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Family planning: a key component of post abortion care. Consensus statement: International Federation of Gynecology and Obstetrics (FIGO), International Confederation of Midwives (ICM), International Council of Nurses (ICN), and the United States Agency for International Development (USAID).
[London, United Kingdom], FIGO, 2009 Sep 25. 4 p.The International Federation of OB/Gyn (FIGO,) the International Confederation of Midwives (ICM) the International Council of Nurses (ICN) and USAID have recently issued this joint statement that makes a compelling case for the provision of voluntary family planning along with post abortion care. A key message is “The provision of universal access to post abortion family planning should be a standard of practice for doctors, nurses, and midwives in public and private health care.” It also provides some insight on organizing services to make it more practical, including providing FP at the point of service delivery. This document can be used as an advocacy tool at a variety of levels including national, district and facility level.
Toolkit to improve private provider contributions to child health: introduction and development of national and district strategies.
Washington, D.C., Academy for Educational Development [AED], Support for Analysis and Research in Africa [SARA], 2005 Jun. 50 p. (USAID Development Experience Clearinghouse DocID / Order No: PN-ADF-758; USAID Contract No. AOT-C-00-99-00237-00)June 2002, the World Bank published a discussion paper titled Working with the Private Sector for Child Health. The paper--developed with technical assistance from the USAID Bureau for Africa, Office of Sustainable Development (AFR/SD) through the Support for Analysis and Research in Africa (SARA) project--lays out a framework for analyzing the contributions of the private sector in child heath. The framework, outlined below, is designed to serve as a basis for assessing the potential of different components of the private sector at country level. The framework identifies the following components of the private sector as being important for child health: Service providers (formal sector, other for-profit, employers, non-governmental organizations [NGOs], private voluntary organizations [PVOs], and traditional healers); Pharmaceutical companies; Pharmacies; Drug vendors and shopkeepers; Food producers; Media channels; Private suppliers of products related to child health, e.g. ITNs; Health insurance companies. (excerpt)
Population and Development Review. 2002 Dec; 28(4):707-733.We begin by briefly describing the shift in population policies. We then set out two theoretical frameworks expected to account for national reactions to the new policy: first, the spontaneous spread of new cultural items and the coalescence of a normative consensus about their value, and second, the directed diffusion of cultural items by powerful Western donors. We then describe our data and evaluate its quality. Subsequently, we analyze the responses of national elites in our five study countries to the Cairo agenda in terms of discourse and implementation. In our conclusion, we evaluate these responses in terms of the validity of the two theoretical frameworks. (excerpt)
Proceedings of the Caribbean Regional Conference "Operations Research: Key to Management and Policy", Dover Convention Centre, St. Lawrence, Barbados, May 31 - June 2, 1989.
[New York, New York], Population Council, 1989. 19,  p.Objectives, proceedings, and conclusions of a Caribbean regional conference on operations research (OR) in maternal-child health and family planning programs (FP/MCH) are summarized. Sponsored by the Population Council, USAID, and UNICEF, participants included policy makers, program managers, service providers, and representatives from international agencies in health and family planning from Antigua and Barbuda, Barbados, Dominica, Grenada, Jamaica, Mexico, St. Kitts-Nevis, St. Lucia, St. Vincent and the Grenadines, Trinidad and Tobago, and the U.S. The conference was held with hopes of contributing to the legitimization of OR as a management tool, and helping to develop a network of program directors and researchers interested in using OR for program improvement. Specifically, participants were called upon to review the progress and results of recent regional OR projects, analyze the utilization of these projects by policy makers and program managers, highlight regional quality of care, and establish directions for future projects in the region. Overall, the conference contributed to the dissemination and documentation of OR, and provided a forum in which to identify important service, research, and policy issues for the future. OR can improve FP/MCH services, and make positive contributions to the social impact of these programs. The unmet need of teenagers and men and structural adjustment were identified as issues of concern. Strategies will need to be developed to maintain currently high levels of contraceptive prevalence, while responding to the needs of special groups, with OR expected to focus on the quality of care especially in education and counseling, and screening and user follow-up. The technical competence of service providers and follow-up mechanisms are both in need of improvement, while stronger institutional and management capabilities should be developed through training and human resource development.
Guidelines require comprehensive steps. Effective use of national family planning guidelines includes dissemination and regular updating.
Network. 1998 Fall; 19(1):6 p..Nearly 50 developing countries have begun developing new or revised national guidelines on family planning (FP) services. This is a collaborative process, involving providers, government officials, technical experts, and others. In developing guidelines for contraception, many national health officials have relied on recommendations developed by the WHO and US Agency for International Development. These recommendations are designed to make services more accessible, more uniform, and of higher quality. Studies also indicate that guidelines affect provider practices. However, effective use of FP guidelines includes dissemination and regular updating. It is noted that significant improvement in the process of care has been found after the introduction of guidelines. Nevertheless, successful introduction of clinical guidelines is dependent on many factors, including the methods of developing, disseminating and implementing these guidelines. Despite the challenges faced in the effective use of national FP guidelines, progress has been made in standardizing national policies that have the potential to improve access and quality.
MOTHERS AND CHILDREN. 1994; 13(1):3.The Comite Tecnico de Apoyo a la Lactancia Materna (COTALMA), the Technical Breastfeeding Support Committee, was founded in Bolivia in 1989. It is financed by the United States Agency for International Development (USAID) and the United Nations Children's Fund (UNICEF). It is administered in coordination with the Ministry of Health (MOH). MOH and UNICEF choose the hospitals, who send teams that include a pediatrician, a gynecologist, a nurse, and a nutritionist. The first phase of the course (5.5 days) covers the scientific background of breastfeeding. A baseline study is then planned and conducted at each hospital. 2 to 3 months later, the second phase takes place during which data is presented and breast feeding programs are developed for each hospital. Communication, training, counseling, and planning and evaluation are covered. Practicums are conducted at hospitals. Trainers are usually members of COTALMA. The person in charge of maternal and child health services at MOH lectures on national health policies concerning mothers and children. Training includes use of the national health card, breastfeeding and child survival, and breastfeeding as a family planning method. Culturally appropriate course materials, which are in Spanish, are adapted from those developed by Wellstart International. Articles by COTALMA members and others are added. Participants are encouraged to train all staff at their institutions.
Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1987. iii, 33,  p. (USAID Contract No.: DPE-5927-C-00-5068-00)Sudan is one of 8 USAID African child survival emphasis countries. This documents focuses upon linking the discrete areas of child survival to each other in efforts to achieve sustained reductions in national morbidity and mortality rates. The scope of the problem is briefly considered as background in the text, followed by a more in-depth presentation of government policy and programs. This section includes examination of the structure and organization of existing health services, child survival activities, and current progress and constraints. Child survival activities are listed as immunization, control of diarrheal diseases, nutrition, child spacing, malaria control, acute respiratory infections, and AIDS. The current strategy of USAID support for these activities is outlined, and includes mention of private volunteer organization and private sector participation. The role of UNICEF, WHO, and the World Bank in child survival in Sudan is also highlighted. Recommendations for child survival strategy in Sudan are presented and discussed at length in the text. Continued support to UNICEF, cost recovery and health care financing efforts through WHO, child spacing and population program support, and support to on-going USAID projects constitute USAID's priorities and emphasis in child survival strategy for Sudan. Detailed short- and long-term recommendations for immunization, control of diarrheal diseases, nutrition, child spacing, and child survival and health care financing are provided following the section on priorities. In closing, staffing and recommendations for malaria and other endemic disease, acute respiratory infections, AIDS, and management are considered. Appendices follow the main body of text.
Baltimore, Maryland, JHPIEGO, 1987. iii, 23 p.The Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) is a private, non-profit corporation affiliated with the Johns Hopkins University, and funded by the U.S. Agency for International Development (USAID). It aims to increase the availability of improved reproductive health services and the number of skilled and knowledgeable health professionals in developing countries, especially in the area of family planning. JHPIEGO has supported educational programs for over 55,000 health care professionals and students from 122 countries since 1974. In 1987, it supported 46 programs for 12, 981 participants in 26 countries. 12,821 were trained in-country, 160 attended regional programs open to professionals seeking training not offered domestically, and an additional 122 studies at the JHPIEGO educational center in Baltimore for an eventual total of 13,103 trainees. 1,719 participants were from Africa, 541 from Asia, 10,426 from Latin America and the caribbean, and 417 from the Near East. Additional accomplishments include the creation of a slide/lecture set on contraception and reproductive health for distribution to selected health care leaders with teaching responsibilities in developing countries. A French translation is being developed. Proceedings from a conference co-sponsored with the World Health Organization, Reproductive Health Education and Technology: Issues and Future Directions, should also be published in Fall, 1988. The report comprehensively describes training objectives and activities for the 4 regions and the educational center, and discusses program evaluation. It further presents training and program support statistics, trends, a financial report, and supporting figures and tables.
FRONT LINES. 1991 Nov; 16.Indonesia's success in reaching World Health Organization (WHO) universal immunization coverage standards is described as the result of a strong national program with timely, targeted donor support. USAID/Indonesia's Expanded Program for Immunization (EPI) and other USAID bilateral cooperation helped the government of Indonesia in its goal to immunize children against diphtheria, pertussis, tetanus, polio, tuberculosis, and measles by age 1. The initial project was to identify target areas and deliver vaccines against the diseases, strengthen the national immunization organization and infrastructure, and develop the Ministry of Health's capacity to conduct studies and development activities. This EPI project spanned the period 1979-90, and set the stage for continued expansion of Indonesia's immunization program to comply with the full international schedule and range of immunizations of 3 DPT, 3 polio, 1 BCG, and 1 measles inoculation. The number of immunization sites has increased from 55 to include over 5,000 health centers in all provinces, with additional services provided by visiting vaccinators and nurses in most of the 215,000 community-supported integrated health posts. While other contributory factors were at play, program success is at least partially responsible for the 1990 infant mortality rate of 58/1,000 live births compared to 72/1,000 in 1985. Strong national leadership, dedicated health workers and volunteers, and cooperation and funding from UNICEF, the World Bank, Rotary International, and WHO also played crucially positive roles in improving immunization practice in Indonesia.
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.
Washington, D.C., International Science and Technology Institute, Population Technical Assistance Project, 1985 Aug 8. v, 7,  p. (Report No. 85-48-018; Contract No. DPE-3024-C-00-4063-00)The objectives of the consultation in Madagascar were to review existing policies and programs in population and family health, to assess government and nongovernment plans and capabilities to program implementation, to review other donor activities, to identify constraints impeding population and family planning activities, and to prepare recommendations for the US Agency for International Development (USAID) assistance to Madagascar. Although the government has no officially proclaimed population policy, there is increasing direct support of family planning. The private family planning association, Fianakaviana Sambatra (FISA) was officially recognized in 1967 and is permitted to import and distribute contraceptives. Sale of contraceptives in private pharmacies also is permitted. The major organization providing family planning services is FISA. The Ministry of Health (MOH) system does not include contraceptive services as part of its health care services, but at the request of MOH physicians, FISA provides services in 40 MOH facilities. Private pharmacies account for most of the contraceptive distribution, with oral contraceptives (OCs) being sold by prescriptions written by private physicians or, on occasion, by public health physicians. Contraceptive services also are provided in the medical centers of at least 3 organizations: JIRAMA, the water and electricity parastatal; SOLIMA, the petroleum parastatal; and OSTIE, a group of private enterprises that has its own health care system. A Catholic organization, FTK (Natural Family Planning Association) provides education and training in natural family planning. Demographic research has not been accorded a high priority in Madagascar. Consequently, the country's capabilities in the area are relatively limited. At this time, demographic research is carried out within several institutional structures. The major donor in the area of population/family planning is UN Fund for Population Activities (UNFPA). Activities of the UN International Children's Emergency Fund (UNICEF) in the area of health are relevant to the planned USAID assistance. For several years, USAID has provided population assistance to Madagascar through its centrally funded projects. Recommendations are presented in order of descending importance according to priorities determined by the consultation team: population policy; training/sensitization of the medical community; support to existing private voluntary organizations; demographic statistics and research; information, education, and communication; and collection and reinforcement of health statistics. In regard to population policy, assistance should be directed to 2 general objectives: providing guidance to the government in deciding which stance it ultimately wishes to adopt officially with regard to population; and encouraging the systematic incorporation of demographic factors into sectoral development planning.
[Unpublished] 1986 Aug. 71,  p. (AID Contract No. DPE-3024-C-00-4063-00)The evaluation of the Resources for Awareness of Population in Development (RAPID II) Project was initiated on June 18, 1985, 25 months into the project operation, to determine if the results of actions undertaken thus far have been adequate to justify the time and money spent on them and to find ways to improve the efficiency and effectiveness of the program efforts. The objective of the 5-year RAPIDS II project is to assist those involved in development planning to better understand the relationship between population growth and socioeconomic development and thereby increase the less developed country (LDC) commitment to efforts designed to reduce rapid rates of population increase. This evaluation report discusses the development assistance context and then focuses on the following: RAPID II operations over the 1984-85 period; policy analyses and LDC subcontracting; the RAPID model and its presentation; visits by the evaluation team to the countries of the Dominican Republic, Ecuador, Cameroon, and Liberia; what works in terms of population policy development; some major problems and potential resolutions; and RAPID II activities over the 1985-88 period. US Agency for International Development (USAID) officials in Washington as well as in the field described RAPID II as being of continuing utility in helping to create a climate favorable to more effective population policies. The review of RAPID II activities was generally positive. The project was identified as useful in several countries of sub-Saharan Africa and Latin America. Due to the evidence of satisfactory performance in the field, the evaluation focused on differences between plan and midterm results with a view toward suggesting course corrections that can improve project performance. As population policy development is an inherently ambiguous field of activity, it has not been possible to draw clear lines between specific policy development activities and policy change in particular countries. Yet, there has been an improvement in the environment for population programs in LDCs. There were significant differences between planned and actual expenditures under the several subcategories of project expenditure. RAPID II total expenditures in the first 2 years of the project equalled budgeted expenditures when the contract was signed, but the distribution of expenditures by category was substantially different from what had been anticipated. It is recommended that emphasis in the project must shift predominantly to policy analyses (80% of remaining funds) and that that RAPID-style presentation resources (20%) be used carefully for only the highest priority requests. In regard to development of LDC subcontracts for policy analysis, efficiency has been low.
Populi. 1985; 12(3):34-9.The US Agency for International Development (USAID) in consultation with the government of Kenya agreed in 1983 to prepare a demonstration family planning project, which would assist the private sector as well as other major nongovernment providers of health services to upgrade their health services, train and augment their nursing and other medical staff, provide family planning equipment and free contraceptives, and establish these health facilities as full-time family planning service delivery points. The Family Planning Private Sector Program (FPPS) will assist 30 private sector firms, "parastatal" organizations, and other private and nongovernment organizations that already provide health services to their workers, their dependents, and in many cases the surrounding communities to upgrade their services and add a full-time family planning facility. As some of the firms or organizations have multiple outlets, the program will create 50 or more new family planning delivery points throughout Kenya, thereby also relieving some of the pressure on government facilities. The FPPS sub-projects are to recruit at least 30,000 new acceptors. FPPS has added a guideline that at least 60% of these new acceptors be retained in the program for at least a period of 2 years. The FPPS program has received an enthusiastic reception from employers, the unions, and nongovernment organizations such as the Protestant Church Medical Association and the Seventh Day Adventists. The FPPS team can provide projects with a variety of services and funds for family planning related equipment, supplies, and activities. These include assistance with project design, training existing medical staff in family planning service delivery, the collection of baseline information, and the provision of funds for equipping family planning clinics. The government has encouraged FPPS to be innovative and to introduce family planning services into as wide a variety of health services as possible. As presently designed, the FPPS program is primarily a service delivery program but is beginning to play an increasingly dynamic role in information and education activities about family planning. From the start, the participating projects demanded assistance in spreading the family planning message to the workers, their families, and the community. It is evident that the program has stimulated management, clinic staff, and workers and has generated competition between projects to reach and exceed their targets of both new acceptors and high continuation rates.
In: Conference for Identification of Unmet Needs in Family Health Care in Anglophone Africa, 1979, London. Report of the Conference. [London, ICM and USAID, 1979]. 5 p..In this report of the Conference for Identification of Unmet Needs in Family Health Care in Anglophone Africa, meeting in London in 1979, objectives were reviewed and shortcomings of health care were outlined. Objectives included the following: giving leaders the opportunity to state their unmet needs in their own country in the field of maternal and child health and family planning; identifying the role of rural health personnel within such programs; and recommending individual midwives capable of implementing in-country programs aimed at meeting the needs. Adequate financial resources were considered to be the primary constraint against development of comprehensive health care services. Generally, there were insufficient facilities to meet the needs of the populations and overcrowding was often encountered. Maldistribution of facilities and services brought a concentration of available care in the urban areas and deficiencies in the rural areas. The scope of maternal and child health care in most countries left room for improvement. Health education, with emphasis on community participation, had been begun in many countries but required strengthening. Every country delegate thought that their health services were unduly concentrated in the urban areas and that the rural areas were neglected. No country had sufficient health personnel at any level, and equipment was scanty and frequently out-of-date. There was a growing realization of the need for the involvement of the community in all aspects of health care delivery. Points highlighted during discussions following presentations included approaches to establishing primary bealth care projects, with the identification, training and utilization of village level workers who were selected by the villages and who would work in their villages following training. The wide variety of care provided by traditional birth attendants highlight the need for training to be based on a spot description of the tasks they would be expected to perform. There were family planning programs in all of the countries, and the majority involved the midwives in some aspect of the program.
Washington, D.C., U.S. Office of International Health, Division of Planning and Evaluation, 1976. 144 p. (Syncrisis: the dynamics of health, XIX)This report uses available statistics to examine health conditions in Senegal and their interaction with socioeconomic development. Background data are presented, after which population, health status, nutrition, environmental health, health infrastructure, facilities, services and manpower, national health policy and planning, international organizations, and the Sahel are discussed. Diseases such as malaria, measles, tuberculosis, trachoma and venereal diseases are endemic in Senegal, and high levels of infant and childhood mortality exist throughout the country but especially in rural areas. Diarrhea, respiratory infections, and neonatal tetanus contribute to this mortality and are evidence of the poor health environment, and lack of basic services including nutrition assistance, health education, and potable water. Nutrition in Senegal appears to be good in general, but seasonal and local variations sometimes produce malnutrition. Lowered fertility rates would reduce infant and maternal mortality and morbidity and might slow the present decline in per capita food intake. At present the government of Senegal has no population policy and almost no provisions for family planning services. Health services are inadequate and inefficient, with shortages of all levels of health manpower, poor planning, and overemphasis on curative services.