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Tropical Medicine and International Health. 2006 Mar; 11(3):255-257.A lavishly sponsored Global Health Summit conference in New York organized in early November by Time magazine included a panel discussion on the pertinent issue of whether global health can be good for business,1 and in the process highlighted many of the contradictions confronting health care providers, policy makers and planners the world over. Attempts to graft compassion onto the root stock of global capitalism have been only partially successful, if at all. Certainly none of the big players in the $3 trillion plus health care industry - whether they be pharmaceutical corporations, equipment manufacturers, hospital chains or health insurers - has been able to demonstrate any long term or sustained commitment to the delivery of health care services to the billions of people in low income countries who currently lack access to them. Many of the 'Global Public Private Partnerships' favoured by the WHO appear to serve largely as public relations campaigns for the private sector 'partners' and also as a means to help them to secure and potentially expand their longer-term market for drugs and vaccines. Meanwhile some of the largest donors supporting such partnerships come from outside of the health care industry altogether - most notably Bill and Melinda Gates, whose benevolent billions also help make Microsoft's cosmic profits seem more socially acceptable. (excerpt)
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.
New York, New York, United Nations Population Fund [UNFPA], 1994. x, 122 p. (Technical Report No. 17)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 the Philippines took place in 1993. In the introductory chapter of this technical report, the Global Initiative is described and the Philippine Population Program is presented in terms of the demographic picture, the population policy framework, the Philippine Family Planning (FP) Program, STD/AIDS control and prevention efforts, and an overview of donor assistance from 1) the UNFPA, 2) USAID, 3) the World Bank, 4) the Asian Development Bank, 5) the Australian International Development Assistance Bureau, 6) the Canadian International Development Agency, 7) the Commission of the European Community, 8) the International Planned Parenthood Federation, 9) the Japanese International Cooperation Agency, and 10) the Netherlands. The second chapter presents contraceptive requirements including longterm forecasting methodology, projected longterm commodity requirements, condom requirements for STD/AIDS prevention, total commodity requirements for 1993-2002, short-term procurement projections, and projections and calculations of unmet need. Chapter 3 covers logistics management for 1) the public sector, 2) condoms for STD/AIDS preventions, 3) NGOs, and 4) the commercial sector. The fourth chapter is devoted to a consideration of private practitioners and a detailed look at the ways that NGOs relate to FP groups. This chapter also covers the work of NGOs in STD/AIDS prevention and coordination and collaboration among NGOs. Chapter 5 is devoted to the private commercial sector and includes information on social marketing, the commercial sector, and duties and taxes. The issues addressed in chapter 6 are contraceptive manufacturing and quality assurance, including the potential for the local manufacture of OCs, condoms, IUDs, injectables, and implants. The national AIDS prevention and control program, the forecasting of condom requirements for STD/AIDS prevention, and policy and managerial issues are considered in chapter 7. The last chapter provides a financial analysis of the sources and uses of funds for contraceptives including donated commodities, the private commercial sector, cost recovery issues, and regulations and policies, such as taxes and duties on donated contraceptives, which affect commodities. 5 appendices provide additional information on contraceptive requirements, logistics management and costs, the private commercial sector, condoms for STD/AIDS prevention, and a financial analysis. Information provided by the texts and appendices is presented in tables and charts throughout the report.
Intermediating development assistance in health: prospects for organizing a public/private investment portfolio.
Washington, D.C., Family Health, 1980 July 23. 162 p.The objective of this study is to identify and assess the potential role of intermediary organizations in furthering AID health assistance objectives. The 1st section of this report is an introduction to the potential roles of intermediaries through health assistance via the private voluntary community. A background of the private voluntary organizations is discussed along with some of the constraints that may impede their activity, such as competing interests, values and priorities. The following section defines what is and should be an intermediary organization along with examples of certain functions involved; a discussion of the experience of AID in the utilization of intermediaries follows. 3 models of utilization of intermediaries are analyzed according to the rationale involved, strategy, advantages and constraints. The 3rd section attempts to define and identify AID's needs for programming its health assistance in regard to primary health care, water and sanitation, disease control and health planning. A detailed analysis of the potential roles of intermediary organizations is discussed in reference to policy development, project development and design, project implementation, research, training and evaluation. The 4th section identifies the programming strengths and interests among listed private voluntary organizations in the US. The 5th section discusses the potential of intermediaries in health assistance in reference to the options for funding them in health and the constraints to direct AID funding of intermediary organizations. The last section discusses a series of recommendations made in regard to the development and funding of an international effort to marshall private resources in support of health assistance. Problems and constraints, as well as resources and opportunities, for the development of this international effort are further discussed.
[Unpublished] 1992. Presented at the 120th Annual Meeting of the American Public Health Association [APHA], Washington, D.C., November 8-12, 1992.  p.External donors provided plenty of funds to nongovernmental organizations (NGOs) in developing countries, hoping the governments would eventually support a national family planning (FP) policy. Lower levels of funding for population programs caused external donors to force NGO FP programs to become self-sustaining. Yet, it is likely to be difficult for them to improve the quality of services, expand coverage, and increase program sustainability all at the same time. External donors consider the 35-50% contraceptive prevalence rates that NGO FP programs are achieving to represent the early stages of sustainability at which time they divert funds to government programs. This loss of funds shifts the NGO program's focus from poor women to income-generation, made possible by targeting middle and upper income women. When diversion of funds resulted in a decline of contraceptive prevalence rates in Sri Lanka and stagnant rates in Pakistan and the Philippines. FP programs in Sri Lanka, Pakistan, and the Philippines first provided physician-controlled, reversible, clinical methods. Those in Sri Lanka and the Philippines next provided contraceptives through a widespread rural community-based distribution system. Pakistan held mass sterilization campaigns to address rapid population growth and high fertility. The management system of the national FP program in Sri Lanka is slow, and disruption of service delivery and supply systems is common Physician-trained nonphysician FP workers and the vertical national health and population sectors caused the stagnation in the public sector. The Philippines has trouble implementing public policy-based FP programs.
Give the people what they want and spread their satisfaction for others to follow. The Indonesia FP experiences.
Jakarta, Indonesia, National Family Planning Coordinating Board, 1989. 12 p. (HMA.78/KA/89)In 1970 when the family planning (FP) program was launched in Indonesia the population numbered 120 million with an annual growth rate of 2.3%. As of the early 1980's the growth rate started to decline, but the population still reached 178 million by 1989. The strategy called for institutionalizing and popularizing the concept of the small, happy, and prosperous family. The program went through several phases: institution-building, maintenance and implementation, and graduation with community participation. Rural successes in contraceptive prevalence has to be counterbalanced by an urban campaign during 1984-85 when rapid expansion of FP courses in 31 cities were initiated. The private sector supply was set up for private clinics taking care of acceptors. The Blue Circle IEC Campaign was instituted with the support of USAID and the Johns Hopkins PCS project. This entailed using private advertising to develop mass media promotion for FP providers of high quality, low cost contraceptives. In 1986 the condom called Dua Lima was introduced by cooperating with the Somarc project of The Futures Group. A 40-60% discount was effected for products under the Blue Circle label. The idea of self-reliant FP has taken hold.
AIDS ACTION. 1989 Jun; (7):1-2.The most valuable resource that NGOs can bring to the AIDS programs is experience in community level work. The 3 basic goals of WHO are to prevent HIV infections and AIDS, to limit the personal and social impact of AIDS, and to unify national and international efforts. NGOs share the first 2 goals and can respond to local needs more quickly than governments. At the national level, 3-5 year plans are created and coordinated with NGOs to avoid duplication of work and to send unified messages. WHO can distribute updated scientific information to NGOs and can receive information on evaluation, planning and project operations from them. The WHO Global Program on AIDS (WHO/GPA) works with AIDS service organizations, NGOs with experience in primary health care, as well as hemophilia societies, ethnic organizations, and labor unions, that are involved in AIDS problems. WHO/GPA is involved in encouraging NGO participation in international meetings, the creation and exchange of information between WHO and NGO groups, and developing a directory of national and international NGOs involved in AIDS prevention. At the national level, they promote coordination of NGOs and national AIDS programs in areas such as the promotion of educational materials.
PEOPLE. 1987; 14(2):33.3 agencies in Turkey are placing family planning centers in factory settings: the Family Planning Association of Turkey (FPAT), the Confederation of Trade Unions (TURK-IS), and the Family Health and Planning Foundation, a consortium of industrialists. The FPAT started with 27 factories 7 years ago, educating and serving 35,000 workers. The 1st work with management, then train health professionals in family planning, immunization, infant and child care, maternal health, education, motivation techniques, record-keeping and follow-up. Worker education is then begun in groups of 50. New sites are covered on a 1st-come-1st-served basis. This program is expected to be successful because newcomers to city jobs are beginning to see the need for smaller families, and accept family planning. TURK-IS has conducted seminars for trade union leaders and workers' representatives and provided contraceptives in 4 family planning clinics and in 20 hospitals run by Social Security, a workers' health organization. They have distributed condoms in factories and trained nurses to insert IUDs in factory units. The businessmen have opened family planning services in 15 factories, with support from the Pathfinder Fund, and hope to make the project self-supporting.
In: Family planning within primary health care, edited by F. Curtis Swezy and Cynthia P. Green. Washington, D.C., National Council for International Health, 1987. 112-4.The World Bank's appreciation of the unique role of NGOs in working beyond the effective reach of government systems in reaching underserved populations and communities has come with its increasing involvement in social sector development. NGO understanding of the needs of communities, underserved populations, and special subgroups constitutes a strong basis for designing and implementing actions to promote social and behavioral change. NGOs can complement the skills available within governments to put their people-oriented policies into meaningful effect. This NGO support may be sine qua non for the success of such policies, and of the programs and projects the Bank supports in the social sectors. The Bank is still developing ways to encourage NGO participation in such programs and projects. Staff in the Population, Health and Nutrition Department of the Bank are directing much more effort now to working with NGOs in family health and population work, particularly in subSaharan Africa where the greatest current challenge exists. At the international level, in order to promote policy dialogue with an operational perspective between the Bank and the NGO community, a Bank/NGO committee has been established. Composed of NGO representatives from both donor and recipient countries and Bank staff, it meets regularly and has proven helpful in identifying mutual interests and common objectives in a number of important areas, including food security. The committee does not replace collaborative mechanisms at the country level, but it has been successful in inspiring both the Bank and NGPs to pursue collaboration more assiduously at the country and sectoral levels.
Populi. 1985; 12(4):22-31.Although the UN's charter (1945) provided for arrangements with non-governmental organizations (NGOs), relations between the 2 have been uneasy, since NGOs are often ignored or not listened to fully. The 1974 World Population Plan of Action delegated NGOs to a peripheral role, but the 1984 Plan both commended their work and recognized the partnership that has developed between governmental and private sector and voluntary organizations in many nations. NGOs include professional organizations, advocacy organizations, and many broadly based organizations for women, youth, churches, education, science, and the environment. This article describes the following NGOs in terms of their growing influence on the UN and how the UN and UNFPA have helped these NGOs make full contributions: 1) the International Union for the Scientific Study of Population (IUSSP), founded in 1928 in Paris, was the first NGO accorded consultative status by the Economic and Social Council; 2) the International Planned Parenthood Federation (IPPF), founded in 1952, attained consultative status in the mid-1960s, and has been on a partnership basis with the UNFPA since its inception, although, in 1984, it became a target of major US policy change; 3) the Population Council, begun in 1952 by John D. Rockefeller under National Academy of Sciences auspices, has trained thousands of demographers, economists, and social scientists and has made major contributions to the UN's 1954-1984 population conferences; 4) other NGOs such as the Population Reference Bureau, the Population Crisis Committee, the Population Institute; and 5) less specialized NGOs such as the International Association for Maternal and Neonatal Health, and the International Association of Obstetrics and Gynecology. NGOs help give the necessary public support to population efforts, but their diversity can cause coordination problems that must be settled as national levels or by the UN.
Populi. 1985; 12(3):34-9.The US Agency for International Development (USAID) in consultation with the government of Kenya agreed in 1983 to prepare a demonstration family planning project, which would assist the private sector as well as other major nongovernment providers of health services to upgrade their health services, train and augment their nursing and other medical staff, provide family planning equipment and free contraceptives, and establish these health facilities as full-time family planning service delivery points. The Family Planning Private Sector Program (FPPS) will assist 30 private sector firms, "parastatal" organizations, and other private and nongovernment organizations that already provide health services to their workers, their dependents, and in many cases the surrounding communities to upgrade their services and add a full-time family planning facility. As some of the firms or organizations have multiple outlets, the program will create 50 or more new family planning delivery points throughout Kenya, thereby also relieving some of the pressure on government facilities. The FPPS sub-projects are to recruit at least 30,000 new acceptors. FPPS has added a guideline that at least 60% of these new acceptors be retained in the program for at least a period of 2 years. The FPPS program has received an enthusiastic reception from employers, the unions, and nongovernment organizations such as the Protestant Church Medical Association and the Seventh Day Adventists. The FPPS team can provide projects with a variety of services and funds for family planning related equipment, supplies, and activities. These include assistance with project design, training existing medical staff in family planning service delivery, the collection of baseline information, and the provision of funds for equipping family planning clinics. The government has encouraged FPPS to be innovative and to introduce family planning services into as wide a variety of health services as possible. As presently designed, the FPPS program is primarily a service delivery program but is beginning to play an increasingly dynamic role in information and education activities about family planning. From the start, the participating projects demanded assistance in spreading the family planning message to the workers, their families, and the community. It is evident that the program has stimulated management, clinic staff, and workers and has generated competition between projects to reach and exceed their targets of both new acceptors and high continuation rates.
Washington, D.C., Population Crisis Committee, 1985 Dec. 8 p. (Status Report on Population Problems and Programs)In 1985 Brazil's new civilian government took a potentially significant step towards political commitment to a national population program by appointing a national Commission for the Study of Human Reproductive Rights and by accepting large-scale external assistance to implement a nationwide maternal and child health program intended to include family planning services. Brazil's traditional pronatalist policy has been undergoing a change since 1974 and family planning is now viewed as an indispensable element of Brazil's development policy. Several laws which had long impeded the growth of family planning services have been revised or repealed. It is no longer illegal to advertise contraceptives, but abortion is only allowed in restricted circumstances. Approval for voluntary sterilization is easier to obtain. Brazilians who practice family planning obtain services primarily through commercial channels or the private sector. The government and private family planners are faced with a major problem of organizing family planning services for rural areas and the vast city slums. The estimated cost of a national family planning program for Brazil is between US$221 million for 1990 and US$182 to US$324 million for the year 2000. The various aspects of the government program are discussed. The private sector was instrumental in introducing family planning to Brazil. A private non-profit organization was established by a group of physicians to encourage the government to develop a national family planning program and to inform the public about responsible parenthood. This organization (BEMFAM) was given official recognition by the federal government and a number of states and declared a public convenience. Another organization (CPAIMC) was established to provide maternal and child health care in poor urban areas. The sources of external aid, accomplishments to date and remaining obstacles are discussed. Sources of external aid include: UNFPA, USAID, IPPF, the Pathfinder Fund and Columbia University's Center for Population and Family Health (CPFH). A change in popular and official pronatalist attitudes has been effected.
Tellus. 1984 Jul; 5(2):8-11, 25-8.Since the formulation of the World Population Plan of Action (WPPA) in Bucharest in 1974, about 80% of governments have endorsed family planning and fertility control. There has been a growing awareness by governments that population planning must be an integral part of general policy formulation. This article describes the issues of central concern to the 1984 International Population Conference in Mexico, highlighting those which result from new global developments over the past decade. Immigration, particularly by exiles and refugees from political persecution, are contributing much more to population instability than foreseen by the WPPA. Internal migration and massive population shifts from rural to urban areas are of increasing concern to governments in developing nations. In developed countries, there has been an emergence of anxiety over zero population growth. The role of privately sponsored programs for population control is much less prominent, as governments take more responsibility for formulating population policy. A report from a meeting of 90 such nongovernmental organizations held in 1983 was reluctantly accepted as an official document at the conference in Mexico. The Canadian Task Force on Population has identified 5 issues of special concern: status of women, the environment, aging, immigration, and family planning. The Task Force includes among its objectives the encouragement of a comprehensive population policy for Canada, focussing both on Canada's special concerns and on its place in the global community. For example, acid rain and improper soil conservation are threatening Canada's status as one of the few viable "bread baskets" for the world. The growing bulge in the population over age 65 will impose economic strain in the future. Sex education for adolescents in inadequate, with only 1/2 of Canadian schools addressing sex and sexuality in the curriculum.
Sex education and family planning services for adolescents in Latin America: the example of El Camino in Guatemala.
[Unpublished] 1984. ix, 54,  p.This report examines the organizational development of Centro del Adolescente "El Camino," an adolescent multipurpose center which offers sex education and family planning services in Guatemala City. The project is funded by the Pathfinder Fund through a US Agency for International Development (USAID) population grant from 1979 through 1984. Information about the need for adolescent services in Guatemala is summarized, as is the organizational history of El Camino and the characteristics of youngg people who came there, as well as other program models and philosophies of sex education in Guatemala City. Centro del Adolescente "El Camino" represents the efforts of a private family planning organization to develop a balanced approach to serving adolescents: providing effective education and contraceptives but also recognizing that Guatemalan teenagers have other equally pressing needs, including counseling, health care, recreation and vocational training. The major administrative issue faced by El Camino was the concern of its external funding sources that an adolescent multipurpose center was too expensive a mechanism for contraceptive distribution purposes. A series of institutional relationships was negotiated. Professionals, university students, and younger secondary students were involved. Issues of fiscal accountability, or the cost-effectiveness of such multipurpose adolescent centers, require consideration of the goals of international funding agencies in relation to those of the society in question. Recommendations depend on whether the goal is that of a short-term contraception distribution program with specific measurable objectives, or that of a long-range investment in changing a society's attitudes about sex education for children and youth and the and the provision of appropriate contraceptive services to sexually active adolescents. Appendixes are attached. (author's modified)
International consultation of NGOs on population issues in preparation of the 1984 United Nations International Conference on Population: report of the consultation.
[Unpublished] . 83 p.196 individuals from 44 countries, representing national and international non-governmental organizations, bilateral agencies and intergovernmental organizations attended the consultation. The purposes of the consultation were: 1) to provide an overview of the contributions of non-governmental organizations to the implementation of the World Population Plan of Action through a wide range of population and population related programs carried out since the Plan was adopted in 1974; 2) to explore what non-governmental organizations believe needs to be done in the world population field during the balance of the century; 3) to prepare for participation in the January 1984 Conference Preparatory Committee meeting and in the Conference itself to be held in August 1984; and 4) to provide suggestions for activities of national affiliates relative to the 1984 Conference. This report provides a synopsis of the plenary sessions and their recommendations. Addresses by numerous individuals covered the following topics: the creative role of non-governmental organizations (NGOs) in the population field; vital contributions of NGO's to the implementation of the world population plan of action; the family; population distribution and migration; population, resources, environment and international economic crisis; mortality and health; and NGO prospects for the implementation of the world population plan of action.
Populi. 1977; 4(1):7-13.The suggestion at a U.N. Children's Emergency Fund staff meeting that 1/2 the organization's money should be spent on preventing the periodic crises, specifically, on family planning, and the other 1/2 on the miseries of living mothers and children was not accepted in 1958. Another chance for dealing with the problem came through the Population Council in New York. Assigned to East Asia, there was no budgetary support for population policies. Only in South Korea, at the suggestion of the Minister of Planning, was a policy for reducing the birthrate announced. It was the local branch of the International Planned Parenthood Federation that undertook most of the training of the over 2000 field workers hired to visit the rural families especially and to establish a supply line for pills, which were a gift from Sweden. The methods used in order of adoption were the IUD, the oral contraceptive, the vasectomy, condom, and later, subsidized female sterilization. This began in 1963, and it is the 1st example of a population program that has grown until it is now 1 of the soundest anywhere. In East Asia every official program was preceded by activity by some private agency. These usually began in a single clinic to meet the urgent need of mothers who had more children than they could afford and care for. Going out and seeing the people in the various countries of East Asia revealed that they too were aware that they had more children than they could afford. In that 3/4 of the people in East Asia live in villages, it is important that every married couple be visited at home by someone who can explain what family planning is all about and how it will benefit the family and the village. An experienced midwife on a small motorcycle can carry with her all the equipment she heeds and attend to 30 or 40 cases in 1 day. Experience in East Asia suggests that any nation that really wants to can reduce its annual population growth rate.
Mount Sinai Journal of Medicine 42(4): 269-276. July-August 1975.The way in which family planning associations have affected policy and the development of government programs and the way government family planning programs have affected private family planning associations is examined. The typical evolution of voluntary family planning association in countries throughout the world is: 1) an initial interest in the unhealthy effects of excess childbearing by physicians and prominent women; 2) development of a local family planning association; 3) provision of family planning services to women of average means; 4) f avorable public response; 5) support and funding provided by internation al organizations; and 6) government entrance onto the family planning scene. Generally, voluntary family planning groups encourage a trend whose time has already come through various changes in the national way of life. Family planning associations flourish with government involvement because there is need for the expertise developed by the voluntary associations. Private organizations are especially active in training, education, youth work, research, and innovation. Voluntary groups can monitor the quality of government family planning programs.
How many people? A Symposium. Foreign Policy Association, 1973. (Headline Series No. 218) p. 7-15. December 1973The progress of the family planning and population control movements are traced with particular regard to the significant role played by early volunteer organizations like the International Planned Parenthood Federation (IPPF) which was formed in 1952 by the National Family Planning Associations of India, the U.S., Britain, Hong Kong Germany, Holland, Sweden and Singapore. Global recognition of the population problem has been fostered in part by the universal trend toward urbanization, the sharp reduction in maternal and child deaths, the gradual improvement in the status of women, and other social changes which created a demand for better living conditions. The current trend toward assessing national development prospects in terms of social objectives represents a merger between demographic policy and family planning programs. This union between the public and private sector is largely due to the efforts of voluntary family planning groups who have sought to demonstrate that provision of birth control services and education would result in individual efforts to control fertility. Pioneers like the IPPF lobbied and forced action on the evidence that family size and population growth are related integrally to the social and economic progress which the UN and national governments were trying to create. In the mid-60s, the UN officially recognized the efforts of volunteer agencies and within 2 years, the World Health Organization, the International Labor Organization, UNESCO, UNICEF and the Food and Agriculture Organization acknowledged the contribution of family planning to their own efforts to improve living standards. By 1965, family planning had been introduced in 92 countries and governments committed to population control numbered 10. The IPPF has received increased funding from the U.S., Britain and Sweden to supplement their aid to emerging voluntary organizations which are still dependent on private funding. Governments rely on the private sector during their early experiments with national services as well as on the efforts of the voluntary movement to get services fully utilized. Public and private sector activities tent to become mutually supportive. No voluntary association has been able to develop a nationwide clinic service alone. Government involvement provides essential public health facilities. Family planning organizations, in continuing roles as catalyst and pressure group, can be vital to emerging national programs, and can assist governments with problems of training, administration, distribution and coordination which are essential to the efficient delivery of services.
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.