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International Journal of Health Planning and Management. 1998; 13:199-215.Although health care reforms have been implemented in both developed and developing countries since the 1980s, there has been little discussion of the historical, social and political contexts in which such reforms have taken place. Health care reforms in developing countries, for instance, have been an integral component of structural adjustment policies, yet scant attention has been paid to these connections nor to their implications. The basic assumptions behind the reforms, and in particular, the ideological underpinnings of health care reorganization, need to be taken into account when considering long-term strategies and policies to provide health services in developing countries. (author's)
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)
Project appraisal document on a proposed International Development Association credit in an amount of US$24 million to the Islamic Republic of Mauritania for a health sector investment project. [Document d'évaluation de projet : proposition de crédit d'un montant de 24 millions de dollars US à l'Association Internationale pour le Développement à la République Islamique de Mauritanie en vue d'un projet d'investissement dans le secteur sanitaire]
Washington, D.C., World Bank, Africa Region, 1998 Feb 24. 24,  p. (Report No. 17396-MR)This project appraisal document presents the proposed international development association credit in an amount of US$ 24 million to the Islamic Republic of Mauritania for a health sector investment project. The overall objective of the Program is to improve the health status of the population in general (and of underserved groups in particular) through the provision of more accessible and affordable quality health services. Specifically, the Program aimed to improve health services quality and coverage; improve health sector's financing and performance; mitigate the effects of major public health problems; and promote social action and create an environment conducive to health. This document is outlined into nine sections which covers the topics on project development objective; strategic context; project description summary; project rationale; summary project analyses; sustainability and risks; main credit conditions; readiness for implementation; and compliance with bank policies. Several annexes are also included in this document.
In: Population distribution and migration. Proceedings of the United Nations Expert Group Meeting on Population Distribution and Migration, Santa Cruz, Bolivia, 18-22 January 1993. Convened in preparation for the International Conference on Population and Development, Cairo, 5-13 September 1994, compiled by United Nations. Department of Economic and Social Affairs. Population Division. New York, New York, United Nations, 1998. 364-9. (ST/ESA/SER.R/133)This paper discusses the health risks that urbanization has brought to developing countries. Urban dwellers, particularly children, women, and elderly people, are vulnerable to health threats associated with overcrowding, pollution, and a host of familiar urban problems that include mental and physical diseases, homelessness, drug abuse, and sexually transmitted diseases as well as violence and social alienation. The evidence available indicates that poor populations have higher rates of maternal mortality and infant mortality and morbidity. Environmental conditions influence certain health risks. The environment exposes children to a high risk of diarrheal diseases and parasitic diseases such as Chaga's disease, filariasis, leishmaniasis, and schistosomiasis. Moreover, urban malaria has become an urgent problem in countries where the disease is endemic. In addition, there is a high risk of accidents and injuries caused by unsafe and overcrowded transport systems. The impact of these problems on the health of urban dwellers requires an assessment of environmental health services and a revitalized role of public health in solving them. The WHO continues to play a role in the development of the concept of adopting a holistic and integrated approach to improving the health status of the population.
HEALTH FOR THE MILLIONS. 1998 Jul-Aug; 24(4):2.Health promotion is going to be a daunting global challenge in the third millennium. WHO is heading the worldwide health promotion campaign and its global health promotion efforts were reflected in the international conferences and the 51st World Health Assembly in Geneva in May 1998 which emphasized the need for partnerships for health, by forging newer and stronger alliances, based on greater equity in health. The two very important tools in effective health promotion programs are health education and health communication. Health promotion interventions have succeeded or failed depending upon the level of people's involvement in them, generated through these two media. In order for the messages to be understood and accepted by the local communities, health promotion programs should be need-specific and their goals realistic. Overall, the whole approach of health promotion needs to adopt a different paradigm if it is to reach the people for whom it is meant.
PEOPLE. 1998 Aug-Nov; 7(3-4):22-4.This paper focuses on the Adolescent Reproductive Health Programme for the Caribbean, a project implemented by the UN Population Fund (UNFPA) to ensure the reproductive health and rights of adolescents in the Caribbean. The UNFPA program, which will last from 1997 to 2000, will seek to help adolescents ages 10-19 years lead healthy lives and have healthy children when the time comes by helping them gain access to the information they need to preserve their reproductive health. Through this program, the UNFPA believes that the number of unwanted teenage pregnancies and abortions will be significantly reduced. These abortions often cause irreparable damage to a girl's reproductive organs, and can even result in death. Also, too many teens are being infected with sexually transmitted diseases such as HIV/AIDS because of an early sexual intercourse and unsafe sexual practices.
PEOPLE. 1998 Aug-Nov; 7(3-4):5-7.The 1998 Caribbean Youth Summit on Adolescent Sexual and Reproductive Health and Rights is a regional youth conference on Adolescent Reproductive Health (ARH) held in Barbados from October 5 to 7, 1998. The conference gathered over 190 participants from youth groups, governmental agencies, and nongovernmental organizations and resulted in the approval of the Declaration on Adolescent Sexual and Reproductive Health and Rights and the Regional Action Plan (RAP). The event aimed to improve reproductive health delivery and services to the Caribbean youth by generating research on ARH delivery and services; encouraging fresh, youth perspectives to enhance advocacy initiatives; enlarging the band of population advocates to the beneficiaries; providing a Caribbean flavored blueprint for the implementation of ARH legislative policy and programmatic actions; and promoting the reproductive health rights and needs of the youth in the Caribbean. Particularly, the RAP called for the creation of youth centers, which provide a variety of services including counseling, medical testing, and other social activities. The Declaration, on the other hand, presented 25 rights, to ensure that young people have access in protecting themselves from unwanted pregnancy and all types of sexually transmitted diseases. Lastly, a communications program was designed which combined traditional folk and modern media.
NGO contributions to sexual and reproductive health and rights in Latin America. Recommendations from civil society for improved follow-up of the Cairo and Beijing commitments.
New York, New York, United Nations Population Fund [UNFPA], 1998. , 27 p.This is a report on a regional meeting sponsored by the UN Population Fund (UNFPA) in collaboration with the Latin American and Caribbean Women's Health Network (LACWHN) and PAHO. The meeting was convened in order to draft recommendations to facilitate implementation of the agreements made at the Cairo and Beijing world conferences. This can be done, it was concluded at the meeting, by implementing or strengthening mechanisms for coordination and /or collaboration between government bodies, NGOs, and international cooperation agencies in the area of sexual and reproductive health and rights. Discussion and analysis focused mainly on the following areas: promoting sexual/reproductive rights, adolescent sexual/ reproductive health, promoting shared responsibilities/ male participation, and incorporating a gender perspective into reproductive health services. The observations and recommendations of the 50 participants are summarized.
Washington, D.C., Population Reference Bureau, 1998 Nov. 32 p.This study is one of a number of case studies coordinated by the Population Reference Bureau (PRB), covering four countries (Morocco, Uganda, Brazil, and India). The objective of the case studies is to determine how central elements of the ICPD [International Conference on Population and Development] Programme of Action have been implemented and to identify achievements and obstacles. The present study on Morocco contains sections on demographic trends, the policy environment for reproductive health, the status of women, reproductive health programs and services, individuals' perceptions of services, and sources of financing for reproductive health care, 1991-1998. (EXCERPT)
CONTACT. 1998 Jun-Sep; (161-162):32-45.This document, the fourth chapter in a 1998 edition of the newsletter of the Christian Medical Commission (CMC), opens by reviewing the bright political beginnings of the decade of the 90s and noting the importance of the CMC's Pharmaceutical Program and breast-feeding program, both begun in the 1980s. The next section reviews the 1992 reorganization of the CMC and how it relates to the traditional tasks of churches and to the World Council of Churches. Next, the chapter considers the challenge posed by HIV/AIDS and how churches and the CMC have responded. This is followed by a review of efforts to build capacity and self-sufficiency in communities that led to a series of think-tank meetings on community-based health development. Next, the chapter focuses on an account of one of these think-tank meetings that took place in 1995 in Africa and resulted in formation of an Africa-wide, community-based health care network. The chapter then turns to a report of a study that indicates some of the reasons that some church hospitals thrive while others exist in a state of permanent crisis. The chapter ends by noting that this newsletter was evaluated in 1993 and how the newsletter will change in order to continue to do its job.
JOICFP NEWS. 1998 Dec; (294):3.This article summarizes statements made by Dr. Nafis Sadik on October 19, 1998, to TICAD II. The address focused on the health challenges that Africa faces. The 1998 population in Africa of 780 million will double to about 1.5 billion in about 25 years. It is likely that this growth will impede socioeconomic development. Quality of life will be reduced by high infant and maternal mortality and high levels of HIV/AIDS. Only a small minority of Africans have access to basic health and reproductive health (RH) services. There are many unwanted births. The impact of HIV/AIDS on women has been very harsh. Life expectancy in some countries has been reduced. 50% of new HIV infections are among young people, who are poorly informed about RH. Health services are not suitable for youth needs. The consequences of early marriage and childbearing are limits to education and employment. Young women face the threat of domestic violence and abuse. Teenagers can be protected against HIV/AIDS and sexually transmitted diseases by institutionalization of sex education. RH needs to stress male responsibility in sexual health and childbearing. Sexual responsibility can be a life-and-death situation. African countries are beginning to integrate population and development policies. African countries need to adopt goals to increase access to RH services and family planning. Access should increase to 20% of population by the year 2000. Integrated programs, empowerment of women in development, male responsibility, and increased literacy should be expanded. UNFPA will continue to give Africa priority through increased resources, staff, and other partnerships.
Lancet. 1998 Sep 12; 352(9131):889.Last week, the Delhi High Court, during its own suo moto motion against the Municipal Corporation of Delhi and the Central government, chastised the government of India and the government of the Delhi state for ignoring warnings concerning dengue. These warnings were given by the World Health Organization (WHO) and experts at the meeting in Pune in 1994. The Court also chastised the government's criminal negligence which caused hundreds of deaths from the disease in 1996. The Court was alerted by mass media reports of the government's failure to deal with the spreading epidemic in the second half of 1996. 10,252 patients were admitted to hospitals in Delhi; 423 patients died. Hospitals were ill equipped, and blood banks were disorganized. There were no dengue control initiatives until 1997, when they were instituted by court order. The 10 major Delhi hospitals are now required to be fully equipped for any dengue outbreak, and the Central and Delhi governments have been ordered to prepare dengue control programs at the national and state levels. Justices Bhandari and Kumar stated that the respondents must adhere to any further suggestions or warnings by WHO, and that a similar blunder must not be repeated.
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.
AMERICAN JOURNAL OF PUBLIC HEALTH. 1998 May; 88(5):727-9.Steps need to be taken to improve the internal efficiency of the World Health Organization (WHO), for the current structural relationships and state of affairs interfere with the WHO's working efficiency. The lack of coordinated policy and action among multiple international agencies with health responsibilities is jeopardizing the attainment of world health objectives. The UN's agencies need to coordinate their activities and cooperate to maximize the efficiency of international health work. While all of the UN agencies have missions which include health functions, nowhere within the UN structure does a supervisory or planning body exist in which the health field may distinguish and delegate specific responsibilities to both avoid duplication and competition, and ensure that no program is overlooked. As it is now, individual UN health agencies pursue narrowly segmented interests and compete with each other for public appreciation and funding. The author examines a few studies of agencies' operational policies and considers the potential for the UN to establish a coordinating structure.
PEOPLE. 1998 Feb; 7(1):5.Consensus was attained among 180 countries meeting at the 1994 International Conference on Population and Development (ICPD) to realize universal access to reproductive health information services by 2015. The ICPD focused global attention upon reproductive and sexual health and rights, as well as gender issues. A UNFPA review of its areas for country collaboration and strategies based upon the ICPD mandate has led to the establishment of new policy guidelines and programmatic priorities for implementation of the ICPD Program of Action, including reproductive health for health promotion and risk prevention, the empowerment of women, IEC and advocacy, and population and development strategy. In an effort to address the challenges presented by reproductive health in the Caribbean region, the UNFPA is collaborating with governmental and nongovernmental organizations in Jamaica, Guyana, and Suriname to fund a pilot project to establish information and services delivery mechanisms for adolescents in selected communities. The UNFPA has decided to target youth in the Caribbean because of that age group's increasing levels of violence, teen pregnancy, HIV infection and AIDS, social and economic alienation, and educational underachievement.
Addis Ababa, Ethiopia, Pathfinder International, .  p.This booklet describes how Pathfinder International is collaborating with the Ethiopian government and nongovernmental organizations (NGOs) to expand the availability of high-quality family planning (FP) and reproductive health services. The introduction notes that Ethiopia is struggling to overcome poverty and that the government has instituted a progressive population policy to overcome the country's high rate of maternal, infant, and child mortality and high population rate. Next, various aspects of the services and leadership offered by Pathfinder since it began work in Ethiopia in 1964 are reviewed, especially the first community-based reproductive health services program in the country and specific integrated reproductive health and FP projects carried out in partnership with several local nongovernmental organizations. The introduction of community-based service delivery methods as a way to improve access to services is then discussed as is Pathfinder's commitment to quality and program sustainability. The booklet also relays Pathfinder's response to the fact that the reproductive health needs of adolescents require a different approach, which once again relies on collaboration with NGOs through the creation of three new youth centers that offer recreational activities as well as reproductive health services and information. Throughout the booklet, case histories are presented of individuals helped by activities supported by Pathfinder. The booklet closes with a look at an effort to train former prostitutes to generate income as hairdressers and tailors and to become community-based reproductive health agents.