketers must have access to the knowledge and skills of commercial marketers in the areas of management, analysis and planning, communications, and research. Social marketers must also have expertise in social development and social research. In reference to the issue papers, the working groups and the advisory council were asked to develop suggestions for 1) overcoming social marketing program management problems, 2) motivating health professionals toward greater involvement in social marketing programs, 3) improving the media planning component of the programs, 4) improving management stability and training for management personnel, and 5) improving program evaluation. Areas addressed by the issue papers were 1) whether social marketing programs should be involved in creating a demand for contraceptives or only in meeting the existing demand, 2) the development of a methodology for assessing why some programs fail and others succeed, 3) the feasibility of using anthropological and questionnaire modules for conducting social marketing research, 4) techniques for overcoming the high level of nonsampling error characteristic of survey data collected in developing countries, 5) techniques for identifying contraceptive price elasticity, 6) the feasibility of using content analysis in social marketing communications, 7) the applicability of global marketing strategies for social marketing, and 8) how to select an an appropriate advertising agency to publicize social marketing programs.