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  1. 1

    Family planning in El Salvador: the achievements of 50 years.

    Santiso-Galvez R; Ward VM; Bertrand JT

    Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr. [22] p. (SR-15-118C; USAID Cooperative Agreement No. AID-OAA-L-14-00004)

    This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. El Salvador has made enormous progress in terms of family planning over the past five decades. It has reduced fertility rates; it has developed a robust legal and regulatory framework for FP; it has allocated resources for procuring contraceptives for its population; it now offers information and contraceptive services to the entire population of the country with the active participation of civil society organizations, especially women’s organizations.
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  2. 2

    Family planning in Nicaragua: the achievements of 50 years.

    Santiso-Galvez R; Ward VM; Bertrand JT

    Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr. [24] p. (SR-15-118F; USAID Cooperative Agreement No. AID-OAA-L-14-00004)

    This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. Nicaragua has made significant progress in improving its macro-level primary health care indicators, reducing maternal mortality and increasing contraceptive prevalence. There has also been increased participation by the Instituto Nicaragense de Seguridad Social (INSS) in providing family planning services and commodities, thus reducing the burden on health ministry facilities. The government has shown its strong commitment to comprehensive services to improve the health of the population.
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  3. 3

    Family planning in Haiti: the achievements of 50 years.

    Ward VM; Santiso-Galvez R; Bertrand JT

    Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr. [28] p. (SR-15-118H; USAID Cooperative Agreement No. AID-OAA-L-14-00004)

    This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. The family planning movement in Haiti began in the 1960s, only a short time after family planning activities had been initiated in many other countries in the Latin American and Caribbean region. Initially, doctors and demographers worked together to encourage government policies around the issue and to begin private sector service provision programs in much the same way early family planning activities occurred elsewhere. Yet, in comparison with other countries within the region, Haiti’s progress on reproductive health has been slow.
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  4. 4

    Family planning in Colombia: the achievements of 50 years.

    Bertrand JT; Santiso-Galvez R; Ward VM

    Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2015 Apr. [26] p. (SR-15-118A; USAID Cooperative Agreement No. AID-OAA-L-14-00004)

    This publication is one of eight case studies that were developed as part of a broader review entitled Family Planning in Latin America and the Caribbean: The Achievements of 50 Years. As its title implies, the larger review documents and analyzes the accomplishments in the entire region since the initiation of U.S. Agency for International Development (USAID) funding in the early 1960s. Family planning has become so deeply entrenched as a social norm in Colombia that it no longer constitutes the special area of interest that it did in the 1960s and 1970s. Nonetheless, challenges remain.
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  5. 5

    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).

    International Federation of Gynecology and Obstetrics [FIGO]; International Confederation of Midwives; International Council of Nurses; 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.
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  6. 6

    WHO / USAID / FHI Technical Consultation: Expanding Access to Injectable Contraception, 15-17 June 2009, Room M405, WHO, Geneva.

    World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI]

    [Unpublished] 2009. 5 p.

    The agenda for the consultation is presented. The objectives of the consultation were: To review systematically the evidence and programmatic experience on interventions designed to expand access to / provision of contraceptive injectables, focusing on non clinic-based services and programs; To reach conclusions on issues: (a) for which evidence is consistent and strong; (b) for which evidence is mixed; and (c) for which evidence is marginal or entirely lacking and, thus requires additional research; To document discussions and conclusions of the Consultation, including policy and program implications, and to disseminate these widely.
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  7. 7

    Contraceptive requirements and logistics management needs in the Philippines.

    United Nations Population Fund [UNFPA]. Technical and Evaluation Division. Maternal and Child Health and Family Planning Branch

    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.
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  8. 8

    Proceedings of the Caribbean Regional Conference "Operations Research: Key to Management and Policy", Dover Convention Centre, St. Lawrence, Barbados, May 31 - June 2, 1989.

    Population Council. Operations Research in Family Planning and Maternal-Child Health for Latin America and the Caribbean Project [INOPAL]

    [New York, New York], Population Council, 1989. 19, [20] 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.
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  9. 9

    Intermediating development assistance in health: prospects for organizing a public/private investment portfolio.

    Family Health

    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.
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  10. 10

    Malaria control program activities, Niger with areas for USAID assistance through NHSS.

    Pollack MP

    [Unpublished] [1987]. 27 p. (USAID Contract No. DPE-5927-C-00-5068-00)

    Health personnel in Niger report that malaria is the leading diagnosis in health facilities (1980-1984), about 380,000 cases/year), but just 19% of the population live within a 5 km radius of a health facility. A 1985 household survey reveals that 31.4% of children had a febrile illness (presumptive malaria) within the last 2 weeks and 22.1% of all child deaths were presumptive malaria related. The Government of Niger began developing a national malaria program in 1985 to reduce malaria-related deaths rather than morbidity reduction, because available data indicated that morbidity reduction was not feasible. There is no standard treatment regimen for presumptive malaria, however. Some studies indicate that an effective dose regimen is 10 mg chloroquine/kg body weight in a single dose. Some health workers use other antimalarial arbitrarily. Lack of uniformity can increase the risk of chloroquine and Fansidar resistant falciparum. Government officials are thinking about having only chloroquine available at first level facilities. It plans to set up national surveillance for chloroquine resistance. Niger has just 1 trained malariologist, indicating a need for training of more staff. To keep government costs to a minimum, it wants to set chloroquine at all points in the distribution network. The program's plan of action also includes chemoprophylaxis for pregnant women, limited vector control in Niamey, and health education stressing reducing breeding sites. A REACH consultant believes that it is possible for the program to reach its coverage targets within 5 years. Obstacles include limited access to health care, unavailable chloroquine in warehouses, and lack of untrained personnel (the main obstacle). The consultant suggests various interventions to help Niger meet its targets, e.g., periodic coverage surveys. The World Bank, WHO, the Belgian Cooperation, and USAID are either providing or planning to provide support to the malaria control programs.
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  11. 11

    Cereal based oral rehydration solution and the commercial private sector. Conference proceedings, March 27, 1992.

    Tucker H; Jansen W

    Arlington, Virginia, Management Sciences for Health, Technologies for Primary Health Care [PRITECH], 1992. 23, [80] p. (USAID Contract No. DPE-5969-Z-00-7064-00)

    Public health professionals are coming to realize that the private sector provides a significant share of health care and that efforts need to be taken to improve access to and use of preventive and curative services. Further, while most USAID-supported activities have and will support the government sector, it nonetheless remains important to mobilize private sector resources to meet public health objectives. PRITECH's initial overtures to foster private sector participation and cooperation between the public and private sectors led it to sponsor an 1-day meeting on cereal-based oral rehydration solution (CBORS) and the private sector. The conference was convened to review the status of ORS products within developing country markets and to develop recommendations for what PRITECH should do to prepare for the arrival of commercial ORS products in these markets. Participants included officials from the WHO, UNICEF, and USAID as well as diarrheal disease experts and marketing specialists from public health organizations. Presentations were made on possible options in cereal-based ORT for dehydrating diarrhea; a WHO perspective on ORS and the commercial marketplace in developing countries; and a market analysis of the arrival of CBORS products. Participants agreed that PRITECH should stay involved with the private sector; that PRITECH should not actively promote the adoption of CBORS products by companies and instead help guide those which choose to manufacture them; and that impact assessments should be conducted in countries where commercial CBORS products exist. Studies will explore caretaker behavior, private health care provider behavior, ORS consumption patterns, ORS market performance, and clinical performance. A section offers precautions for companies introducing commercial CBORS products, while 1 of 8 appendices discusses mobilizing the commercial sector for ORS marketing in Pakistan.
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  12. 12

    Assuring health sector policy reforms in Africa: the role of non-project assistance.

    Foltz AM

    [Unpublished] 1992. Presented at the 120th Annual Meeting of the American Public Health Association [APHA], Washington, D.C., November 8-12, 1992. 27, [1] p.

    In the mid 1980s, USAID started nonproject assistance, mainly in the economic sectors, to African countries. The countries received nonproject assistance after they fulfilled conditions which influence institutional and/or policy reforms. The longest running health sector reform program in Africa was in Niger and was slated to receive portions of the funds after fulfilling 6 specific predetermined reform activities. Yet, between 1986 and 1991, Niger had implemented only 2 of them. It did accomplish the population/family planning reforms: expansion of family planning services, a national population policy, analyses and implementation of improvements in the pricing and distribution of contraceptives, and legalization of use and distribution of contraceptives. Continuing economic deterioration during the 1980s and political upheavals after 1989 somewhat explained why the other reform activities were not implemented. Other equally important factors were a very complex sector grant design (more than 20 reforms in 6 policy/institutional areas) with little incentive to realize the reforms, insufficient number of staff (limited to senior personnel) to implement the reforms, and just 1 USAID staff to monitor and facilitate activities. The nonproject assistance for the primary health care (PHC) system in Nigeria had a simpler design than that in Niger. The reform goals were shifting responsibility for PHC from curative care to preventive health services. After USAID and the Nigerian government signed an agreement, they included policy reforms promoting privatization of health services. Only 1 reform was implemented. Factors which could lead to success of nonproject assistance include host government needs to perceive it owns the objectives and building financial and institutional sustainability. In conclusion, nonproject assistance can be effective when implementing policy reforms that the host government has already adopted.
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  13. 13

    Child survival strategy for Sudan, USAID/Khartoum.

    Harvey M; Louton L

    Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1987. iii, 33, [22] 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.
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  14. 14

    Contraceptive use and commodity costs in developing countries, 1990-2000.

    Mauldin WP; Ross JA

    International Family Planning Perspectives. 1992 Mar; 18(1):4-9.

    Estimates of the level of contraceptive use (and its cost) in developing countries that will be needed over the next decade in order not to exceed the UN's medium population projection for the year 2000 are provided. The UN's medium projection calls for population in the developing world to increase to about 5 billion by the year 2000, a projection that has become somewhat of a goal for the population establishment, which is concerned over the impact of rapid population growth. To comply with the medium projection, population growth during the 1990s must be limited to 969 million. Relying on data from the UN, USAID, and a number of surveys, the present level of contraceptive prevalence, the prevalence of specific methods, and the present costs are calculated and future needs are estimated. Presently, the number of married women of reproductive age (15-44) in developing countries is estimated at 757 million, a figure expected to increase to about 970 million by the year 2000, according to the UN medium projection. Currently at 51%, contraceptive prevalence will have to increase to 59% to meet the medium projection. And in order to reach this level of prevalence, it is estimated that over the next 10 years service providers will have to perform more than 150 million sterilizations and distribute almost 8.8 billion cycles of oral contraceptives, 663 million contraceptive injections, 310 million IUDs, and 44 billion condoms. Providing these contraceptive commodities will likely cost about $5.1 billion. The public sector will probably have to contribute about $4.2 billion of the cost, unless a concerted effort is made to increase the share carried by the commercial and private sectors.
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  15. 15

    Strengthening of the Niger EPI, USAID / Niamey, January 5 - February 2, 1987.

    Claquin P; Triquet JP

    Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1987. [50] p. (USAID Contract No. DPE-5927-C-00-5068-00)

    In 1987, consultants went to Niger to prepare the plan of operations for the national Expanded Programme on Immunization (EPI). US$ 6 million from the World Bank Health Project and around US$ 5 million from the UNICEF EPI Project were available for EPI activities. Low vaccination coverage prevailed outside Niamey. Outbreaks of diseases that EPI can prevent continued to kill children. The cold chain was not maintained, especially at the periphery. Mobile teams continued to use inadequate strategies. Record keeping did not exist. The central level did not supervise the periphery. EPI staff at departmental and division levels did not have current written guidelines. Not only did poor working communications exist between the central level and the periphery, but also between the EPI Director and the other Minister of Health divisions, between WHO and UNICEF, and between both UN agencies and EPI. The EPI Director did have a good relationship with the USAID office, however. No one took inventory of EPI resources or monitored temperatures at any point in the cold chain. Even though the World Bank Health Project intended to five EPI 50 ped-o-jets, 46% of the existing 88 ped-o-jets were in disrepair and no one knew how to repair and maintain them. Thus EPI should not routinely use ped-o-jets. The consultants recommended that USAID stay involved with EPI in Niger since the EPI Director considered it an acceptable partner. EPI staff at each level should take a detailed inventory of all material resources. Effective and regular supervision should occur at the central, regional, and peripheral levels. A health worker needs to record the temperature of the refrigerator twice a day. Technical grounds should determine the standardization and selection of all equipment. Someone should maintain an adequate supply of spare parts and technicians should undergo training in maintenance.
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  16. 16

    U.S. population assistance: issues for the 1990s.

    Conly SR; Speidel JJ; Camp SL

    Washington, D.C., Population Crisis Committee, 1991. 52 p.

    Noting that US population assistance programs have suffered from ideological controversies and increasing bureaucratization, this publication outlines the actions needed to reinvigorate and redirect US population assistance programs, including the Agency for International Development (AIDS), the largest financial assistance provider and condom supplier to developing countries. The extent of family planning during the 1990s will have a definite impact on the years to come, since this decade represents the last opportunity to prevent the doubling of the world's population before it stabilizes during the 21st century. An example of the ideological controversies, the Reagan administration, prompted by anti-abortion groups, withdrew support from the UNFPA and the International Planned Parenthood Federation (IPPF). The publication makes recommendations at 3 levels -- for the President and Congress, for AID, and for the Office of Population. Recommendations for the President and Congress include: reasserting White House leadership on world population issues; increasing population assistance to $1.2 billion by the year 2000; resuming funding to the UNFPA and IPPF; and eliminating statutory restrictions relating to abortion. Concerning AID, the publication urges: broadening its birth control approach to include injectable contraceptives, safe abortion services, and adolescent and female education programs; increasing contraceptive distribution; improving quality of services; etc. Recommendation for the Office of Population include: taking responsibility for providing technical support to AID's country level population programs; coordinating the activities of private institutions and AID activities; and stressing long-term institution building needs of family planning programs.
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  17. 17

    World Bank raises population lending.

    PEOPLE. 1991; 18(4):33.

    Never before has the World Bank (WB) spent more money than the United States Agency for International Development (USAID) on population and family planning programs (FP). The WB's budget calls for US$340 million dollars for FP compared to USAID which has budgeted US$322 million, some of which may not be allocated. The 1991 WB figure is double the 1990 of US$169 million which was an increase of 40% over the 1989 figure. Total international FP in 1989 was US$757 million including WB and USAID. In the last 25 years the US has Contributed over US$4 billion to FP. Japan contributes about 8% (they announced they will increase their spending on FP by 1.8% for 1991). Norway, Sweden, the Netherlands, Canada, Germany, and the United Kingdom each provide about 4-6% of the total. However, FP accounts for only 1.3% of all total official development assistance. In 1991 the WB has 13 new programs and loans which will be given to Nigeria and Rwanda for the 1st time. The United Nations Population Fund (UNFPA) estimates that a total of US$4.5 billion is needed by 2000 just for FP, with developing countries contributing the same amount. The US house of Representatives recently voted to increase spending with US$300 million for FP in addition to USAID's budget bringing the total up to US$400 million for 1992. Estimates suggest the US should increase spending to $600 million in 1992 and US$1.2 billion by 2000.
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  18. 18

    USAID steps up anti-AIDS program.

    USAID HIGHLIGHTS. 1991 Fall; 8(3):1-4.

    This article considers the epidemic proportion of AIDS in developing countries, and discusses the U.S. Agency for International Development's (USAID) reworked and intensified strategy for HIV infection and AIDS prevention and control over the next 5 years. Developing and launching over 650 HIV and AIDS activities in 74 developing countries since 1986, USAID is the world's largest supporter of anti-AIDS programs. Over $91 million in bilateral assistance for HIV and AIDS prevention and control have been committed. USAID has also been the largest supporter of the World Health Organization's Global Program on AIDS since 1986. Interventions have included training peer educators, working to change the norms of sex behavior, and condom promotion. Recognizing that the developing world will increasingly account for an ever larger share of the world's HIV-infected population, USAID announced an intensified program of estimated investment increasing to approximately $400 million over a 5-year period. Strategy include funding for long-term, intensive interventions in 10-15 priority countries, emphasizing the treatment of other sexually transmitted diseases which facilitate the spread of HIV, making AIDS-related policy dialogue an explicit component of the Agency's AIDS program, and augmenting funding to community-based programs aimed at reducing high-risk sexual behaviors. The effect of AIDS upon child survival, adult mortality, urban populations, and socioeconomic development in developing countries is discussed. Program examples are also presented.
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  19. 19

    [Development, human rights and woman's condition: a new age] Desarrollo, derecho humanos y la condicion de la mujer: un nuevo enfoque

    Isaacs SL

    PROFAMILIA. 1989 Jun; 5(14):8-10.

    After World War II (WWII) concern grew about the economic and social development of Third World countries. Most countries in Africa, Asia and the Middle East were European colonies while Latin America, even though independent was completely dominated by the US. These countries are characterized by: 1) a poor majority ruled by a small rich minority; 2) large rural populations migrating to the cities resulting in bottlenecks and unemployment; 3) bad health status with deteriorating nutritional states; 4) large families; 5) low levels of education (2/3 of the women in the world are illiterate and 90% live in 17 countries); 5) high levels of corruption in public positions; 6) governments ruled by a military dictator; 7) women in the lowest positions with limited legal rights. After WWII the Marshall Plan was instituted in developing countries (LDCs) to provide economic aid to development a model that used per capita income to measure a country's progress. During the 70's and 80's this model was questioned and more emphasis was put on the need for social and institutional development before investing in economic development. The World Bank and USAID have been promoting the role of the public sector, a strategy that has lowered inflation but has also affected the poor in many countries. For example, infant mortality in Brazil is higher now than 10 years ago. A wise development policy should recognize the need of LDCs to develop their own models while emphasizing agricultural development rather than industrial. Development is never accomplished until every citizen participates in their community. Improving the status of women is not only a human right but a high priority in achieving development. Women in LDCs only have partial rights--they cannot own land, nor inherit, and are not given any credit. Development is not only increasing the per capita income, it includes improving health, education, nutrition, and the quality of life of all its citizens. International law recognizes the rights of women and these are stated in the Convention on Eliminating all Forms of Discrimination Against Women.
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  20. 20

    Foreign assistance in the 1990s and the role of population.

    Baldi P

    [Unpublished] 1988 Apr 12. Paper presented at a colloquium on U.S. International Population Assistance in the 1990s, convened by The Futures Group as part of the Project on Cooperation for International Development: U.S. Policy and Programs for the 1990s and Blueprint for the Environment, April 12, 1988, Washington, D.C. 11 p.

    This article identifies the need for a reformulated foreign assistance program, explores alternatives to the current program, and proposes means of implementing alternatives. Reduced budget resource availability, and the growing support, in the US and abroad, for the concept of ecologically sustainable development highlight the inadequacy of the current US foreign aid program. Sustainable development uses as its guiding principle a goal of "meeting the and aspirations of the present without compromising the ability to meet those of the future." Sustainable development should be the foreign policy theme for the '90s, running through every aspect of US foreign assistance, and promoting self-sufficiency and economic viability for developing countries. To obtain this goal a comprehensive redefinition of US foreign assistance and foreign policy objectives is necessary. This redefinition should include a sharper focus for the US Agency for International Development (US AID), under the Foreign Assistance Act, with fewer restrictions and maximum flexibility for design and implementation of projects. The US AID should also stress relationships with other countries in devising plans and dividing up areas of assistance. FUrthermore, technical centers should be the focal point of organization in US AID. Approaches to the implementation of development assistance are discussed, among them--structuring US AID as a grant-giving institution, or as a bilateral or multilateral institution, or diminishing its role and creating an Asian Development Foundation. An approach which would fit with the sustainable development construct is for US AID to target technical areas as well as priority countries. However, each approach has its drawbacks and is driven in part by fund availability. The field of international population and family planning is offered as an example of a successful foreign assistance approach. The factors involved in this model included strong leadership, valuable congressional support, measurability, and flexible approaches, as well as a cadre of trained population officers. An agency focus on ecologically sustainable development includes population programs as a major component.
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  21. 21

    List of key issues to consider.

    Futures Group

    [Unpublished] 1988 Apr 12. Paper presented at a colloquium on U.S. International Population Assistance in the 1990s, convened by The Futures Group as part of the Project on Cooperation for International Development: U.S. Policy and Programs for the 1990s and Blueprint for the Environment, April 12, 1988, Washington, D.C. 5 p.

    A colloquium on US International Population Assistance in the 1990s was held April 12, 1988 in Washington, D.C. Key policy issues discussed included: 1) administrative restrictions on population assistance, 2) funding for UNFPA and IPPF, 3) US AID's position concerning abortion, informed consent, adolescent programs, and natural family planning, 4) the possible reduction of the US development program, 5) the US's role in and position on international population efforts, 5) whether US AID should continue to provide contraceptives, 7) how much of US AID's effort should be devoted to service delivery, 8) pushes for major reforms in the operations of the World Bank and UNFPA, 9) where and how to concentrate limited resources, and, 10) how the population programs should deal with AIDS. Program implementation issues considered included: 1) the appropriate role of Private Voluntary Organizations in US AID's population program, 2) using the private sector as a means of delivering family planning supplies and services, 3) the extent to which family planning programs should be linked to other development programs, particularly health services, and, 4) improving the quality of family planning services. Organizational issues considered included: 1) the most appropriate mix between bilateral and central funding for population activities, 2) the organization of US AID programs with a geographic or substantive focus, 3) the recruitment of new, well qualified health/population officers, and, 4) the possibility of a Population Bureau within US AID. Technology issues included: 1) possibly devising programs to make better use of present contraceptive technology, 2) US AID's role in supporting biomedical research to develop new contraceptives, 3) if US AID should press the Federal Drug Administration to approve an injectable contraceptive, and, 4) how US AID could stimulate more research and testing by other donors and the private sector.
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  22. 22

    The control of AIDS.

    Sencer D

    In: Workshop on the Integration of AIDS Related Curricula into Family Planning Training Programs, Quality Hotel, Arlington, Virginia, May 10-11, 1988. Documents, distributed by The Family Planning Management Training Project [FPMT] of Management Sciences for Health [MSI] Boston, Massachusetts, Management Sciences for Health, The Family Planning Management Training Project, 1988 May. [24] p..

    Current objectives in the fight against AIDS are focused on reducing transmission. International cooperation must be guided by principles including allowing the World Health Organization and participating governments, not donors, to determine policy; work done in developing countries must achieve the same standards as in the US; relationships between health and population programs, donor agencies and governments must be characterized by cooperation, not competition; and flexibility is necessary to respond to new information. Sensitivity is essential, as the control of AIDS involves personal issues, and the diagnosis of AIDS has profound implications. Surveillance is essential to detect and control infection and to guide public policy. As few infections currently result from medical injection, interventions have focused on the difficult problem of modifying sexual behavior, with little success. Social research is essential to determine means of behavior modification and to evaluate their efficacy. A brief history of the AIDS epidemic, as well as a summary of its epidemiology are provided. Efforts to control the spread of AIDS and to care for victims are draining the resources of basic health care programs, interfering with the delivery of primary health care. The extra demands that will be placed on family planning programs, including the shift in emphasis to barrier methods will strain these programs. WHO is currently undertaking a global effort to reduce morbidity and mortality from HIV infections and prevent transmission. Its strategies focus on preventing sexual, blood borne and perinatal transmission, therapeutic drugs against HIV, vaccine development, and helping infected people, and society, deal with the illness. Other agencies which have developed programs are USAID, the DHHS and the Centers for Disease control in the US.
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  23. 23

    Policy directions for rural water supply in developing countries.

    Burton I

    [Washington, D.C.], U.S. Agency for International Development, Bureau for Program and Policy Coordination, 1979 Apr. 43 p. (A.I.D. Program Evaluation Discussion Paper No. 4)

    The current state of knowledge on design, installation and maintenance of rural water supply systems is surveyed. Present statistics suggest that it may be possible to provide safe water for everyone during the 1980-1990 period designated as the International Drinking Water Decade. The results on a regional basis are uneven. Africa is making rapid progress in providing rural water supply and may equal Latin America, which had been far ahead. Southeast Asia, however, represents a major problem. More than 60% of the world's population without reasonable access to water is in this area. There are a number of evaluations underway, including studies by OECD, UNICF-WHO, IBRD, International Research Center, and a number of bilateral agencies like AID. All these evaluations have a non-hardware component of rural water programs in common. Maintaining the system once it is installed is one of the key elements in the long term success or failure of rural water schemes. There are 3 reasons for failure: 1) the technology; 2) the capability; and 3) the motivation. In many cases, lack of spare parts and motivation are to blame for system failure. There remains a need to strengthen the capacity of national water programs. Unless this takes place, there will be no sustained progress. Commitment on all levels will help insure continual success of rural water efforts. Successful programs will also require balance between hardware, community involvement, and repair and maintenence. One useful approach would be to fund programs, not projects. There are 2 activities that AID should consider: rehabilitation of existing systems and development of methodologies to measure consumer satisfaction with water systems. A need to: 1) keep abreast of technological development; 2) assess the need for manpower training; 3) encurage local manufacturers; 4) evaluate and strengthen the ability of national organizations and programs; 5) provide materials for health community involvement guidelines; and 6) collabotate and coordinate with other agencies exists.
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  24. 24

    Fording the stream.

    Otero M

    World Education Reports. 1985 Nov; (24):15-7.

    In the last decade we have come to radically redefine our understanding of how women fit into the socioeconomic fabric of developing countries. At least 2 factors have contributed to this realignment in our thinking. 1st, events around the UN Decade for Women dramatized women's invisibility in development planning, and mobilized human and financial resources around the issue. 2nd, the process of modernization underway in all developing countries has dramatically changed how women live and what they do. In the last decade, more and more women have become the sole providers and caretakers of the household, and have been forced to find ways to earn income to feed and clothe their families. Like many other organizations, USAID, in its current policy, emphasizes the need to integrate women as contributors to and beneficiaries of all projects, rather than to design projects specifically geared to women. Integrating women into income generation projects requires building into every step of a project--its design, implementation and evaluation--mechanisms to assure that women are not left out. The integration of women into all income generating projects is still difficult to implement. 4 reasons are suggested here: 1) resistance on the part of planners and practitioners who are still not convinced that women contribute substantially to a family's income; 2) few professionals have the expertise necessary to address the gender issue; 3) reaching women may require a larger initial investment of project funds; and 4) reaching women may require experimenting with approaches that will fit into their village or urban reality.
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  25. 25

    Family planning program funds: sources, levels, and trends.

    Nortman DL

    New York, New York, Population Council, Center for Poplicy Studies, 1985 Aug. 42 p. (Center for Policy Studies Working Papers No. 113)

    This analysis of family planning program funding suggests that current funding levels may be inadequate to meet projected contraceptive and demographic goals. Expenditures on organized family planning in less developed countries (excluding China) totaled about US$1 billion in 1982--about $2/year/married woman of reproductive age. Cross-sectional analysis indicates that foreign support as a proportion of total expenditures decreases with program duration. Donor support to family planning in less developed countries has generally declined from levels in the late 1970s. This is attributable both to positive factors such as program success and increased domestic government support as well as requirements for better management of funds and the worldwide economic recession. Foreign assistance seems to have a catalytic effect on contraceptive use only when the absorptive capacity of family planning programs--their ability to make productive use of resources--is favorable. The lower the stage of economic development, the less visible is the impact of contraceptive use or fertility per investment dollar. On the other hand, resources that do not immediately yield returns in contraceptive use may be laying the foundation for later gains, making increased funding of family planning programs an economically justifiable investment. The World Bank has estimated that an additional US$1 billion in public spending would be required to fulfill the unmet need for contraception. To increase the contraceptive prevalence rate in developing countries to 58% (to achieve a total fertility rate of 3.3 children) in the year 2000 would require a public expenditure on population programs of US$5.6 billion, or an increase in real terms of 5%/year. Improved donor-host relations and coordination are important requirements for enhancing absorptive capacity and program performance. A growing willingness on the part of donors to allow countries to specify and run population projects has been noted.
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