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Geneva, Switzerland, UNAIDS, 1998. 7 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/98.18)Strategic planning, as developed in the present guide, defines not only the strategic framework of the national response, i.e. its fundamental principles, broad strategies, and institutional framework, but also the intermediate steps that need to be achieved in order to change the current situation into one that represents the objectives to be reached. In normative--as opposed to strategic--planning, activities are planned according to universal norms that apply to all beneficiaries, irrespective of their conditions or situations. Strategic planning takes an issue's underlying determinants into account, which vary according to the persons concerned (e.g. their social class, religion, culture, gender specificities, etc.) and according to situations that may alter rapidly over time. Strategic planning means adapting norms to a given or changing situation. A strategic plan, therefore, includes a normative as well as a strategic dimension. (excerpt)
Guide to the strategic planning process for a national response to HIV / AIDS. 4. Resource mobilization.
Geneva, Switzerland, UNAIDS, 2000 Aug. 19 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/00.21E)The major focus of this module is on 'mobilization of resources' and it should primarily be read or used in conjunction with each of the first three modules. Those who will use it are the situation analysis and/or the response analysis team, and the team responsible for the formulation of the strategic plan. However there will also from time to time be a need to secure resources after the formulation of the strategic plan, for instance to support the expansion of emerging successful strategies, or to supplement shortfall in funding for a priority strategy or a catalytic project. This module will therefore also deal with relevant approaches, techniques and methods for that purpose. Following an overview and definition of resources and resource partners, the module: highlights the ways in which resources are effectively mobilized through a strategic planning process; describes specific approaches to mobilization of 'additional' resources in the course of the implementation of the strategic plan. (excerpt)
Chinese Primary Health Care. 2000; 14(9):11-14.To set up the research priorities for the broader reproductive health programmes, the World Health Organization (WHO) has given a high priority to planning and programming for reproductive health, which aims at improvement of the delivery of reproductive health services. In 1998, with a financing support by Ford Foundation, the Foreign Loan Office of the China Ministry of Health (MoH) initiated a program in poor rural areas of China entitled reproductive health improvement project (RHIP) in 4 of the 71 World Bank/MoH of China "Health VIII Project" Counties. This paper reports the approaches and entry points of RHIP: (1) Participatory planning; (2) Operations research; and (3) Listening to women's voice at the rural communities. It is expected that these approaches and entry points will be useful for improvement of reproductive health services in other rural areas of China. (author's)
Country commodity manager. CCM: a computer program for the management and forecasting of reproductive health commodity needs. Instruction manual. Software version 2.
New York, New York, UNFPA, 2004. 47 p. (E/800/2004)The purpose of the Country Commodity Manager (CCM) is to assist country offices in their efforts to assess their reproductive health commodity requirements, stock positions, and possible shortfalls. CCM is an easy-to-use program which can quickly generate models and reports which will: 1) forecast reproductive health commodity requirements based on logistics and inventory data, 2) validate this forecast utilizing demographic data, and 3) warn of future reproductive health commodity shortfalls. CCM also provides a mechanism to readily transmit each country’s data to UNFPA headquarters from their country offices for use in generating global level reports for the purposes of planning, advocacy and resource mobilization. In this latest release of the software, we have added other reproductive health commodities and kits to the list of contraceptives that was managed in the first version. Our goal is to collect global data on all of these commodities. This new release also includes the much requested ability for users to add the names of any other commodities they wish to the data tables to be managed and reported on by CCM. (excerpt)
A bilingual regional workshop: Methodologies for Designing and Implementing Multimedia Communication Strategies and National Communication Policies, Niamey, Niger, 1-5 April, 2002. Final report. [Un atelier régional bilingue : Méthodologies pour la conception et l'implémentation de stratégies de communication multimédia et de politiques de communication nationales à Niamey, au Niger. Du 1er au 5 avril 2002. Rapport final]
Rome, Italy, FAO, 2002. vii, 59 p.The principal objective of the meeting was to provide a forum for the exchange of views on and discussions of specific needs and expectations of different national communities. Three documents, as well as this final report, were published as a result of the workshop: A methodological guide to creating a multimedia communication strategy; A guide to creating and implementing national policies on information and communication for sustainable development in Africa; A report on the definition and implementation of national communication for development policies, with case studies from Mali, Burkina Faso, Niger and Guinea-Bissau. We hope that workshop participants were inspired and enabled to develop and implement sectoral strategies for multimedia communication and national communication for development policies in their countries. The FAO Extension, Education and Communication Service (SDRE) is ready and willing to provide technical support to their activities. (excerpt)
Belize City, Belize, Ministry of Health, 1984. , 54 p. (EPI/84/003)An evaluation of the Expanded Program on Immunization (EPI) in Belize was conducted by the Pan American Health Organization/World Health Organization at the request of the country's Ministry of Health. The evaluation was undertaken to identify obstacles to program implementation, and subsequently provide national managers and decision makers with viable potential solutions. General background information is provided on Belize, with specific mention made of demographic, ethnic, and linguistic characteristics, the health system, and the EPI program in the country. EPI evaluation methodology and vaccination coverage are presented, followed by detailed examination of study findings and recommendations. Achievements, problems, and recommendations are listed for the areas of planning and organizations, management and administration, training, supervision, resources, logistics and the cold chain, delivery strategies, the information and surveillance system, and promotion and community participation. A 23-page chronogram of recommended activities follows, with the report concluding in acknowledgements and annexes.
Community involvement in health development: challenging health services. Report of a WHO Study Group.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1991; (809):i-iv, 1-56.In order to make community involvement in health development (CIH) a reality, countries need to go beyond endorsement of the idea and take concrete steps, reports a WHO study group examining the issue. While the idea of community involvement has gained widespread acceptance, most health services have been slow in making the necessary institutional and organizational changes, and in providing the necessary money and staff time. Furthermore, most CIH efforts have concentrated on the community side of involvement, neglecting the health development aspects and the context in which the involvement takes place. The Study Group, which met in Geneva on December 1989, was concerned with identifying specific obstacles to CIH implementation and providing recommendations. The report discusses such issues as the political, social, and economic contexts of CIH; the methodology of CIH; the training of health personnel; the strengthening of communities for CIH; and the monitoring and evaluation of such programs. Among the report's major findings: most countries have yet to truly commit to CIH; CIH programs lack the necessary support and resources; effective coordination at all levels is imperative; health personnel must be adequately educated on the principles and practices of CIH; and some health ministries promote too narrow an understanding of health. The report contains recommendations for both countries and for WHO. The recommendations for countries include several measures directed at the ministries of health, including a provision that the ministries develop guidelines for the implementation of CIH at the district level.
Bangkok, Thailand, ESCAP, 1984. 323 p. (ESCAP Programme on Health and Development Technical Paper No. 66/PHD 19; ST/ESCAP/286)This training manual describes the organization of the courses, the course syllabus, the 1983 course on planning, development and health, the follow-up evaluation of the training courses of 1976-82 and the specialized activities in planning for health and development at ESCAP. Planning for health is viewed as an integral part of overall development planning with the conscious incorporation of clear goals, to help ensure that development programs have a positive impact on the health of the region's poor. ESCAP's training program aims to amplify, in concrete terms, the close relationship between health and development and to build the capability to take an integrated and multisectoral approach to inproving health and accelerating development. The design and implementation of a training program oriented to strengthen capacities in planning, development and health is a function of these 3 terms. The basic frame has remained farily similar to the 1976 course. Training aims at behavior change--to strengthen capacity for action, rather than to accumulate knowledge and information for information's sake. Training objectives must be appraised in terms of relevance, adequacy, effectiveness, efficacy and impact before actual implementation beings. The course is conceived as a unified, multi-sectoral approach to assess the health situation and propose intervention measures aimed at the elimination of the social causes of ill-health and disease of a country. The focus is in the relationships between health and development through systems analysis and relevant planning tools. The aim of the courses is to produce a cadre of planners for health with an innovative and intersectoral outlook, consistent with the dynamic approaches in health, development and planning and with abilities to convince the higher planning structures, rally political support and enlist coummunity involvement with focus on Health for All by the Year 2000. Tables and charts facilitate understanding of concepts involved in this training.
Program report [of the Central America regional seminar-workshop entitled] New Focuses of Family Planning Program Administration: Analysis of Contraceptive Prevalence Surveys and Other Program Data, [held in] Antigua, Guatemala, May 25-30, 1980.
[Washington, D.C., CEFPA, 1980.] 30 p. (Contract AID/pha-c-1187)This report 1) presents a summary of the planning process of the seminar-workshop in family planning held in Antigua, Guatemala from May 25-30, 1980; 2) reviews program content and training methodology; and 3) provides feedback on the evaluation of the program and in-country follow-up responses to the workshop. Negotiations were made between the Centre for Population Activities (CEFPA) officials, USAID (U.S. Agency for International Development) population/health officials, and family planning officials from each participating country to elicit program suggestions and support. The ensuing communication process facilitated the development of the program in many ways, including: 1) program design, which incorporated in-country family planning program needs, suggested workshop topics, and country-specific requests for workshop objective; 2) participant selection; and 3) USAID mission commitment. The workshop aimed to provide an opportunity for leaders of family planning and related programs to make an intelligent and effective use of data available to them. The training methodology consisted of structured small-group exercises. Program content included: 1) contraceptive prevalence survey case exercise, which aims to identify problem areas and need in the delivery of family planning and maternal child health services as a tool in assessing progress towards family planning goals; 2) other data sources available to family planning program managers, including World Fertility Survey data and program service statistics; 3) program alternatives in the form of mini-workshops on such topics as logistics management, improving clinic efficiency, primary health and family planning, adolescent fertility, and voluntary sterilization; and 4) program planning, which enables participants to interpret data and apply them in the planning process. In evaluating the workshop, a majority of the participants reported that the workshop and their own personal objectives were either completely or almost completely achieved, and they also indicated that more workshops at the regional and national levels should be conducted.
A critical review of priority setting in the health sector: the methodology of the 1993 World Development Report.
HEALTH POLICY AND PLANNING. 1998; 13(1):13-31.The 1993 World Development Report (WDR) identifies the following problems in the health sector of developing countries: escalation of costs, misallocation of public funds, and the inefficient and inequitable use of available funds. Policies are suggested in the WDR to help developing country governments improve their populations' health. Technological limitations and resource scarcity mean that not all health needs can be met. Priorities must therefore be set for health services. The report therefore also introduces a new methodology to improve government spending based upon epidemiological and economic analysis, with analysis leading to the establishment of a league table of priority health interventions, cardinally ranked by health gain per dollar spent. Use of the table should improve the efficiency of public health expenditure. The Ministries of Health of many countries have shown interest in designing a national package of essential health services, using the methodology. An overview of the methodology is presented, as well as the main issues and problems in estimating the burden of disease, and the cost-effectiveness of interventions. Strengths and weaknesses in the databases, value judgements, and assumptions are identified.
Washington, D.C., American Association for World Health, 1998. 47 p.World Health Day, established by the World Health Organization (WHO), is celebrated on April 7 in the 191 WHO member countries. WHO has designated Safe Motherhood as the common theme for 1998 World Health Day activities. Safe Motherhood is an international initiative aimed at ensuring women have safe pregnancies and deliveries and healthy infants. This manual was prepared as a resource for those involved in the planning of World Health Day 1998 in the US, where the slogan is: "Invest in the Future: Support Safe Motherhood." After providing background information on the global importance of the prevention of maternal mortality and morbidity, the manual sets forth detailed guidelines on forming an organizing committee, selecting events and activities, choosing a location, creating a planning schedule, identifying community resources, defining target audiences, using the mass media to publicize events, hospitality arrangements, and program evaluation. World Health Day activities appropriate for individuals, communities, workplaces, schools, religious organizations, government agencies, and health care settings are suggested. Also included, for possible reproduction, is a series of fact sheets on topics such as pregnancy-related mortality in the US, maternal nutrition, sexually transmitted diseases, family planning, prenatal care, warning signs during pregnancy, and breast feeding. Finally, lists of state contacts and hotlines are appended.
WORLD HEALTH STATISTICS QUARTERLY. RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1994; 47(3-4):98-100.Health futures is defined as a set of tools that can help explore probable, plausible, possible, and preferable futures for guiding actions whereby potential health threats could be anticipated. The World Health Organization (WHO) is promoting national futures studies for health planning and development as confirmed at the World Health Assembly in 1990. WHO began scanning the field of health futures and learning about the methods used for trend assessment and forecasting. An international consultation on health futures was convened in July 1993 and attended by 38 experts. The consultation proposed follow-up activities sharing studies and methods through international publications; establishing electronic communication to this end; developing a handbook on health futures; and cataloguing experts, institutions, and training opportunities in health futures. A variety of people presented a wide range of studies on the purposes of health futures studies, methodologies, and funding; there were 5 scenarios for health care in the United States (continued growth/high technology, hard times/governmental leadership, buyer's market, a new civilization, healing and health care). The consultation focused on 6 themes, including assessing health technology. An extensive study undertaken in the Netherlands between 1985 and 1988 identified emerging health technology: neurosciences, the use of lasers in treating ischemic heart disease, biotechnology, new vaccines, genetic testing, computer-assisted medical imaging, and home care technologies. Health resources projection was also described for China using simulation models for 3 estimates of demand for hospital beds and doctors between 1990 and 2010. Also presented was Statistics Canada's new population-health model (POHEM), which is based on an individual life-cycle theory of health. A well-institutionalized modeling system by the US Bureau of Health Professions was introduced, showing the physician-supply model for forecasting purposes in the debate over health care reform. Artificial neural networking was introduced for predicting hospital length-of-stay.
Developing a focused ethnographic study for the WHO acute respiratory infection (ARI) control programme.
In: RAP: Rapid Assessment Procedures. Qualitative methodologies for planning and evaluation of health related programmes, edited by Nevin S. Scrimshaw and Gary R. Gleason. Boston, Massachusetts, International Nutrition Foundation for Developing Countries, 1992. 215-25.The development process used to construct and test a protocol for conducting community-based, focused ethnographic studies of acute respiratory infections (ARI) in children is described. The development of the Focused Ethnographic Study (FES) protocol is a component of the behavioral research activities of the ARI Program of the World Health Organization, which attempt to generate ethnographic data on beliefs and practices related to pneumonia and other respiratory conditions. The goal of this Program is to reduce mortality from ARI in children in developing countries. Some of the requirements of FES research are the distinction between lower vs. upper respiratory infections and research has to be completed in a relatively short period of time. The protocol on how to collect, analyze, and present data is the primary means of attaining the project objectives. The protocol consists of the overview of the project, guidelines on research management, specific research procedures, preparing the report, using the information from the study, and adapting the ARI household morbidity and mortality treatment survey. The program manager's questions are concerned with: 1) caretaker and household recognition and interpretation of ARI symptoms; 2) ARI household management practices; 3) patterns of care seeking; 4) maternal expectations concerning ARI treatment; 5) perspectives of practitioner on maternal care-seeking; and 6) recommendations concerning communication with mothers. Specific data-gathering techniques included: key informant interviews, free listing of illnesses and symptoms, narratives, hypothetical scenarios, and inventory of home medications. The first field study was carried out in July-August 1989 in Mindoro Oriente Province in the Philippines; the next round of studies took place in Turkey, Ghana, Honduras, Haiti, and Egypt. Common findings from ARI FES studies indicated: 1) peoples' explanatory models of ARI were complex, with differentiation of symptoms, but diagnoses varied; 2) milder conditions were perceived as likely to worsen if not treated; and 3) home remedies were universal.
In: RAP: Rapid Assessment Procedures. Qualitative methodologies for planning and evaluation of health related programmes, edited by Nevin S. Scrimshaw and Gary R. Gleason. Boston, Massachusetts, International Nutrition Foundation for Developing Countries, 1992. 51-9.The objectives of nutritional surveillance were published in 1976 by the World Health Organization and subsequently elaborated upon by the Cornell Nutritional Surveillance Program (CNSP) in 1984. The uses of nutritional surveillance are: 1) problem identification and political sensitization; 2) policy formulation and planning; 3) program management and evaluation; and 4) timely warning and intervention. The vast majority of countries embarking on nutritional surveillance did so without having performed the prior steps of identifying decision-makers and the type of surveillance systems required. The most common type was nutritional monitoring, which could not facilitate decisions on immediate action. Ancillary data were adequate only for confirming that locations with a high prevalence of protein-energy malnutrition (PEM) also have a high prevalence of socioeconomic deprivation without pinpointing specific factors. Rapid assessment procedures (RAP) face similar problems, which could be improved by the development of guidelines. Another reason for linking qualitative methodologies to nutritional surveillance is that the infectious disease model of surveillance is not the most appropriate one for nutritional surveillance because of the complex etiology of chronic PEM. Timely warning and intervention systems (TWIS) are relevant in warding off possible food crises, as the case of Central Lombok District of Indonesia illustrated. Qualitative information methods were used in collecting agro-meteorological indicators by extension workers; assessing household food consumption patterns; alerting of district officials to an impending food crisis; and evaluating the extent to which this system triggered decisions. Nutritional surveillance for policy and planning is difficult to implement, as the examples of Costa Rica and Kenya showed. In the former, a national sample survey of low-weight-for-age children stratified according to father's occupation revealed the highest rate of malnutrition in sugar cane and banana plantations because of poor water and high food prices. This finding led to legislative action.
Adaptation of anthropological methodologies to rapid assessment of nutrition and primary health care.
In: RAP: Rapid Assessment Procedures. Qualitative methodologies for planning and evaluation of health related programmes, edited by Nevin S. Scrimshaw and Gary R. Gleason. Boston, Massachusetts, International Nutrition Foundation for Developing Countries, 1992. 25-38.The history and current status of rapid assessment procedures (RAP) are reviewed from the perspective of one of the most well-known leaders of the methodological approach. Both the accomplishments of RAP to date and its limitations are described. The first methodology for rapid assessment came from rural sociology, called rapid rural appraisal, primarily applied to agriculture and rural development. Anthropologists working in public health also began to systematize their own practical approach to program planning, which led to the UN University 16 Country Study and to the development of the RAP field manuals. The objective of the 16 country health studies was to assess nutrition and primary health care programs from the household perspective and as rapidly as possible. The application of anthropology to program planning assumes that there are other tools than the large survey and field trips. These include observation, participant observation, formal and informal interviews, conversation, and group discussion (focus groups) to evaluate health programs. The traditional approach of one person or a team at a site for 1 year had to be altered for the evaluation of nutrition and primary health care programs. The UN study plan was contingent on 1) researchers already familiar with the language and the culture and 2) working with a limited list of objectives or data collection guidelines. The RAP guidelines were designed to allow anthropologists to spend 6 weeks in a community where primary health care was in place and to obtain household views on the health service. The beliefs and behaviors across 514 households in 42 communities in 16 countries were described, indicating that all used indigenous practitioners and various indigenous and Western biomedical health resources. The mother was the primary diagnostician of health-seeking behavior; and all used herbs for prevention and treatment. RAP does not replace traditional anthropology, it is an additional method.
In: RAP: Rapid Assessment Procedures. Qualitative methodologies for planning and evaluation of health related programmes, edited by Nevin S. Scrimshaw and Gary R. Gleason. Boston, Massachusetts, International Nutrition Foundation for Developing Countries, 1992. 11-23.Rapid assessment procedures (RAP) grew explosively in the 1980s in the social investigation of development work, with four main trends to be distinguished: 1) fast repertoire enrichment with new and imaginative procedures; 2) application of RAP in new sectors through content-adaptation and cross-fertilization (rapid rural appraisal by Chambers); 3) geographic broadening in both elaboration and application of RAP (from Sussex, England, to Thailand, Kenya, and India); and 4) the growing shift from technique to substance. There has been compelling demonstration of RAP's potential for changing and improving the planning of development. RAP can increase the planners' ability to put people first in the development projects. Furthermore, a decade of RAP work has launched some social sciences on a path of methodological retooling. Some major development agencies (the World Bank, USAID, ODA) have started to use RAP. The World Bank has been striving to promote the use of sociological/anthropological investigation methods for generating social information needed in projects. The RAP field work of a medical anthropologist who had received a 2-year contract from USAID to conduct research in Swaziland within a water-borne disease project illustrates the value of RAP. He questioned the lengthy sample survey and carried out an informal study of the health beliefs and behavior among traditional healers and rural health motivators. Within 6 months he collected sociocultural information and specific health-related data which led to significant improvement in the public health network via cooperation between traditional and modern health practitioners. The epistemological risks of RAPs result from the limitations intrinsic to the procedures themselves: accuracy, representativeness, cultural appropriateness, and subjectivity. The extrinsic risks are an improper contextual place or weight within the research strategy. These limitations can be overcome by professional training of RAP practitioners. Nevertheless, RAPs are not a universal cure for gaps in social information, and long-term social research is still essential.
HEALTH POLICY AND PLANNING. 1992 Dec; 7(4):364-74.The Director of WHO's Regional Office for Africa presents a health development framework based on the primary health care (PHC) concept. the government should review national health policies, national health strategies, and national heath services to resolve basic issues. Then it should define the framework for health development by breaking down the goal into operational target-oriented subgoals for individuals, families, and communities, by creating health districts as operational units, and by organizing support for community health. Once this framework has been decided, the government should use it to restructure the national health systems. At the district level, health and development committees, helped by community health workers, and district health teams would be responsible for community health education and activities. The provincial health offices would oversee district activities, select and adapt technologies, and provide technical support to communities. A board would manage the provincial hospitals (public, private, and voluntary). These hospitals would work together to organize secondary medical care programs. A public health office wold link them with the provincial health centers. Other sectors would also be involved, e.g., departments of education and water. The national health ministry would set national policies, plans, and strategies. A suprasectoral health council would coordinate cooperation between universities and other sectors and external agencies. National capacity building would involve establishing management cycles of health development, using national specialists as health advisors, and placing health as a priority in development. To implement this framework, however, the government needs to surmount considerable structural economic, and social obstacles by at least decentralizing and integrating health and related programs at the local level, fostering a national dialogue, and promoting social mobilization.
London, England, International Planned Parenthood Federation [IPPF], 1992 Sep. 93 p.20 participants from 9 sub-Saharan countries and the UK discuss men's negative attitudes towards family planning (the leading obstacle to the success of family planning in Africa) at the November 1991 Workshop on Male Participation in Family Planning in The Gambia. Family planning programs have targeted women for 20 years, but they are starting to see the men's role in making fertility decisions and in transmitting sexually transmitted diseases (STDs). They are trying to find ways to increase men's involvement in promoting family planning and STD prevention. Some recent research in Africa shows that many men already have a positive attitude towards family planning, but there is poor or no positive communication between husband and wife about fertility and sexuality. Some family planning programs (e.g., those in Sierra Leone, Nigeria, Ethiopia, and Zimbabwe) use information, education, and communication (IEC) activities (e.g., audiovisual material, print media, film, workshops, seminars, and songs) to promote men's sexual responsibility. IEC programs do increase knowledge, but do not necessarily change attitudes and practice. Some research indicates that awareness raising must be followed by counseling and peer promotion efforts to effect attitudinal and behavioral change. The sub-Saharan Africa programs must conduct baseline research on attitudes and a needs assessment to determine how to address men's needs. In Zambia, baseline research reveals that a man having 1 faithful partner for a lifetime is deemed negative. Common effective needs assessment methodologies are focus group discussions and individual interviews. Programs have identified various service delivery strategies to meet these needs. They are integration of family planning promotion efforts via AIDS prevention programs, income-generating schemes, employment-based programs, youth programs and peer counseling, male-to-male community-based distribution of condoms, and social marketing. Few programs have been evaluated, mainly because evaluation is not included in the planning process.
An agenda for action in sub-Saharan Africa. A collaborative initiative of the World Bank, UNFPA and IPPF.
INTEGRATION. 1991 Mar; (27):10-7.An Agenda for Action to Improve the Implementation of Population Programs in Sub-Saharan African in the 1990s is a joint project of the World Bank, the UN Population Fund, the IPPF, the WHO and the African Development Bank. The goals of the agenda are to build public consensus and commitment to population activities, to bring together beneficiaries, implementors and policy makers with these groups to improve population program implementation, to share country program experiences, to make African institutions responsible for ("Africanize") the Agenda, or ultimately to include demographic factors in development. 20 African countries are the focus of the Agenda, grouped by region and language. Major issues include socio-cultural and economic roadblocks, poor transportation infrastructure, lack of community participation, no alternatives to early marriage for women, poor political commitment by decision-making or health ministries. Family planning programs can be improved by better contraceptive technology, program design, and human and financial resources for implementing programs. The methods by which the Agenda proposes to reach its goals are to do literature searches of action strategies, in-depth country analyses, inter-country sharing of experiences, analysis of implementation capability based on case studies, and analysis of contraceptive technology assisted by WHO's Special Programme of Research, Development and Research Training in Human Reproduction and the Population Council. The Agenda will be managed by a Population Advisor Committee, which is an African "think tank," and regional Country Group Task Forces, coordinated by the World Bank's Africa Technical Department.
[Unpublished] 1989. 30 p. (WHO/GPA/NPS/89.1)Of the 83 countries whose National Acquired Immunodeficiency Syndrome (AIDS) Program (NAP) which have already implemented a medium-term plan, 7 have carried out a systematic review of program progress and efficiency; 4 more such reviews are planned fo r 1989 and over 60 for 1990. To assess early experiences with NAP reviews, an informal consultation was organized in Geneva in October 1989 by the World Health Organization's Global Program on AIDS. Although the review is a management tool and distinct from evaluations of program effectiveness and management, both processes are required for program assessment and reprogramming. The main areas that should be covered by NAP reviews include management, strategies, financing and policies, and monitoring. The review of the management system should focus on internal administrative capacities, personnel management, program coordination effectiveness, and logistics. The review of strategies should focus on whether management structures for the implementation of various goals are in place. The pertinent areas for the financing review are the use of adequate resources, accountability, potential for program sustainability, and efficient use of resources. Finally, monitoring is achieved through the establishment of a management information system. In addition, there are 3 review grades. Grade 1 is an annual internal review conducted by the program manager and key NAP staff, Grade 2 is a more limited review with participants from outside the NAP with expertise in a specific program area, and a Grade 3 review is a comprehensive exercise aimed at bringing about major changes in the NAP. For this review process to be meaningful, there should be an active exchange of information between NAPs, the World Health Organization, and the international community.
Assessing the impact of new contraceptive technologies on user satisfaction, use-dynamics, and service systems.
PROGRESS. 1989; (11):2-3.A summary of the recommendations stemming from conference on the Demographic and Programmatic Consequences of Contraceptive Innovations, sponsored by the U.S. National Academy of Sciences in 1988, is provided by the WHO. While typical research on introduction of new contraceptive methods concerns cohort studies of users' problems and perspectives, a larger view of use-dynamics, choice behavior and client satisfaction with overall care is lacking. It is popular to hypothesize that user satisfaction improves with numbers of contraceptive options, but the literature does not provide clear evidence on this point, and none at all on introduction of new methods. Three main issues should be addressed: what is the impact of a new method on client perception of overall care, on contraceptive behavior, and on operation of the family planning program. To get this information usually requires prohibitively costly, time-consuming research. Low cost approaches are available, however, taken from the type of large-scale, community-based repeat observation studies now used to monitor trials of pharmaceuticals for tropical diseases, and treatments of rare conditions, such as vitamin A. Statistical techniques have been developed to adjust for censoring bias. Another type of field research that can be adapted to this research is the epidemiological field research of the type used in the Matlab, Bangladesh cholera vaccine study, later utilized to study acceptance of family planning services. Without such studies, the social and programmatic rationale for introduction of new contraceptives will be open to debate.
Geneva, Switzerland, WHO, 1988. iv, 27 p. (WHO AIDS Series 1)The World Health Organization (WHO) has prepared a set of guidelines for national AIDS programs that includes objectives, initial assessment, strategies, medium-term goals, suggested activities and necessary periodic evaluation. Because of the nature of the HIV infection, national tactics are similar, regardless of the case rate in any particular region. HIV has spread world-wide, and checking its further spread will entail education for the change of deep-seated behaviors by all. The objectives of an AIDS control program are to prevent HIV transmission, and to reduce the consequent morbidity and mortality. Strategies include prevention of its spread by sexual and perinatal transmission, blood products, injections, skin-piercing practices, and iatrogenic spread. Countries 1st form a national AIDS committee. An initial epidemiological and resource assessment is made. Sexual transmission is controlled primarily through a long-term commitment to a factual, consistent education campaign. Later, more specific targets and behaviors must be addressed. A more detailed list of activities is suggested for securing the blood and blood product system, and supplying clean medical instruments. Perinatal transmission should be addressed by identifying, educating, and counseling infected women. The impact of AIDS on individuals, groups and societies can be reduced by diagnosis, treatment, counseling, training of health workers, setting up a case-reporting system. A re-evaluation strategy is vital for replanning, learning by doing, assessing trends and providing information for donors.
Food emergency in wonderland: a case study prepared by the League of Red Cross and Red Crescent Societies for the training of relief workers.
In: Advances in international maternal and child health, vol. 4, 1984, edited by D.B. Jelliffe and E.F. Jelliffe. Oxford, England, Oxford University Press, 1984. 110-23.This monograph chapter is an exercise whose aim is to help relief workers to be better equipped to solve the practical problems of an emergency relief operation. Its events and contents are imaginary, but are drawn from direct experience. It has been used extensively in Red Cross training projects in several countries, and is designed, 1st, to be complemented with other types of educational media, and 2nd, to be adapted to the training requirements of diverse types of project, through "biasing" in favor of health, nutrition, sanitation, or logistics. A description is given of the management of the case study educational setting, based on real experience with the use of the material; the best results appeared achieveable through a class session on part 1, consisting of initial assessment of an hypothetical nutritional emergency, followed by work in small groups on part 2. Part 1 consists of presentation of situation characteristics, e.g. "overworked health assistant reports a big increase in chest infections, diarrhea, and typhus," and "there is a hand-dug well 1/2 mile from the shelter." Part 2 describes the situation 2 months later, after intervention has begun. Situation characteristics appear such as, "Records from clinic attendance indicates that the commonest disease symptoms are diarrhea, cough with or without temperature, general aches and pains, worms, and eye infections." The case study also includes additional information on food stocks, demographic data, and nutritional survey data (the latter not included in this article). Concluding the article are examples of topics for group discussions and presentations.
New York, New York, United Nations, 1985. 52 p. (ST/ESA/SER.E/39)This monograph presents an overview of the content and direction of courses designed to prepare planning coordinators of developing nations to approach population and development policy making in a richly informed interdisciplinary manner. The conceptual framework for such a curriculum is presented 1st in a theoretical section on the links between the key concepts of population and development. Next, recommendations on curriculum design emphasize 2 main lines of focus: 1) understanding the cultural context in which developmental planning takes place; 2) exploring the available means of action in terms of strategies corresponding to explicit transitional goals in relation to the identified context. The emphasis, rather than on specific technical expertise, should be on providing information on the range of tools available for use in the field at a later stage. The 3rd section involves course orientation; the aim is to turn out planning coordinators capable of formulating integrated population policies. The curriculum should be geared to occupational groups, including senior management, middle-level staff, educators and researchers, and executing agents. Section 4 covers course admission requirements, criteria for teachers and locations. Section 5 presents recommendations for subject matter, presenting a 2 year curriculum, each year divided into 4 modules: 1) knowledge of the context; 2) the population component; 3) the instruments of change, involving developmental economics and planning; and 4) techniques of analysis, systems analysis, econometrics, forecasting and more. An outline of the curriculum detailing topics, course length, and general and specific goals for each course follows. A bibliography covering general works, works on economics, sociology, anthropology and systems concludes the document.
Bangkok, Thailand, ESCAP, 1984 Apr. 175 p. (ESCAP Programme on Health and Development Technical Paper No. 65/BCS 12; ST/ESCAP/291)The recognition of the necessity of involving the community in development efforts has been a turning point in the evolution of development thinking in recent years. Since 1978, the UNICEF Regional Office for East Asia and Pakistan and ESCAP have been conducting a series of training seminars where local development, basic services and primary health care are discussed as part of village reality. This volume reviews this experience, generalizing it to enhance adaptation. The seminars are a learning by doing and experience-sharing process. Group discussion and reflection on relevant issues are focused on. The seminars are oriented to community life as a whole, considering primary heatlh care as an entry point for coummunity development which involves generation of services within the community, supplemented by delivery of services from other institutional levels. This report describes the overall framework, including the organization of the 1983 seminar and the training approach, and the syllabus and evaluates the seminars. The goal of the seminar is the promotion of basic community health care in the countries of the region to improve the quality of life of the poor. Each participant discusses his/her work experience. Basic needs, basic services and primary health care are examined and a field-study phase at village-level is organized. Planning capabilities are developed by a phase of planning for basic and community services and primary health care. A module on national development, basic needs approach and production-oriented development is introduced. Finally, each participant prepares a draft project proposal for training for his/her own country situation. The evaluation of a program includes both its delivery system component and its eventual impact. The seminars used questionnaires, special group discussions and interviewing of the participants. The aim was to scrutinize the relevance and potential for modification of knowledge, attitudes and practice (KAP) rather that the actual impact actual impact achieved. Behavioral change should be evaluated on at least 2 levels: the individual and the collective. The structure, clustering and frequency of response to a given question in an evaluation questionnaire and the average level of awareness about a particular issue are 2 important measures to analyze. Seminar participants were mainly middle level personnel, but included some junior and senior officials from ministries of health, interior or home affairs and agriculture; training institutes; rural development institutes; planning commissions and universities.