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Africa Renewal. 2007 Oct; 21(3):7.Until six years ago, Eugenia Uwamahoro and several of her eight children had to trek 2 kilometres each day to a river to get about 140 litres of water for drinking, cooking, washing and feeding her four cows. There was a water pump in her village, Nyakabingo, in Rwanda's Gicumbi district, but it hardly functioned. Then the Rwandan government, with financial support from the UN Children's Fund (UNICEF), repaired the pump, and the community contracted a private manager to maintain it. "It has improved my life," Ms. Uwamahoro told African Renewal. "Now we can rest." Not only has the pump saved her considerable time and effort, but she also gets her household's daily water supply at lower cost than she would have from the private village water carriers who cart it up from the river. Many villagers "are happy to pay for the improved service," says Kamaru Tstoneste, who operates the pump. But some villagers cannot afford the cost. So community leaders compiled a list of the neediest households, and review it from time to time. "This group gets an agreed quantity of free supply," Mr. Tstoneste told Africa Renewal. Still, he adds, "Old habits die hard. There are those who refuse to pay for water and still go to the river." (excerpt)
Bulletin of the World Health Organization. 2006 May; 84(5):405-411.Since the first WHO Model List of Essential Medicines was adopted in 1977, it has become a popular tool among health professionals and Member States. WHO's joint effort with the United Nations Committee on Economic, Social and Cultural Rights has resulted in the inclusion of access to essential medicines in the core content of the right to health. The Committee states that the right to health contains a series of elements, such as availability, accessibility, acceptability and quality of health goods, services and programmes, which are in line with the WHO statement that essential medicines are intended to be available within the context of health systems in adequate amounts at all times, in the appropriate dosage forms, with assured quality and information, and at a price that the individual and the community can afford. The author considers another perspective by looking at the obligations to respect, protect and fulfil the right to health undertaken by the states adhering to the International Covenant of Economic, Social and Cultural Rights (ICESCR) and explores the relationship between access to medicines, the protection of intellectual property, and human rights. (author's)
UN Chronicle. 1990 Dec; 27(4): p..A new Programme of Action aimed at advancing the world's poorest countries offers a "menu approach" for donors to increase their official aid to the least developed countries (LDCs), stressing bilateral assistance in the form of grants or highly concessional loans and calling on donors to help reduce LDC debt. The Programme was adopted by consensus at the conclusion of the Second United Nations Conference on the LDCs (Paris, 3- 14 September). The UN recognizes more than 40 developing countries as "least developed". Although individual nation's indicators vary, in general LDCs have a per capita gross domestic product (GDP) of approximately $200 a year, a low life expectancy, literacy rates under 20 per cent and a low contribution of manufacturing industries to GDP. Reflecting the emergence during the 1980s of new priorities in development strategy, the Programme of Action for the LDCs for the 1990s differs from the Action Programme adopted at the first UN Conference on LDCs held in 1981 in Paris. The new Programme emphasizes respect for human rights, the need for democratization and privatization, the potential role of women in development and the new regard for population policy as a fundamental factor in promoting development. Greater recognition of the role of non-governmental organizations in LDC development is also emphasized. (excerpt)
Agenda. 1981 Apr; 2-5.81% of USAID's in-country development assistance funds are provided for countries with per capita incomes under $625 per year, and 61% to those with incomes under $360. The 2 measures of effectiveness of foreign aid are the extent to which aid contributes to a country's overall economic growth, and by the degree to which aid fosters social justice and equity. India and Korea are cited as examples of countries which have benefitted from foreign aid. India can now produce all the food grains it will need for the next 20 years, according to the World Bank. In 1980 the World Health Assembly announced that smallpox had been wiped out, thus saving 10,000 lives a year. The U. S. contributed $27 million as well as technical assistance and leadership for the eradication effort. The case for promoting equity is more elusive than for promoting growth, because USAID's explicitly equity-oriented projects are relatively recent and because the poorest groups have endured discrimination for so long that reaching them and gaining their confidence and involvement in development activities is difficult. 10% of USAID's development assistance is given through private and voluntary organizations. These groups have a reputation for reaching the grassroots poor. USAID also tries to work with multilateral and other bilateral donors to help host governments on the policy issues that influence development. Most Third World governments have come to see the need for equity.
CBFPS (Community-based Family Planning Services) in Thailand: a community-based approach to family planning.
Essex, Connecticut, International Council for Educational Development, 1978. (A project to help practitioners help the rural poor, case study no. 6) 91 pThis report and case study of the Community-Based Family Planning Service (CBFPS) in Thailand describes and evaluates the program in order to provide useful operational lessons for concerned national and international agencies. CBFPS has demonstrated the special role a private organization can play not only in providing family planning services, but in helping to pioneer a more integrated approach to rural development. The significant achievement of CBFPS is that it has overcome the familiar barriers of geographical access to family planning information and contraceptive supplies by making these available in the village community itself. The report gives detailed information on the history and development of the CBFPS, its current operation and organization, financial resources, and overall impact. Several important lessons were learned from the project: 1) the successful development of a project depends on a strong and dynamic leader; 2) cooperation between the public and private sectors is essential; 3) the success of a project depends primarily on the effectiveness of community-based activities; 4) planning and monitoring activities represent significant ingredients of project effectiveness; 5) a successful project needs a sense of commitment among its staff; 6) it is imperative that a project maintain good public relations; 7) the use of family planning strategy in introducing self-supporting development programs can be very effective; 8) manning of volunteer workers is crucial to project success; and 9) aside from acceptor recruitment in the short run, the primary purpose of education in more profound matterns such as childbearing, womens'roles in the family, and family life should also be kept in mind. The key to success lies in continuity of communication and education.
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.
Washington, D.C., U.S. Agency for International Development, May 1982. 12 p. (A.I.D. Policy Paper)Estimates indicate that 600 million people in less developed countries (LDCs) are in danger of not getting enough to eat. This policy paper reviews the justifications for US investment in improving nutrition in LDCs and sets out some policy guidelines for USAID programs. The objective of the nutrition policy is to maximize the nutritional impact of USAID's economic assistance. The policy recommendations are to place the highest priority on alleviating undernutrition through sectoral programs which incorporate nutrition as a factor in decision making. This can be effected through identifying projects based upon analysis of food consumption problems; this is especially appropriate in formulating country development strategies, especially in the areas of agriculture, rural development, education and health. USAID will give increasing attention, through research, analysis, experimental projects, and programs, to improve the ability to utilize the private sector whenever feasible to implement the policy, and to target projects to at-risk groups with the design of overcoming or minimizing constraints to meeting their nutritional needs. It will also monitor the impacts of development projects and strengthen the capacity of indigenous organizations to analyze and overcome nutrition problems.