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Arlington, Virginia, Partnership for Child Health Care, 1995. , 11,  p. (Trip Report; BASICS Technical Directive: 008-GU-01-015; USAID Contract No. HRN-6006-Q-08-3032)As part of a series of activities designed to reduce morbidity and mortality from acute respiratory infections in children under the age of 5 in Guatemala, a consultant from the BASICS (Basic Support for Institutionalizing Child Survival) program visited Guatemala in 1995 to analyze, modify, and field test the protocol developed by the USAID Mission to document the degree to which drugs prescribed for pneumonia are available in the community through the private sector. This field report provides background information and describes the current situation in Guatemala in terms of availability of drugs in the public sector through the Ministry of Health, the Drogueria Nacional, municipalities, and the Pan American Health Organization. Relevant activities in the private sector are also described, including the for-profit businesses as well as services provided by UNICEF, the European Union, and nongovernmental organizations. A brief overview of one health area gives an example of the current situation. The result of this consultancy visit was the determination that the situation merited adjustment of the originally requested study and that the survey as designed would likely require modification and application within target communities. Included among the appendices is the original protocol developed for assessing community drug availability.
[Introduction: community and commercial programs in Latin America] Introduccion: programas comunitarios y comerciales en America Latina.
In: Estrada A, ed. [Family planning in Latin America: community and commercial programs]. Planificacion familiar en America Latina: programas comunitarios y comerciales. Washington, D.C., Batelle, Aug. 1981. 3-41.Introduces the importance of bilateral family planning programs in Latin America. These programs, both community and commercial, provide permanent and reversible methods of birth control. Female sterilization, vasectomy, condoms and the pill are the methods of choice provided by these organizations. The difference between the commercial and community programs lies in the method of distributing birth control. The commercial enterprises are connected with clinics, and pharmacies and supermarkets. Clients must receive some form of instruction in order to procure birth control devices at a nominal cost. The community programs are primarily operative outside the urban areas, in isolated mountain villages where no clinics are located. Representatives of PROFAMILIA set up informal offices to prescribe and distribute birth control. These representatives, while not usually medical personnel, are trained as counselors and either provide a temporary and reversible method of birth control or arrange to accompany the client to a city where appropriate sterilization procedures may be provided. The various branches of PROFAMILIA in Colombia, Guatemala, Mexico, Peru, Brazil and Haiti are financed through the UN Family Planning Association. The pill, diaphragms, spermicides and condoms are supplied through Syntex, Emko and Akwell Companies of the United States, Eisai of Japan and Schering, Wyeth and Norwich of Colombia.
In: Potts M, Bhiwandiwala P, eds. Birth control: an international assessment. Baltimore, Maryland, University Park Press, 1979. 71-91.The planning, implementation, achievements, and existing problems facing a pilot community-based distribution (CBD) family planning program in Thailand are described. The program was begun in 1973-74 under auspices of IPPF following the Thai government decision to allow trained midwives to dispense oral contraceptives. Experience with the program has shown that such programs can provide adequate levels of medical supervision, be culturally acceptable, and have a decided impact on national fertility within 2 years. Administrative, financial, and structural elements of the program are summarized. The program was started to provide an alternative to existent clinical services and provide more complete coverage in rural areas. The IPPF donor relationship was useful to the launching of the program. The program has concentrated on training local nonmedical personnel for distribution of oral contraceptives and condoms. Both local doctors and field supervisors are available for advice to the distributors. The program now extends to all areas of the country. Communications activities play a large role in the program. Demographic effects of the program to 1977 are tabulated. The pilot project also involved an institutional and a private sector distribution program. There is need for a greater variety of contraceptive methods available through the program sources. Integrated family planning/development projects are now being tried.
Contact. 1983 Oct; (75):1-16.Investigates health planners' assumptions about community particiation in health care. Primary health care aims to make essential health care accessible to all individuals in the community in an acceptable and affordable way and with their full participation. It is the strategy propagated by the World Health Organization to provide health for everyone by the year 2000. Community participation is seen as the key to primary health care and has raised many assumptions and expectations among health planners. Community people are seen as a vast untapped resource which can help to reduce the cost of health care by providing additional manpower. It is also expected that community people want to participate in their own health care because they wish to serve their community and to have a part in decisions which affect them. In the early 1970's, programs were developed out of church-related efforts. They pioneered many of the ideas which became principles of primary health care. The church-related programs were nongovernmental and therefore flexible. They had the same goal of letting the community take responsibility for their own health care; program planners were primarily medical people trained in Western medicine. The planners were concerned with the plight of the poor. However, the programs tended to reflect planners' hopes for, rather than the community's understanding of, the community health problem. The author concludes that the assumptions that planners make about their programs need to be critically analyzed. Investigations need to be made into community perceptions and expectations of their role in health programs. Studies need to be undertaken to identify the potentials and problems of community participation and the record of established community health care programs needs to be examined.