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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)
Geneva, Switzerland, World Health Organization [WHO], Division of Analysis, Research and Assessment, 1996. iv, 51 p. (WHO/ARA/96.1)This booklet presents the WHO global initiative for equity in health and health care that aims to promote and support practical policies and action to reduce avoidable social gaps in health and health care. The initiative builds on work conducted over the last 3 decades, towards health for all by the WHO and other agencies, but is based on a critical reassessment of needs and strategies in view of current economic, social and political conditions prevailing throughout the world. The objectives of the initiative are 1) to make the reduction of social gaps in health and health care a priority on the agendas for policy and action of national and international organizations; 2) to support targeted research and ongoing monitoring activities needed to develop and evaluate effective and efficient policies to reduce social gaps in health and health care; and 3) to promote and support international exchange of experiences likely to be effective and efficient in reducing social gaps in health and health care. In coordination with the Swedish International Development Cooperation Agency, the WHO has funded initial planning and development and projects that are now under way in one African country and one Asian country. Meanwhile, nongovernmental and governmental organizations in several other countries have expressed interest in participating. Additional sources of support are needed to expand and further develop the initiative, linking it with complementary effort.
[Unpublished] .  p.This paper presents a summary of the key points of a statement on quality of care that was developed jointly by the International Planned Parenthood Federation (IPPF) technical expert panels. Quality of care is an essential element of the IPPF Strategic Plan, called Vision 2000, which places the following challenge before the IPPF: successfully addressing the need for quality of care is the key to the future viability and continued credibility of IPPF and family planning associations (FPAs) as the conscience of the family planning movement. In order to provide quality of care, the clients' rights and the providers' needs have to be addressed. Following this framework recognizes the rights of clients to information, access, choice, safety, privacy, confidentiality, dignity, comfort, continuity, and self-expression. Providers, for their part, should have the following needs met: training, up-to-date information, adequate physical infrastructure and family planning supplies. Quality of care at the strategic level should involve aspects of advocacy, access to education and services, as well as monitoring. The role of IPPF and FPAs in demonstrating quality of care is discussed. In brief, it is the responsibility of FPAs to ensure that quality of care is provided within whatever is available, and to devise an effective, permeating and sustained environment and system for improved quality of care.
Malaria control in Africa: a framework for the implementation of the regional malaria control strategy 1996-2001.
Brazzaville, Congo, WHO, Regional Office for Africa, 1996. 35 p.Nearly 18% of Africans live under the threat of epidemic malaria and 30-35% of health service consultations are malaria-related. About 70-80% of malaria cases in Africa are currently treated outside the formal health care system, with traditional medicine or self-medication. The Interregional Malaria Conference, held in Brazzaville in 1991, adopted a new regional strategy for malaria control in Africa based on early diagnosis and prompt treatment, anti-vector activities wherever sustainable and cost-effective, forecast and prevention of epidemics, and integration of antimalarial activities into primary health care. This document assesses progress toward these goals and outlines a malaria prevention and control strategy for 1996-2001. The action strategy for the coming period focuses on reducing malaria-related mortality and morbidity and socioeconomic losses through a gradual strengthening of local and national capacities. Key strategies include integration of malaria control in overall disease control at the district level, strengthening the community role, and formation of partnerships. This will require support for program and case management, training in malariology, monitoring and supervision, and technical and financial support to African countries. Monitoring indicators at the district level are the percentage of properly treated cases of malaria among children under 3 years old, availability of antimalarial drugs, and number of health workers trained in the management of different forms of malaria.
Measuring the achievements and costs of reproductive health programs. Report of a meeting of the Working Group on Reproductive Health and Family Planning, the World Bank, June 24-25, 1996.
[Unpublished] 1996.  p.The Working Group on Reproductive Health and Family Planning is a joint project of the Health and Development Policy Project and the Population Council. On June 24, 1996, members of the Working Group met to discuss ways of measuring the achievements and costs of family planning and reproductive health programs. It is particularly important to revise family planning program evaluation methods so that they are consistent with a client-centered, reproductive health approach, and to develop ways of evaluating the costs and effectiveness of the components of comprehensive reproductive health care. This report is comprised of papers on the following topics: performance indicators with regard to making the transition from a demographically-oriented family planning program to a client-centered reproductive health paradigm; monitoring and evaluating reproductive health and family planning programs; incorporating indicators into reproductive health projects; disability adjusted life years and reproductive health; assessing the costs of reproductive health programs; and the cost of reproductive health. A summary is presented of the technical group meeting discussion.
URBANISATION AND HEALTH NEWSLETTER. 1996 Mar; (28):7-13.This article identifies some urban health challenges and discusses World Health Organization (WHO) concepts of public health, a Municipal Health Plan, and the WHO Healthy Cities Program (HCP). A healthy city is defined as one that continually creates and improves the physical and social environment and expands community resources for enabling the mutual support among population groups for living. Urbanization is advancing rapidly, but government resources are not keeping pace with people's needs. By 1990, at least 600 million urban people in developing countries faced life and health threats. There is poverty, inadequate food and shelter, insecure tenure, physical crowding, poor waste disposal, unsafe working conditions, inadequate local government services, overuse of harmful substances, and environmental pollution. Poor people in cities frequently must satisfy all their basic needs in health, welfare, and employment. There is exposure to early sexual activity of adolescents, transient relationships, high levels of prostitution, and limited birth control. Unsustainable use of natural resources and environmental destruction pose threats to urban productivity and restrict future development options. The WHO launched a "Health for All" campaign in 1978, based on 4 basic principles. The HCP, which is based on these principles, has expanded to many cities. It measures the health burden and makes health issues relevant and understandable to local agencies through analysis and policy advocacy. The Municipal Health Plan facilitates awareness of environmental and health problems in schools, work and marketplaces, health services, and among other organizations.
FORUM. 1996 Dec; 12(2):27-9.65 council members, their guests, and invited speakers convened at the 1996 International Planned Parenthood Federation's (IPPF) Western Hemisphere Regional council meeting held in Mexico City during September 20-21 to focus upon strategies for working with governments in the context of declining multilateral support. The IPPF's new charter on sexual and reproductive rights was introduced to the council during the meeting and programs discussed which actively involve males in family planning. The meeting was hosted by MEXFAM, the Mexican family planning association. Since 80% of births in Mexico occur among the poorest 20% of the population, MEXFAM focuses upon serving those least served by other agencies. The association has 17 clinics, works directly with more than 2000 community workers, and provides services paid for through contracts with more than 300 businesses. Sharing many of MEXFAM's concerns, Mexico's Ministry of Health plans to use a $400 million loan received from the World Bank to take health services to isolated rural communities. The course of the meeting is described.
FORUM. 1996 Dec; 12(2):7-8.Community milk distribution posts are places where poor families with children under age 12 years can buy milk at subsidized prices. The centers are run by a social service agency called Liconsa and are located in marginalized neighborhoods around Mexico City. MEXFAM, the International Planned Parenthood Federation affiliate in Mexico, offers health services to women through 25 of these centers. Women who visit milk centers can therefore conveniently have their blood pressure, weight, and height measured; receive vaccines, parasite treatment, diabetes screening, and family planning information; and obtain contraceptive pills, injectables, and condoms while they pick up their milk. Counselors are on site. Referrals for other health services and contraceptive methods are made to the MEXFAM Community Clinic and MEXFAM's Medical Services Center as needed. Each site provides services to approximately 250 women.
QA Brief. 1996 Summer; 5(1):19-21.In November 1995, a World Bank mission went to Jordan to conduct a study of the health sector. The study recommended three strategies to reform the health sector: decentralization of Ministry of Health (MOH) management; improvement of clinical practices, quality of care, and consumer satisfaction; and adoption of treatment protocols and standards. The MOH chose quality assurance (QA) methods and quality management (QM) techniques to accomplish these reforms. The Monitoring and QA Directorate oversees QA applications within MOH. It also institutes and develops the capacity of local QA units in the 12 governorates. The QA units implement and monitor day-to-day QA activities. The QM approach encompasses quality principles: establish objectives; use a systematic approach; teach lessons learned and applicable research; use QA training to teach quality care, quality improvement, and patient satisfaction; educate health personnel about QM approaches; use assessment tools and interviews; measure the needs and expectations of local health providers and patients; ensure feedback on QA improvement projects; ensure valid and reliable data; monitor quality improvement efforts; standardize systemic data collection and outcomes; and establish and disseminate QA standards and performance improvement efforts. The Jordan QA Project has helped with the successful institutionalization of a QA system at both the central and local levels. The bylaws of the QA councils and committees require team participation in the decision-making process. Over the last two years, the M&QA Project has adopted 21 standards for nursing, maternal and child health care centers, pharmacies, and medications. The Balqa pilot project has developed 44 such protocols. Quality improvement (COUGH) studies have examined hyper-allergy, analysis of patient flow rate, redistribution of nurses, vaccine waste, and anemic pregnant women. There are a considerable number of on-going clinical and non-clinical COUGH studies. Four epidemiological studies are examining maternal mortality, causes of death, morbidity, and perinatal mortality.
REPRODUCTIVE FREEDOM NEWS. 1996 Jul 26; 5(13):8.The United Nations Conference on Human Settlements, also known as the Habitat II conference, met in Istanbul from June 3 to 14. It was the last major UN gathering of this millennium and the first major UN meeting since 1995's Fourth World Conference on Women (the "Beijing Conference")--and thus an important opportunity for a wider international community to weigh in on agreements reached in Beijing and at the International Conference on Population and Development, held in Cairo in 1994. The final document that emerged from Habitat II, the "Global Plan of Action," affirmed crucial elements of those earlier accords. The Habitat documents calls for action to "[d]evelop and implement programmes to ensure universal access for women throughout their life-span to a full range of affordable health care services, including those related to reproductive health care, which includes family planning and sexual health, consistent with the Report of the International Conference on Population and Development." Language adopted at the Cairo meeting is also affirmed in Habitat's call for "universal access to the widest range of primary health care services." Perhaps most significantly, the Istanbul document reiterated an important declaration from the Beijing conference: "While the significance of national and regional particularities and various historical, cultural, and religious backgrounds must be borne in mind, it is the duty of all States to promote and protect all human rights and fundamental freedoms." Most of the 189 UN members and observer states that attended the conference upheld all three of these provisions. Only a small group of states--Argentina, Guatemala, Iran, Jordan, Lebanon, Malta, Qatar, Saudi Arabia, Sudan, Syria, United Arab Emirates, Yemen, and the Holy See--filed reservations on the health care sections. (full text)