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Vaccine. 2016 Oct 10; 34(43):5144-5149.BACKGROUND: The African Region is set to achieving polio eradication. During the years of operations, the Polio Eradication Initiative [PEI] in the Region mobilized and trained tremendous amount of manpower with specializations in surveillance, social mobilization, supplementary immunization activities [SIAs], data management and laboratory staff. Systems were put in place to accelerate the eradication of polio in the Region. Standardized, real-time surveillance and response capacity were established. Many innovations were developed and applied to reaching people in difficult and security challenged terrains. All of these resulted in accumulation of lessons and best practices, which can be used in other priority public health intervention if documented. METHODS: The World Health Organization Regional Office for Africa [WHO/AFRO] developed a process for the documentation of these best practices, which was pretested in Uganda. The process entailed assessment of three critical elements [effectiveness, efficiency and relevance] five aspects [ethical soundness, sustainability, involvement of partners, community involvement, and political commitment] of best practices. A scored card which graded the elements and aspects on a scale of 0-10 was developed and a true best practice should score >50 points. Independent public health experts documented polio best practices in eight countries in the Region, using this process. The documentation adopted the cross-sectional design in the generation of data, which combined three analytical designs, namely surveys, qualitative inquiry and case studies. For the selection of countries, country responses to earlier questionnaire on best practices were screened for potential best practices. Another criterion used was the level of PEI investment in the countries. RESULTS: A total of 82 best practices grouped into ten thematic areas were documented. There was a correlation between the health system performances with DPT3 as proxy, level of PEI investment in countries with number of best practice. The application of the process for the documentation of polio best practices in the African Region brought out a number of advantages. The triangulation of data collected using multiple methods and the collection of data from all levels of the programme proved useful as it provided opportunity for data verification and corroboration. It also helped to overcome some of the data challenge. Copyright (c) 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.
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.
Lancet. 1995 Jul 29; 346(8970):301.The World Bank, in "India's Welfare Programme: Towards a Reproductive and Child Health Approach," a review done with the Ministry of Health and Family Welfare, makes the following recommendations: 1) eliminate method-specific contraceptive targets and incentives, and replace them with broad reproductive and child health goals and measures; 2) increase the emphasis on male contraceptive methods (which account currently for only 6% of contraceptive use); 3) improve access to reproductive and child health services; 4) increase the role of the private sector by revitalizing the social marketing program; and 5) encourage experimentation with an expanded role for the private sector in implementing publicly funded programs. Since the launch of the family planning program in 1951, mortality has fallen by two-thirds, and life expectancy at birth has almost doubled. However, the population has almost doubled since 1961. By 2025, it is expected to be 1.5-1.9 billion. By 1992, India had achieved 60% of its goal for replacement fertility (2.1 births per woman), decreasing from 6 births per woman in 1951-1961 to 3-4 births per woman. Meeting India's unmet need for family planning would allow the replacement fertility goal to be reached. Female education and employment would add to the demand for smaller families and assure continuing declines in fertility and population growth rate. The report also highlights problems in implementation of the program, including program accessibility and quality of care. The report cites National Family Health Survey data which shows that only 35% of children under 2 received all six vaccines in the program, while 30% received none. The bank's "1993 World Development Report" recommended spending $5.40 per head for maternal and child health and family welfare programs; India spends $0.60. Massive borrowing will be required.
FRONT LINES. 1989 Dec; 6, 13.Projects supported by the Directorate for Population (S&T/POP) of the U.S. Agency for International Development and aimed at increasing for-profit private sector involvement in providing family planning services and products are described. Making products commercially available through social-marketing partnerships with the commercial sector, USAID has saved $1.1 million in commodity costs from Brazil, Dominican Republic, Ecuador, Indonesia, and Peru. Active private sector involvement benefits companies, consumers, and donors through increased corporate profits, healthier employees, improved consumer access at lower cost, and the possibility of sustained family planning programs. Moreover, private, for-profit companies will be able to meet service demands over the next 20 years where traditional government and donor agency sources would fail. Using employee surveys and cost-benefit analyses to demonstrate expected financial and health benefits for businesses and work forces, S&T/POP's Technical Information on Population for the Private Sector (TIPPS) project encourages private companies in developing countries to invest in family planning and maternal/child health care for their employees. 36 companies in 9 countries have responded thus far, which examples provided from Peru and Zimbabwe. The Enterprise program's objectives are also to increase the involvement of for-profit companies in delivering family planning services, and to improve the efficiency and effectiveness of private volunteer organizations in providing services. Projects have been started with mines, factories, banks, insurance companies, and parastatals in 27 countries, with examples cited from Ghana and Indonesia. Finally, the Social Marketing for Change project (SOMARC) builds demand and distributes low-cost contraceptives through commercial channels especially to low-income audiences. Partnerships have been initiated with the private sector in 17 developing countries, with examples provided from the Dominican Republic, Liberia and Ecuador. These projects have increased private sector involvement in family planning, thereby promoting service expansion at lower public sector cost.
HEALTH POLICY AND PLANNING. 1991 Dec; 6(4):327-35.Many non-governmental organizations (NGO) remained in the Wollo region of Ethiopia following famine relief and emergency medical service efforts of 1984-85. Since then, these organizations have helped identify strategies and processes needed to implement Ministry of Health (MOH) policies, especially in the area of integrated maternal-child/curative health services. This paper discusses the strengths and weaknesses of 4 broad approaches to health development adopted by the NGOs over the post-famine relief period of 1986-88, and considers further strategic adaptation in later years. Under the themes of direct management, clinic adoption, impact area, and air-drop resources, earlier NGO approaches largely suffered poor sustainability, non-replicability, and inefficient use of resources. Moreover, these approaches distracted the MOH from pursuing its own viable approaches, effectively stymieing the development of district and regional health systems. Later NGO approaches support improvements in the MOH's priority health programs through the provision of technical and material assistance for analyzing, developing, and implementing improved systems of district health management and care. NGOs wishing to adapt their existing programs into a comparable health systems approach should build upon existing relationships with the MOH in support of district and regional health services, foster skill development among indigenous health personnel, seek avenues to improve efficiency, and promote activity-based training and regional and district health team management.
Nairobi, Kenya, Family Planning Association of Kenya, 1980. , 164 p.The proceedings of the Second Management Seminar for senior volunteers and staff of the Family Planning Association of Kenya (FPAK), held in December 1979, with appendices, are presented. The 1st 3 days consisted of lectures and plenary discussions on topics such as communication strategies, family guidance, youth problems, and contraceptive methods; the last 2 days were group discussions, reports and summary evaluations. 40 participants took part in the evaluation, expressing satisfaction with knowledge gained in communications, family life education, and IPPF organization and skills. They expressed the need to learn more about family counseling, youth problems, population, and integrated approaches. The seminar recommended that FPAK be more innovative to retain volunteers, plan its communication strategy more carefully, train and involve volunteers in programming, study traditional family planning methods, provide family counseling services, fully exploit the media, and use it to clarify misconceptions and introduce community-based distribution.
In: Management information systems and microcomputers in primary health care, edited by Ronald G. Wilson, Barbara E. Echols, John H. Bryant, and Alexandre Abrantes. Geneva, Switzerland, Aga Khan Foundation, 1988. 17-20.A wide array of issues must be addressed if the development and use of management information system (MIS) and microcomputers are to improve management of primary health care (PHC) programs and increase the equity and cost-effectiveness of PHC. These issues include: specification of the purpose and objectives of MIS at community and district levels; distinquishing types of information required; the understanding of organizational issues that must be resolved as a result of introducing MIS; the practical definition of the most useful indicators of program effectiveness and efficiency; the specification and monitoring of data collection, compilation, and analysis requirements and procedures; procedures for generating and using processed MIS data and management information; the PHC program's capacity to absorb technological innovations; and personnel requirements. The need for improved data systems must be recognized. Data quality and systematic flow of information must be ensured from the field level upwards, and minimum information requirements need to be defined. The success of any MIS is heavily dependent on feedback of the data collected. Unless staff at all levels of a PHC program understand the importance of the data they are collecting, the value and use of the information system will be negligible. Examples of the Egyptian government's National Health Information System and the role of the World Bank are used to show how MIS and microcomputer can be introduced and used in PHC.
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.
In: The Population Debate: Dimensions and Perspectives, Vol. II. N.Y., U.N., 1975, pp. 506-513. (Population Studies, No. 57)Add to my documents.
Evaluation report of UNFPA assistance to the National Family Planning Programme of Thailand: Project THA/76/PO1--expansion of family planning services and support to the infrastructure of the NFPP and Project THA/76/PO5--National Family Planning Communication Programme.
New York, New York, United Nations Fund for Population Activities, April 1982. 74 p.Looks at the contribution of the United Nations Fund for Population Activities (UNFPA) to Thailand's National Family Planning Program (NFPP) and assistance given to NFPP through project THA/76/PO1: Expansion of Family Planning Services and Support to the Infrastructure of the NFPP, and THA/76/PO5: National Family Planning Communication Program. The UNFPA has been assisting population projects in Thailand since 1971. Over 90% of the funding has gone to support the NFPP in its service delivery activities, training, and information, education, and communication activities. The long range objectives of both projects was to contribute to decreasing the annual rate of population growth from above 2.6% in 1976 to 2.1% by the end of 1981. The THA/76/PO1 project was to assist the Ministry of Public Health in implementing its national population policy through expansion of its family planning service network. The THA/76/PO5 project was to assist the Ministry of Public Health in its communication program in support of family planning. Achievements and projects of the NFPP are discussed and their general strategy, planning, research, evaluation, approaches in mass communication, and small group activities are also covered. The evaluation Mission made numerous recommendations and suggestions concerning reprogramming of 1982 activities. The recommendations and suggestions were addressed to the government for its consideration and to UNFPA for policy and program decisions.