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Draft team member contributions to mid-term evaluation of the Population and Family Planning Project (608-0171) in Morocco.
[Unpublished] 1988 Mar. 13 p.The draft team member contributions to the mid-term evaluation of the population and family planning project in Morocco examine current progress and address future needs. Increased awareness of at least 1 method of family planning was attributed to a USAID-funded project. But, problems of access, religious constraints, and lack of method-specific media campaigns need to be addressed. An increased effort to direct promotion efforts toward men is needed, as a prior immunization program showed that the husband was a key factor in encouraging mothers to bring their children to be vaccinated. Because the local health worker plays a critical role at the community level, training and support for these workers should be emphasized. Media-specific and audience-specific campaigns, by the government and private sector, should focus on the most cost-effective means of reaching the provincial level population. Donor organizations (such as UNICEF, UNFPA and USAID) should address the IEC needs identified by the central health education office, whose role and supporting functions need to be strengthened. Content of family planning materials must be method-specific, using a systematic methodology to address problems of inappropriateness, inadequate contraceptive mix, and lack of field worker training materials. Improved distribution methods for existing materials, as well as increased use of television and mass media are viable options. Using the community more effectively by encouraging leader motivation and instituting incentives could help to improve promotional and distributional activities at the provincial level. An evaluation of training needs revealed that the workshop method of training may be overemphasized, and most health workers expressed a desire for lengthened training. The private sector could be sensitized to public health issues and needs and, in conjunction with out of country technical assistance, produce effective social marketing of contraceptives within the Moroccan context. Coordination with other donors would be beneficial, with the exchange of documents and meetings between the groups.
Grass roots, herbs, promoters and preventions: a reevaluation of contemporary international health care planning. The Bolivian case.
Social Science and Medicine. 1983; 17(17):1281-9.In evaluating a United States Agency for International Development (USAID) project in Bolivia, the author argues that the program unwittingly contributed to the situation that created Bolivia's political problems. A 5-year pilot project which covered 39 villages and colonies in the Montero district in the state of Santa Cruz began in 1975 and was completed in 1980. In 1980 the project was "deobligated" when all but essential economic aid to Bolivia was halted following a political coup. The pilot project was based on 1) community participation through health care; 2) a referral system from health post of the promotor to the center with an auxiliary nurse midwife, to secondary and tertiary care in hospitals by physicians; 3) an emphasis on preventive medicine; and 4) the use of traditional medicine along with other therapy by the promotor. Although these concepts sound appropriate, they are in fact derived from contemporary thought in advanced industrial societies. The assumptions about social reality that are inherent in these plans actually misconstrue Bolivian society. The unintended consequences of the project actually diminish rural health care. A difference between the Western health planner's conception and the Bolivian conception--of community, of effective referral systems, of preventive and indigenous medicines--can have the effect of producing a health care program that has little resemblance to what was originally intended. The Bolivian elite actually manipulated the USAID health care programs through hegemony in the villages. The Jeffersonian concept of community is not applicable in Bolivia where resources are only exchanged through personal contacts. In villages of multiple class or ethnic groups or both or in villages with close ties or histories of ties with larger, more cosmopolitan groups, multiple different interests exist. These work against each other to prevent the very cooperation envisioned by the health care programs. The author suggests that developed countries should consider native ideologies, native social relations, and indigenous medicine more sensitively in design.
Integrating oral rehydration therapy into community action programs: what role for private voluntary organizations?
Washington, D. C., CEFPA, 1980. 42 p.A workshop, sponsored by the Centre for Population Activities, the National Council for International Health, and the Pan American Health Organization, meet in 1980 to discuss the use of ORT (oral rehydration therapy) in health and development programs and to determine how private and voluntary organizations could be encouraged to become involved in efforts to extend ORT availability. ORT is a technique for reducing dehydration in patients suffering from prolonged diarrhea. Diarrhea related dehydration is a serious problem among children in developing countries, especially among malnourished children. In 1975, 5 million children under 5 years of age died from diarrhea in Latin America, Africa, and Asia. The therapy consists of administering a solution of sodium chloride, sodium bicarbonate, potassium chloride, glucose, and water to the patient in order to balance the composition of body fluid. Initially the solution had to be administered intravenously at a treatment center; however, the solution can now be administered orally to mildly or moderately dehydrated patients by the patient's family in the home setting. The solution is given to the patient frequently and amount is determined by the patient's thirst for the solution. Packets containing enough dry ingredients to mix with 1 liter of water are now available. These packets can be centrally or locally manufactured. The solution can be mixed at health centers upon request, or the packets can be distributed directly to family members who are then taught how to mix and administer the solution. Various community action programs can incorporate an ORT component. Personnel in these community action programs, working at all organizational levels, should receive training in ORT. Community workers should receive intensive training so that they in turn can teach families in the community to use the therapy. The programs should use all available communication channels to send out accurate messages about ORT. The program should also organize the distribution of the packets and develop evaluation procedures for the ORT program component. WHO, UNICEF, USAID, and the National Council for International Health provide various forms of assistance to governments or to private and voluntary organizations interested in developing ORT programs.
CBFPS (Community-based Family Planning Services) in Thailand: a community-based approach to family planning.
Essex, Connecticut, International Council for Educational Development, 1978. (A project to help practitioners help the rural poor, case study no. 6) 91 pThis report and case study of the Community-Based Family Planning Service (CBFPS) in Thailand describes and evaluates the program in order to provide useful operational lessons for concerned national and international agencies. CBFPS has demonstrated the special role a private organization can play not only in providing family planning services, but in helping to pioneer a more integrated approach to rural development. The significant achievement of CBFPS is that it has overcome the familiar barriers of geographical access to family planning information and contraceptive supplies by making these available in the village community itself. The report gives detailed information on the history and development of the CBFPS, its current operation and organization, financial resources, and overall impact. Several important lessons were learned from the project: 1) the successful development of a project depends on a strong and dynamic leader; 2) cooperation between the public and private sectors is essential; 3) the success of a project depends primarily on the effectiveness of community-based activities; 4) planning and monitoring activities represent significant ingredients of project effectiveness; 5) a successful project needs a sense of commitment among its staff; 6) it is imperative that a project maintain good public relations; 7) the use of family planning strategy in introducing self-supporting development programs can be very effective; 8) manning of volunteer workers is crucial to project success; and 9) aside from acceptor recruitment in the short run, the primary purpose of education in more profound matterns such as childbearing, womens'roles in the family, and family life should also be kept in mind. The key to success lies in continuity of communication and education.
In: Inter-Governmental Coordinating Committee (IGCC) and The Population Commission of the Philippines. Financial management of population/family planning programmes. (A Report of the IGCC Regional Workshop/Seminar on the Financial Management of Population/Family Planning Programmes, Manila, Philippines, March 15-17, 1976). Kuala Lumpur, Malaysia, IGCC, . 139-56.The Philippine government indicated its support for family planning as an organized policy in 1968. Since that time, the program has received financial support from the government and from various international organizations, most notably USAID and UNFPA. The Philippine national program has experimented with certain incentive policies to influence family size. The Commission on Population is the governmental central policy-making, planning, and funding agency for population concerns. The Commission's approach is noncoercive. It stresses clinic service, training, information/education/communication, and research. Funding and financial management for the program are discussed. There is a need to increase the program's outreach to rural communities. Planning must originate from provincial and regional levels, not from central administration. Experiments have been done to involve rural workers and to treat family planning as an integral part of the national development program. Recommendations are made for ways in which to improve existing service and extend it into other areas of planning and research.