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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)
Washington, D.C., Deloitte Touche Tohmatsu, Commercial Market Strategies, 2004 May. , 25 p. (Working Paper; USAID Contract No. HRN-C-00-98-00039-00)Although health-related CSR programs are fairly common, reproductive health (RH) and family planning (FP) initiatives are underrepresented in the global portfolio of CSR programs. These programs might include maternal and child health, STI/HIV/AIDS prevention and education, and provision of contraceptives. To help facilitate the inclusion of RH initiatives in CSR programs, this paper addresses the following questions: What are the motivations behind CSR programs, and what are current CSR trends? What characterizes different CSR models, and how does each model lend itself to the inclusion of family planning and reproductive health services? What opportunities exist for partnerships focused on reproductive health? To answer these questions, CMS conducted in-depth interviews with more than 50 business leaders whose companies are noted for their CSR programs. CMS’s research was designed to unearth the depth and detail of CSR processes from the corporate perspective, seeking to understand why corporations become involved in CSR, as well as how they do it, so that this knowledge could be applied to potential RH initiatives. CMS’s research clearly shows that corporate culture and values drive CSR initiatives. There are usually both internal and external motivations for these programs. Most companies do not view their social and financial responsibilities as mutually exclusive; instead, they link CSR to their core business strategies. CMS also found that a company’s stakeholders play an influential role in selecting and designing its CSR program. Companies are increasingly interested in forming partnerships with the public sector or NGOs, in order to bring technical expertise or other resources to CSR programs. (excerpt)
In: Women, international development, and politics: the bureaucratic mire. Updated and expanded edition, edited by Kathleen Staudt. Philadelphia, Pennsylvania, Temple University Press, 1997. 167-182.Using a feminist lens to inspect current PVO (private voluntary organization) family planning programs, we first define the feminist perspective as it applies to such programs and then compare that feminist vision with the reality found in the field. This paper examines the political dynamics of working for a feminist agenda within the community of population PVOs. The following case study illustrates these dynamics and leads to a discussion of both the obstacles to the realization of a feminist vision and the political strategies and attitudes that help implement this vision. Together, we draw on seventeen years of work with a variety of PVOs involved in family planning and reproductive health. (excerpt)
UN urges broadcasters to air AIDS programmes. Entertainment is better than factual films for increasing awareness.
Lancet. 2004 Jan 24; 363(9405):295.UN secretary-general Kofi Annan hosted a roundtable meeting at the UN headquarters in New York on Jan 15 to launch the Global AIDS Media Initiative—a project to help increase awareness of AIDS by use of international media. Executive representatives from over 20 broadcast media companies were invited to pledge their support and to commit airtime to entertainment programmes involving AIDS-related storylines. “As leaders of the media, you have the power and the reach to disseminate the information people need to protect themselves from HIV/AIDS”, Annan told delegates. (excerpt)
In: European Population Conference / Conference Europeenne sur la Population. Proceedings / Actes. Volume 2. 23-26 March 1993, Geneva, Switzerland / 23-26 mars 1993, Geneve, Suisse, [compiled by] United Nations. Economic Commission for Europe, Council of Europe, United Nations Population Fund [UNFPA]. Strasbourg, France, Council of Europe, 1994. 383-9.The European Association of Population Studies (EAPS) was founded in 1993 to disseminate information and organize workshops with affiliated individuals and institutions. The priority topics are international migration, fertility and the family, health and mortality, population growth and age structure, and international cooperation. Within each of these broad areas, workshops and conferences have taken place, and proceedings have been published. This article summarizes the nature of conferences held in each of the five topic areas. For example, joint institutional responsibility among Dutch and European groups, including EAPS, resulted in a 1991 international symposium on the demographic consequences of international migration. In 1985, a symposium was held in Belgium on one parent families. In 1989, a workshop was held on female labor market behavior and fertility. In 1990, a workshop was held on mortality and health care systems in developed countries. Methods of European mortality analysis were discussed at a 1990 international seminar in Lithuania. The impact of policies without explicit demographic goals was discussed at an international conference held in Germany in 1986. Kinship and aging research were discussed in 1988 in Hungary. A workshop was held in Germany in 1993 on pension, health care, labor market, and birth control policies. Data comparability issues in Europe were reviewed in 1991. The first European Population Conference was held in 1987 in Finland; the second was held in 1991 in France.
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.
Singapore, Singapore Planned Parenthood Association, . , 38 p.The 1992 Annual Report of the Singapore Planned Parenthood Association contains an account of the history and organization of the association, a list of members of the executive council and of the management, program, and fund-raising committees and staff for 1992-93. A message is relayed from the president and reports are given by the honorary secretary, the honorary treasurer, the executive director, and the chairman of the program committee. A list is included of members of the International Planned Parenthood Federation. Programs and activities for 1992 included 1) training workshops and teaching programs, 2) parent education programs, 3) Family Week and special events, 4) family life education programs, 5) youth forums and seminars, 6) public education programs, and 7) a counseling and referral service. Program outputs for 1991 and 1992 are compared in a statistical summary of number of activities and number of participants; a profile of clients by sex, language, age, race, religion, marital status, and occupation; and a summary of presenting problems (contraception and conception, sexual matters, physical changes and development, interpersonal relationships, and others including venereal diseases and AIDS). A similar profile of the telephone counseling service is given. The financial report contains the auditors' report, balance sheet, and statements of income, expenses, and functional expenses. Appended are lists of donors; participating schools, institutions, ministries, organizations, and agencies; and new members.
Report of the National Seminar on Environment and Sustainable Development, Aden, 25-27 February 1989.
[Unpublished] 1989. iv, 131 p.The 1989 final report on the environment and sustainable development includes a summary of events an a summary of types of participants in attendance. The purpose of the seminar was to provide senior national experts, policy makers, planners, and executives (in conjunction with UN representatives) with a forum for examination of issues and to propose recommendations and solutions. The level of awareness must be raised among officials and the public. Policy instruments and action must be identified in order to contribute to sustainable growth and the alleviation of poverty. The principle components of a national environmental strategy were to be outlined. The National Council for Environmental Protection needed to be reactivated. After the opening statements, the topics included in this presentation were the organization and agenda for 5 working groups, development projects and environmental considerations, environmental legislation and institutions, marine and coastal areas environment and resources, environmental awareness and education and human resources, policies and future trends, the seminar declaration and recommendations, and closing statements. The full text is provided for the opening statements, the closing statements, and the background papers. Lists of additional background papers and the seminar steering committee members are also given. The seminar declaration referred to the interlocking crises of development, environment, and energy. Population growth threatens world survival, particularly in the poorest countries. Expected economic growth will further deplete environmental resources and contribute to pollution. The world is bound together by these concerns. International debt forces poor countries to overexploit resources and destroy their production base. Developing countries are still in economic disarray. Economic reform hasn't worked for poor countries, and the resource gap is widening between countries. The answer is sustainable development, which is based on an equitable and rational exploitation of natural resources. International cooperation and peace must be strengthened dialogue and understanding and support for the UN.
NGO's Role and Involvement in the Prevention and Control of AIDS, New Delhi. Report of a regional workshop, 30 October - 1 November 1990.
[Unpublished] 1991 Feb 19. , 19 p. (SEA/AIDS/22; WHO Project: ICP GPA 511)This regional workshop aimed to exchange information, inform nongovernmental organizations (NGOs) on the epidemiology and control of AIDS, share the experience of NGOs, identify improvements in the involvement of NGOs in AIDS control programs, and understand the impact of discriminatory measures. Topics for discussion were the global and the southeast Asian regional AIDS/HIV situation and control, the role of NGOs in control, the legal, ethical, and human rights issues in AIDS prevention and control, and the involvement of NGOs in prevention and control of AIDS. participants represented Bhutan, India, Indonesia, Maldives, Mongolia, Myanmar, Nepal, Sri Lanka, Thailand, India, and the WHO secretariat. NGOs provide information, education, policy advocacy, training, counseling, and assistance to those affected by HIV/AIDS. The methods used were culturally-sensitive mass media; a positive, holistic, and flexible approach; promotion of self esteem and confidence in target groups; target group representation; maintenance of direct contact and education for specific groups; policy advocacy; research and monitoring functions; peer group formation support; public awareness creation; and provision of medical services. Recommendations were made to NGOs to collaborate with one another and with governments, to help strengthen international and national cooperation for AIDS prevention and control, to monitor media information for reliability and uniformity and contextual relevance and lobby for necessary changes, and to set an example of human and compassionate treatment and respect the rights of AIDS/HIV and marginalized groups to medical and social services and treatment, education, employment, housing, social life, freedom of movement, freedom of choice on blood testing, and freedom from discrimination. NGOs involved need to mobilize other NGOs in AIDS prevention. Governments should include NGOs on national AIDS committees, particularly those which are community-oriented, and not politically affiliated and those which work with women and marginalized groups. Governments need to update curricula and provide family life education including education on AIDS for formal and informal groups and government officials. Governments should also set an example of responsible behavior which respects the human rights of people with AIDS, fund NGOs to train trainers, and use mass media. WHO should be more sensitive to the needs of NGOs and work to keep NGOs in the information loop of international and national governments.
Status of family planning activities and involvement of international agencies in the Caribbean region [chart].
[Unpublished] 1970. 1 p.Add to my documents.
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.
IMMUNIZATION FOCUS. 2000 May; 1.After the launching of the Global Alliance for Vaccines and Immunization (GAVI), more than 50 countries have signed up to participate in its initiative of providing a wider immunization program. After an initial gift of US $750 million over 5 years from the Bill and Melinda Gates Foundation, these countries detailed their current immunization activities, plans, and needs. Part of the Global Fund for Children's Vaccines is to be spent on newer vaccines, such as those against hepatitis B and yellow fever, which many governments are eager to introduce. GAVI announced that it needed US $200 million more per year, on top of the US $150 million per year already pledged to the fund, to reduce by half the number of un-immunized children in poor countries by the year 2005.
New York, New York, UNFPA, 1993. vii, 95 p.The results of a family planning program review and strategy evaluation are reported by the UN Population Fund mission to Malaysia. This report provides background information on socioeconomic and demographic conditions, the National Population Policy and its development, and plans and programs of the National Population Program for Malaysia. Information is also given on the extent of external assistance received from multilateral, regional, bilateral, and nongovernmental organizations. Demographic conditions are described as including a population growth rate of 2.6% annually. The highest population growth rates are in Sabah (5.7%). Contraceptive prevalence in 1988 is reported as 49%, but 41% of needs for birth spacing and limitation are not being met. The quality of life among poor Malays in rural areas has improved very little. The National Population Program, which was established in 1966, aims to balance economic and demographic conditions, to educate and train a population for adjusting to socioeconomic changes, and to develop and promote responsible life styles. A National Policy on Women, which was adopted in 1989, is included in the 1991-95 plan of action. Improvements are reported as necessary among high risk mothers over 35 years of age and with high parities and in the contraceptive delivery system. Internal migration and urbanization create pressures on the environment and on the infrastructure. Government policy is reported to have shifted to a multisectoral, multidisciplinary approach and to community based programs. Suggestions are made to enhance population and development planning and research in Sabah and Sarawak and to expand and direct IEC to male audiences. Training is needed for sensitizing personnel to gender issues. Support is needed for the National Clearinghouse for women and action oriented women's projects.
Japan fully endorses ICPD Program of Action. Deputy expresses support for reproductive health and partnerships with NGOs.
JOICFP NEWS. 1994 Nov; (245):1.Japan as well as the US desire to promote the worldwide effort to respond to population and AIDS issues. The Global Issues Initiative, supported by both countries, was established in February 1994 for international support of population and AIDS. Japan, as part of its official development assistance, is the largest donor and plans to contribute between 1994 and 2000 about $3 billion. Japan also endorses the Program of Action recommended by the International Conference on Population and Development (ICPD) in September 1994. Japan supports a comprehensive approach to the population issue which includes policies on basic health, education, and the status of women. Reproductive health is considered very important in addressing the population issue. There must be respect for human rights, improvement in the status of women, and promotion of women's participation in decision making. Japan's efforts toward this end have included the Global Initiative and distribution of a Maternal and Child Health Handbook, which includes reproductive health information for the adolescent, pregnant mother, and nurturing mother. Information is provided on child care, childbirth, and pregnancy and is directed to helping women make informed choices. Fertility and mortality decline in Japan has been accomplished through informed choice of women and changed attitudes and conduct of men. Governments and international organizations do not always deliver adequate services. The role of nongovernmental organizations in filling the gaps in service delivery is recognized by Japan as essential. Grassroots organizations complement existing structures and operations. Japan's endeavors to increase support for grassroots projects in its bilateral programs from planning stages through project implementation. Japan hopes that the UN Plan of Action will be adopted internationally, which would provide a supportive community for cooperative effort. The delegation to the ICPD was headed by Deputy Prime Minister of Foreign Affairs Yohei Kono, and this article provided a summary of his address to the ICPD.
FOCUS ON GENDER. 1994 Jun; 2(2):6-12.A broad overview was provided of the changes occurring in women's health in the context of donors. In the 1990s, women's health issues began to be addressed by reproductive health rather than by family planning and maternal and child health programs in official and nongovernmental development programs (NGOs). The World Health Organization definition of reproductive health includes the right of to regulate and control their own fertility. There is international donor recognition, such as the United Nations Population Fund support for the WHO definition, children by choice, and reproductive health services for women. Family planning programs have tended to use the "welfare approach" of targeting women as mothers, and their children. Welfare programs began distribution of contraceptives, when the US Agency for International Development began in the 1960s its policy of contraceptive promotion. Target populations in developing countries were reached through social welfare and health service programs, which included women as passive recipients. The issues of poverty, environmental degradation, and violence were unheeded. The period of 1975-85 marked the emergence of discussion about women's role in society. Links were made between high fertility and low status. The research focus was on determinants of fertility decline, regardless of equity issues. Women were encouraged to become involved in political, social, economic, and education activities as a means of creating a "favorable climate for pursuing population...goals." The development literature relegated women to the subordinate position of meeting demographic objectives. The focus on poverty alleviation opened up the literature to the complexities of the relationships between fertility, education, and work. Empowerment has grown out of the framework and enhanced development. Reproductive health programs are still limited in their offerings, but there has been expansion through the linkages with NGOs. Women's preparatory meetings before the Cairo conference have stressed that gender equity and reproductive rights be placed within a broad framework with policy support.
Bethesda, Maryland, University Research Corporation, 1991 Apr. ix, 77,  p. (BAN-14; USAID Contract No. DPE-3030-C-00-5043-00; TvT No. BAN-SAS-04-10)Save the Children has a women's savings program (SAVE), which is an integral part of its comprehensive integrated rural development program. Women's savings groups were introduced in Bangladesh on an experimental basis in 1982. Over the years, these indigenous small groups have evolved from simple "savings" groups to dynamic forums to improve women's economic and social horizons and enable them to gain greater control over their lives and those of their children. An operations research study was undertaken, at a cost of US $35,874, to examine and document the impact of womens' savings groups on contraceptive use. The study was undertaken in 8 villages in Nasirnagar Upazila where SAVE programs were in operation: 5 villages where programs were initiated in 1982 (old villages) and 3 villages (new villages) where programs were begun in 1989. 2 comparison villages (without SAVE programs) were also selected at random from among the villages in the same geographic area. The experimental and comparison villages were similar in terms of household size, age, parity, and total fertility of the married women of reproductive age. The study employed a quasi-experimental design. Data were collected using a baseline survey and a mini-contraceptive prevalence survey conducted in both experimental and comparison villages as well as 2 rounds of individual and group interviews with selected savings group members and nonmembers in the experimental villages. Relevant cost data were obtained from SAVE/Dhaka. Selected variables from the SAVE project management information systems (PMIS) were also used for comparison with similar variables obtained in the baseline survey. Womens' savings groups, combined with family planning (FP) motivation, supplies, and services can be an effective strategy of raising contraceptive prevalence in rural Bangladesh. Contraceptive use, both ever and current, was higher in the experimental than in comparison villages and was higher in the old than in the new villages. Contraceptive use was higher among savings group members than among nonmembers, and contraceptive use was higher among the latter group than in the comparison villages, suggesting that the SAVE program helped raise contraceptive use among both members and nonmembers in the project villages. Current use at the baseline among members was 30.9 and 16.9% among members in old and new villages, respectively, and 7.3% in the comparison villages. Among nonmembers, current use was 17.9% in the old villages and 12.9% in the new villages. Current contraceptive use declined from 30.9 to 25.4% in the old villages over the life of the project. One of the main reasons reported for discontinuation was nonavailability of FP methods.
Evaluating the effectiveness of newly introduced interventions in Pathfinder Community Based Service (CBS) projects: a report on an operations research project.
Chevy Chase, Maryland, University Research Corporation, Family Planning Operations Research / Asia Project, 1987 Dec 20. 78 p. (BAN-07; USAID Contract No. DPE-3030-C-00-5043-00)In Bangladesh, the Pathfinder Fund operates community-based distribution (CBD) family planning (FP) projects in 24 urban areas. While implementing these projects, Pathfinder discovered a number of interrelated operational problems including inadequate coverage of clients, inaccurate record-keeping, and poor planning and supervision of field operations. Therefore, 3 management interventions, a new workplan system, reduced client-worker ratio, and a simplified recordkeeping and control system, were tested in different combinations or packages in 7 of the 24 areas served. An operations research study, which cost US $58,612, examined whether the interventions had been implemented as planned and assessed the impact of the interventions on improving coverage, acceptance, and prevalence of FP. A nonexperimental design was used, because the program was not set up as a research project and no baseline data or control groups existed. Data were collected from secondary sources, service statistics, interviews with project staff and key informants, and a representative survey of 1,400 married women of reproductive age, 200 from each of the project areas. A combination of all 3 interventions proved to be the most effective package, followed by a combination of the workplan and reduced client/worker ratio. The new workplan alone seems to be the most effective single intervention. Contraceptive prevalence was highest in an area when all 3 interventions were introduced and lowest when only one was introduced. The workplan systematized the workers' activities, ensured regular visits to assigned couples, facilitated supervision, expanded coverage, and improved contact. The simplified recordkeeping system systematized recordkeeping, helped promote effective supervision and monitoring, and aided in evaluation of worker performance. Based on the findings, Pathfinder has introduced the 3 interventions in all its CBD project sites.
Washington, D.C., World Bank, 1992. , 26 p. (Poverty and Social Policy Series Paper No. 1)This discussion of ways to achieve sustainable development, which is synonymous with poverty reduction, has grown from the World Bank's effort to assess the institutional aspects of development. The operation of the World Bank has been based on the market principal of demand stimulating supply. When it comes to the poor, however, service organizations have tended to decide what services were needed and to supply those services, instead of being driven by demands generated by the poor themselves. Allowing poverty reduction programs to be energized by the demands of the poor and regarding the poor as customers rather than as beneficiaries would empower the poor to increase their opportunities for self-fulfillment. Demand, of course, can be nurtured when its impediments are understood; it can also be enhanced by improving the quality of services. Application of these practices in the fields of education, population, health, and nutrition are described, with an in-depth look at the Yemen Arab Republic's Second Education Project. The relationship of demand to water and sanitation services is also considered. An understanding of the needs of the poor is gained in 2 ways. First, the informal institutions through which poor people act must be examined by participating in a learning process using qualitative techniques such as focus group interviews, social marketing, and participant observations. Beneficiary assessment is an especially important strategy during project design and project evaluation. Second, direct staff exposure to the poor is essential, since some aspects of poverty defy objective analysis. If development efforts lead to a thickening social web of nongovernmental organizations, with an attendant use of local personnel, an understanding of the grassroots realities of poverty will be enhances. When the efforts of informal groups are combined with those of formal organizations, sustainable poverty reduction can be achieved. The organizational implications of this approach are considered, including intermediation, organizational pluralism and competition, demand as "voice," nongovernment organizations, catalysts, and training. In-depth examples of this principle at work are given for the Korean experience in financing universal primary education, the Malawi Rural Water Supply Project, and the Menaka integrated development project in Mali. Operational implications are also detailed with particular emphasis on adopting a learning stance and on staffing. This recommended inversion in the operating principles of the World Bank will help the public sector achieve a vision of development as a process that enables clients to release themselves from poverty.
[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.
International Family Planning Perspectives. 1993 Jun; 19(2):61-6.The constituents of women, population, and the environment proved to be explosive when representatives from the 3 groups came together during preparations for the UN Conference on Environment and Development (UNCED), which took place in Rio de Janeiro in June 1992. In its aftermath, feminists, population planning advocates, and environmental activists were concerned about the direction of their respective movements and the future of cooperative ventures. The key parties desire reconciliation, as time is approaching for meetings sponsored by the UN: the International Conference on Population and Development, in Cairo in 1994, and the next international women's conference, in Beijing, China, in 1995. Representatives of a wide array of nongovernmental organizations (NGOs) confronted the government delegations during the final governmental preparatory committee meeting in New York just prior to UNCED. The draft of the meeting's official document, known as Agenda 21, made a compelling case for the population-environment link. The US delegation sent by the Bush Administration insisted on deleting from Agenda 21 any references to changes in behavior aimed at reducing consumption in the industrialized world. The Vatican's goal was to deemphasize the population issue in the global environmental debate and to eliminate any mention of family planning (FP). In Rio at UNCED, many prominent government delegates addressed population stabilization for sustainable development. Population planning and environmental activists insisted that rapid population growth is a critical international issue and that FP can be perceived as a social and individual good. Many feminists would prefer that the world debate about population focus less on fertility-related phenomenon and more on how population size and growth affect a particular community and lifestyle. The National Wildlife Federation observed that environmentalists must devote more attention to the consumption issue in the industrialized world.
BRITISH JOURNAL OF GENERAL PRACTICE. 1990 Aug; 40(337):341-4.In spite of Vietnam's 40-year history of war, infant mortality rate of 50-60/1000 live births in urban areas, life expectancy of 55 years for women and 61 years for men, growth rate of 21.5/1000 population and population totaling 61-66 million in 1986, the health status of the Vietnamese, is better than the mean for all African countries and no worse than developing countries with a GNP per head greater than Vietnam's US 210. The incidence of infectious disease remains high for both adults and children, with malaria leading for adults and diarrheal disease for children as well as malnutrition due to dietary insufficiency. Air pollution, poor sanitation, and chemical pollution of water supplies pose a serious threat to health in Saigon, as do dioxin-related diseases in the surrounding countryside. A decentralized government hospital service with health centers in all communities provides 1 doctor for every 18,000 population. This system is criticized for lack of attention to socioeconomic conditions or diet. The health care strategy developed in 1986 targets the following goals for 1990: adequate nutrition, drinking water, essential drugs, and sanitation as well as more extensive immunization, family planning services, and home treatment of illness. Along with the 3000 community health centers, community health workers provide basic treatment and health education from their homes. Although the health system is paternalistic, vital provisions of salts and sugars for combating diarrhea, and A and D supplements and food are given to the poor. Dr. Duong Quynh Hoa's pediatric research institute, children's hospital, and new medical school are principally concerned with the development of socioeconomic conditions where the doctor is only 1 among many collaborating to improve the quality of life. One pediatric center project, for example, has been successful in promoting the active participation of people in an environmental hygiene program, a clean drinking water program, immunization efforts, and a diarrhea control program funded through UNICEF, WHO, and French and British charities. Investment is being sought from developed countries for economic development and food aid.
In: Overcoming world hunger, [compiled by] Columbia University. American Assembly. Englewood Cliffs, New Jersey, Prentice-Hall, 1969. 137-70.The role of the US in facing the problems of population growth and food supply in less-developed countries is discussed. In April, 1967, the International Planned Parenthood Federation held its International Conference at Santiago, Chile, and some 25 countries adopted official policies encouraging family planning. Despite the Pope's statement in July, 1968, endorsing only the rhythm method of fertility control, government leaders around the world were increasingly emphatic about the population problem. The United Nations was expected to develop a strong program in the population field. Most of the increases in population would come in less-developed regions and demands for food would rise faster than population growth rates. A 4% increase of annual rates in grain production in developing countries was needed, nearly double their historic rates. Many new wheat, corn, and rice crop varieties were developed at the international research centers established by the Rockefeller and Ford Foundations. Much of the fertilizer to produce the bumper 1967-68 crop of food grains in India was financed by USAID. To build a competent technological and scientific research and development system for agriculture in less-developed countries requires the training of many young scientists and cooperation among national institutions in the developing countries. To establish incentive prices for agricultural products must be a central objective of national policy in developing countries in order for rapid agricultural growth to occur. A policy which would enable developing countries to achieve self-sustaining growth would give and top priority to their food and population problems would cost the US between .5 and 1% of its gross national product. This US policy could have very important effects in 5 to 10 years if it were combined with strong development programs and matching aid from advanced countries. The US has promoted multilateral assistance, but some other developed countries have been reluctant to raise their contributions.
In: Overcoming world hunger, [compiled by] Columbia University. American Assembly. Englewood Cliffs, New Jersey, Prentice-Hall, 1969. 89-135.Advances in physics, geology, chemistry, and biology have provided information about how soils affect plant and animal productivity. In agriculture, adaptive research involves 1) the development of crop varieties with the greatest productive capacity which are also resistant to pests, 2) practices that will maximize yields, 3) the determination of nutritional requirements, and 4) studies of the quality of harvested products. Successful programs necessitate the careful study of national needs; research and production goals; research and training programs through existing or newly created institutions; capable career scientists placed in charge with the needed technical and financial support; college graduates being trained through internships; the most outstanding people given opportunities for advanced study for leadership; and the provision of markets by governments, with incentive prices, credit at reasonable rates, and the development of irrigation schemes. Multinationals which can provide technical help include the Food and Agriculture Organization of the United Nations, the United Nations Development Program, the International Bank for Reconstruction and Development, the Inter-American Development Bank, the Asian Development Bank, and the Colombo Plan. The successes of USAID include a project in Turkey to increase spring-wheat productions; Operation Spread in the Philippines which aided that country's self-sufficiency in rice; and a highly effective corn production campaign in Kenya. As a result of a cooperative venture in the early 1940s between Mexico and The Rockefeller Foundation, by 1968 Mexico's national average wheat yields/acre were almost quadruple the average in 1043, corn yields were double those of 1943 and potato production was more than triple that of 1950. The Ford and Rockefeller Foundations in 1961 jointly founded the International Rice Research Institute located at Los Banos, the Philippines. The International Corn and Wheat Improvement Center (CIMMYT) evolved from The Rockefeller Foundation's earlier cooperative work in Latin America, CIMMYT conducts fundamental research on corn and wheat, and cooperative relationships are maintained with interested countries in Latin America, Asia, East and West Africa, and the countries of the Near East.
Washington, D.C., World Bank, 1987. xi, 62 p. (World Bank Technical Paper No. 61)The problem of desertification in the Sahelian and Sudanian Zones (SSZ) of West Africa is addressed. Desertification is defined as the process of sustained decline in biological productivity of arid and semiarid land. Desertification is complex and poorly understood and is caused by the interaction between drought and human abuse. Better management is a viable long term solution. In the SSZ, there is variable rainfall and low fertility soil, and resources are overexploited by humans. The focus of discussion is on defining the nature of the problems and the geographic features of the SSZ; the problem is complex and multifaceted and includes population pressure. The nature of and pressures on traditional production systems (agrosylvicultural, agrosylvipastoral, and sylvopastoral) are described as well as the carrying capacities of traditional production systems. Past development activities and common weaknesses of development activities are reviewed with reference to the agricultural, livestock, and forestry sectors. The elements of a strategy for better resources management are delineated. Some general observations are made. Actions are defined with reference to pressure on 1) carrying capacity (CC) in areas where the ratio of population (RP) does not exceed CC, where RP slightly exceeds OC, and where RP greatly exceeds CC; the issue of irrigation increasing carrying capacity is dealt with. Other elements are 2) upgrading competence in research and training, 3) reducing demand (population and wood), and 4) the policy environment (land law and incentives). Implications for actions are indicated for the members of the Comite Inter-Etats de Lutte contre la Secheresse dans le Sahel, governments, financiers in general, and for the World Bank group in particular. A statistical appendix is provided with information on land distribution, soil suitability, population and distribution by a number of factors, and carrying capacity. Elementary erosion techniques and research orientations also are provided.