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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.
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.
London, England, IPPF, July 1982. 4 p. (IPPF Fact Sheet)Discusses the movement to establish groups of Parliamentarians on Population and Development throughout the world. The movement grew out of the need to create understanding among legislators and policymakers of the interrelationship between development, population, and family planning. Parliamentarian groups can help to ensure that population and family planning are included in development plans and that resources are committed to population and family planning programs. The main initiative for the establishment of Parliamentarian groups and for their regional and international cooperation came from the United Nations Fund for Population activities (UNFPA). The International Planned Parenthood Federation (IPPF) has been involved from the beginning and works closely with UNFPA. The meeting of Parliamentarians on Population and Development during 1981 resulted in important regional developments, with IMF affiliates playing a major role. The Washington Conference on Population and Development included Parliamentarians from the Caribbean and Latin America. Priorities for formulating population and development policies were identified. The African Conference of Parliamentarians on Population and Development marked the first time that a major conference on so sensitive an issue was held in Africa. The Beijung conference was attended by 19 Asian countries and resulted in a declaration calling on Parliaments, governments, UN agencies, and nongovernmental organizations to increase their commitment to all aspects of population and family planning. National developments in India and the Philippines are also discussed. Many of the countries with Parliamentary groups on Population and Development have governments that are involved in providing international population assistance. Greater commitment to population as a crucial factor in development through the establishment of links with governments and parliamentarians is an action area within the IPPF 1982-84 plan.
[Operational sequence for the implementation of a subregional food and nutrition strategy] Secuencia operativa para la implementacion de una estrategia subregional de alimentacion y nutricion.
In: Lineamientos de una estrategia Andina de alimentacion y nutricion [by] Junta del Acuerdo de Cartegena. Grupo de Politica Technologica. Proyectos Andinos de Desarollo Technologico en el Area de los Alimentos. Lima, Peru, Junta del Acuerdo de Cartagena, Grupo de Politica Technologica, Proyectos Andinos de Desarollo Technologico en el Area de los Alimentos, 1983. 143-74.This article outlines and diagrams a recommended operational sequence for implementation of food and nutrition strategy for the Andean region. The multisectorial strategy envisioned by the planners would involve the supply and demand for foods; basic health, environmental sanitation and educational services; and food information and technology. The integrated, multisectorial nature of the strategy requires policies, plans, and programming designed to facilitate harmonious development of all the necessary elements within the 5 Andean countries. The proposed methodology for operationalizing the strategy is based on a systems focus which covers all aspects of production, processing, distribution, final consumption, and technoeconomic policies for food and nutrition. Because the food and nutrition strategy is more than a production program, its design should identify interrelations between the availability and prices of foods, external commerce, industrial trends, food commerce and distribution, and food consumption in adquate quantities by the entire population. A basic service component for health should also be included for the Andean population because of its relationship to nutritional aspects. The suggested instrument for operationalizing the systems focus is the "Methodology for Evaluation andprogramming of Technological and Economic Development of Production and Consumption Systems" developed by the Andean Projects for Technological Development Food Group for the Group for Technological Policy of the Cartagena Accord. The methodology consists of a manual and a "Model of Numerical Experimentation", which permits identification of system components, calculation and evaluation of relevant aspects of each production factor, and design and selection of development alternatives. The Model of Numerical Experimentation" allows simulation of goals for satisfaction of needs, exports of final products, import substitution, different production technologies, commercial margins, subidies, customs duties, taxes and exchange rates and related variables. Various food production systems have already been studied using the methodology in each of the 5 Andean countries. It is recommended that implementation of aspects of the food and nutrition strategy involving food production and consumption proceed in 8 operational sequences: 1) characterization of the current industrial, agroindustrial, and fishing economy 2) identification and selection of basic foods and/or strategies 3) representation and quantification of each of the selected systems 4) evaluation of each system and intersystem relationship 5) identification and selection of systems of production of alternative foodstuffs 6) proposal for a national and regional food system 7) concerted development programming for the regional food system and 8) design of mechanisms of evaluation and follow-up.
[Towards a subregional food and nutrition strategy. How to begin?] Hacia una estrategia subregional en alimentacion y nutricion por donde empezar?
In: Lineamientos de una estrategia Andina de alimentacion y nutricion [by] Junta del Acuerdo de Cartegena. Grupo de Politica Technologica. Proyectos Andinos de Desarollo Technologico en el Area de los Alimentos. Lima, Peru, Junta del Acuerdo de Cartagena, Grupo de Politica Technologica, Proyectos Andinos de Desarollo Technologico en el Area de los Alimentos, 1983. 111-42.This work suggests objectives, rationale, methods, and organizational structure for an Andean regional food and nutrition strategy. Although a food and nutrition policy is a desired goal in the region, the complexities of the problem and the fact that definitive solutions require a broad development strategy hamper development of a food and nutrition strategy. The food strategy initially should address aspects of food supply, food demand and utilization through provision of basic services, and food information and technology. The food supply strategy should involve 4 types of foods and 3 types of nutrients causing specific deficiencies. The food types should include 1) foods competitively produced in the region but not widely utilized by the Andean population, such as rice from Colombia or fish and seafoods from Peru and Ecuador 2) required foods not yet produced competitively in the region but capable of production within 5 years, such as meat from Bolivia or oils from Venezuela, Ecuador, Peru, and Colombia 3) foods competitively produced whose availability should be assured more widely in seasonal and geographic terms, such as sugar cane, bananas, potatoes, and yucca. 4) foods not currently produced competitively in the region and not likely to be produced within 5 years but which are important to the local diet and are in chronically short supply, such as maize, wheat, flours, oils, and fats. The deficiency-causing nutrients would be iodine, vitamin A, and ferrous sulphate or other iron derivatives. Basic services to be added or improved should include primary health care programs and environmental sanitation programs. Information and technology components of the food and nutrition strategy would initially involve the investigation and transferrance of technology for each step affecting food supply and demand for goods and services included in the overall strategy, as well as attempts to develop a basic data base concerning the interventions adopted. The organizational structure for the food and nutrition strategy should be flexible, with a lower level including a technical work group and an upper level composed of representatives of various sectors and organizations which would coordinate policy design and implementation.