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  1. 1
    337665

    A practical guide for engaging with mobile network operators in mHealth for reproductive, maternal, newborn and child health.

    World Health Organization [WHO]; United Nations Foundation

    Geneva, Switzerland, WHO, 2015. [36] p.

    The field of mobile health (mHealth) is experiencing a real need for guidance on public-private partnerships among players as diverse as the mobile industry, technology vendors, government stakeholders and mHealth service providers. This guide provides a practical resource for mHealth service providers (e.g. developers and implementers) to partner more strategically with one of these critical players -- the mobile network operators (MNOs). Despite the growing literature on how to develop partnerships, there is a lack of clear, practical strategies for the health community to engage with MNOs to better scale up mHealth services. This document distils best practices and industry-wide lessons by providing key motivators, challenges and recommendations for mHealth service providers to engage with MNOs for scaling up their initiatives. (Excerpts)
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  2. 2
    332101

    Affordable Medicines Facility - Malaria. Frequently asked questions.

    Global Fund to Fight AIDS, Tuberculosis and Malaria

    [Geneva, Switzerland], Global Fund to Fight AIDS, Tuberculosis and Malaria, 2010 Jan 12. 17 p.

    The AMFm is an innovative financing mechanism to expand access to affordable artemisinin-based combination therapies (ACTs) for malaria, thereby saving lives and reducing the use of inappropriate treatments. The AMFm aims to enable countries to increase the provision of affordable ACTs through the public, private not-for-profit (e.g. NGO) and private for-profit sectors. By increasing access to ACTs and displacing artemisinin monotherapies from the market, the AMFm also seeks to delay resistance to the active pharmaceutical ingredient, artemisinin.
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  3. 3
    342018
    Peer Reviewed

    International health policy and stagnating maternal mortality: is there a causal link?

    Unger JP; Van Dessel P; Sen K; De Paepe P

    Reproductive Health Matters. 2009 May; 17(33):91-104.

    This paper examines why progress towards Millennium Development Goal 5 on maternal health appears to have stagnated in much of the global south. We contend that besides the widely recognised existence of weak health systems, including weak services, low staffing levels, managerial weaknesses, and lack of infrastructure and information, this stagnation relates to the inability of most countries to meet two essential conditions: to develop access to publicly funded, comprehensive health care, and to provide the not-for-profit sector with needed political, technical and financial support. This paper offers a critical perspective on the past 15 years of international health policies as a possible cofactor of high maternal mortality, because of their emphasis on disease control in public health services at the expense of access to comprehensive health care, and failures of contracting out and public–private partnerships in health care. Health care delivery cannot be an issue both of trade and of right. Without policies to make health systems in the global south more publicly-oriented and accountable, the current standards of maternal and child health care are likely to remain poor, and maternal deaths will continue to affect women and their families at an intolerably high level.
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  4. 4
    322596

    The Positive Partnerships Program in Thailand: empowering people living with HIV. Highlights.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2007 Sep. 15 p. (UNAIDS Best Practice Collection; UNAIDS/07.25E; JC1362E)

    A project rolling out in rural Thailand, the Positive Partnerships Program (PPP), has shown that targeted economic assistance can boost self-esteem, ambition and hope-all of which help reinvigorate community bonds and have a beneficial impact in promoting enabling environments for HIV prevention and treatment efforts. This best practice document examines how and why PPP may serve as a flexible and adaptive model in other countries. The project has two distinct yet complementary goals. to enable people living with HIV to lift themselves out of poverty, through the provision of microcredit loans that allow people to set up small businesses in their communities; to reduce HIV-related stigma and discrimination against people living with HIV through business partnerships between one HIV-positive person and one HIV-negative person. The enthusiastic response to PPP from people living with HIV and funders alike serves as a useful reminder of the need to develop comprehensive strategies in response to the AIDS epidemic that reflect a full range of economic, social, legal and political considerations-not just those narrowly based on health. (excerpt)
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  5. 5
    322595

    The Positive Partnerships Program in Thailand: empowering people living with HIV.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2007 Jul. 48 p. (UNAIDS Best Practice Collection; UNAIDS/07.22E; JC1260E)

    Nearly 600 000 people are living with HIV in Thailand. As in every other country, most are poor and many are isolated from their communities. Breaking down the mutually reinforcing barriers of poverty and stigma they face has proved immensely difficult. These barriers are not insurmountable, however. A new project rolling out in rural Thailand, the Positive Partnership Program (PPP), has shown that targeted economic assistance can boost self-esteem, ambition and hope-all of which help reinvigorate community bonds and have a major, positive impact on HIV prevention and treatment efforts. The core of PPP is the provision of microcredit loans to resource-constrained HIV-positive individuals who otherwise have no access to credit in conventional, affordable ways. These loans are intended to support the efforts of people living with HIV to lift themselves out of poverty by setting up small businesses in their communities. Closely linked to this poverty-reduction goal is another vital objective: the reduction of HIV-related stigma and discrimination. As conceptualized by PPP's implementing entity-the Population and Community Development Association (PDA), a Bangkok-based nongovernmental organization-a unique aspect of the PPP project greatly facilitates progress towards achieving these two goals simultaneously: loans are given out not to people living with HIV alone but to partnerships between an HIV-positive and an HIV-negative person. By the end of 2005, a total of 375 partnerships had been formed since the project began in January 2004. (excerpt)
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  6. 6
    319307

    IFC against AIDS -- protecting people and profitability.

    Lutalo M

    Washington, D.C., World Bank, Global HIV / AIDS Program, 2006 Aug. 11 p.

    AIDS has wide consequences for development, and presents enormous challenges to businesses in the worst hit countries. The epidemic affects workers, managers and markets by increasing costs and reducing productivity. The International Finance Corporation (IFC), the private sector arm of the World Bank Group, works with client companies to mitigate the effects of the epidemic on their operations through its IFC Against AIDS program. The program works with companies in Africa and India, and efforts are underway to raise awareness among clients in China and assess program conditions in Russia. (author's)
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  7. 7
    299615

    Public health, innovation and intellectual property rights: unfinished business [editorial]

    Turmen T; Clift C

    Bulletin of the World Health Organization. 2006 May; 84(5):338.

    The context for this theme collection is the publication of the report of the Commission on Intellectual Property Rights, Innovation and Public Health. The report of the Commission -- instigated by WHO's World Health Assembly in 2003 -- was an attempt to gather all the stakeholders involved to analyse the relationship between intellectual property rights, innovation and public health, with a particular focus on the question of funding and incentive mechanisms for the creation of new medicines, vaccines and diagnostic tests, to tackle diseases disproportionately affecting developing countries. In reality, generating a common analysis in the face of the divergent perspectives of stakeholders, and indeed of the Commission, presented a challenge. As in many fields -- not least in public health -- the evidence base is insufficient and contested. Even when the evidence is reasonably clear, its significance, or the appropriate conclusions to be drawn from it, may be interpreted very differently according to the viewpoint of the observer. (excerpt)
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  8. 8
    299291

    Microcredit: moving women forward - Microcredit Summit Campaign - Brief article.

    Hughes D

    UN Chronicle. 2000 Summer; 37(2):[3] p..

    Elvia is 25. She is a single mother in Guatemala, a country where the non-governmental organization CARE reports that approximately 20 per cent of women under 18 become unwed mothers. Elvia comes from a large, poor family (11 brothers and sisters). She became pregnant at 19 and was abandoned by the baby's father. She later took loans from CARE and has created a sewing and chicken-raising business. With her mother, she sells 600 chickens every seven weeks. She vows to make sure her six-year-old daughter does not make the same mistakes she has made. It was with women like Elvia in mind that more than 2,900 people from 137 countries gathered from 2 to 4 February 1997 at the Microcredit Summit in Washington, D.C. The delegates launched a nine-year campaign to reach 100 million of the world's poorest families, especially the women of those families, with credit for selfemployment and other financial and business services by the year 2005. (excerpt)
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  9. 9
    283481

    Creating markets for new vaccines. Part II: Design issues. Draft.

    Kremer M

    [Unpublished] 2000 Apr 13. 64 p.

    Malaria, tuberculosis, and African strains of AIDS kill almost 5 million people annually, primarily in poor countries. Despite recent scientific advances, research on vaccines for these diseases remains minimal. This is in large part because potential vaccine developers fear that they could not sell enough vaccine at a sufficient price to recoup their research expenditures. The U.S. administration and the World Bank have each recently proposed programs that would help developing countries to purchase vaccines for these diseases, if and when they are developed. Such programs could both create incentives for vaccine research and help increase accessibility of vaccines once they are developed. This paper explores the design of such programs. It focuses on commitments to purchase new vaccines. For vaccine purchase commitments to spur research, potential vaccine developers must believe that the sponsor will not renege on the commitment once vaccines have been developed and research costs sunk. There is a tradeoff between enhancing credibility with potential vaccine developers by specifying rules for vaccine eligibility and pricing in detail, and preserving flexibility to judge suitability of vaccines after they have been developed and tested. In any case, eligibility will need to be interpreted after candidate vaccines have been developed. The credibility of purchase commitments can be enhanced by including industry representatives on committees making eligibility decisions, insulating committee members from political pressure through long terms, and establishing a minimum price for vaccine purchases under the program. (excerpt)
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  10. 10
    283480

    Creating markets for new vaccines. Part I: Rationale. Draft.

    Kremer M

    [Unpublished] 2000 Apr 13. 49 p.

    Malaria, tuberculosis, and AIDS kill approximately 5 million people each year. The overwhelming majority of deaths occur in poor countries. Despite recent scientific advances, research on vaccines for malaria, tuberculosis, and African strains of HIV remains minimal. This is in large part because potential vaccine developers fear that they would not be able to sell enough vaccine at a sufficient price to recoup their research expenditures. This paper sets out the economic rationale for committing in advance to purchase vaccines once they are developed. The U.S. administration’s budget proposal includes a tax credit for vaccine sales. The World Bank has proposed establishing a vaccine purchase fund. Such commitments could potentially create incentives for vaccine research and help increase the accessibility of any vaccines developed. (excerpt)
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  11. 11
    280047

    Global programmes.

    United Nations High Commissioner for Refugees [UNHCR]

    In: Global appeal, 2003. Strategies and programmes, [compiled by] United Nations High Commissioner for Refugees [UNHCR]. Geneva, Switzerland, UNHCR, 2003. 36-51.

    Ensuring equal rights and access by refugee women to all aspects of protection and assistance provided by UNHCR, is central to the Office’s refugee protection mandate. This policy commitment is grounded in international agreements and standards, such as the Beijing Declaration and Platform for Action, and the Convention on the Elimination of all Forms of Discrimination against Women (CEDAW). UNHCR employs various strategies to make good this commitment, including: elaborating policy guidelines and training materials; providing technical advice and support to operational units; pursuing consultations and partnerships with refugees, particularly women; piloting innovative approaches to empower refugee women; and monitoring and evaluating field-related activities. During the global consultations with refugee women in 2001, the High Commissioner made five commitments: the promotion of women’s equal participation in leadership and decision-making; equal participation in the distribution of food and non-food items; individual registration and documentation of refugee women; support for integrated sexual and gender-based violence programmes at national levels; and the inclusion of sanitary materials within standard assistance packages provided to refugees. These commitments continue to be implemented in practical and measurable ways. (excerpt)
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  12. 12
    274801

    Investing in a comprehensive health sector response to HIV / AIDS. Scaling up treatment and accelerating prevention. WHO HIV / AIDS plan, January 2004 - December 2005.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2004. 72 p.

    This document discusses the context for the work being undertaken in WHO’s HIV/AIDS programme. It analyses the epidemiological situation and includes the most recent estimates of antiretroviral coverage, the global strategic framework and current challenges to translating this into results at the country level (Section 1 – Background). Section 2 describes the comparative advantages offered by WHO, the functional areas of activity within the HIV/AIDS area of work for 2004–2005 and the specific focus of the programme on scaling up antiretroviral therapy and accelerating HIV prevention. Section 3 describes how WHO is structured and how resources and capacity are being reoriented to support country-level action. Section 4 illustrates how WHO works within the United Nations system and with other partners. Section 5 outlines the resources required in 2004–2005 for WHO to accomplish its stated contribution to HIV/AIDS. Section 6 describes the mechanisms for technical and managerial oversight of the HIV/AIDS programme. The WHO HIV/AIDS Plan is not a detailed work plan. Rather, it provides an overall framework to guide the departments responsible for HIV/AIDS in preparing such work plans at the country, regional and headquarters levels of WHO. These work plans are now being developed and will define the specific tasks and activities required to bring the WHO HIV/AIDS Plan to fruition, together with timelines and resource requirements. Joint planning sessions between headquarters, regional and country offices integrate the work of the three levels to ensure that all priority needs are addressed and that gaps in resources are identified. (excerpt)
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  13. 13
    181292

    Public-private partnerships for public health.

    Reich MR

    Cambridge, Massachusetts, Harvard Center for Population and Development Studies, 2002 Apr. ix, 205 p. (Harvard Series on Population and International Health)

    This book presents the results of the workshop. The essays in this volume offer some fresh perspectives on partnerships, probe some troubling questions, and provide empirical evidence of both benefits and challenges of public-private partnerships. The participants in the meeting also achieved some progress in creating a shared vocabulary, or at least shared understanding, on points of contention, suggesting that dialogue among partisans in public health can help move debates about critical issues forward. (excerpt)
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  14. 14
    173180
    Peer Reviewed

    Increasing transparency in partnerships for health -- introducing the Green Light Committee.

    Gupta R; Cegielski JP; Espinal MA; Henkens M; Kim JY

    Tropical Medicine and International Health. 2002 Nov; 7(11):970-976.

    Public–private partnerships have become central to efforts to combat infectious diseases. The characteristics of specific partnerships, their governance structures, and their ability to effectively address the issues for which they are developed are being clarified as experience is gained. In an attempt to promote access to and rational use of second-line anti-tuberculosis (TB) drugs for the treatment of multidrug-resistant TB, a unique partnership known as the Green Light Committee (GLC) was established by the World Health Organization. This partnership relies on five categories of actors to achieve its goal: academic institutions, civil society organizations, bilateral donors, governments of resource-limited countries, and a specialized United Nations agency. While the for-profit private sector is involved in terms of supplying concessionally priced drugs it is excluded from decision-making. The effectiveness of the partnership emerges from its review process, flexibility to modify its modus operandi to overcome obstacles, independence from the commercial sector, and its ability to link access, rational use, technical assistance, and policy development. The GLC mechanism may be useful in the development of other partnerships needed in the rational allocation of resources and tools for combating additional infectious diseases. (author’s)
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  15. 15
    120853

    Contraceptive requirements and logistics management needs in Bangladesh.

    United Nations Population Fund [UNFPA]. Technical and Evaluation Division. Reproductive Health / Family Planning Branch

    New York, New York, UNFPA, 1995. ix, 115 p. (Technical Report No. 23)

    This report contains the results of a 1994 UN Population Fund (UNFPA) mission to Bangladesh undertaken on behalf of the UN's Global Initiative on Contraceptive Requirements and Logistics Management Needs. After presenting an executive summary, the report opens with an introductory chapter which describes the UNFPA Global Initiative, Bangladesh's population and family planning (FP) policies, policy strategies, the structure of the national FP program, the delivery of FP services, and donor assistance. Chapter 2 covers contraceptive requirements and reviews the longterm projection methodology as well as projects to meet government objectives for the year 2005. The third chapter deals with logistics management in terms of distribution channels and contraceptive supply systems. Chapter 4 discusses various aspects of contraceptive manufacturing including taxes and duties and quality assurance. The next chapter looks at the role of nine nongovernmental organizations (NGOs) and the private sector (private practitioners, private corporations, and the social marketing company). This chapter also covers the sexually transmitted disease (STD)/HIV/AIDS prevention activities undertaken by NGOs and coordination and collaboration between NGOs and the government. Chapter 6 is concerned with the use of condoms for STD/HIV/AIDS prevention, and chapter 7 provides a financial analysis of the allocations and expenditures of the government program, the World Bank-assisted program, the UNFPA-assisted program, and the program supported by the US Agency for International Development. This chapter also considers financial aspects of program performance, contraceptive requirements, contraceptive consumption and costs, and sustainability.
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  16. 16
    096820

    Contraceptive requirements and logistics management needs in Viet Nam.

    United Nations Population Fund [UNFPA]. Technical and Evaluation Division. Maternal and Child Health and Family Planning Branch

    New York, New York, United Nations Population Fund [UNFPA], 1994. ix, 92 p. (Technical Report No. 16)

    In 1989, the UN Population Fund (UNFPA) began its "Global Initiative" to estimate "Contraceptive Requirements and Logistics Management Needs" throughout the developing world in the 1990s. After the initial study was completed, 12 countries were chosen for the preparation of more detailed estimates with information on program needs for logistics management of contraceptive commodities, options for local production, the involvement of nongovernmental organizations (NGOs) and the private sector in the supply of contraceptives, condom requirements for sexually transmitted disease (STD)/HIV/AIDS prevention, and financing issues. The fact-finding mission to Viet Nam took place in 1993. This technical report presents a consensus of the findings and conclusions of that mission. After an executive summary and introductory chapter, which discusses population and family planning and the AIDS epidemic in Viet Nam, chapter 2 covers contraceptive requirements including longterm forecasting methodology, projected longterm contraceptive commodity requirements, short-term forecasting and requirements, and forecasting of condom requirements for HIV/AIDS prevention. Logistics management is considered next, with emphasis on public and private organizations which participate in contraceptive distribution, procurement, and allocation to outlets; the reception, warehousing, and distribution of contraceptives; warehousing regulations; the logistics management information system; and monitoring. Chapter 4 deals with contraceptive manufacturing and discusses the regulatory environment and quality assurance, condoms, IUDs, oral and other steroidal contraceptives, and related issues. The fifth chapter presents the role of NGOs and the private sector and discusses mass organizations, social marketing, and future private-sector options, opportunities, and constraints. A financial analysis provided in chapter 6 relays sources and use of funds, trends in financial contributions for 1985-2000, future funding requirements, and contraceptive cost implications for individuals. The final chapter considers condom programming for HIV/AIDS prevention with information given on current status and patterns; projected trends; the National AIDS committee; an overview of international donor assistance; major condom distribution channels and outlets, condom demand-generation activities, forecasting requirements for 1993-2002, and condom supply activities. A summary of key knowledge, attitude, and practice findings about AIDS and condoms is appended as is additional information on contraceptive requirements and condom programming for HIV/AIDS prevention. The report contains 17 tables and 1 figure, and 18 specific recommendations are made for the topics covered.
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  17. 17
    082167

    Evaluation of recent changes in the financing of health services. Report of a WHO Study Group.

    World Health Organization [WHO]. Study Group on the Evaluation of Recent Changes in the Financing of Health Services

    WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1993; (829):i-v, 1-74.

    A study group was convened at World Health Organization (WHO) headquarters over December 10-17, 1991, to evaluate recent changes in the financing of health services. Specifically, they were to review, compare, and analyze the principal types of change in health financing which countries have implemented over the past decade; review evidence on the effects of these changes on the provision and utilization of health services including health status where possible; make conclusions on the contribution of different methods of financing to the functioning of health systems based on primary health care; and recommend strategies and actions which countries and WHO could use to improve the performance of health systems by changes in financing, and to support the prospective and retrospective appraisal of financing options. To that end, the group looked at changes in the mix of sources of finance for the health sector; changes in the methods of paying care providers; changes in the relative roles of government, care providers, purchasers, and consumers in organizing and delivering health services; consequences of these changes; and approaches to evaluating financing changes. The group found common trends toward liberalization, increased use of nongovernment financing sources, and greater emphasis upon market mechanisms and incentives to help structure health sector operations. While these trends may be evident, however, the exact form of changes in health care financing has varied according to the structure of the existing health system and the political viability of change in the system in different countries; reforms may complement each other or have negative effects upon one another. Policy objectives must be carefully defined before making broad decisions about changes in financing. Further, as the interactions between market-driven systems and government policy and practice are considered, one must not lose sight of the government's role in policymaking, regulation, information gathering, and dissemination. Governments also finance vector control, water supply, and the control of infectious diseases. Recommendations are made to countries, WHO, and other international agencies concerned with health.
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  18. 18
    081945

    Conservation of West and Central African rainforests. Conservation de la foret dense en Afrique centrale et de l'Ouest.

    Cleaver K; Munasinghe M; Dyson M; Egli N; Peuker A; Wencelius F

    Washington, D.C., World Bank, 1992. xi, 353 p. (World Bank Environment Paper No. 1)

    This World Bank publication is a collection of selected papers presented at the Conference on Conservation of West and Central African Rainforests in Abidjan, Ivory Coast, in November 1990. These rainforests are very important to the stability of the regional and global environment, yet human activity is destroying them at a rate of 2 million hectares/year. Causes of forest destruction are commercial logging for export, conversion of forests into farmland, cutting of forests for fuelwood, and open-access land tenure systems. Other than an introduction and conclusion, this document is divided into 8 broad topics: country strategies, agricultural nexus, natural forestry management, biodiversity and conservation, forest peoples and products, economic values, fiscal issues, and institutional and private participation issues. Countries addressed in the country strategies section include Zaire, Cameroon, Sao Tome and Principe, and Nigeria. The forest peoples and products section has the most papers: wood products and residual from forestry operations in the Congo; Kutafuta Maisha: searching for life on Zaire's Ituri forest frontier; development in the Central African rainforest: concern for forest peoples; concern for Africa's forest peoples: a touchstone of a sustainable development policy; Tropical Forestry Action Plans and indigenous people: the case of Cameroon; forest people and people in the forest: investing in local community development; and women and the forest: use and conservation of forestry resources other than wood. Topics in the economic values section range from debt-for-nature swaps to environmental labeling. Forestry taxation and forest revenue systems are discussed under fiscal issues. The conclusion discusses saving Africa's rainforests.
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  19. 19
    075934

    Global population assistance report, 1982-1990.

    United Nations Population Fund [UNFPA]

    New York, New York, United Nations Population Fund [UNFPA], 1992 Apr 1. v, 102 p.

    The global population assistance report for the UN Population Fund (UNFPA), 1982-90, provides background on development activities, the levels and trends in international assistance, current commitments, expenditures, types of programs funded, and future resource requirements. Numerous tables, maps, and figures in the appendix provide information on commitments and expenditures by country and region historically. The report highlights the following: 1) a record high for grants totaling US$801.8 million, 2) an increase of 12% from 1989 to 1990 in commitments, 3) the US, Japan, Norway, Germany, Canada, Sweden, the United Kingdom, Netherlands, Finland, and Denmark as donors comprising 96% of commitments all increasing contributions, 4) the World Bank increasing its loan agreement from US$125 to US$169 million between 1989-90, 5) donors commiting aid in roughly equal proportions: 30% to bilateral aid, 34% to UN agencies, and 35% to nongovernmental organizations, 6) the donor contributions of population assistance as a % of Official Development Assistance dropping from 1.21% to 1.18% between 1989-90, 7) and US$9 billion/year being required in order to meet the medium projection target in 2000. Expenditure increased in Africa from US$128 to US$153 from 1989 to 1990. Stable expenditures amounted to US$208 million in Asia and the Pacific, US$92 million in Latin America and the Caribbean, and US$52 million in the Middle East and north Africa. The use of multiple channels of support means the distribution of assistance is adapted to local conditions. 66% of all exenditures go toward family planning services, 15% for information, education, and communication, and 5% for basic data collection.
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  20. 20
    075783

    Family planning programme sustainability: a review of cost recovery approaches.

    Ashford LS; Bouzidi M

    London, England, International Planned Parenthood Federation [IPPF], 1992 Mar. iv, 81 p.

    Participants at the October 1991 IPPF seminar on Program Sustainability through Cost Recovery addressed the challenge of continuing to provide even more family planning (FP) services to the poorer segments of society while at the same time ensuring program survival. Field reports indicated a variety of funding sources, including user fees, social marketing programs, income generating schemes unrelated to FP, service agreements with the public sector, and private sources. Fees comprise the most common means of recovering FP program costs, but there is substantial diversity based on the income of the user, location of the service, and type of service provided. In view of field reports presented at the workshop, 6 broad recommendations were developed: 1) any approach to program sustainability must place the needs of the clients first; 2) sustainability should be an integral part of the organization's longterm strategic plan; 3) cost-effectiveness is a requirement; 4) periodic analyses of service costs, overhead costs, and costs per unit of output should be undertaken to monitor cost-effectiveness; 5) greater inter-IPPF cooperation and sharing of experiences should be encouraged; and 6) a business plan is essential for cost recovery. In countries where family planning acceptance is low and donor funds are available, FP associations are urged to focus on resource development rather than cost recovery from users. FP associations that provide health education services are encouraged to derive income from the sales of IEC materials or seminar fees. In some cases, higher fees can be charged for specialized services such as infertility counseling, but care must be taken to avoid diverting the program's emphasis from the primary task of managing the family planning program. The cost recovery schemes selected--fees, sales, insurance, or community fundraising--should always be consistent with the association's role in the national population program.
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  21. 21
    068563

    Meeting the future. Where will the resources for the USSR's family planning programs come from?

    Laskin M

    INTEGRATION. 1991 Sep; (29):6-7.

    Providing resources for family planning programs in the USSR, where an extremely high rate of abortions threatens the lives of women, will require a multi-sectoral approach involving the government, international agencies, and the private sector. Every year, some 10-13 million of the USSR's 70 million women of fertile age undergo an abortion (only 7 million of the abortions every year are considered legal). A recent report indicates that only 15-18% of Soviet women have not had at least one abortion in their lifetimes. A result of the high rate of illegal abortions, morbidity and mortality affects many Soviet mothers. Additionally, infant mortality rates is as high as 58.5% in some areas of the USSR, a figure similar to that found in developing countries. Knowledge of modern contraception is high, but use remains low. This is due primarily to the lack of contraceptive availability. IUD's injectables, implants, and oral contraceptives are scarce. And even when oral contraceptives are available, few women opt for this method, due to the rampant misinformation and exaggeration concerning its side-effects. While the USSR does produce condoms, their quality is poor. Part of the solution to the lack of available contraception rests in the transition to a market economy. As the demand for these services increases, the market will begin meeting this demand. The government also has a important role to play, which includes the provision of information, medical and paramedical education, sex education, and service delivery. And international agencies will need to provide the necessary technical assistance.
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  22. 22
    060875

    Developing a self-financing, factory-based contraceptive distribution project in St. Lucia.

    Logan D

    Washington, D.C., TvT Associates, MORE Project, 1990 Mar. [2], 26, [12] p. (USAID Contract No. DPE-3030-C-00-8167)

    A revitalized, nearly self-sufficient, factory-based contraceptive distribution project has existed in St. Lucia since the beginning of 1990. Seeded in 1981, with 1-year funding from the International Planned Parenthood Federation, the project was on shaky financial footing through the 1980s. The Family Planning Association (FPA) of St. Lucia, with the technical assistance of the Maximizing Results of Operations Research (MORE) project, has, however, turned the project into a viable distribution program financially-backed by factories employing almost 2,500 workers. This successful turnaround is due largely to the accomplishments of a MORE business consultant who made 2 field visits in 1989. In addition to helping the FPA expand the project, the consultant developed a business plan, and encouraged factory owners and business leaders to back the project. He held both individual meetings and a formal group presentation. The business plan, and activities and results of the field visits are presented in the report. The consultant found a 1-to-1 sales approach best in recruiting company members for the project, supports continued application of the formal presentation, suggests a hotel setting for business group meetings, and notes island-wide consensus for support of the project. Although not quite finalized, and expected to work on a restricted operating budget, the project's largest remaining obstacle is where to locate the nurse.
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  23. 23
    068883
    Peer Reviewed

    Public and private donor financing for health in developing countries.

    Howard LM

    INFECTIOUS DISEASE CLINICS OF NORTH AMERICA. 1991 Jun; 5(2):221-34.

    Public and private domestic expenditures for health in a total 148 developing countries for 1983, were estimated to be $100 billion. 1986 external donor health expenditures totalled $4 billion, a small percentage of overall health expenditure for developing countries. U.S. direct donor assistance for development was 0.5% of the federal budget for 1988, with approximately 10% of all U.S. development assistance allocated for health, nutrition, and population planning. As such, the U.S. accounts for 13% of total health contributions from external donors to developing countries. Approximate at best, private and volunteer organizations are estimated to contribute 20% of all such health assistance. Developing countries are therefore required to efficiently use their own resources in the provision of national health services. Technical assistance and donor experience also counting as external assistance, the overall supply of health financing is far greater than developing country demand in the form of well-articulated, officially approved proposals. Reasons for this imbalance include health ministry unfamiliarity with potential donor sources, passive approaches to external financing, unfamiliarity with proposal preparation, increasing competition from other sectors of developing nations, limited numbers of trained personnel, and lack of an international system of support to mobilize financing. The paper discusses 6 years of Pan American Health Organization interventions for resource mobilization in Latin America and the Caribbean, and suggests World Health Organization regional extension backed by U.S. encouragement and support.
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  24. 24
    066196

    The state of world population 1991.

    Sadik N

    New York, New York, United Nations Population Fund [UNFPA], 1991. [4], 48 p.

    Developing countries increased their commitment to implement population policies in the late 1980s and early 1990s with the support and guidance of UNFPA. These policies focused on improving, expanding, and integrating voluntary family planning services into social development. 1985-1990 data revealed that fertility began to fall in all major regions of the world. For example, fertility fell most in East Asia from 6.1-2.7 (1960-1965 to 1985-1990). This could not have occurred without strong, well managed family planning programs. Yet population continued to grow. This rapid growth hampered health and education, worsened environmental pollution and urban growth, and promoted political and economic instability. Therefore it is critical for developing countries to reduce fertility from 3.8-3.3 and increase in family planning use from 51-59% by 2000. These targets cannot be achieved, however, without government commitments to improving the status of women and maternal and child health and providing basic needs. They must also include promoting child survival and education. Further people must be able to make personal choices in their lives, especially in contraceptive use. Women are encouraged to participate in development and primary health care in Kerala State, India and Sri Lanka. The governments also provide effective family planning services. These approaches contributed significantly to improvements in fertility, literacy, and infant mortality. To achieve the targets, UNFPA estimated a doubling of funding to $9 billion/year by 2000. Lower costs can be achieved by involving the commercial sector and nongovernmental organizations, building in cost recovery in the distribution system of contraceptives, operating family planning services efficiently, and mixing contraceptive methods.
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  25. 25
    059851

    Health care financing in Latin America and the Caribbean, 1985-89: findings and recommendations.

    Gwynne G; Zschock DK

    Stony Brook, New York, State University of New York at Stony Brook, 1989 Sep. xiv, 65 p. (Health Care Financing in Latin America and the Caribbean [HOFLAC] Research Report No. 10)

    Recently a 4 year research project was conducted in Latin America and the Caribbean on health care financing, sponsored by the US Agency for International Development. The work focused on 3 areas: health care costs, household demand for health care, and alternatives to the financing of health care from general tax funds. The work focuses on 10 countries of lower to middle income with small populations (except Peru), making them comparable. In most of these countries unfavorable economic conditions have prevented the governments from expanding primary health care, and have caused the deterioration of many health services. These conditions have stimulated private health care spending which has expanded in proportion of total health financing. Cost studies have indicated a wide variation of annual costs of primary care in the public, social security, and private sectors. In hospitals the larger facilities take a bigger share than standard accounts show. Research suggests that if user fees were charged for outpatient care in public hospitals, the overall use would stay the same, but some users would switch to private providers. Since private hospitals charge considerable more, inpatient care is more suited to public facilities. Findings here show the importance of social security in the financing of medical care, especially in these countries where 20-30% is paid from it. Recommendations from these studies include limiting personnel expenditures and cost containment in hospitals.
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