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Cervical cancer screening and management of cervical pre-cancers. Training of community health workers.
New Delhi, India, WHO, Regional Office for South-East Asia, 2017. 92 p.The training manual is designed to assist in building capacity of community health workers (CHWs) in educating women and community members on relevant aspects of cervical cancer prevention. The manual aims to facilitate improvement in communication skills of CHWs for promoting uptake of cervical cancer screening services in the community. The primary intention of this manual is to assist CHWs in spreading community awareness on cervical cancer prevention and establishing linkage between the community and available screening services. The information and instructions included in the manual can be used by both the facilitators and CHWs while participating in the training. The manual contains nine different sessions to assist CHWs to be acquainted with different aspects of cervical cancer prevention at the community level with focus on improving their communication skills. Each session contains key information in ‘question and answer’ format written in simple language so that CHWs can comprehend the contents better. At the end of each session, there are group activities like role plays, group discussion and games for active learning. These are intended to give opportunity to CHWs to learn by interacting with each other and also relate themselves with their roles and responsibilities at the community level. The manual includes ‘notes to the facilitator’ on how to conduct various sessions as per the given session plan. A set of ‘Frequently Asked Questions’ has been included to help the CHWs provide appropriate information to women and community members.
Geneva, Switzerland, WHO, 2009. 7 p. (WHO/FCH/CAH/09.02)This new statement provides critical new guidance to governments, USAID missions, UN agencies, non-governmental organizations (NGOs) and other development partners on prevention and management approaches that can be delivered through home visits in the baby’s first week of life. Of the estimated 8.8 million children under 5 that die each year – 3.7 million are newborn infants who die within the first four weeks after birth. Up to two-thirds of these deaths can be prevented through existing effective interventions delivered during pregnancy, childbirth and in the first hours, days and week after birth. A growing body of knowledge has shown that home visits by appropriately trained workers to provide newborn care can significantly reduce neonatal mortality even where health systems are weak. WHO and UNICEF therefore recommend home visits for the care of the newborn child in the first week of life (within 24 hours, on the third day and, if possible, on the seventh day of life) as a complementary strategy to facility-based postnatal care in order to improve newborn survival.
Africa Renewal. 2008 Jan; 21(4):8-11.Pumwani Maternity Hospital, in Nairobi, Kenya, is the largest maternal health centre in East and Central Africa. Located close to Mathare and Korogocho, two of Nairobi's biggest slums, the hospital helps some 27,000 women give birth each year. Most are poor and young, between the ages of 14 and 18. The government-run hospital struggles to provide even the most basic services, since it lacks sufficient resources, equipment and staff. "We told patients to buy their own things because of the shortage of supplies," explains Evelyn Mutio, the former head of the hospital's nursing staff. "We told patients to come with gloves, to buy their own syringes, needles, cotton wool and maternity pads." The Pumwani Maternity Hospital exemplifies the state of the health infrastructure in Africa. According to the World Health Organization (WHO), high service costs, lack of trained staff and supplies, poor transport and patients' insufficient knowledge mean that 60 per cent of mothers in sub-Saharan Africa do not have a health worker present during childbirth. That heightens the risks of complications, contributing to greater maternal and child death and disability. (excerpt)
Journal of Midwifery and Women's Health. 2007 Jul-Aug; 52(4):398-405.Although numerous health care interventions have been implemented in Pakistan, the high maternal and neonatal mortality rates still remain a challenge. Developed countries have reduced maternal and neonatal mortality rates by improving the skill and knowledge levels of nurse-midwives. This paper reviews maternal and neonatal health issues, challenges in current midwifery education, and the role of government and international agencies in Pakistan. The exact maternal and neonatal mortality rates in Pakistan are unknown; a census has not occurred since 1998, and data provided in more recent studies were presented in summary format. A number of factors that contribute to the high mortality rate could easily be controlled by using competent nurse-midwives throughout all levels of the Pakistani health care system. A reduction in the maternal mortality rate is likely to occur if the Pakistan government and international agencies work together to implement specific recommendations in maternal and neonatal health. These recommendations include: 1) holding an invitational conference; 2) strengthening the existing midwifery and Lady Health Visitor curricula; 3) pilot testing an expanded midwifery program; and 4) advocating for and obtaining political commitments and resources for midwifery education. (author's)
Prototype home-based mother's record: a guideline for its use, and adaptation in maternal and child health/family planning programmes and a reference manual for field testing and evaluation.
[Unpublished] 1985. , 119 p. (MCH/85.13)There is a need for a simple, home-based maternal record that can monitor breastfeeding and family planning practices during the interpregnancy period, identify high-risk women, and guide health care workers in the timely management of care to be provided in the home and at the next referral level. This record should further serve as an educational tool that promotes the concept of participation in self- care. Maternal cards used in clinics and hospitals are difficult for primary health care workers with limited education to complete and are not designed to be adapted to the changing health problems and health needs in a given community. In response to this situation, the World Health Organization's Maternal-Child Health Unit has designed a prototype home-based mother's record that can serve as a starting point for the design of more area-specific ones. The record contains 6 panels: 1 for data and risk conditions suggested by past history; 3 for data on past pregnancies, deliveries, and postpartum periods; 1 to monitor health progress before the 1st pregnancy or during the interpregnancy interval; and 1 for recording recommendations to the referral center. It is important that any mothers' records developed should be field tested to evaluate the physical condition of the card after 1 year of use, the extent of use of the record, the quantity of information collected and its usefulness, the assessment of health workers about the value of the record, risk factors identified, utilization of referral sources and family planning services, and linkages with other health records.
Geneva, Switzerland, WHO, 2000. v, 43 p. (WHO Technical Report Series No. 898)Life expectancy is increasing in many parts of the world, whereby not only are more people living to old age, but more are also living with disabling conditions. These conditions include people who are chronically ill, who have serious disabilities, who have HIV/AIDS, who are mentally ill, who are victims of accidents and disasters, and who are elderly. Many of these conditions need continuing care and support, not simply looking after them but enabling them to live their lives as fully and as rewardingly as possible. This report by an international WHO Study Group examines the options of long-term care. It points to the benefits that home-based care offers to the patient, while stressing that the personal and health needs of caregivers in the home must not be compromised. Families have practiced home-based long-term care for centuries, and family members will always remain a valuable resource for care. This report argues that it is time for health systems to take responsibility for providing caregivers in families and communities with the support they need both to help make their tasks more bearable and to bring a greater share of benefit to the patient.
INTERNATIONAL NURSING REVIEW. 1991 Mar-Apr; 38(2):31.A brief report summarizes issues and concepts discussed by participants from Malawi, Tanzania, and Zambia at the 2nd ICN/WHO intercountry conference in Lusaka, Zambia. Broadly discussing nursing care of people with HIV/AIDS and their families, counseling and case/family support should be considered major components of local initiatives in Africa. While local constraints must be recognized in diagnosing, counseling, caring for, and supporting cases and families, programs may also build upon community strengths. Present official health services are often unable to accommodate the needs of all patients with HIV/AIDS. Participants therefore examined innovative, new home-based approaches to care and case/family support. Examples of community-based support programs tailored to meet local needs are mentioned. The role of counseling in both case/family support and for behavioral change is also voiced. A multidisciplinary approach carried out by open, flexible, and understanding personnel is required. Nurses must provide clinical care to cases while also working to facilitate behavioral change.
[Unpublished] 1986. Presented at the 1986 ICOMP Biennial International Conference, San Jose, Costa Rica, May 1-4, 1986. 10,  p.Only about 5% of women in Liberia of child-bearing age who need family planning services have access to such services. A recent study on adolescent sexuality in Monrovia, the capital city of Liberia, revealed that lack of information and unavailability of services accounted for 90% of contraceptive nonuse. In rural areas of the country, there is a belief that a large number of children have high economic value-- daughters bring dowries while sons help with farm work. There is a high infant mortality rate, and parents tend to have many children with the hope that some will survive to adulthood. The society looks with disfavor on those sought to be infertile or unable to have children as often as other persons of similar age. And political leaders are reluctant to advocate any policies on family planning. Given this cultural environment, communications components are essential to any effective family planning programs. Radio and television would be ideal media for publicizing family planning information, but commercial broadcasting is expensive and public service spots are limited. The press cannot be utilized effectively in a country with a literacy rate of 25%. The only communications tool utilized to any extent by family planning programs in Liberia is interpersonal contact through clinic and home visits, lectures, and counseling. But there is little supervision of such contacts and a virtual absence of systematic evaluation to determine the impact of these contacts on family planning services. Agencies in Liberia providing family planning services such as the Family Planning Association of Liberia (funded by IPPF) and the government's Ministry of Health and Social Welfare should build effective communications programs to improve their services.
Development. 1988; (4):55-60.UNICEF aided the Basic Urban Services for Katchi Abadie (BUSTI) in performing and action research project in order to study and improve the role of poor women in Pakistan. The study was conducted in Baldia Town Karachi (pop. 200,000 in 1979) and lasted over 6 years (1979-1986). Women and children were hired to work on the Baldia Soakpit Pilot project and were found to be illiterate. Distance, lack of money, and the need for help around the house were cited as reasons for illiteracy among children. The women in the community organized a traditional program of home schooling in 1981 and hired 10 girls who had at least a high school education to teach. 300 children participated in this program. The Baldia Memon Jamat NGO offered a health training program for young girls of the community. Several criteria, including teaching experience and economic status, were used to choose among the applicants. The home school program has expanded since 1981. 120 teachers and 4000 children took part in the program in 1988. The teachers organize a mothers' meeting once a month and are now registered as the Home School Teachers' Welfare Organization. Primary care and vaccinations are given through the home schools. Women play crucial roles in the development of the project, as developers, managers, and organizers. Young women have gained independence through education without sacrificing traditional values. The utilization of women in and by this program has helped increase women's self-esteem and has increased respect for these women from the community. The hope is that traditional barriers against the participation of women in community development will eventually be eradicated.
Emphasis. 1986 Winter; 22-4.The Adolescent Parent Program for Learning Essential Skills (APPLES), designed as a 4-part program to serve pregnant, parenting, and at-risk adolescents in McLean County, Illinois, is considered a model program because of the comprehensive manner in which it addresses the issue of adolescent pregnancy. Designed by Planned Parenthood of Mid Central Illinois (PPMCI) administrative and educational staff, APPLES develops and coordinates services to adolescent parents and provides expertise and strategies for educating at-risk adolescents. APPLES currently has the support and cooperation of 16 youth-serving agencies. 1 essential component of the APPLES program is the Home Visitor Program. Under a subcontract with the McLean County Health Department, each APPLES Home Visitors team is made up of a registered nurse and 1 social worker. The Home Visitors provide aggresive advocacy tailored to the young family's special needs, such as securing adequate housing, transportation, child care, or financial assistance. In addition, APPLES home visitors provide in-home, one-on-one education. Home Visitors assess the child's developmental progress and teach the parents what developmental skills to watch for. Antoher component of APPLES is "Time Out," a weekly peer support group that provides an opportunity for adolescent mothers to share the frustrations and triumphs of parenting. The groups are facilitated by trained volunteers, some of whom were teen mothers. Time Out is a short-term (3-4 months) empowerment/affirmation model that integrates information sharing, consciousness raising, education, and skills development. While mothers take time out for themselves, their children are cared for by trained child development volunteers who use creative play and individual assessment to develop a new activity each week for the mother and child to do at home. The Developmental Day Care component provides adolescent parents with alternatives and partial financing for child care to allow them to continue their education or job training. APPLES staff work with both care providers and young parents to locate day care facilities. ADAM is the support component for adolescent fathers. It works through the PPMCI education staff to promote awareness, education, and prevention for the at-risk adolescent population. ADAM encourages adolescent fathers to be informed of their rights as well as their responsibilities. It provides counseling and support for these young men. Brief educational/support group sessions for Grandparents Too Soon (GTS) were initiated to center on peer help in dealing with feelings, fears, and frustrations.
Joicfp Review. 1985; (9):12-7.In 1970, a Dutch medical team began work in the city of El Kef in Tunisia on a project designed to bring family planning into rural areas. The project aimed to persuade the rural people to use urban health centers, but this approach failed partly because of the remoteness of the communities and their reluctance to discuss personal matters with strangers. Funded by UNFPA, a new project began to recruit and train local girls as home health visitors or aides-familiales, an approach which became the central focus of the El Kef project. The International Planned Parenthood Federation (IPPF) took over the project and expanded it to include nutrition, health care, health education, family planning, disease prevention and domestic crafts. 4 goals were fixed for the project: total vaccination coverage for children; elimination of severe malnutrition; reduction of infant mortality; and use of family planning practice by at least 1/2 the women of childbearing age. An efficient recordkeeping system enabled the project to be carefully evaluated and provides much-needed data, showing where it has achieved its aims and where new efforts should be directed. The project resulted in large numbers of women receiving ante-natal advice, child care and family planning from their local health centers. 860 pregnant women were followed up during the 3-year study period. Some 57% of pregnant women went for advice; only 15% went for postnatal care, but 50% of the women under 50 attended child welfare sessions during the study period for weight checks, nutrition advice, vaccination and treatment for minor ailments. Over the 3 years, the number of contraceptive users more than trebled, from 14% to 54%. The IUD was the most popular method. The most successful aspect of the project was the emphasis on maternal and child health, and the home visits were the most motivating feature. Vaccination became more popular. A further aspect of the project was the training in home improvement skills, like sewing, knitting and gardening. After 4 years in the field the aides familiales were a valuable resource of skill and experience. Family planning was integrated with maternal and child health in the government program through the health infrastructure.
London, International Planned Parenthood Federation, Evaluation and Social Sciences Department, May 1976. (Research for Action No. 2) 13 pThe Botswana government, now an affiliate member of the International Planned Parenthood Federation (IPPF), and the IPPF have collaborated since 1969 in the stablishment of family planning services within the maternal and child health programs. Evaluation of the family planning aspects of this program conducted between April 1972 and October 1973 focused on 3specific research studies: 1) a description of the Family Welfare Educator cadre in Botswana, their workload, problems, and training; 2) an analysis of service statistics generated by the Maternal and Child Health Family Planning programs; and 3) a follow-up survey to trace family planning acceptors. By April 1972, 60 women had been trained as family welfare educators. A weekly reporting system was introduced as a means of establishing contact between the family welfare educators and the Office for Maternal and Child Health/Family Planning, learning about the problems workers encountered, and assessing their work. In studying the service statistics it was learned that over the 5 years of this study period 72% of the clients received oral contraceptives, 16% IUDs, and 2% injections on their 1st visit to the clinic. The ratio of oral contraceptives to IUD acceptors changed from .75:1 in 1968 to 28:1 in 1972. It was found that nearly 1/3 of the clients discontinued contraceptive use within 3 months and nearly 2/3 within a year. It was recommended that greater emphasis be placed on the IUD as a method of contraception. Regarding the follow-up survey, a 100% sample of new acceptors in the selected months was drawn from the records of Gaborone and Serowe clinics and data were abstracted from the individual client cards at each clinic. It was learned that 20% of the women interviewed discontinued contraception within 6 months and 34% within a year. These continuation rates were lower than those derived from service statistics. It was recommended that follow-up surveys be repeated at regular intervals in order to monitor the acceptability of the program to new acceptors and to ensure client feedback to improve the program.
Asian and Pacific Population Programme News. 1977; 6(4):24-25.In Nepal the promotion of activities aimed at improving the skills and status of women was formerly the task of the national organization, Mahila Sangathan, but is now the responsibility of the newly created Subcommittee for Women's Affairs. The subcommittee operates under the guidance of the Co-ordinating Council for Social Services under the sponsorship of Her Majesty the Queen. The subcommittee cooperates through chapters located in each of the country's 75 districts. Many of these chapters are actively engaged in 1) promoting family planning via door to door campaigns and through training local women for family planning motivational work; 2) stimulating the production and marketing of crafts made by women; 3) providing legal assistance to women; and 4) conducting literacy programs for approximately 10,000 women. A new headquarters for the subcommittee is being built with UNESCO assistance. The committee hopes to establish a library in the new building since a lack of reading material is hindering progress in its literacy program.
IPPF Situation Report, September 1972. 7 pHong Kong, with 3858 people/sq km, is 1 of the world's most densely populated areas. Family planning was introduced in 1936 by the Hong Kong Eugenics League and 5 clinics were operating by 1940. The Family Planning Association (FPA) was formed in 1950 and was a founder member of IPPF in 1952. Interest in family planning increased as massive immigration from China added to overcrowding. The government supports FPA (in 1972 the grant was U.S.$254,545) and houses 80% of the FPA clinics in government properties. At present there are 46 female clinics providing 189 sessions per week and 2 male clinics operating eac h week. The decline from 54 to 48 clinics is due to the new emphasis on full-time rather than part-time clinics. In 1971 there were 347,894 attenders, an increase of 18% over 1970, and 31,898 new acceptors, an increase of 4%. There has been continued increase in the number of patients requesting oral contraceptives (70.6% in 1971). The IUD began to decline after bad publicity surrounded a large number of loops which had broken in the uterus; in 1971 only 6% of acceptors asked for IUDs. Condoms account for 11.5% and injectables, 3.6%. FPA offers subfertility and marriage guidance services and is extending its Papanicolaou smear service. An active media campaign, exhibitions, and seminars are conducted. Until 1967 fieldwork consisted of random home visits. An efficiency study led to concentration on maternal and child health clinics, postnatal clinics, and follow-up home visits. Home visi ts are still made on request. A number of international trials for various contraceptives have been run in Hong Kong. Many church and international organizations are helping to finance family planning activities, both through FPA and through their own organizations.
Report from the United States of America. (Planned Parenthood Federation of America Inc. World Population Emergency Campaign).
In: International Planned Parenthood Federation (IPPF). Proceedings of the seventh conference of the IPPF, Singapore, February 10-16, 1963. Changing patterns in fertility. Amsterdam, Excerpta Medica, 1964. 734-9. (International Congress Series No. 72)The Planned Parenthood Federation of America Incorporated World Population Emergency Campaign's goal is to provide "leadership for the universal acceptance of family planning." The effort is concerned with reaching this objective in both the U.S. and among all members of the International Planned Parenthood Federation. The national organization is composed of 101 affiliates who are maintaining 201 birth control centers. Any education project or activity in the U.S. Planned Parenthood is focused on 1 or more of the following objectives: 1) providing more people with family planning information and motivation to use birth control; 2) raising the local and world level of public unders tanding about the value of and need for family planning; 3) helping educate professionals involved in family planning services and programs; 4) stimulating action by local and national governments to help provide birth control through tax supported channels; and 5) raising money to support the increasing number of Planned Parenthood efforts in the U.S. and to provide additional funds in support of the International Planned Parenthood Federation and its member organizations. Within this framework, education and service has been geared to students, professional workers, industrial workers, agricultural migrants and low income urban families. Different mass media techniques are used to obtain the various educational objectives among the different groups of people. Efforts to stimulate action on the part of the U.S. government involves both increasing the public awareness of the need for such action and direct dealings with government officials and advisors on these matters. The use of mass media in soliciting increased financial support for Planned Parenthood remains mainly indirect with volunteers requesting financial support from individuals. As a voluntary organization receiving no government funds, a large number of volunteers are depended upon to supplement the work of the professional staff. Professional staff assistance is available from national headquarters to assist affiliates in all program areas, to aid other communities in organizing Planned Parenthood Committees, and to work with public health departments in order to promote the development of family planning services as part of their maternal and child health services.
London, Eng., International Planned Parenthood Federation, 1982. 67 p.Add to my documents.