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  1. 1

    Family planning in Haiti: the achievements of 50 years.

    Ward VM; Santiso-Galvez R; Bertrand JT

    Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr. [28] p. (SR-15-118H; USAID Cooperative Agreement No. AID-OAA-L-14-00004)

    This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. The family planning movement in Haiti began in the 1960s, only a short time after family planning activities had been initiated in many other countries in the Latin American and Caribbean region. Initially, doctors and demographers worked together to encourage government policies around the issue and to begin private sector service provision programs in much the same way early family planning activities occurred elsewhere. Yet, in comparison with other countries within the region, Haiti’s progress on reproductive health has been slow.
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  2. 2

    Perspectives of external support agencies: comments from the UNCHS experience.

    Lorentzen J

    In: Indonesia's urban infrastructure development experience: critical lessons of good practice, edited by Hendropranoto Suselo, John L. Taylor and Emiel A. Wegelin. [Nairobi, Kenya], United Nations Centre for Human Settlements [HABITAT], 1995. 174-85.

    This monograph chapter discusses the historical experience of the UNCHS in providing technical support to the government of Indonesia's Integrated Urban Infrastructure Development Program (IUIDP). Technical cooperation began in 1978, when a national urban development strategy (NUDS) was adopted and implemented during 1978-85 by the Indonesian Ministry of Public Works and the Directorate General of Human Settlements. IUIDP included a national strategy for urban development through the year 2000. NUDS was intended to be flexible and change with conditions. It was understood that effective management and development of cities and towns would be a major challenge over time. Its success or failure would affect national objectives more than spatial demographic changes. NUDS recognized the importance of local government responsibility for urban development and service delivery and the role of the private sector, community groups, and individuals in planning, developing, and operating urban infrastructure and services. Financing would rely on local revenue generation. Agencies operated as enterprises. The focus was on increasing institutional resources for operations and maintenance, on improving existing built-up areas, and on shifting emphasis to service delivery. Integrated investment programs by sector would be needed locally. The need was to strengthen existing institutions and processes. In 1989, the program was expanded with the hindsight that effective intergovernmental and interdepartmental coordination was required. A management group was established to this end. Despite the over ambitiousness of the Project Document, seven important outcomes did occur.
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  3. 3

    Improving people's health through planning.

    Pan American Health Organization [PAHO]


    From 1961 onwards, the Pan American Health Organization (PAHO) has been instrumental in the setting of regional health plans, each of which has served as a blueprint for hemispheric and national action. In 1961, when the Charter of Punta del Este proclaimed the 10-year public health program of the Alliance for Progress, health became a concern of chiefs of state. The 10-year public health program set forth the goals to increase life expectancy by a minimum of 5 years and to improve individual and public health. In 1963 the Task Force on Health at the ministerial level met. PAHO convened over a 15-year period a series of 4 special meetings of Ministers of Health. PAHO and the Center for Development and Social Studies (CENDES) in Venezuela worked together to devise the CENDES/PAHO method of normative planning. The presidents of most of the American states, meeting in Punta del Este in 1967, committed themselves to the expansion of programs for the improvement of health. At the 1972 meeting the ministers devised a new 10-Year Health Plan for the Americas declaring health a universal right. At the 1977 meeting the ministers endorsed the goal of health for all; they adopted a regional policy that defined primary health care. In 1980 the regional strategies spelled out the targets essential to achieving the goal of health for all by the year 2000: immunization services will be provided by 1990 to 100% of children under 1 year of age; and access to safe drinking water and sewage disposal will be extended to 100% of the population. During 1987-1990 PAHO was to channel its efforts toward development of health services infrastructures with emphasis on primary health care. The XXIII Pan American Sanitary Conference, meeting in 1990, established guidelines for 1991-1994 in the area of health programs, the environment, food and nutrition, eradication of preventable diseases, maternal and child health, workers' health, drug addiction, and AIDS.
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  4. 4

    Health: a condition for development.

    Pan American Health Organization [PAHO]


    The decisions of the first Pan American Sanitary Conferences, which focused on improving sanitary conditions and decreasing pestilent diseases in ports and territories, undoubtedly were aimed at facilitating international trade. The creation of the International Sanitary Bureau and the adoption of the Pan American Sanitary Code were pivotal steps in establishing a firm basis for hemisphere-wide cooperation. The VIII Pan American Sanitary Conference, held in 1927, recommended that member countries establish special agencies within their health administrations in order to ensure the best possible living and working conditions for workers. The creation of the World Health Organization in 1948 represented an enormous humanitarian step, in that it legitimized the desire of the majority of the countries in the world to consider health as a fundamental human right. An agreement signed in 1950 with the Organization of American States set forth PAHO's functions as a specialized inter-American agency, defining the way in which the 2 organizations would coordinate their efforts and reinforcing the concept of health as a basic component of development. Particular emphasis was placed on programs aimed at controlling various diseases as, for example, the malaria campaign; projects to supply water; and general sanitation, as a means of preventing basic health problems. The 10-Year Health Plan for the Americas covered the 1970s. The target of health for all by the year 2000 was adopted in 1977 by the 30th World Health Assembly. By 1980, all the countries had formulated national health strategies and many had developed health sector plans. The campaign launched in 1985 to eradicate poliomyelitis was successful. Some countries had succeeded in boosting life expectancy, reducing infant mortality, and increasing immunization against the common childhood diseases. Yet after 2 decades of economic growth, the number of poor people had increased by 50%, inequalities had been exacerbated, and numerous health needs were not being met.
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  5. 5

    Health and the environment.

    Pan American Health Organization [PAHO]


    In 1902 the First General International Sanitary Convention specified that countries should dispose of garbage to prevent the spread of diseases and to disinfect the discharges of all typhoid and cholera patients. The Pan American Sanitary Bureau was to elicit information regarding the sanitary conditions in their ports and territories and to encourage seaport sanitation, sewage disposal, soil drainage, street paving, and elimination of the sources of infection from buildings. The 2nd and 3rd Pan American Conferences of National Directors of Health, in 1931 and 1936, focused on topics of urban and rural sanitation, safe water and milk supplies, and industrial hygiene. In 1948 the Inter American Association of Sanitary Engineering (AIDIS) was created for the exchange of new ideas, experiences, and technologies. From 1942 to 1948, these special public health services benefited an estimated 23 million people by extending potable water supply and sanitation in the region and training hundreds of Latin American sanitary engineers. The 1961 American Governments' Charter of Punta del Este envisioned extending, over a 10-year period, water supply and excreta disposal services to 70% of the urban and 50% of the rural populations. In 1968, the Pan American Health Organization (PAHO) established the Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS), with headquarters in Lima. Over the years, CEPIS projects have encompassed air pollution, wastewater treatment and stabilization ponds, water treatment systems, solid waste collection and treatment, development of water and sewerage systems, and industrial hygiene. The 10-Year Health Plan for the Americas (1971-1980) stipulated that cities with more than 500,000 inhabitants establish programs to control pollution. 10 years later, actual coverage was: urban water supply, 82%; urban sewerage, 78%; rural water supply, 47%; and rural excreta disposal, 22%. PAHO's recent policy, Strategic Orientations and Program Priorities for 1991-1994, formulates workers' health programs with the aim of increasing service coverage to curtail risks to occupational health.
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  6. 6

    The right to health -- 1958-1975.

    Pan American Health Organization [PAHO]


    In signing the Act of Bogota in 1960, the member countries of the Organization of American States agreed to cooperate in promoting accelerated economic and social development. The Charter of Punta del Este, Uruguay, in 1961, had the objectives of increasing life expectancy by a minimum of 5 years and improving health. Death rates for infectious diseases were 41% lower in 1963 compared to 1956; those for diseases of the digestive system decreased 35%; and those resulting from ill-defined causes dropped 35%. Malaria deaths dropped from an annual average of 43,368 during 1950-1952 to 2285 in 1964. The Ten-Year Health Plan for the Americas, 1971-1980, gave first priority to the rights of the 120 million people without access to even minimal care. The Pan American Health Organization (PAHO) continued its efforts to eradicate Aedes aegypti, vector of both yellow fever and dengue. To combat poliomyelitis, PAHO collaborated on trials of live attenuated poliovirus vaccine. It also prepared a continental plan to combat tuberculosis and intensify leprosy case detection. Other targets were measles, whooping cough, tetanus, diphtheria, typhoid fever, plague, and such parasitic afflictions as Chagas' disease and schistosomiasis. Both the Charter of Punta del Este and the Ten-Year Health Program singled out sanitation, water supplies, and sewerage services, and during the 1960s and 1970s PAHO gave priority to environmental health. During this period its rural health strategy targeted some 40% of the population; and between 1970 and 1973, 35-40% of the total PAHO budget was dedicated to educational activities. Immunization programs were stepped up, breast-feeding stressed, education of mothers promoted, and prenatal and perinatal health services emphasized. Throughout the 1960s and early 1970s, PAHO developed research projects in acute infections, nutritional states, the role of Simuliidae as vectors of onchocerciasis, live attenuated virus vaccine against foot-and-mouth disease, and zoonoses and their prevention.
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  7. 7

    The burgeoning Bureau -- 1920-1946.

    Pan American Health Organization [PAHO]


    The 6th International Sanitary Conference of the American Republics met in Montevideo, Uruguay, December 12-20, 1920, and elected the US Surgeon General, Dr. Hugh S. Cumming, to head the Pan American Sanitary Bureau. When the 7th Pan American Sanitary Conference met in Havana, Cuba, in 1924, it drafted a Pan American Sanitary Code, which was eventually ratified as an international treaty by all 21 republics. The Bureau assumed in 1926 responsibility for the Pan American Conferences of National Directors of Health of the American Republics. Taking place between Pan American Sanitary Conferences, 6 Conferences of National Directors were held between 1926 and 1948. In the annual report of the Director for 1922, the Bureau's areas of activity had been limited to sanitary engineering, medical instruction conferences, smallpox vaccination, health education materials, ship fumigation, and solid waste incineration. The Director's report for 1927 noted widening continental concerns: drug addiction, venereal disease, sanitary administration, tuberculosis, intestinal parasites, leprosy, trachoma, malaria, puericulture, climate and disease, and immigration. Health conditions according to the report of the director for 1930-1931 included plague in Ecuador, Peru, Argentina, and Chile; yellow fever, mostly in Brazil; typhus in Bolivia, Brazil, Chile, Mexico, and the United States; undulant fever in the United States; onchocerciasis in Guatemala and Mexico; malaria in many of the countries; tuberculosis and small pox in practically all of them; measles and whooping cough in all the countries; and an increasing cancer death rate throughout the region. In April 1936 the directors approved a 7-point program on yellow fever control; discussed bubonic plague, brucellosis, malaria, trachoma, and onchocerciasis; industrial hygiene, maternal and child health, control of venereal disease and malaria, smallpox, typhoid and diphtheria vaccines, and continuation of experimental work in the use of bacillus Calmette-Guerin vaccine.
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  8. 8

    A regional call to arms -- 1946-1958.

    Pan American Health Organization [PAHO]


    In February 1946, a United Nations Technical Preparatory Committee for the International Health Conference met to create an international health organization, the World Health Organization. The International Health Conference convened on June 19, 1946. On July 22, 1946, 61 states signed the Constitution of the World Health Organization. The XII Pan American Sanitary Conference, held in Caracas, Venezuela, in January 1947 decided to consolidate the Pan American Sanitary Bureau's separate identity, reorganizing it as the Pan American Sanitary Organization (PASO). PASO was to cooperate with WHO without becoming absorbed by it. The Bureau of PASO focused on addressing such epidemic diseases as typhoid, smallpox, plague, malaria, and dysentery; excessive child mortality; inadequate nutrition; lack of modern hospitals; and low average life expectancy. The Bureau had special programs for the eradication of Aedes aegypti and malaria. It organized seminars, special training courses, and workshops, awarded fellowships, and helped schools expand their courses. Special projects on health administration, mental health, and alcoholism were developed. The Bureau set up immunization campaigns against diphtheria and whooping cough in unison with UNICEF. In 1949, the eradication of yaws was proposed, and the Bureau and UNICEF launched a successful program based on universal application of a single penicillin shot. In 1950, the eradication of smallpox was initiated, and subsequently PAHO promoted studies to perfect the dried smallpox vaccine for tropical climates. In 1950 the XIV Pan American Sanitary Conference declared the eradication of malaria a priority goal. The Bureau and the countries no longer focused on preventing the passing of diseases from one country to another but on eradicating diseases at their very source.
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  9. 9

    Global population assistance report, 1982-1988. September 1, 1989. Final report.

    United Nations Population Fund [UNFPA]

    New York, New York, UNFPA, 1989 Sep 1. vi, 82 p.

    International population assistance became a distinct form of aid in the 1950's . Since then assistance grew until 1972 when it reached US $400 million. In 1985 it reached its highest peak of US $512.5 million and has since declined to below US $500 million. Population assistance accounts for 1.3% of Official Development Assistance (ODA), a substantial decline from the near 2% levels attained in the 70's. This report provides information on the levels, trends and nature of population assistance from 1982-88. It is divided into 2 sections: donors and recipients. 17 donor countries provide all population assistance (PA); among these only 10 provide 95% of all funds. The US is the largest donor providing US$200 million annually (accounting for 50%) followed by Japan who contributes US$50 million (constituting 10% of the total). The 8 other countries include Canada, Denmark, Germany, Finland, the Netherlands, Norway, Sweden and the United Kingdom. 3 major categories are used for PA: 1) bilateral aid from individual country donors; 2) aid to UN organizations and 3) aid to non-governmental organizations. The recipients are grouped by regions: sub-Sahara Africa, Asia and the Pacific, Latin America (including the Caribbean) and the Middle East-North Africa. Asia has received 1/2 of all PA through bilateral channels; Latin America's PA increased up to 1985 through NGO and bilateral channels, but declined thereafter; Africa's PA began through UN channels in 1982 but by 1986 bilateral and NGO channels increased. Most of the differences in PA are due to the political and administrative conditions of population policy formulation in the developing countries, and reflect the politics and diplomacy of international assistance in general. (author's modified)
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  10. 10

    The U.S. international family planning program: under siege.

    Planned Parenthood Federation of America [PPFA]

    New York, New York, PPFA, 1987. 16 p.

    This brochure published by the Planned Parenthood Federation of America, (PPFA) tells the story of the dismemberment of the U.S. international family planning policy from 1961 to 1987. Official family planning policy began in the U.S. in 1961 with Kennedy's endorsement of contraceptive research. In 1968 Congress first allotted foreign aid funds for family planning. By 1973, the tide turned with Helms' amendment to the foreign assistance act prohibiting use of funds to support abortion. In 1983, USAID cut funds for the prestigious journal International Planning Perspectives, because the agency's review board chairman objected to an article on health damage of illegal abortion and mention of legal abortion. It took a court ruling to restore funds. In the same year, the Pathfinder Fund was pressured to accept the U.S. policy articulated in 1984 as the "Mexico City Policy." This ideology states that the U.S. would no longer support any program that performs, advocates, refers or counsels women about abortion, even if those activities are legal and funded by non-U.S. sources. Next, USAID pulled support from the International Planned Parenthood Federation (IPPF). The U.S. has multiplied support for natural family planning 10-fold to $8 million, and permitted organizations to counsel clients in this method without offering conventional alternatives. In 1986, the U.S. dropped support for the U.N. Fund for Population Activities, claiming alleged Chinese compulsory abortions as a reason. The PPFA has sued for a reversal of the policy of withholding USAID funds from FPIA, the international division of PPFA. The main arguments are presented, along with a list of typical FPIA projects.
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  11. 11

    The regional population programmes of the United Nations.

    Menon PS


    The Population Commission guided the development of specific population programs at the regional level in the mid-1950s, introduced progressively in the developing regions: Asia and the Pacific; Latin America and the Caribbean; Africa; and Western Asia. Their approaches were 1) The staffing of the regional commission secretariats with demographers to carry out demographic research relevant to the respective region; and 2) the development of regional training centers to build up technical personnel to assist Governments and institutions in analyzing demographic aspects of development problems in each region. The regional secretariats have helped incorporate population requests into studies and research carried out on regional and country-level development issues, through its own regional studies; the organization of seminars; and emphasis of the population element in policy formulation and development. Each secretariat has concentrated, under regional commission guidance, on crucial regional population problems. While the Economic Commission for Africa emphasizes data collection and analysis, the Asia and the Pacific Region concerns have been largely in population policy formulation. The Latin America and the Caribbean regional program stresses technical assistance in demographic training, research and dissemination of information, whereas the Western Asia program stresses demographic data collection and analysis. The depth and scope of these regional programs has depended on the changing state of demographic development. UN regional training centers: the International Institute for Population Sciences (IIPS) at Bombay, India (1951); the Latin American Demographic Center (CELADE) at Santiago, Chile (1958); the Cairo Demographic Centre (1962); the Regional Institute for Population Studies at Accra, Ghana; and the Institut de Recherche Demographique (IFORD) at Yaounde, Cameroon (1971); have provided population training programs, and trained nearly 2,000 specialists. Training and research has moved in the population and development direction.
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  12. 12

    Population assistance to governments.

    Gille H


    The Population Commission was originally charged with providing information and advice to the Economic and Social Council on population trends and issues, not direct technical assistance to governments: the needed factual basis was lacking and technical assistance was not yet a major activity of the United Nation (UN). By the 1950s, a technical assistance program focusing on data collection and analytical studies had been adopted. The 1st assistance request in population policy and action programs came from the Indian Government in 1952, followed by requests from Indonesia, Thailand, and Brazil. In 1952 the 1st 2 UN-supported regional demographic centers were founded. After the 1960 censuses, the emphasis of UN technical assistance in the population field shifted from statistical activities and training to developing methods for dealing with population problems. The early 1960s saw confrontation on whether technical cooperation should be provided by the UN for population action programs. In 1965 a high-level UN expert group was sent to India to make recommendations for the national FP program, and an ad hoc expert group recommended to the Commission that the UN respond to requests for assistance on all aspects of population, including FP. In 1966 the General Assembly unanimously adopted a resolution calling on the UN and its agencies to provide population technical assistance, and in 1967 the commission voted to give high priority to research and technical assistance in the fertility area. To finance this expanded role, the Secretary-General established, in 1967, a special UN Trust Fund for Population Activities, to be managed by the UN Secretariat. A Population Program and Projects Office was established in the Population Division and by 1969 Population Program Officers were stationed in developing countries to assess needs and assist in formulating population assistance requests. The assistance demang grew rapidly and the Fund reference terms were expanded, responsibililty for its administration being transferred to the UN Devleopment Program.
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