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WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (749):1-86.This report makes a special effort to present practical information on the control of intestinal parasitic infections. It covers the following: public health significance of intestinal parasitic infections (methods of assessment, helminthic infections, and protozoan infections); the costs of not having a control program (nutrition, growth, and development; work and productivity; and medical care); prevention and control strategies (epidemiological foundation, objectives and general approaches, implementation strategies, costs and financing, methodologies and tools, and strategy for prevention and control); national programs (justification; objectives and strategies; planning; program and implementation; training, education, and dissemination of information; program monitoring and evaluation; and technical guidance); and program support (the role of the World Health Organization, technical and research organizations, funding agencies, industry, and information flow). Current experience suggests that intestinal parasite control programs are appropriate and socially advantageous because people can actually see the effects of primary health care intervention and start to learn some simple facts about health care by watching their village or community become healthier as a result of the control measures. There are 3 major areas in which the lack of control program is responsible for significant losses: nutrition, growth, and development; work and productivity; and medical care costs. Countries in which intestinal parasitic infections and diseases constitute a significant health problem need to consider adopting a national policy for their prevention and control. Recent experience in various countries has demonstrated the effectiveness of periodic deworming and standard case management at the primary health care level in reducing most of the problems associated with intestinal parasitic infections. Support can come from outside the country as well as from national authorities. Support from the outside may be available in the areas of management, technical expertise (which includes research), funding, and exchange of relevant information. The World Health Organization can provide both technical and managerial expertise in the design of programs.
WHO Programme in Maternal and Child Health and Family Planning. Report of the second meeting of the WHO Programme Advisory Committee in Maternal and Child Health, Geneva, 21-25 November 1983.
[Unpublished] 1984. 95 p. (MCH/84.5)The objectives of the 2nd meeting of the Program Advisory Committee (PAC) for the World Health Organization's (WHO's) Program in Maternal and Child Health, including Family Planning (MCH/FP) were to 1) assess the MCH/FP program's achievements since the 1st PAC meeting in June, 1982, 2) determine the level of scientific and financial resources available for the program, and 3) to examine the role of traditional birth attendants (TBAs) in the delivery of MCH/FP services. The committee reviewed the activities and targets of the program's 4 major areas (pregnancy and perinatal care, child health, growth, and development, adolescent health, and family planning and infertility), and developed a series of recommendations for each of these areas. Specific recommendations were also made for each of the major program areas in reference to the analysis and dessimination of information and to the development and use of appropriate health technologies. Upon reviewing the role of TBAs in the delivery of MCH/FP services, PAC recommended that all barriers to TBA utilization be removed and that training for TBAs should be improved and expanded. PAC's examination of financial support for MCH/FP activities revealed that for a sample of 26 countries, the average annual amount allocated to MCH activities was less than US$3/child or woman. This low level of funding must be taken into account when setting program targets. International funding agencies did indicate their willingness to increase funding levels for MCH programs. The appendices included 1) a list of participants, 2) an annotated agenda, 3) detailed information on the proposed activities of the program's headquarters for 1986-87, and 4) a description of the the function, organizational structure, and technical management of the MCH/FP program. Also included in the appendices was an overview of the current status of MCH and a series of tables providing information on infant, child, and maternal health indicators. Specifically, the tables provided information by region and by country on maternal, child, and infant mortality; causes of child deaths; maternal health care coverage; contraceptive prevalence; infant and child malnutrition; the number of low weight births; adolescent health; teenage births; breast feeding prevalence and duration; and the proportion of women and children in the population.
Paper presented at the Nineteenth Session of the UNICEF/WHO Joint Committee on Health Policy, Geneva, February 1-2, 1972. 40 pFamily planning is an integral part of the health care of the family and has a striking impact of the health of the mother and children. Many aspects of family planning care require the personnel, skills, techniques, and facilities of health services and is thus of concern to UNICEF and WHO. Once individual governments have determined basic matters of family planning policy and methods, UNICEF and WHO can respond to requests for assistance on a wide range of activities, with the primary goal being the promotion of health care of the family. Emphasis will be placed on achieving this by strengthening the basic health services that already have a solid foundation in the community. The past experience of UNICEF and WHO should provide valuable guidance for assistance to the health aspects of family planning, particularly as they relate to the planning and evaluation of programs; organization and administration; public education; the education and training of all medical personnel; and the coordination of family health activities both inside and outside the health sector. The review recommends that UNICEF and WHO first regard the capacity of the host country to absorb aid and maintain projects, and that specific family planning activities, such as the provision of supplies, equipment, and transport, be introduced only when the infrastructure is actually being expanded. Capital investment should be viewed in relation to the government's ability to meet budgetary and staff requirements the new facilities demand.
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.
Washington, D.C., Futures Group International, POLICY Project, 1998 Sep. vii, 69 p.This report presents case studies of reproductive health (RH) and family planning programs and policies in Bangladesh, India, Nepal, Ghana, Jordan, Senegal, Jamaica, and Peru. Data were obtained from in-depth interviews among 20-44 individuals in each country who were key representatives of population and RH government ministries, parliaments, academia, nongovernmental organizations, women's groups, donor agencies, and health care staff. Findings focus on the following topics: RH context; the policy process; participation, support, and opposition; policy implementation; financial resources; and general implementation. Progress is gauged based on improving knowledge of stakeholders; planning for integrated and decentralized services; developing human resources; improving quality of care; addressing legal, social, and regulatory issues; clarifying donors' role; and maintaining long-term aims. All countries made considerable, though limited, progress according to the mandates of the 1994 Cairo Plan of Action. Population size ranges from 2.6 million in Jamaica to nearly 1 billion in India. The countries vary in level of urbanization, literacy, fertility, contraceptive prevalence, infant mortality, maternal mortality, and prenatal care and delivery. Although the social, cultural, and economic contexts vary, all countries have a subordinate role for women. All countries struggled with setting priorities, financing, and implementation. Bangladesh made the greatest progress. Jordan still emphasizes mostly family planning. India, Nepal, Jordan, Senegal, and Peru will need donor funding to advance a broad constellation of services.
Arlington, Virginia, John Snow [JSI], Resources for Child Health [REACH], 1988 Sep. , 99,  p. (USAID Contract No. DPE-5927-C-00-5068-00)Building upon smallpox and measles immunization campaigns originally supported by USAID, the Centers for Disease Control, and the World Health Organization, the African region Combatting Childhood Communicable Diseases (CCCD) Project began providing immunizations, oral rehydration therapy for children with diarrhea, and malaria prophylaxis services in 1982. The project was approved in September, 1981, for spending of $47 million through fiscal 1988, and was designed to be implemented through existing publicly operated health service delivery systems with recipient CCCD project countries helping to finance recurrent costs and providing human resources for project implementation. Accordingly, almost all country project agreements were written to ensure that country governments would provide financial support for activities through direct budget allocations, user fees, or some combination of the 2. Regular analyses of service provision were also agreed upon. The development and implementation of user fees have taken place, but the overall theoretical financial strategy has yet to be met in any country project. This document discusses financing achievements and what more is needed to ensure longer term project financial sustainability. Sections review country-specific agreements to spell out original USAID/country terms on financing components; consider the capacity of CCCD project governments to finance recurrent costs in their respective macroeconomic contexts; present highlights of a review of CCCD project financing activities; summarize an evaluation of alternative health financing options; give conclusions of analyses on the financial sustainability of CCCD project activity; and make recommendations for future USAID CCCD project support with respect to financing and economics.
EPI in the Americas. Report to the Global Advisory Group Meeting, Alexandria, Egypt, 22-26 October 1984.
[Unpublished] 1984. 15 p.This discussion of the Expanded Program on Immunization (EPI) in the Americas covers training, the cold chain, the Pan American Health Organization's (PAHO) Revolving Fund for the purchase of vaccines and related supplies, evaluation, subregional meetings and setting of 1985 targets, progress to date and 1984-85 activities, and information dissemination. All countries in the Region of the Americas are committed to the implementation of the EPI as an essential strategy to achieve health for all by 2000. During 1983, over 2000 health workers were trained in program formulation, implementation, and evaluation through workshops held in Argentina, Brazil, Cuba, El Salvador, and Uruguay. From the time EPI training activities were launched in early 1979 through 3rd quarter 1984, it is estimated that at least 15,000 health workers have attended these workshops. Over 12,000 EPI modules have been distributed in the Region, either directly by the EPI or through the PAHO Textbooks Program. The Regional Focal Point for the EPI cold chain in Cali, Colombia, continues to provide testing services for the identification of suitable equipment for the storage and transport of vaccines. The evaluation of solar refrigeration equipment is being emphasized increasingly. PAHO's Revolving Fund for the purchase of vaccines and related supplies received strong support from the UN International Children's Emergency Fund (UNICEF), which contributed US $500,000, and the government of the US, which contributed $1,686,000 to the fund's capitalization. These contributions raise the capitalization level to US $4,531,112. Most countries are gearing their activities toward the increase of immunization coverage, particularly to the high-risk groups of children under 1 year of age and pregnant women. To evaluate these programs, PAHO has developed and tested a comprehensive multidisciplinary methodology for this purpose. Since November 1980, 18 countries have conducted comprehensive EPI evaluations. 6 countries also have had followup evaluations to assess the extent to which the recommendations from the 1st evaluation were implemented. At each subregional meeting, participants met in small discussion groups to review each other's work plans and discuss appropriate targets for the next 2 years. Immunization coverage has improved considerably in the Americas over the last several years. Figure 2 plots the incidence rates of polio, tetanus, diphtheria, whooping cough, and measles from 1970-83 in the 20 countries which make up the Latin American subregion. If all countries meet their 1985 targets, immunization coverages for DPT and polio will range from 60-100%, with most countries attaining coverages of over 80%. For measles, 1985 targets range from 50-95%, and from 70-99% for BCG. The main vehicle for dissemination of information is the "EPI Newsletter," which publishes information on program development and epidemiology of the EPI diseases.
Expanded Programme of Immunization Eastern Mediterranean Region. A report for the EPI Global Advisory Group Meeting, Alexandria, 21-25 October 1984.
[Unpublished] 1984. 10,  p. (EPI/GAG/84/WP.7.a)The strategy adopted by the Members States of the Eastern Mediterranean Region (EMR) to achieve the objective of the promotion of the Expanded Program of Immunization (EPI) through primary health care (PHC) concentrates on strengthening synergistic integration of EPI with other services. Activities have been planned and implemented or are being implemented at the Regional Office and at the country level. 21 countries of the Region now have either a full-time or part-time manager or an EPI focal point. This is a considerable development, for in 1982 there were EPI managers in 9 countries. Except for 3 countries, all national EPI managers/focal points have received senior level training in EPI. At delivery points, vaccination is performed to a large extent by multipurpose health workers, but full-time vaccinators are available in about 6 countries. All field workers have received training at their respective regional levels. Limited financial resources continue to be 1 of the primary constraints of the program in the Region. Plans to resolve this problem include: counteracting wastage factors; close collaboration with the UN International Children's Emergency Fund (UNICEF) and other international agencies at the country level to standardize approaches and avoid overlap; tapping regional and international voluntary agencies to increase their contributions; and increased use of associate experts, UN volunteers, and national technical staff. The overall information system is to some extent weak and suffers from irregularity and a lack of continuity. Regular reports are received from 9 countries which have World Health Organization staff. Repeated requests from other countries yield incomplete and at times contradicting data. Research efforts are directed towards operational areas, and research in strategies, integration, community, and surveillance areas is being encouraged.
New York, New York, United Nations, 1985. v, 58 p. (Economic and Social Council Official Records, 1985. Supplement No. 10; E/1985/31; E/ICEF/1985/12)The major decisions of the UN Children's Fund Executive Board in their 1985 session were to: approve several new program recommendations and endores a major emergency assistance program for several African countries; approve initiatives to accelerate the implementation of child survival and development actions, particularly towards the goal of achieving universal immunization of children against 6 major childhood diseases by 1990; adopt a comprehensive policy framework for UN International Children's Emergency Fund (UNICEF) programs concerning women; approve UNICEF revised budget estimates for 1984-85 and budget estimates for 1986-87; and make a number of decisions on ways to improve the administration and the role of the Board. The Board members both reported on and heard evidence of the encouraging results of recent efforts to implement national child survival and development programs. Reports of the successful immunization campaigns in Burkina Faso, Colombia, El Salvador, and Nigeria were welcomed, along with the news that half a million children were saved during the year through the use of oral rehydration therapy. Stronger efforts were encouraged to improve results in the areas of breastfeeding and growth monitoring. Implementation issues in connection with child survival and development actions were a continuing focus of Board attention during the session. The accelerated implementation of child survival and development actions was accorded the highest priority in approving the medium-term plan for 1984-88. The Board also adopted a resolution that sought to draw the attention of world leaders, during their observance of the 40th anniversary of the UN, to the importance of reaffirming their commitment to accelerate the implementation of the child survival and development resolution and realizing universal immunization by 1990. Delegations commended the results of the World Health Organization/UNICEF joint nutrition support program but noted that malnutrition among women and children appeared to be increasing. Water supply and sanitation activities were encouraged, and the Board stressed that those actions should be linked with health and hygiene education. The Board endorsed the report on recent UNICEF activities in Africa. Many delegations spoke in support of the increased aid to Africa. Major emphasis was given to linking emergency responses with ongoing UNICEF programs. The Board approved new multi-year commitments from general resources totalling $303,053,422 for 28 country and interregional programs and noted 32 projects totaling $223,215,000 to be funded from specific-purpose contributions. The Board stressed the importance of ensuring that child survival and development actions were integrated with continuing efforts in other of UNICEF action. The Board approved a commitment of $252,550,443 for the budget for the biennium 1986-87.
Report of the evaluation of UNFPA assistance to Colombia's Maternal, Child Health and Population Dynamic's Programme, 1974-1978.
New York, United Nations Fund for Population Activities, July 1981. 181 p.This report for UNFPA (United Nations Fund for Population Activities) on Colombia's Maternal and Child Health and Population Dynamics (MCH/PD) program was prepared by an independent team of consultants which spent 3 weeks in Colombia in February 1980 reviewing documents, interviewing key personnel and observing program services. The report consists of 8 chapters. The 1st describes the terms of references of the evaluation mission. The 2nd chapter provides background information on Colombia and identifies some of the principal environmental factors that affect the program. Chapter 3 describes the organizational context within which the program operates. The chapter also includes a discussion of the UNFPA funding and monitoring mechanism and how that affects program planning and operations. Chapter 4 is a description of the program planning process; goals, strategies and objectives, and of the UNFPA and government inputs to the program between 1974-1978, the period under review. A large part of the report is devoted to describing and assessing each program activity. Chapter 5 consists of descriptions of management information; maternal care; infant, child and adolescent care; family planning; supervision; training; community education; and research and evalutation studies. Chapter 6 is an analysis of the program's impact on: maternal morbidity and mortality; infant morbidity and mortality; and fertility. Chapter 7 summarizes the Mission's conclusions and lists its recommendations. The final chapter deals with the Mission's position in relation to the 1980-1983 proposal. Appendices provide statistical data on medical activities, contraceptive distribution and use, content of training courses, target population, total expenditures, and norms for care, as well as organizational charts, individuals interviewed, and UNFPA assistance to other agencies in Colombia. (author's modified)