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In the shadow of the temple: cross-cultural sensitivity in international health program development.
Ethnicity and Health. 2000; 5(2):161-71.Many authorities recognize the concept that sensitivity to a recipient people's culture during the formulation and implementation of international health programs is a basic component to the success of those programs. Nevertheless, international health agencies have consistently failed in realizing truly successful projects in recipient countries by their neglect to fully take culture into account. The reasons are complex, and their comprehension involves an understanding of who is involved in international health programs, the history of those programs, and the conflicts that arise when outside agencies fail to understand--or be understood by--those who are on the receiving end of programs. This paper will scrutinize international health care assistance and development from the points of view of both donor agencies and recipient countries. Examples are presented from countries and regions worldwide. The challenges in maintaining cultural sensitivity will be described, analyzed, and potential solutions will be offered. (author's)
[Nairobi, Kenya], International Planned Parenthood Federation, Africa Region, . 28 p.This profile of Sierra Leone discusses the following: geographical features; neighboring countries; ethnic and racial groups and religion; systems of government; population, namely, size, distribution, age/sex distribution, and women of reproductive age; socioeconomic conditions -- agriculture, industry, exports, imports, employment, education, health, and social welfare; family planning/population -- government policies, programs, Planned Parenthood Association of Sierra Leone (PPASL), nongovernment organizations and voluntary agencies, private organizations, sources of funding, and future trends of policies and programs; and the history, constitution, and structure and administration of the PPASL. According to the 1974 census, the population of Sierra Leone totaled 2,735,159. In 1980 it was estimated to have grown to 3,474,000. With an average annual growth rate of about 2.7%, it is expected to reach 6 million in 2000 and to have doubled in 27 years. Sierra Leone has a population density of 48 people/sq km. In 1974, 27.5% of the population lived in urban centers with 47% living in Freetown alone. The indigenous population includes 18 major ethnic groups; the Temne and Mende are the largest of these. The percentage of nonnationals increased from 2.7% in 1963 to 2.9% in 1974 and includes nationals mainly from the West African subregion with a sprinkling of British, Lebanese, Americans, Indians, and others. In 1974 the sex ratio was 98.8 males/100 females. In 1981 it was estimated that 41% of the total population was under age 15 and 5% over age 65, making the dependency burden very high. Agriculture is now the main focus of the government's development policy. Minerals are an important source of foreign exchange. It was estimated in 1980 that the total economically active population would reach 1.2 million, of whom the majority would be employed in agriculture. Women made up approximately 1/3 of the economically active population in 1970. The adult literacy rate recently has been estimated at 12% of the population. The government allows the PPASL to freely operate in the country, but it has not as yet declared a population policy. In 1973 the government did recognize the effects of rapid population growth on the nation's socioeconomic development. As a pioneering organization in family planning, the PPASL has made considerable effort in promoting the concept of responsible parenthood. Its motivational programs are geared towards informing and educating the public on the need for having only those children whom individuals and couples can adequately provide for in terms of health, nutrition, education, clothing, and all other basic necessities. Family planning services are provided to meet the demand thus created to enable families and individuals to exercise free and informed choice for spacing or limiting of children. Between 1971 and 1983 the UN Fund for Population Activities (UNFPA) provided financial assistance to Sierra Leone for population activities in the amount of US$2,659,382.