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In: Country studies on strategic management in population programmes, edited by Ellen Sattar. Kuala Lumpur, Malaysia, International Council on Management of Population Programmes, 1989 May. 1-23. (Management Contributions to Population Programmes Series Vol. 8)Brazil has a population of 144 million with an annual growth rate of 2.1%. Brazil also has the highest economic disparity rate in the world, with 65% of the population living below the poverty line. Despite some degree of governmental acceptance of family planning, the government does not have the resources to support an effective program, and it is therefore up to nongovernmental agencies to expand the population's access to family planning. BEMFAM, the Family Well-Being Civil Society, was founded in 1965 to stimulate the creation of a government family planning program. BEMFAM was affiliated with the International Planned Parenthood Federation in 1967 and was granted recognition as a public utility in 1971. BEMFAM's 1st community program was in Rio Grande do Norte, and it was shortly extended to other northeastern states. As a result of political leadership seminars held by BEMFAM in 1980 and 1981, state legislators took the lead in creating the Representatives Group for Population and Development Studies with the goal of integrating state legislatures to implement a national family planning program. Due to BEMFAM's influence, the northeast is the 1 region where people expect to get contraceptives from government health centers. BEMFAM's work is concentrated in 4 areas: studies and surveys; information, education, and communication; training; and service delivery. According to the results of the Brazil Demographic and Health Survey carried out in 1986, 99% of women know of at least 1 contraceptive method, but only 43% use one. The most used method is female sterilization, followed by the pill (28% and 25% respectively). Brazil's new constitution designates family planning as a basic human right. BEMFAM will implement 6 strategies to increase the level of family planning in Brazil. 1) It will act to influence political leaders to improve family planning programs. 2) It will spread information and knowledge about family planning to the community at large. 3) It will train health professionals in family planning. 4) It will assist government agencies and private programs to maintain standards of service. 5) It will conduct studies and carry out research related to family planning, health, and development. 6) It will continually upgrade its own staff and facilities. BEMFAM has prioritized its efforts according to location, need, and sustainability of the programs.
ESCAP/POPIN Working Group on Development of Population Information Centres and Network: report on the meeting held from 20 to 23 June 1984.
Popin Bulletin. 1984 Dec; (6-7):99-102.The Expert Working Group on the Development of Population Information Centers and Networks met in June 1984 to consider the organizational and technical aspects of the development of national population information centers in the countries in the Bangkok region, as well as national, regional and global networking. Representatives from China, India, Indonesia, Malaysia, the philippines, the Republic of Korea, Sri Lanka, Thailand and Viet Nam participated in the meeting. POPIN was represented by its coordinator. Among the major issues considered by the Working Group were the role and functions of population information centers with special reference to the positioning of centers in national population programs user-oriented products to facilitate the utilization of research findings for policy formulation and program implementation, and the possible approaches to be developed by population centers in facilitating in-country networking to extend population information services beyond capital cities to the local level. The mandate and responsibilities of national population information centers should be explicitly stated by the highest authority. Centers should contribute to the national population programs by collecting, processing and disseminating population information effectively. Greater flexibility in performing activities should be given to centers. Training of staff should be expanded; external funding should be continued; and research and evaluation techniques should be developed. Surveys of users and their needs should be periodically undertaken to determine needs. Systematic user education programs should be provided and policy makers should be informed of current research findings and policy implications. Automation of bibliographic information should be undertaken. The Asia-Pacific POPIN Newsletter produced by ESCAP should be institutionalized as a channel of information centers in the region. ESCAP should take the initiative in establishing a South Asian network along the lines of ASEAN-POPIN to facilitate exchange of ideas and information. Efforts should be directed at linking the WHO Health Literature Library and Information Serivces (HELLIS) and POPIN in the Asian and Pacific region.
Inquiry. 1975 Jun; 12(2 Suppl):148-55.The intention in this discussion is to describe the health care system in a rural area of 1 not atypical developing country, Ghana. Some of the deficiencies of the system are reviewed from a sociological perspective, and the components of 1 potential approach for reducing the health problems in this and similar situations are outlined. About 12% of Ghana's 8.5 million population (1970) live in the larger cities and urban areas. The majority of the population lives in small towns and especially in villages and hamlets scattered throughout the country. The country has about 670 physicians registered, but most of these physicians are concentrated in the urban areas. In the rural areas, the existing health care delivery system consists of a regional hospital offering specialized services, with decentralized and less specialized services extending toward the periphery of the system. What this means is 1 or more district level hospital and a modest number of health centers and posts throughout the rural areas. Emphasis in this decentralized system is on static health facilities that provide elementary medical care primarily on an outpatient basis, referral of the more complicated and/or serious cases to the system's higher levels, and various mother and child preventive health services. Also there are individuals and mobile teams to monitor sanitary conditions and provide immunization coverage to large portions of the population on a campaign basis. This pattern of health care may be found in similar form throughout most of the countries of the developing world. There have been concerted efforts to increase the availability and efficiency of health care delivered throughout Ghana, but there are prominent problems. In the Wenchi District there are 4 mission hospitals located in the 3 largest towns. These hospitals have their own outpatient activities and receive patients who are referred from the more peripheral government health facilities. There is a reasonable distribution of health personnel in the district, and a large proportion of the population uses the modern health facilities. Given a theoretical commitment to the reasons why a rural health care provision system should be based on community involvement and activities, the World Health Organization is trying to work with governments who want to implement such a program. Certain operational components are necessary. A specific project is planned for the Wenchi district. Preparatory work includes codification of various potential village projects in the form of simple procedures that can be carried out by village health workers, should the community identify related needs and adopt such projects. These project guides must also include training instructions, supervisory and resupply guidelines, instructions for referral of more complicated cases, and evaluation procedures which can be used and understood at the village level. Coordination and cooperation procedures will have to be established at both the district and subdistrict levels.
Reports prepared for World Health Organization Consultation, May 1976. Various pagings.Add to my documents.
Geneva, Switzerland, World Federation of Public Health Associations, 1983 Jul. 104 p.The objective of this report is to help persons who are not training specialists to decide policy and planning questions and to oversee the implementation of training. The report is written as a series of issues that must be faced and resolved. The issues discussed concern effective program design, the kind of training efforts that should be supported, the design and implementation of the training, what should be taught, who should be trained, trainee and trainer selection, the nature of training curricula and materials, the location and duration of training sessions and training evaluation. For some issues, such as defining the Community Health Worker's (CHW) role, skills and activities, or the need for institutional development, there are specific recommendations; for others, like location planning, only pro and con arguments are given. Planners are urged to decide how training fits into their program, and how much effort to invest, given competing priorities. The report is intended to stimulate discussion by raising questions and suggesting considerations relevant to answering them. Reviews and examples of existing efforts in a number of countries are used in the appendices as illustrations of the ways in which various projects sought to tailor training needs and skills to local requirements and constraints. Appendix B presents synopses of CHW training in selected projects following a set of characteristics--scale of project, trainees' previous education, duration and schedule of training, trainers' preparation, production of training methods and materials, methods of evaluation and community participation. These are followed by a descriptive summary of the projects. Lists of resource institutions and organizations for CHW training, and of recommended readings are provided.