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Belize City, Belize, Ministry of Health, 1984. , 54 p. (EPI/84/003)An evaluation of the Expanded Program on Immunization (EPI) in Belize was conducted by the Pan American Health Organization/World Health Organization at the request of the country's Ministry of Health. The evaluation was undertaken to identify obstacles to program implementation, and subsequently provide national managers and decision makers with viable potential solutions. General background information is provided on Belize, with specific mention made of demographic, ethnic, and linguistic characteristics, the health system, and the EPI program in the country. EPI evaluation methodology and vaccination coverage are presented, followed by detailed examination of study findings and recommendations. Achievements, problems, and recommendations are listed for the areas of planning and organizations, management and administration, training, supervision, resources, logistics and the cold chain, delivery strategies, the information and surveillance system, and promotion and community participation. A 23-page chronogram of recommended activities follows, with the report concluding in acknowledgements and annexes.
Management information systems in maternal and child health / family planning programs: a multi-country analysis.
STUDIES IN FAMILY PLANNING. 1991 Jan-Feb; 22(1):19-30.Management and information systems (MIS) in maternal and child health were surveyed in 40 developing countries by trained consultants using a diagnostic instrument developed by UNFPA and the Pan American Health Organization (PAHO). The instrument covered indicators of input (physical infrastructure, personnel, training, finances, equipment, logistics), output (recipients of services, coverage, efficiency), quality, and impact, as well as frequency, timeliness and reliability of information. The consultants visited national and 2 provincial level administrative and service points of public and private agencies. Information on input was often lacking on numbers and locations of populations with access to services. In 15 countries data were lacking on personnel posts filled and training status. Logistics systems for equipment and supplies were inadequate in most areas except Asia, resulting in shortfalls of all types of materials and vehicles coinciding with idle supplies in warehouses. Financial reporting systems were present in only 13 countries. Service outputs were reported in terms of current users in 13 countries, but the proportion of couples covered was unknown in 25 countries. 2 countries had cost-effectiveness figures. Redundant forms duplicated efforts in half of the countries, while data were not broken down at the usable level of analysis for decision-making in most. Few African countries had either manual or computer capacity to handle all needed data. Family planning data especially was not available to draw the total picture. Often information was available too late to be useful, except in Portuguese speaking countries. Even when quality data existed, managers were frequently unaware of it. It is recommended that training and consultancies be provided for managers and that these types of surveys be repeated periodically.
Washington, D.C., PAHO, Pan American Sanitary Bureau/Regional Office of the World Health Organization, 1985. xix, 265 p. (Official Document No. 201)Efforts to meet the goal of health for all by the year 2000 have been hampered by the internal and external problems faced by many countries of the Americas. The pressures of external debt have been accompanied by a reduction in the resources allocated to social sector programs, including health programs. In addition, the conflict in Central America has constrained solutions to subregional problems. The health sector suffers from uncoordinated services, lack of trained personnel, and waste. Thus 30-40% of the population do not have access to basic health services. In 1984, the governments in the region, together with the Pan American Health Organization (PAHO), undertook projects in 5 action areas: new approaches and technology, development, intra- and intersectoral linkages, joint activities by groups of countries, mobilization of national resources and external financing, and preparation of PAHO to meet the needs of these processes. New approaches include the expansion of epidemiological capabilities and practices, the use of low-cost infant survival strategies, the improvement of rural water supplies, and the development of domestic technology. Interorganizational linkages are aimed at eliminating duplication and filling in gaps. Ministers of health and directors of social security programs are working together to rationalize the health sector and extend coverage of services. Similarly, countries have grouped to deal with common problems and offer coordinated solutions. The mobilization of national resources involves shifting resources into the health field and increasing their efficiency and effectiveness by setting priorities. External resources are recommended if they supplement national efforts and are short-term in nature. In order to enhance these strategies, PAHO has increased the managerial and operating capacity of its central and field offices. This has required consolidating programs, retraining staff, and instituting information systems to monitor activities and budgets. The report summarizes health indicators and activities by country, for all nations under PAHO.