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Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1987. iii, 33,  p. (USAID Contract No.: DPE-5927-C-00-5068-00)Sudan is one of 8 USAID African child survival emphasis countries. This documents focuses upon linking the discrete areas of child survival to each other in efforts to achieve sustained reductions in national morbidity and mortality rates. The scope of the problem is briefly considered as background in the text, followed by a more in-depth presentation of government policy and programs. This section includes examination of the structure and organization of existing health services, child survival activities, and current progress and constraints. Child survival activities are listed as immunization, control of diarrheal diseases, nutrition, child spacing, malaria control, acute respiratory infections, and AIDS. The current strategy of USAID support for these activities is outlined, and includes mention of private volunteer organization and private sector participation. The role of UNICEF, WHO, and the World Bank in child survival in Sudan is also highlighted. Recommendations for child survival strategy in Sudan are presented and discussed at length in the text. Continued support to UNICEF, cost recovery and health care financing efforts through WHO, child spacing and population program support, and support to on-going USAID projects constitute USAID's priorities and emphasis in child survival strategy for Sudan. Detailed short- and long-term recommendations for immunization, control of diarrheal diseases, nutrition, child spacing, and child survival and health care financing are provided following the section on priorities. In closing, staffing and recommendations for malaria and other endemic disease, acute respiratory infections, AIDS, and management are considered. Appendices follow the main body of text.
General lessons learned from evaluations of MCH/FP projects in Botswana, Malawi, Swaziland and Zambia.
New York, New York, UNFPA, 1984 Dec. iv, 41 p.4 maternal-child health/family planning (MCH/FP) projects were evaluated by the United Nations Fund for Population Activities (UNFPA) in the Southern Africa Region between 1981-1984. The projects were in Botswana, Malawi, Swaziland and Zambia. An overriding finding at the time of the Evaluation Missions was the acceptance of family planning (child spacing) by all 4 governments, when at the onset of the projects, family planning was either not included in the project documents or was included only as a minor contributant to the MCH programs. The intervention by UNFPA was very important for the acceptance and promotion of family planning activities by the governments. The Evaluation Missions concluded that there were 3 primary reasons for the successful intervention: UNFPA has a broad mandate to provide assistance in MCH and FP, a commitment to development projects in line with the governments' priorities, and the ability to fund projects very quickly, facilitating project implementation. Each of the 4 projects is assessed in terms of population policy changes, MCH/FP program strategy and serive delivery, organization of the MCH/Fp unit, health education, training, evaluation and research systems, and administration and management. Essential factors affecting the project are outlined and recommendations made. The last section discusses general lessons derived from the MCH/FP projects evaluated. 5 areas are identified where similar problems exist to varying degrees in all the projects evaluated. These are: training of medical personnel in FP (the main MCH/FP service provider in these projects was the nurse/midwife); supervision of personnel and the supply and distribution of contraceptives; research and evaluation, especially regarding the sociocultural setting of target populations and the inadequacy of existing service statistics and other sources of data; project monitoring (technical and financial) and finally project execution by the World Health Organization (WHO). Specifically in regard to the recruitment of experts, the provision of supplies and equipment, and the provision of funds for local costs, WHO execution has been deficient.
Report on the evaluation of UNFPA assistance to the Sudan population and housing census of 1983: project SUD/79/P01.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1985 Mar. xi, 40 p.Since the evaluation report of the 1973 Census of Sudan made recommendations on how to improve census implementation for the 1980 round, UNFPA felt it to be important to see if the 1983 census took them into account and if it achieved better results. The project document included 3 objectives concerning data collection and analysis: the availability of accurate and up-to-date information on the total population of Sudan, on the components of population growth, and on demographic, social and economic characteristics; and 2 objectives concerning institution building: the availability of trained statistical personnel and the strengthening of data processing facilities. 2 of the 5 objectives have been achieved--up-to-date information on the total population of Sudan and for all recognized civil sub-divisions is available and a new computer facility with adequate capacity and configuration has been installed and is in operation. The caliber of staff in the census office is high, and the training program overall was adequate. The census communication campaign emphasized the use of mass media. Overall, the publicity for the census was considered by the Mission to have been good. Although the enumeration took longer than scheduled in some areas, the observance of the enumeration timetable can be considered satisfactory. Data preparation and electronic processing have been severely delayed due to the low productivity of the computer staff. The strong points of the project were the high priority given to the census by the government; the better planning for the 1983 census as compared with the 1973 census; and the high quality of technical assistance provided by UN advisors. Weak points have been the lack of long-term resident advisors in general census organization, cartography and data analysis; the delay in the provision of government and UNFPA inputs; and the loss of trained personnel from the Department of Statistics, particularly in data processing.
Report on the evaluation of UNFPA assistance to the civil registration demonstration project in Kenya: project KEN/79/P04.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Dec. xi, 36 p.Kenya established a compulsory vital statistics and civil registration system in 1963 and it was extended nationwide in phases until it covered the whole country by 1971. Serious under-registration of births and deaths however, has persisted. In order to improve registration coverage, the government submitted a proposal to UNFPA to support experimentation with ways to promote registration in some model areas. The original project document included 4 immediate objectives: the strengthening of the civil registration system in the model areas including the creation of a new organizational structure, the training of project personnel and the decentralization of registration activities; the improvement of methods and procedures of registration through experimentation; the collection of reliable vital statistics in the model areas; and, the establishment of a public awareness program on the need for civil registration to ensure the continuation and extension of the new system. Of the 4 objectives of the project, 2 have been achieved--the strengthening of civil registration in the model areas and the improvement of methods and procedures of registration. The major deficiency during the project period was the lack of required staff in the field. The primary feature which distinguishes the project is that traditional birth attendants and village elders become key persons at the village level and act as registration informants after receiving training. The strong points of the project are the high quality of technical assistance provided by the executing agency, the close collaboration among various government departments, and the choice of project strategy and model area. Recommendations have been made to correct the problems of a lack of key personnel at the head office and in the field, and the expansion of registration to new areas before consolidation was completed in the old areas.
Report on the evaluation of UNFPA assistance to the family health programme of Zambia: project ZAM/74/PO2 (February - March 1984).
New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Sep. x, 38,  p.The objective of the Family Health Program of Zambia is to enhance the health and welfare of Zambians, particularly mothers and children, through an increase in coverage of the population served through under-5s clinics, pre- and post-natal services and child spacing activities. The Mission found that the strong points of the project are the increasing commitment of the Government to incorporate family planning activities as an essential component of its family health and primary health care programs; the training and health education components of the program; and the enthusiasm and ability of the Zambian Enrolled Nurse/Midwives in organizing maternal child health/family planning services at service delivery points. Factors which appear to have hindered a more effective project performance have been the restriction on prescribing contraceptives by anyone but physicians; the imbalance in implementation among the project components; the failure to appoint international and national staff to key positions and with a timing that would have enabled staff members to support each other as members of a coordinated team; weak supervision; no research and evaluation activities; transport problems; the lack of use of, and updating of, the project plans; and the absence of a tripartite review early in the project's life to address implementation problems.
Journal of Applied Behavioral Science. 1983; 19(3):307-17.Applied behavioral science is both relevant and responsible to Third World development, but so far, these qualities have neither been recognized nor acted upon. This relevancy and responsibility lie in 3 basic areas that could significantly contribute to development programs and that have numerous implications for the ABS field: the training of trainers, organization design and development, and development strategies. In programs that generally last 4 weeks, officers were trained in a wide variety of practice theories and skills. Basic communication skills--active listening, paraphrasing, giving and receiving feedback have formed the foundation of these programs. An effective linkage between development programs and the community requires that the development worker not only transfer cognitive material but also work with farmers in developing skills and in exploring attitudes and values. The area of organizational design relates specifically to the professional and experience of ABS practitioners. Third World countries need to design development organizations that do not depend upon such external influences as donor agencies; to design organizations connected to the constituent culture, history, and traditions; and to design organizations that focus on problems. As a field, ABS exercises little influence on development in the Third World. In order to further its influence, development strategies should include exchanges between ABS professionals. Third World practitioners, for example, need support in building in-country capabilities. With an ABS exchange network, they may look to their colleagues in the industrialized countries for such support, and in turn, they may offer ABS practitioners in industrialized countries opportunities for involvement in development in Third World countries.
Evaluation of the regional advisory services in population education and communication in Sub-Saharan Africa of FAO, the ILO and UNESCO, 1978-1982.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1983 Jun. iv, 64 p.This evaluation was conducted to assess alternative modes of providing regional population education and communication (PEC) advisory services in the African Region in the future, in addition to assessing past performance of existing projects. In the absence of specific and measurable project objectives, as well as uniform, reliable and comparative data for the different projects included in this evaluation, it was not possible to determine exactly the quantity and quality of the achievements of the regional advisory projects over the period under review. Nevertheless, it is concluded that the achivements had been relatively limited, partially because of inherent difficulties associated with the provision of advisory services in the region (e.g., distances, inter-and intra-country communication problems) but more so because of weaknesses in the formulation and implementation of the regional advisory projects. These weaknesses include: 1) differing views on the part of the Executing Agencies and the United Nations Fund for Population Activities (UNFPA) about the functions of the regional advisors which underlie the rather vaguely defined functions presented in the project documents; 2) insufficient planning of the regional advisory teams' activities; and 3) recruitment difficulties which led to vacancies and high turnover as well as to the hiring of partially qualified advisors. Furthermore, the present arrangement for the delivery of regional PEC advisory services, e.g., separate agency teams and advisors located in different countries, impedes the effective delivery of services because the advisors under this arrangement cannot function as 1 team. It is recommended that the functions of the regional PEC advisors in Africa be concentrated on assistance to country project formulation, advice on country project management and systemenatic particiaption in country project monitoring and evaluation. Recommended regional PEC advisory services are 1 team for PEC in the non-formal sector and another team for population education in the formal sector. Other recommendations deal with the role of Headquarters vis a vis regional follow-up and monitoring/supervision of regional advisors, other in-country activites and need for resident country advisors.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1982 Dec. xi, 44,  p. (Project SWA/75/P01)The long range objective of this project (1976-1981) was to improve and enhance the health and welfare of mothers and children, especially in rural areas. In assessing Project achievements and the degree to which progress toward the long term objective has been accomplished, the Evaluation Mission found that the immediate objectives had, to a large degree, been met within the general framework of the Ministry of Health's (MOH) development program. Service delivery points in governmental, mission private and industrial/plantation health facilities are now widely distributed throughout Swaziland. The integration of preventive and curative is clearly in place in the rural health clinics and health centers. Analysis of service statistics data indicates that a large % of pregnant women attend antenatal clinics. Family planning services are now offered in 86 clinics with 27,094 clinic attendances recorded for 1981. The pill is the most popular method, followed by condoms, injectables and IUDs. An adequate though incipient health education program is functioning. The MOH strengthened the health infrastructure for, and has in place a program of, maternal child health (MCH) and family planning (FP). The strong points of the program are the government's commitment to MCH/FP, the general strategy, the training component, the number and quality of staff involved in service delivery, the number of service delivery points and the system of recruitment and the employment of Rural Health Motivators (RHM). Weak points, which appear to have hindered a more effective program performance, are planning and management, the lack of solid socio-anthropological knowledge to base, the lack of a focal point for FP, supervision at all levels and the lack of monitoring and evaluation which, if properly undertaken, could have led to changes and adjustments in the program. Future activities supported by the United Nations Fund for Population in the organization and management of family planning activities within the MCH program and within other government and voluntary organizations. UNFPA should help the government prepare a new proposal for UNFPA assistance to family planning activities in the country and should consider supporting supervision and training activities.