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In: ICORT II proceedings. Second International Conference on Oral Rehydration Therapy, December 10-13, 1985, Washington, D.C., [edited by] Linda Ladislaus-Sanei and Patricia E. Scully. Washington, D.C., Creative Associates, 1986 Dec. 83-5.At a recent international conference on Oral Rehydration Therapy (ORT) there were discussions on policy issues. Advances in oral rehydration solution (ORS) local production, and the use of private sector and public sector distribution. It was agreed that the roles of ORS packets and home solutions must be carefully thought through and the be the basis of the program. If ORS is going to be available at the household level then the use of the private sector should be considered. The policy to use informal distribution channels and traditional healers has shown to increase public access to ORS. Also, donor support of ORS commodities may not lead to self sufficiency. Governments should plan for self sufficiency in advance and should manage donor support. Advances in local ORS production include factors that promote low cost production such as efficient personnel, economical procurement of materials, appropriate choice of equipment, minimizing duties, and using existing production facilities. The adoption of a citrate ORS formula allows the use of cheaper packaging material. The private sector can and should be used to make ORS available on a wide scale. Product pricing is a highly complex problem and the mothers ability to pay must be balanced against the profit incentives in the distribution system. Subsidies have been necessary to encourage the private sector and mass media campaigns have proven to be a useful subsidy. The key factor in gaining wide coverage is the person who contacts the mother. Competition can be useful in gaining greater effective usage but there are tradeoffs. The high costs of import licenses and hard currency have been stumbling blocks for the private sector production in some countries. It was found that it is inadvisable to set up a separate distribution system for ORS and it should not be given priority over other child survival interventions. Also a policy of cost recovery can make a program more viable in the absence of donor assistance and has increased confidence in the product and therapy.
In: ICORT II proceedings. Second International Conference on Oral Rehydration Therapy, December 10-13, 1985, Washington, D.C., [edited by] Linda Ladislaus-Sanei and Patricia E. Scully. Washington, D.C., Creative Associates, 1986 Dec. 85-9.Training for oral rehydration therapy (ORT), requires a broad area of education not only for health workers, but for community leaders and children. In some countries, doctors refuse to use ORT and mothers may not understand how to make the solutions properly, even though the information is available. In some clinics, diarrhea cases are mixed with others and can be left for a long time unattended. For successful programs in ORT, training must be done by qualified personnel; doctor- nurse teams have been recommended. There should be plenty of ORT packets available and medical personnel should handle at least 10-15 cases personally and work with the mother directly. Also, follow-up is needed to help people manage when they return to their homes. Training activities and financing should include the private sector, as well as government and other organizations, and evaluation and monitoring are and integral part of theses programs. Operations research is needed to enhance training. Donor support can include the following: creation of ORT units in medical schools. Curricula reform in schools, distribution of WHO materials to communities, assistance in training private sector people, and other approaches such as residency programs and operations research for better training programs.
Washington, D.C., World Bank, Population, Health and Nutrition Dept., 1986 Dec 31. 124 p.In the current environment of general budget stringency in developing countries, it is unrealistic to push for more public spending for health services. The answer to this health crisis is to relieve government of much of the responsibility for financing those kinds of health services for which the benefits to society as a whole (as opposed to direct benefits to the users of the service) are low, freeing public resources to finance those services for which benefits are high. The intent is to relieve government of the burden of spending on health care for the rich, freeing public resources for more spending for the poor. Individuals with sufficient income should pay for their curative care. The financing and provision of these "private" health services should be shifted to a combination of the nongovernment sector and a public sector reorganized to be more financially self-sufficient. A shift such as this would increase the public resources available for those types of health services which are "public goods" and currently are underfunded "public" health programs, such as immunization, vector control, some prenatal and maternal care, sanitary waste disposal, and health education. Also such a shift would increase the public resources available for simple curative care and referral for the poor who now only have limited access to low quality services of this nature. Government efforts to cover the full costs of health care for everyone from general public revenues have contributed to 3 sets of problems in the health systems of many countries: an allocation problem -- insufficient spending on cost-effective health activities; an internal efficiency problem -- inefficient public programs; and an equity problem -- inequitable distribution of benefits from health services. 4 policies for health financing are proposed to raise revenues for important health programs, increase the efficiency of public health services, and make the system better serve the poor. These are: charging users of public health facilities; providing insurance or other risk coverage; strengthening nongovernmental health activities; and decentralizing government health services. A table summarizes the effects of each of the 4 options for reform in alleviating health sector problems.
The ECOP-ILO Population Education Program: a report on program implementation (January 1985 - December 1986).
[Unpublished] . 11 p.A 2-year (Jan. 1985 - Dec. 1986) Population Education Project was carried out by the Employers Confederation of the Philippines (ECOP) and the International Labor Organization (ILO) with the objectives of informing employers of the importance of population and family life education and assisting them in the provision of family life education programs and family planning services for their workers. ECOP undertook a preliminary survey of 269 companies, which showed that: 1) Only 49 had family planning programs; 2) Only 37 of the others had any interest in having one; 3) Only 8.7% of the workers were acceptors; 4) Only 45 companies had clinics; 5) Only 7 had incentive schemes to motivate the workers; and 6) 98% of the 210 respondents felt that ECOP should not be involved in family planning. To accomplish its objectives ECOP held 22 population education seminars, attended by 98 company representatives over the 2-year period. With the assistance of the Population Center Foundation (PCF) ECOP established an In-Plant Family Planning Program, which determined the existing knowledge, attitude and practice of workers; recruited and trained clinic staffs and volunteers; disseminated information; and delivered family planning commodities and services. The ECOP also approved an incentive scheme to encourage employers to support the program. The ECOP Population Unit participated in the 1986 Philippine International Trade Fair by setting up exhibits, showing audiovisual presentations, and distributing ILO handbooks on population education. The ECOP project officer attended an inter-country population workshop in Tokyo. The ECOP recommended that the participating companies meet to discuss the project's accomplishments, implement incentive plans, assist in setting up family planning programs, join with family planning agencies to provide services, devise ways of making men aware of their responsibilities in family planning, and study the productivity of workers who practice family planning.
JOURNAL OF POPULATION STUDIES. 1986 Jun; (9):193-212.Population studies have been well developed in many countries of the world, but not so in Taiwan. Many academic people and general citizens in the Taiwan area are still not very familiar with the significance of population research within and outside of the nation. The purpose of this paper is to help readers understand the importance and development situation and trend of the field of population studies, so that they can be motivated to carry out population research and can become more knowledgeable of institutions and organizations both in Taiwan and abroad. Important concepts of the development and trend of population studies presented in this paper are developed by the author after many years of population study. Most sources used in this paper are secondary, and appear in various population references and documents of population organizations. The paper includes 3 main parts: the importance of population studies, the development of population studies in Taiwan, and international population research and sponsoring organizations and agencies. In the 1st part, the important need for population studies has been comprehensively discussed. In the 2nd part, discussions are extended to 3 subjects government's role on data collection and data analysis, teaching and research developments in acdemic institutions, and the role of private organizations in the promotion and application of population studies. In the 3rd part, more than 70 international institutions and agencies of population studies have been introduced and examined. Partticular attention has been paid to characteristics and functions of 3 organizations: UN Population Divisions, IUSSP, and CICRED. In addition, many other international public and private agencies in different countries have been listed and their locations mentioned. In this paper, discussion has not focused on the development of population in the US. It is because the development status in the US is unusually important and requires a separate, special report. The author has made such a report on population studies in the US a decade ago, and it will not be repeated here. (author's modified) (summary in ENG)
International Journal of Health Services. 1986; 16(1):121-39.This article analyzes the patterns of health sector aid to India since 1947, summarizing criticisms such as the extension of dependency relationships, inappropriate use of techniques and models (maintenance costs of large projects are often too high for poor undeveloped countries), and Malthusianism in population programs. The major source of foreign assistance has been the US, amounting to US$107 million from 1950-1973; this figure is broken down to detail which foundations and agencies provided assistance, and how much, over this time period. Foreign assistance for family planning is also discussed. Most health policies adopted in India today predate independence and were present in plans established by the British. New patterns in health aid are described, such as funding made available in local currency to be spent on primary care and especially maternal and child health. The focus of foreign aid has been preventive in emphasis and oriented towards the primary care sector. In some periods it has contributed a substantial share of total public sector expenditures, and in some spheres, it has played a major role, particularly the control of communicable diseases. However, the impact of less substantial sums going to prestige medical colleges or to population control programs should not be ignored. Several aid categories have been of dubious origin (PL-480 counterpart funds and US food surpluses as the prime examples). However, the new health aid programs do not deserve the ready dismissal they have received in some quarters.