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Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2006; 20(1):54-59.The Pan American Health Organization traces its origin back to the First General International Sanitary Convention of the American Republics, which was held in Washington, D. C., in December 1902. At the top of the agenda of the meeting were the complex public health issues involved in fighting yellow fever and other epidemic infectious diseases. The final resolution of the first convention stated, "It shall be the duty of the International Sanitary Bureau to lend its best aid and experience toward the widest possible protection of the public health of each of the said Republics, in order that disease may be eliminated and that commerce between said Republics may be facilitated." In the 19th century, efforts at inter-American cooperation had been limited almost exclusively to assisting commerce, and had had almost nothing to do with health. In 1923 the International Sanitary Bureau changed its name to the Pan American Sanitary Bureau, which would eventually become known as the Pan American Health Organization (PAHO) (1). Pan-Americanism is the guiding principle upon which PAHO was founded. That principle is expressed in the PAHO Member States' commitment to working together to improve the health of their citizens and to support the countries facing the greatest need. This principle recognizes that many health problems require a collective effort. The PAHO Member States acknowledge that the health and public health of one's neighbors is a shared responsibility of all. Pan-Americanism is grounded in values aimed at breaking down the barriers of health inequities. This principle is perhaps even more relevant today in a world of free trade and vast movements of people. (excerpt)
Toronto, Canada, International Council of AIDS Service Organizations [ICASO], 1998 Jun. 16 p.Over the past few years, the International Council of AIDS Service Organizations (ICASO) and its component networks and organizations have undertaken a process to determine how best to highlight human rights activities within the work it does on HIV/AIDS. This process included the ICASO Inter-Regional Consultation on Human Rights, Social Equity and HIV/AIDS, which was held in Toronto, Canada, in March 1998. This consultation constituted the first ever international meeting specifically focussing on HIV/AIDS and human rights, social equity and community networking issues. The plan described in this document is an important milestone in this process. It is part of ICASO’s ongoing efforts to provide a framework that will be useful in the work of community-based HIV/AIDS organizations. The consultation also formally endorsed the International Guidelines on HIV/AIDS and Human Rights issued by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Office of the United Nations High Commissioner on Human Rights. Participants to the Consultation believe that the Guidelines provide a platform for the development of activities and initiatives, including advocacy education. Community-based organizations (CBOs) would need to prioritize and select specific issues they feel are critical to their efforts in prevention of HIV/AIDS, and in the care and support of those living and affected by HIV/AIDS. Section 2.0 of the document describes the links between human rights and HIV/AIDS. Section 3.0 outlines a framework for the work ICASO will be doing over the next several years in the area of human rights, social equity and HIV/AIDS. The framework consists of guiding principles, role statements, goals, objectives, activities and structures. The framework has been prepared primarily from a global perspective. Finally, Section 4.0 contains work-plans from three of the five regions of ICASO (Asia/Pacific, Africa, and Latin America and the Caribbean) showing how human rights issues will be incorporated into their work. (excerpt)
Surveillance for tuberculosis in the Eastern Mediterranean Region. [Surveillance de la tuberculose dans la région de la Méditerranée Orientale]
Eastern Mediterranean Health Journal. 1996; 2(1):129-134.Tuberculosis is an important public health problem in the Eastern Mediterranean Region. It is crucial for each country to develop a national tuberculosis surveillance system. WHO has developed a standardized tuberculosis surveillance system through which two important indicators for tuberculosis control, a cure rate and a case detection rate, can be collected. The number of countries that have adopted the WHO tuberculosis surveillance system has been increasing in the Region. At the moment, 13 countries have reported a cure rate, which is the most important indicator for national tuberculosis control programmes. It is hoped that more countries will adopt this system. (author's)
Project appraisal document on a proposed loan of US $10.0 million and a proposed credit of SDR 36.8 million to the People's Republic of China for a Health Nine project.
Washington, D.C., East Asia and Pacific Region, Human Development Sector Unit, 1999 Apr 14. , 63 p. (Report No. 19141-CHA)This project appraisal document of the World Bank details the proposed loan of US $10 million and a proposed credit of special drawing right for nine health projects in the People's Republic of China.
Precis. 1999 Winter; (176):1-6.Over the past 15 years, the World Bank has provided policy advice and project support to Zimbabwe, which has proven valuable to the country's health sector. However, the impact of health system performance and health outcomes has been undermined by economic stagnation and a devastating AIDS epidemic. According to Joint UN Programme on HIV/AIDS, 26% of the adult population in Zimbabwe is infected with HIV. Furthermore, the flaws in the design of the country's Economic Structural Adjustment Program contributed to the strains on the health sector, particularly with regard to civil service reform and health sector staffing. In response to this problem, the World Bank can increase its effectiveness in the sector by fitting program design to accommodate institutional and political constraints and to take advantage of existing capacities. Furthermore, the government must give priority to reducing the budget deficit and restructuring debt service to prevent further deterioration in the public health sector. Lastly, the government must also take immediate steps to give priority to AIDS prevention--particularly to substantially increase resources devoted to behavior change-- and mount an effective intersectoral response to the epidemic.
UNFPA fifth country programme of assistance to the government of Kenya, 1997 to 2001. Framework for the reproductive health sub-programme.
[Unpublished] 1997 Dec. xiii, 32 p.This project between the UN Population Fund and Kenya's Ministry of Health proposes to strengthen technical and institutional capacity at all levels in the effective provision of reproductive health (RH) services during 1997-2001. The aims are to increase quality and accessibility of RH by a specific percentage, to reduce maternal mortality by 20%, to reduce perinatal morbidity and mortality by 30%, and to increase contraceptive prevalence by 20% in selected districts and Nairobi slums. The aims are also to provide youth-appropriate RH services, to reduce the spread of sexually transmitted infections (STIs) including HIV/AIDS, and to intensify IEC activities in support of RH services and other activities. This proposal describes the background, justification, and health reforms in Kenya; the RH achievements and lessons learned; selected issues to be addressed in the national RH program; goals; strategies and activities; monitoring and evaluation; the institutional framework; related activities and funding sources; and the summary budget. The budget will be shared between the Government (60%) and implementing nongovernmental organizations (40%). About 10% will be directed to IEC. The total summary budget is US$13 million. The main strategy for preventing STIs and HIV/AIDS is to integrate the education within day-to-day activities of health staff and to train service providers (SPs) at all levels. Surgical gloves and male-friendly services will be provided to all SP points. Technical support will be provided by advisers in Addis Ababa, selected national consultants, and field office program staff.
In: Women's health and apartheid: the health of women and children and the future of progressive primary health care in Southern Africa, edited by Marcia Wright, Zena Stein and Jean Scandlyn. New York, New York, Columbia University, 1988. 84-9.There is a large discrepancy between maternal mortality rates in developed and developing countries, with maternal mortality as a leading cause of death of young women in poor countries. There has been renewed interest in maternal mortality among international agencies and major foundations quite recently. Women and children form up to 2/3 of the population of many developing countries, and over 1/2 of primary health care resources are devoted to maternal and child health programs. Nevertheless, little of this is directed at maternal mortality; most goes to immunization, oral rehydration for diarrhea, monitoring children's growth, and promoting breastfeeding. While some of the international health community attribute the long neglect of maternal mortality to not knowing the extent and severity of the problem before, prior data existed demonstrating the alarmingly high rates. Low maternal mortality in the West may have distracted attention from the international problem. Sexism may have been a major factor, as even today efforts to reduce maternal mortality need to be justified in terms of the implications for the family, children and society as a whole. The reasons for the current concern are not clear, but may relate to an interest in concrete issues after the United Nations Decade for Women, or real surprise in the international community once the problem was pointed out. As various agencies rush to establish maternal mortality programs, it is imperative to evaluate which approaches will be really effective. Critical evaluation of programs is necessary to capitalize on the current interest.
[Unpublished] 1988 Dec 9. Paper presented at The Northeastern Regional meeting of The National Council for International Health (NCIH) co-sponsored by the Center for Population and Family Health of the Columbia University School of Public Health, at the Kellog Conference Center, Columbia University, New York City, December 8-9, 1988. 7 p.To specify the integration of AIDS policies with existing family planning associations around the world, the International Planned Parenthood Federation (IPPF) gave a policy speech at the Dec. 1988 Northeast Regional Meeting of the NCIH. The speech had a dual purpose. One was to outline the best way to deal with a centralizing problem like AIDS by using a decentralized system like IPPF. The second was to answer 5 questions posed by the meeting which were: how do individual government and agency AIDS policies fit in with global AIDS policies?, how does the publication of new data impact policy formation?, how are priorities determined as in treatment vs. prevention?, what are the linkages between family planning, population, and AIDS programs?, and have examples of other health policies been helpful in the formulation of AIDS policies? IPPF policy is to direct a centralized special unit to integrate with existing family planning work and not displace it. This unit would collect and distribute information, discuss ideas, provide technical assistance in developing programs, and channel necessary funds. The emphasis is that the programs would be done by family planning workers who are all nationals, and therefore the best to relate to and work with their own people. 2 publications have been released by IPPF called 'Preventing A Crisis' and 'Talking AIDS' which concentrate on teaching associations and field workers how to treat subjects with dignity and respect while dealing with situations that are relevant to them and their community.
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.
Report on the evaluation of various family life education projects with particular emphasis on youth in the English-speaking Caribbean: country reports.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Nov. xiv, 89 p.UNFPA has provided funding for various family life education (FLE) projects with particular emphasis on youth in the English-speaking Caribbean since the mid-1970s; this report is an independent evaluation of the projects in Antigua, Barbados, Dominica, Jamaica, St. Lucia, and St. Christopher and Nevis. Although birth rates are relatively low in the English-speaking Caribbean, the incidence of adolescent pregnancy and the number of births to women under the age of 20 is an important problem in the region. The Mission concluded overall that the projects have contributed to pioneering and groundbreaking efforts demonstrating that it is possible to initiate and make considerable progress in the implementation of FLE/FP programs for adolescents even when adolescent pregnancy and births are still highly sensitive and controversial issues and when there are no official policies in favor of such programs. The Mission concluded also that project design had improved over the years and projects have moved from addressing a wide variety of broad issues to a more focused consideration of adolescent fertility. All the projects included in the evaluation have contributed to the training in FLE/FP of a large number of family life educators, teachers, and nurses and, as a result, have significantly strengthened professional national capability. The projects have shown that despite the lack of official policy approving FLE in schools and generally overcrowded curricula, FLE can be introduced into schools. In the area of FP service delivery, the projects included in the evaluation have contributed to making FP services generally available through integration with the government maternal and child health services. The main management issues across the projects were similar and included staffing, coordination, supervision, monitoring and evaluation. There is a need to adjust project design so that gender separation is minimized and that the FLE content deals better with issues such as self-awareness, sex roles, and self-esteem. The wider impact of the projects included in this evaluation, to be reflected, for example, in reduced incidence of teenage pregnancy, reduced maternal and infant/child morbidity and mortality, and more generally in the life patterns of women, cannot yet be measured.
Joicfp Review. 1985 Oct; 10:28-31.Umati is a nongovernmental and nonprofit voluntary family planning organization which pioneered family planning activities in Tanzania in 1959. Umati was also assigned a role in the MCH program to ensure that the family planning component be given equal priority with the other components of the health program. Umati assists the Ministry of Health in its efforts to increase awareness of the advantages of family planning and responsible parenthood; gives advice on service delivery as well as assists the Ministry of Health in its task of training family planning service providers; and assists the Ministry of Health in the procurement and distribution of contraceptives and equipment. Umati is supported by the International Planned Parenthood Federation (IPPF). The integrated project aims to compensate for some of the deficiencies inherent in the MCH program. The project should respond to other community needs in order to attract and sustain the interest and active participation of community members. Parasite control and nutrition have been selected as priority health concerns. The integrated project must belong to the community. The following channels are being utilized on the local level: the local steering committee; the project volunteers; the Family Planning Association of Tanzania; MCH unit of the government; the government environmental sanitation unit; primary schools; religious institutions; the village government; and information, education and communication. The project should be evaluated and should be flexible.
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.
Bangkok, Thailand, ESCAP, 1984 Apr. 175 p. (ESCAP Programme on Health and Development Technical Paper No. 65/BCS 12; ST/ESCAP/291)The recognition of the necessity of involving the community in development efforts has been a turning point in the evolution of development thinking in recent years. Since 1978, the UNICEF Regional Office for East Asia and Pakistan and ESCAP have been conducting a series of training seminars where local development, basic services and primary health care are discussed as part of village reality. This volume reviews this experience, generalizing it to enhance adaptation. The seminars are a learning by doing and experience-sharing process. Group discussion and reflection on relevant issues are focused on. The seminars are oriented to community life as a whole, considering primary heatlh care as an entry point for coummunity development which involves generation of services within the community, supplemented by delivery of services from other institutional levels. This report describes the overall framework, including the organization of the 1983 seminar and the training approach, and the syllabus and evaluates the seminars. The goal of the seminar is the promotion of basic community health care in the countries of the region to improve the quality of life of the poor. Each participant discusses his/her work experience. Basic needs, basic services and primary health care are examined and a field-study phase at village-level is organized. Planning capabilities are developed by a phase of planning for basic and community services and primary health care. A module on national development, basic needs approach and production-oriented development is introduced. Finally, each participant prepares a draft project proposal for training for his/her own country situation. The evaluation of a program includes both its delivery system component and its eventual impact. The seminars used questionnaires, special group discussions and interviewing of the participants. The aim was to scrutinize the relevance and potential for modification of knowledge, attitudes and practice (KAP) rather that the actual impact actual impact achieved. Behavioral change should be evaluated on at least 2 levels: the individual and the collective. The structure, clustering and frequency of response to a given question in an evaluation questionnaire and the average level of awareness about a particular issue are 2 important measures to analyze. Seminar participants were mainly middle level personnel, but included some junior and senior officials from ministries of health, interior or home affairs and agriculture; training institutes; rural development institutes; planning commissions and universities.
[Geneva, Switzerland], WHO, 1982. 17 p. (HRG/CRU.1/Rev.1/Mtg.1)In 1979, a WHO team collaborated with national personnel in The Gambia in developing a comprehensive primary health care (PHC) plan of action for the period 1980/81 - 1985/86. In his address to the legislature in August, 1980, the president declared that the plan involved the active participation of local communities and emphasized programs for health promotion and disease prevention. This monograph reports on a meeting of the Gambian Ministries of Economic Planning and Industrial Development and of Health, Labor and Social Welfare in June 1982. Improvements in rural health are a basic need. In order to provide PHC, it was fully realized that a strong supportive infrastructure was essential. The village sensitization program was considered as vital for success. Not 1 village has rejected PHC or its responsibilities. The training program for community health nurses, village health workers and traditional birth attendants was proceeding according to plan for the various levels. Recognizaing that an efficient drug supply was essential, concomitant action had been taken to reorganize the central store. Another essential element without which success could not be achieved related to provision of transport and facilities for their maintenance, so that communications could be assured with rural areas. The need for a radio network to link 6 staions and 26 sub-stations was stresses. The list of participants and the agenda are attached as are the requirements for external support for the planned provision of PHC which were considered by the participants of the meeting.