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POPULATION RESEARCH ABSTRACT. 1991 Dec; 2(2):3-11.An overview, objectives, implementation, and research and evaluation studies of 2 India Population Projects in Karnataka are presented. The India Population Project I (IPP-I) was conducted in Karnataka and Uttar Pradesh. India Population Project III (IPP-III) took place between 1984-92 in 6 districts of Karnataka: Belgaum, Bijapur, Dharwad, Bidar, Gulbarga, and Raichur, and 4 districts in Kerala. The 6 districts in Karnataka accounted for 36% (13.2 million) of the total national population. The project cost was Rs. 713.1 million which was shared by the World Bank, and the Indian national and regional government. Due to poor past performance, these projects were undertaken to improve health and family welfare status. Specific project objectives are outlined. IPP-I included an urban component, and optimal Government of India program, and an intensive rural initiative. The urban program aimed to improved pre- and postnatal services and facilities, and the family planning (FP) in Bangalore city. The rural program was primarily to provide auxiliary nurse-midwives and hospitals and clinics, and also supplemental feeding program for pregnant and nursing mothers and children up to 2 years. The government program provided FP staff and facilities. IPP-I had 3 units to oversee building construction, to recruit staff and provide supplies and equipment, and to establish a Population Center. IPP-III was concerned with service delivery; information, education, and communication efforts (IEC) and population education; research and evaluation; and project management. Both projects contributed significantly to improving the infrastructure. A brief account of the types and kinds of studies undertaken is given. Studies were grouped into longitudinal studies of fertility, mortality, and FP; management information and evaluation systems for health and family welfare programs; experimental strategies; and other studies. Research and evaluation studies in IPP-III encompassed studies in gaps in knowledge, skills, and practice of health and FP personnel; baseline and endline surveys; and operational evaluation of the management information and evaluation system; factors affecting primary health care in Gulbarga district; evaluation of radio health lessons and the impact of the Kalyana Matha Program; and studies of vaccination and child survival and maternal mortality. Training programs were also undertaken.
Mexico City, Mexico, MEXFAM, 1988 Feb. , 10 p.During 1987 the Mexican Federation for Family Planning (MEXFAM) continued developing its programs following the same orientation as in the previous year, but at a slower pace intended to achieve a greater degree of consolidation. A permanent mechanism for qualitative evaluation was arranged with the Mexican Institute for Social Studies, an external organization. Work was initiated in 4 new states, bringing the total to 26 of Mexico's 32 states. Activities were suspended in Yucatan because new information revealed that fertility rates were relatively low. MEXFAM does not seek to provide massive family planning coverage but rather to act as a catalyst for family planning activities. MEXFAM is expanding its program of "community doctors", in which it assists young medical school graduates to establish practices in underserved urban areas. In a similar program, "affiliate doctors", physicians already established in their communities, receive technical assistance and materials to begin offering family planning services. During 1987, MEXFAM initiated the "Young People" program to provide sex and family planning education to young people under 20 in schools, clubs, and recreation centers. Various films were made to provide sex education to the Young People program. They were well received in Mexico and some were broadcast in other countries. In 1987, 382,328 new users were served, compared to 174,634 in 1986. 73% of the new users were in MEXFAM programs and the rest were in collaborative programs. Mexico's deteriorating economic situation in 1987 was reflected in increasing resource scarcities for public health organizations. The broad geographic distribution and remoteness of some MEXFAM programs pose a serious challenge for control and supervision. Programs have been grouped into logistic centers with responsibility for supervision assigned on a regional basis. MEXFAM is making great efforts to improve its record system, adapt it to International Planned Parenthood Federation requirements, and make it compatible with the Ministry of Health record system. A certain amount of confusion is anticipated in 1988 as workers become accustomed to new record formats. User payments are the main source of local revenues for MEXFAM. Given Mexico's poor economic situation, the prospects for an increase in local donations are poor, but efforts to raise funds locally are continuous. 4 new external donors were added in 1987. The International Planned Parenthood Federation continues to be the main source of funds. 87% of MEXFAM funds were directly spent on projects and 13% on administration and general services in 1987.
PEOPLE. 1987; 14(2):33.3 agencies in Turkey are placing family planning centers in factory settings: the Family Planning Association of Turkey (FPAT), the Confederation of Trade Unions (TURK-IS), and the Family Health and Planning Foundation, a consortium of industrialists. The FPAT started with 27 factories 7 years ago, educating and serving 35,000 workers. The 1st work with management, then train health professionals in family planning, immunization, infant and child care, maternal health, education, motivation techniques, record-keeping and follow-up. Worker education is then begun in groups of 50. New sites are covered on a 1st-come-1st-served basis. This program is expected to be successful because newcomers to city jobs are beginning to see the need for smaller families, and accept family planning. TURK-IS has conducted seminars for trade union leaders and workers' representatives and provided contraceptives in 4 family planning clinics and in 20 hospitals run by Social Security, a workers' health organization. They have distributed condoms in factories and trained nurses to insert IUDs in factory units. The businessmen have opened family planning services in 15 factories, with support from the Pathfinder Fund, and hope to make the project self-supporting.
In: Family planning within primary health care, edited by F. Curtis Swezy and Cynthia P. Green. Washington, D.C., National Council for International Health, 1987. 112-4.The World Bank's appreciation of the unique role of NGOs in working beyond the effective reach of government systems in reaching underserved populations and communities has come with its increasing involvement in social sector development. NGO understanding of the needs of communities, underserved populations, and special subgroups constitutes a strong basis for designing and implementing actions to promote social and behavioral change. NGOs can complement the skills available within governments to put their people-oriented policies into meaningful effect. This NGO support may be sine qua non for the success of such policies, and of the programs and projects the Bank supports in the social sectors. The Bank is still developing ways to encourage NGO participation in such programs and projects. Staff in the Population, Health and Nutrition Department of the Bank are directing much more effort now to working with NGOs in family health and population work, particularly in subSaharan Africa where the greatest current challenge exists. At the international level, in order to promote policy dialogue with an operational perspective between the Bank and the NGO community, a Bank/NGO committee has been established. Composed of NGO representatives from both donor and recipient countries and Bank staff, it meets regularly and has proven helpful in identifying mutual interests and common objectives in a number of important areas, including food security. The committee does not replace collaborative mechanisms at the country level, but it has been successful in inspiring both the Bank and NGPs to pursue collaboration more assiduously at the country and sectoral levels.
WORLD HEALTH. 1988 Jan-Feb; 12-3.The 40th anniversary of WHO marks 40 years of working actively with non-governmental organizations (NGOs) in a multiplicity of ways in a wide variety of WHO programs. NGOs themselves will share in marking the anniversary with special health promotion events connected to their own activities all over the world. WHO in its turn is happy to pay tribute to their valuable work and to further encourage their sterling support for the mix of national, regional and global action which will lead to a healthier world. A growing partnership between governments and NGOs is a clear necessity for the attainment of Health For All. Dialogue and interaction between governments, NGOs and WHO as partners in health can be a vital key for turning health strategies into action. Experiments in partnership, promoted and supported by WHO, were carried out between 1982 and 1985 in several countries with greatly differing cultural backgrounds, geographical settings and health problems. In this article are presented a few examples of the many different partnerships which are developing and which illustrate how this international call for cooperation has been taken up; the Board of Recognized Medical Institutions of Rwanda (BUFMAR), the SEWA-Rural in Gujarat, India, and Rotary International.
[Unpublished] . 7 p.In San Diego, California's Working Together Project, Planned Parenthood has collaborated with private industry employers to bring family life education into the employment setting for low-income workers. To date, this project has reached 1200 adolescents and adults in industries in San Diego. The target population includes large numbers of Hispanics in the agricultural and textile manufacturing industries and in the hotel and tourist trades. The curriculum includes short, bilingual presentations that provide information on nutrition, communication skills, stress management, and family planning. During the planning phase, support is sought from employer personnel representatives, labor unions, legislators, other family life education providers, school officials, and the ethnic communities. The development of a Leadership Committee has fostered a positive relationship between family planning agencies and the business and civic sectors of the community. A billingual health educator monitors all program materials to ensure that they are culturally appropriate and sensitive. The business community has been responsive to the program because of its potential to reduce employee absenteeism and turnover and to increase morale and productivity. Family life education is promoted as a means of enabling employees to take less time off of work to solve personal problems, recover from stress-related illnesses, and avoid unintended pregnancies. The project's annual budget is US$65,000, which has been funded through grants.
Populi. 1985; 12(3):34-9.The US Agency for International Development (USAID) in consultation with the government of Kenya agreed in 1983 to prepare a demonstration family planning project, which would assist the private sector as well as other major nongovernment providers of health services to upgrade their health services, train and augment their nursing and other medical staff, provide family planning equipment and free contraceptives, and establish these health facilities as full-time family planning service delivery points. The Family Planning Private Sector Program (FPPS) will assist 30 private sector firms, "parastatal" organizations, and other private and nongovernment organizations that already provide health services to their workers, their dependents, and in many cases the surrounding communities to upgrade their services and add a full-time family planning facility. As some of the firms or organizations have multiple outlets, the program will create 50 or more new family planning delivery points throughout Kenya, thereby also relieving some of the pressure on government facilities. The FPPS sub-projects are to recruit at least 30,000 new acceptors. FPPS has added a guideline that at least 60% of these new acceptors be retained in the program for at least a period of 2 years. The FPPS program has received an enthusiastic reception from employers, the unions, and nongovernment organizations such as the Protestant Church Medical Association and the Seventh Day Adventists. The FPPS team can provide projects with a variety of services and funds for family planning related equipment, supplies, and activities. These include assistance with project design, training existing medical staff in family planning service delivery, the collection of baseline information, and the provision of funds for equipping family planning clinics. The government has encouraged FPPS to be innovative and to introduce family planning services into as wide a variety of health services as possible. As presently designed, the FPPS program is primarily a service delivery program but is beginning to play an increasingly dynamic role in information and education activities about family planning. From the start, the participating projects demanded assistance in spreading the family planning message to the workers, their families, and the community. It is evident that the program has stimulated management, clinic staff, and workers and has generated competition between projects to reach and exceed their targets of both new acceptors and high continuation rates.
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.
Food and Nutrition Bulletin. 1982 Jan; 4(1):7-16.This study describes 3 nutrition intervention programs in Sri Lanka; Lanka Jathika Sarvodaya Samgamaya; Redd Barna, the Norwegian Save the Children Program; and the US Save the Children fund. The Sarvodaya Shramadana Sangamaya is a private, nonprofit organization that began in 1958 devoted to mobilizing voluntary labor for village reconstruction. It is now engaged in a series of development projects in over 2,000 villages. One of its main objectives is to mobilize community resources for development. The children's service now integrates pre-school, nutrition, and community health services. There are an estimated 86 day care centers. The main service available in these day care centers, apart from physical care, is the provision of nutrition. Pre-school nutrition programs are also administered. The program costs about Rs230/beneficiary per year. The International Council of Educational Development from the United States was invited to review the program. Recommendations are given. The Norwegian Save the Children (Redd Barna) program in Sri Lanka was started in 1974. Projects are of 2 types: 1) settlement projects; and 2) integrated community development projects which aim to improve the standard of living with particular attention to child welfare. The US Save the Children Fund (SCF), a private, nonprofit voluntary organization, began its 1st project in Sri Lanka in urban community development in a slum and squatter settlement within Colombo. It focused on housing, but also includes other programs such as health and nutrition. These activities are carried out through a pediatric clinic, a home visits register, a nutritional status survey, a supplementary feeding program, nutrition, education, and a day care center. The approximate cost of the nutrition program would be Rs7700/month for an average of Rs13/month, or Rs156/year/beneficiary.
World Development. 1982; 10(7):573-84.Current efforts at involving communities in health activities are analyzed from a number of perspectives. Participation may be mainly aimed at easing resource constraints, through involvement in the implementation of health activities. Examples are the construction of health infrastructure, or the enlistment of community health workers--though in Latin America strong medical resistance to delegation has severely restricted their tasks. Participation in decision making has been even more limited, with the exception of some small scale NGO (nongovernmental organizations) sponsorship projects with conservative or progressive orientations also differ in degree of participation. The structure of the community, and the sociopolitical context in which it exists, are examined for the different constraints and opportunities they present to community participation for health. (author's modified)
Contact. 1983 Oct; (75):1-16.Investigates health planners' assumptions about community particiation in health care. Primary health care aims to make essential health care accessible to all individuals in the community in an acceptable and affordable way and with their full participation. It is the strategy propagated by the World Health Organization to provide health for everyone by the year 2000. Community participation is seen as the key to primary health care and has raised many assumptions and expectations among health planners. Community people are seen as a vast untapped resource which can help to reduce the cost of health care by providing additional manpower. It is also expected that community people want to participate in their own health care because they wish to serve their community and to have a part in decisions which affect them. In the early 1970's, programs were developed out of church-related efforts. They pioneered many of the ideas which became principles of primary health care. The church-related programs were nongovernmental and therefore flexible. They had the same goal of letting the community take responsibility for their own health care; program planners were primarily medical people trained in Western medicine. The planners were concerned with the plight of the poor. However, the programs tended to reflect planners' hopes for, rather than the community's understanding of, the community health problem. The author concludes that the assumptions that planners make about their programs need to be critically analyzed. Investigations need to be made into community perceptions and expectations of their role in health programs. Studies need to be undertaken to identify the potentials and problems of community participation and the record of established community health care programs needs to be examined.
London, England, IPPF, Europe Region, 1982. 62 p.The final report of the Migrants and Planned Parenthood (MPP) Project, a cooperative effort between the European Region of International Planned Parenthood Federation (IPPF), Pro Familia, and other European Planned Parenthood Associations (PPA), is presented. Increasing contact with migrant clients stimulated Pro Familia to ask IPPF to evaluate existing family planning services for migrants and consider transnational coordination and sociopolitical action in this area. 13 countries were represented in this project: 4 donor countries (Italy, Portugal, Turkey, and Yugoslavia); 7 recipient countries (Belgium, Federal Republic of Germany, Luxembourg, Netherlands, Norway, Sweden, and the United Kingdom); and 2 through correspondence (France and Ireland). 2 questionnaires were administered. The 1st was aimed at detailing European migratory movements and the ethnicity of target groups in each country; the 2nd explored PPA attitudes toward migrant clients and the need for migrant-specific services. Project conclusions were based on a series of plenaries and sub working group meetings held during 1981-82. (Reports of these meetings are included as Appendices to the final report.) It is recommended that the MMP Project continue until a Regional Policy Statement can be produced. The Regional Council is requested to develop a handbook of general guidelines for migrant work and should nominate a nonsalaried regional migrant ombudsperson. Each PPA is requested to select a liaison person for migrant work. Other tasks proposed for PPAs include: personnel training, production of educational materials for migrants, and cooperation with migrant's organizations. Family planning and health should be integrated into general migrant services offered by other institutions. PPAs in donor countries should consider special programs for groups affected by migration, e.g., wives remaining behind and returning migrants. Discussions are to be held on how to reach illiterate migrants and develop wider channels of materials distribution. Future workshops may be scheduled to train family planning personnel to work with migrants. In terms of services, PPA personnel are warned that problems outside the scope of family planning are likely to be encountered in work with migrants. Attention should be given to making services more accessible. Possible measures include mobile clinics, domiciliary services, provision of interpreters, and child care. The need for sex segregation and use of female personnel is also stressed.
Summary: field trip report, Agency for International Development, Sri Lanka, (Colombo, Kalutara, Kandy and Nuwara Eliya), July 14 to August 2, 1982.
[Unpublished] 1982. 19 p.This report, prepared for the US Agency for International Developement (USAID), provides a description and assessment of the 4 social marketing programs operating in Sri Lanka, an inventory of the program's current contraceptive supplies, an estimate of the programs' supply requirements for 1983-85, and several recommendations for improving social marketing activities in the country. The assessment was made during a brief visit to Sri Lanka in the summer of 1982. Supply requirements were difficult to assess since there is little coordination between the programs. The programs are supplied by a variety of donor organizations, and record keeping is inadequate in some programs. The 4 programs are operated by 1) the Family Health Bureau (FHB) of the Ministry of Health, 2) the Family Planning Association of Sri Lanka (FPASIL), 3) Population Services International (PSI), and 4) Community Development Services (CDS). The FHB program sells oral contraceptives (OCS) and condoms. During 1983-85, most of the program's supplies are expected to be obtained form the UN Fund for Population Activities. The FPASIL program was initiated in 1974 and distributes 10 brands of condoms and 3 brands of OCS. The program receives supplies from the International Planned Parenthood Federation and USAID. The PSI program trains Ayurvedic practitioners to distribute OCs and condoms. Most of the contraceptives are distributed free of charge but some are marketed. The program obtains its supplies from the FHB stocks and distributes them to the practitioners via the postal system. The Community Development Service is a privately run organization which conducts a variety of projects including the marketing of OCs and condoms through health workers and Ayurvedic practitioners. The program is supplied by several donors and is currently requesting condoms from USAID. Detailed information on the program is unavailable; however, it appears that the program overestimated its contraceptive needs for 1983. Between 1975-82, the proportion of married women of reproductive age relying on traditional methods increased from 17%-25%, the proportion relying on sterilization increased from 13%-17%, and the proportion using other modern methods increased from 11%-13%. In 1982, the proportion using OCs was 2.64% and the proportion using condoms was 3.19%. The marketing programs distribute primarily condoms and OCs. Estimated USAID delivery requirements for 1983 included 3,500,000 condoms for the FHB and FPASIL programs and 700,000 cycles of OCs for the FPASIL program. Requirements for 1984 could be estimated only for the FPASIL program and included 800,000 OC cycles and 8,500,000 condoms. The Ministry of Health should commission an outside review of all social marketing activities to identify appropriate and complementary functions for the 2 major programs (FPASIL and FHB) and a local review of the Ayurvedic practitioner training and distribution programs of CDS and PSI. Condoms provided by USAID for the FHB and CDS programs should differ in brand and packaging from those marketed by FPASIL. The progrms' service statistics and logistics should be improved. Research should be undertaken to identify factors contributing to the increase in the use of traditional contraceptive methods and to explore why only minimal increases in the use of modern contraceptives have occurred since 1975. Consideration should be given to setting up a central warehouse for stocking the nation's contraceptive supplies. All programs would then obtain their supplies from this central facilities. USAID assistance would be available for implementing a number of these recommendations.
Hong Kong, Family Planning Association of Hong Kong, 1983.  p.This 1982-83 Annual Report of the Family Planning Association (FPA) of Hong Kong reports on the following: program administration; activities of the International Planned Parenthood Federation (IPPF); personnel; clinical services; surgical services; laboratory services; affiliated volunteer groups; education; information; library services; motivation and promotion; statistics and evaluation; training; the Vietnamese Refugees Project; and the Youth Advisory Service. The Association's services are managed by 133 full-time and 21 part-time staff. The clinic attendance figures quoted are for the 1982 calendar year; otherwise, the report refers to the current financial year. There were 43,818 new cases and 51,031 old cases making a total clinic attendance figure of 257,185. Of the 772 female applicants for sterilization, 599 female clients were treated for sterilization in 1982, 502 having mini-laparotomy and 97 having culdoscopic sterilization. 367 vasectomies were performed, representing an increase of 8.6% over the previous year. Educational efforts took the form of Working Youth's Programs, Sexual Awareness Seminars, Sex in Marriage Seminars, Family Planning Talks, and talks and lectures on various topics related to family planning and sex education. Information activities included exhibitions, columns in newspapers and magazines, media coverage and advertisements, and talks by Association staff to various service clubs and community organizations and universities. Resource development efforts took the form of the production of new family life education resources as well as other resource materials; film, slide, and video production; and audiovisual services. The 1982 Knowledge, Attitude, and Practice Survey revealed that 59.2% of the 1403 currently married women interviewed approved, with or without reservation, of the provision of a contraceptive services to the unmarried. 30.5% disapproved of it, and 10.4% had no idea or gave no answer. Studies of the termination of pregnancy and a family life education survey also were conducted. Training efforts included sex education seminars for social workers, a sex education course for secondary school teachers, a sex education seminar for student guidance officers, and an advanced course on human sexuality for social workers and teachers. Total clinic attendance recorded for the Vietnamese Refugees project was 2680; 580 were new cases. The Youth Advisory Service recorded a big increase in the number of new clients (1723), old clients (270), with a total attendance of 3901.