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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.
Summary and evaluation report: Program Year 2, July 1, 1973 - June 30, 1974, Contract Aid/La-707 (Regional).
Washington, D.C., Development Associates, . 28 p.An evaluation of a project to provide training and academic programs in family planning, demography, and population studies to Latin American and Caribbean grantees from July 1, 1973-June 30, 1974, finds the project met or surpassed most of its goals. 775 grantees were recruited in 27 countries and trained in the U.S., Puerto Rico, Canada, and 9 Latin American countries; the original goal was 500 grantees. 66% (491) of the short-term grantees participated in programs in their own or other Latin American countries; 34% (253) were in the U.S. or Puerto Rico. 30 were enrolled in academic and other long-term programs. 735 were trained in 48 groups ranging from 2-55 in size; 10 received individual instruction. A change of Mexican government policy allowed grantees from that country. Brazilians received grants through a relaxation of the prohibition against Title 10 activities. Grants to Uruguay, Argentina, and Chile were drastically reduced because of their governments' lowered priorities for population and family planning. At Harbor General Hospital, Los Angeles, a long-range program for training paraprofessionals as family planning specialists was begun and included in-country, follow-up technical assistance. Development Associates (DA) has trained 4 groups of nurse-midwives in Spanish at its Denver Family Planning Training Center since November, 1973.
Paris, Organisation for Economic Cooperation and Development, Development Centre, 1978. 193 p. (Development Centre Studies)The World Population Conference which took place in Bucharest in 1974 witnessed many debates and rhetorical controversies over the role of family planning programs in Third World countries and their relation to development. This report is the result of a collaborative study realized by the Development Centre and the World Bank which investigates how developing countries, as well as aid agencies, are thinking about population problems and, as a consequence, about population assistance in the "post-Bucharest era." The report includes detailed surveys of 12 developing countries, representing Asia, Africa, Latin America and the Middle East. It also interviews and reports on the activities of a large number of population assistance agencies. The roles of international organizations such as the UNFPA, the UN population division and the World Bank itself are assessed in terms of their impact on national development through population control efforts. Reviews of assistance provided to developing nations by nongovernmental agencies, private foundations and developed nations are also presented. Each country paper presented provides an overview of the country's demographic characteristics; a summary of history of population policies, pre- and post-Bucharest era; an overview of population strategies past and present, their integration with other-sector activities; family planning program administration; and a survey of all forms of population assistance available and utilized by the country. Macro-level analyses of changes in family planning assistance by organizations since Bucharest, as well as micro-level, country-specific studies of how each nation has assimilated these changes and has developed a specific population policy are provided.
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.
IPPF Situation Report, June 1973. 10 p.The Indonesian Planned Parenthood Association (IPPA) was founded in 1957 and pioneered family planning services. It made little headway duri ng the pronatalist Sukarno regime, but in 1967 the present government announced an intensive family planning program and the IPPA was named as an implementing unit in 1971. 2 primary roles now are the training activities for fieldworkers and the development of community education and motivation programs. This complements the national mass media program. In 1970 the government took over all clinics except those in the Outer Islands (the islands outside Java, Bali, and Madura). The IPPA runs 150 clinics in the Outer Islands, is responsible for all supplies and maintenance, and has a number of model clinics in Java and Bali. The Community Education program has 8 components: speakers bureau, family planning clubs, mobile audiovisual units, exhibitions, tr aditional media, special events, local mass media support, and evaluatio n. In 1971 the 'ippa trained 2951 people; in 1972 this was increased by 25%. In 1973 the target is training 3000 fieldworkers with 16 centers for training and 16 field demonstration areas. An agreement with the U.N. Fund for Population Activities/International Development Association (UNFPA/IDA) will provide for building, equipping, and staffing. The research and evaluation function is also expanding to complement government activities. The government program aims to train 20,250 medical and paramedical personnel over 5 years and medical schools have incorporated the teaching of population and family planning. Government allowances are being curtailed for all children over 3 for government workers. An active clinic program aims to set up 1200 fully equipped and 1250 moderately equipped facilities by 1973. An active media campaign has been launched and for the 1st time in the population field the UNFPA and the IDA are helping to finance a project to expand a family planning program and broaden its activities. This su pport will provide for physical facilities, technical assistance, training, motivation, evaluation, research, and population education.
Studies in Family Planning. 1972; 3(7):151-156.In Thailand the family planning program is integrated into health services. During 1971 there were 404,187 new acceptors, the majority of which chose the pill since they are prescribed by midwives and are available in more than 3500 centers. The number of pill acceptors increased from approximately 8800 per month to more than 30,000 after auxiliary midwives were officially authorized to prescribe oral contraceptives. In 1972 a pilot program was started to train paramedical personnel to insert IUDs. In 1971 12-month continuation rates were 75% for the IUD (with the majority of women expelling them having reinsertions), 65% for the pill, with more than 20,000 sterilizations. A major effort will be made during 1972 to introduce vasectomy more widely. More than 80% of acceptors are from rural areas, with 90% having less than 4 years of education. Postpartum acceptors accounted for 16% of the national program. Since 85% of all deliveries occur at home, the postpartum concept should be adapted to these women. In a 1970 followup survey of 2597 acceptors in the 3 largest cities, among IUD users, expulsions were negatively correlated and removals positively correlated with age; pregnancies were 3%. Pills were more widely accepted than IUDs in all age groups, and younger women definitely preferred them. The source of family planning information was: husband, 47%; health personnel, 38%. It is estimated that 144,000 couple years of protection were provided in 1971, and 393,000 in 1972 -- 3% and 8% respectively of married women of reproductive age. Cost of the program is estimated to be US$.08 per capita or US$7.00 or $8.00 per acceptor. The greatest problem has been lack of effective supervision at the field level. The usefulness of family planning field workers is being studied.
Journal of Medical Education. 1969 Nov; 44(11 Pt 2):2074-222.This article describes the activities in the field of population and family planning of the following international organizations: United Nations, World Health Organization, Pan American Health Organization, Development Assistance Committee, Swedish International Development Organization, International Planned Parenthood Federation, and Pan American Federation of Associations of Medical Schools. It also describes the following U.S. governmental and private agencies: Department of Health, Education, and Welfare, Department of State, Agency for International Development, Population Reference Bureau, Population Council, Ford Foundation, Rockefeller Foundation, W.K. Kellogg Foundation, Josiah Macy, JR. Foundation, Milbank Memorial Fund, Pathfinder Fund, and the Population Crisis Committee.