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Your search found 51 Results

  1. 1

    USAID / Moldova antitrafficking assessment -- critical gaps in and recommendations for antitrafficking activities.

    Arnold J; Doni C

    Washington, D.C., Development Alternatives, WID Tech, 2002 Oct. [65] p. (USAID Contract No. FAO-0100-C-00-6005-00)

    The objective of this assessment is twofold: (1) to provide USAID/Western New Independent States (WNIS) with a road map of existing trafficking-prevention activities undertaken by donor agencies and bilateral, international-development and host-country-government institutions and nongovernmental organizations (NGOs) in Moldova; and (2) to help USAID/WNIS identify critical gaps in existing approaches in Moldova that new interventions might address. The road map and accompanying list of recommendations provide U.S. government officials in USAID/WNIS with the information and tools necessary to design specific activities at a later date. (excerpt)
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  2. 2

    Birth spacing -- report from a WHO technical consultation.

    World Health Organization [WHO]. Department of Reproductive Health and Research; World Health Organization [WHO]. Department of Making Pregnancy Safer

    Geneva, Switzerland, WHO, 2006. [4] p. (Policy Brief)

    The World Health Organization (WHO) and other international organizations recommend that individuals and couples should wait for at least 2-3 years between births in order to reduce the risk of adverse maternal and child health outcomes. Recent studies supported by the United States Agency for International Development (USAID) suggest that an interval of 3-5 years might help to reduce these risks even further. Programme managers responsible for maternal and child health at the country and regional levels have requested WHO to clarify the significance of the new USAID-supported findings for health-care practice. To review the available evidence, WHO, with support from USAID, organized a technical consultation on birth spacing on 13-15 June 2005 in Geneva, Switzerland. The participants included 35 independent experts as well as staff of the United Nations Children's Fund (UNICEF), WHO and USAID. The specific objectives of the meeting were to review evidence on the relationship between different birth-spacing intervals and maternal, infant and child health outcomes, and to provide advice on recommended birth-spacing intervals. (excerpt)
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  3. 3

    Toolkit to improve private provider contributions to child health: introduction and development of national and district strategies.

    Prysor-Jones S; Tawfik Y; Bery R; Wolff A; Bennett L 3d

    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)
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  4. 4

    WHO updates medical eligibility criteria for IUCDs.

    Kenya. Ministry of Health; Family Health International [FHI]

    Nairobi, Kenya, Ministry of Health, 2004 Jun. [2] p. (IUCD Method Briefs Update)

    The World Health Organization (WHO) recently revised the guidelines for IUCD use as part of an update of its Medical Eligibility Criteria for Contraceptive Use (MEC). These revisions will improve quality of care and reduce medical barriers for women who are considering an IUCD as a contraceptive method. Based on the latest clinical and epidemiological research, the revisions are particularly significant for women at risk of sexually transmitted infections (STIs), including HIV, and women living with HIV or AIDS. Research has shown that while some conditions restrict IUCD initiation, they do not necessarily affect the safety of continued use. Under the new guidelines, for example, a client who has gonorrhea or chlamydial infection is considered a Category 4 for IUCD initiation and should be advised to choose another method. However, if an IUCD user develops an STI, she can be treated with antibiotics without the IUCD being removed (Category 2). In addition, the client should be counseled about partner notification and treatment, and condom use. (excerpt)
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  5. 5

    HIV / AIDS, law and human rights: a handbook for Russian legislators.

    Narkevich MI; Polubinskaya SV

    Moscow, Russia, Transatlantic Partners Against AIDS, 2005. 52 p.

    The purpose of this Handbook is to assist members of the Federation Council and deputies of the State Duma of the Russian Federation, and other Russian officials on the federal and regional levels, in enacting appropriate legislation and legislative reform to address AIDS, whether they be initiatives prohibiting discrimination against PLWHA or members of highly vulnerable groups, laws guaranteeing reliable HIV prevention information for all Russian citizens, or other policy priorities — and ensuring adequate fiscal and other resources to support them. This Handbook provides examples of the best legislative and regulatory practices gathered from around the world. Best practices are given for each of the 12 guidelines contained in the International Guidelines on HIV/AIDS and Human Rights, published in 1998 by the Office of the United Nations High Commissioner for Human Rights (UNHCHR) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). The Handbook also presents detailed information on the Russian AIDS epidemic with regard to the establishment and implementation of these Guidelines. Most importantly, the Handbook outlines concrete recommendations on measures that legislators can take to protect human rights and promote public health in responding to the epidemic. (author's)
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  6. 6
    Peer Reviewed

    Willingness to pay for AIDS treatment: myths and realities.

    Binswanger HP

    Lancet. 2003 Oct 4; 362(9390):1152-1153.

    By AIDS day 2002, HIV/AIDS in Africa had killed 20.4 million and infected 29.4 million people. This number of deaths is seven times that in the Nazi holocaust, and it approaches the death toll associated with transatlantic slave trading. Treatment for AIDS includes monitoring of disease progression, psychosocial support, provision of adequate nutrition, teaching healthy living and survival skills, prophylaxis and treatment of opportunistic infections, and antiretroviral treatment. Such holistic treatment can now be provided at an all-inclusive cost of about US$600 dollars per year. Yet most African countries and donors still judge this amount to be too costly. The cost of not treating a person with AIDS includes the loss of output of each patient; loss of income of care-givers; cost of treatment in homes, clinics, and hospitals; funeral costs; death and survivor benefits; and the cost of orphan care and support. These costs are met by patients, families, employers, governments, and society at large. On economic grounds alone treatment should be provided for all those for whom the present value of expenses exceeds the cost of not giving treatment. Results of several studies show that this situation is now true for many classes of people and workers. The issue has become not whether we can afford to treat, but whether we can afford not to. Here, I review imagined obstacles and faulty arguments against large-scale treatment programmes, and show that unwillingness to pay is the main reason for inaction. (excerpt)
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  7. 7

    The safety and feasibility of female condom reuse: report of a WHO consultation, 28-29 January 2002, Geneva.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2002. [3], 15 p.

    According to the recommendations of the first consultation, this second meeting (January 2002) was planned to review the resulting data and to develop further guidance on the safety of reuse of the female condom. The specific objectives and anticipated outcomes of this second consultation were to: Review the results and evaluate the implications of the recently completed microbiology and structural integrity experiments and the human use study; Develop a protocol or set of instructions for disinfecting and cleaning used female condoms safely; Outline future research areas and related issues for programme managers to consider when determining the balance of risks and benefits of female condom reuse in various contexts and settings. (excerpt)
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  8. 8

    Addressing the "in" in food insecurity.

    Webb P; Rogers B

    Washington, D.C., Academy for Educational Development [AED], Food and Nutrition Technical Assistance Project, 2003 Feb. 32 p. (Occasional Paper No. 1)

    This paper, commissioned to support the development of the Office of Food for Peace's new Strategic Plan, analyzes the implications of these trends in poverty and malnutrition for USAID food security programming. The paper argues for a conceptual shift that explicitly acknowledges the risks that constrain progress towards enhanced food security, and addresses directly the vulnerability of food insecure households and communities. Enhancing peoples' resiliency to overcome shocks, building people's capacity to transcend food insecurity with a more durable and diverse livelihood base, and increasing human capital will result in long-term sustainable improvements in food security. (excerpt)
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  9. 9

    Behavioral interventions for the prevention of sexual transmission of HIV. [Intervenciones conductuales para la prevención de la transmisión sexual del VIH]

    Institute of Medicine. International Forum for AIDS Research

    Washington, D.C., Institute of Medicine, International Forum for AIDS Research, [1992]. 8 p.

    The fourth meeting of the International Forum for AIDS Research was organized around three overall objectives: a) to consider a model for categorizing behavioral interventions; b)to share information about current behavioral intervention programs in which IFAR members are involved; and c) to foster discussion about the adequacy of present strategies. The meeting began with an analytical phase that explored aspects of methodology, followed with presentations on selected programs, and concluded with a generic case study exercise that highlighted different social scientific perspectives on producing change in human behavior. (excerpt)
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  10. 10

    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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  11. 11

    The blurred line between aiding progress and sanctioning abuse: United States appropriations, the UNFPA and family planning in the P.R.C.

    Gellman TA

    New York Law School Journal of Human Rights. 2000; 17(3):1063-1104.

    This note discusses the trend in People's Republic of China programs, international standards of human rights, legislative trends, and the United States budget for fiscal years 2000 and 2001 as they apply to family planning programs. Specifically, this discussion shows why Congress should condition funding of these programs based on assurances of compliance with human rights standards. Part I presents an overview of the P.R.C. programs. Part II reviews internationally accepted standards of human rights concerning reproduction and population control, as well as China's violations of these rights. Part III describes UNFPA funding of the P.R.C.'s programs, emphasizing their latest 4-year program. Part IV discusses the legislative trend since 1985 of limiting or halting funding to the programs, and the current state of the federal budget regarding these appropriations. Part V discusses the global gag rule and the necessity of its removal. Part VI considers recently proposed legislation regarding funding family planning. Finally, the conclusion proposes a possible solution to the family planning dilemma in the face of both the continuing need for assistance and the continued existence of human rights abuses. (excerpt)
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  12. 12

    [Workshop on quality assurance of salt iodinization programs, October 1996] Atelier en matiere d'assurance de la qualite des programmes d'iodation du sel, Octobre 1996.

    John Snow [JSI]. Opportunities for Micronutrient Interventions [OMNI]; Program Against Micronutrient Malnutrition

    [Arlington, Virginia], JSI, OMNI, 1997 May. [6], 37 p. (USAID Contract No. HRN-C-00-93-00025-08)

    Despite the considerable progress which has been achieved in establishing salt iodination programs with the goal of covering broader populations in more countries, salt produced for eventual human consumption tends to be either over- or underiodized. To resolve that problem, quality assurance systems need to be created and implemented to ensure that the iodized salt being produced and consumed meets certain key standards. This workshop grew out of the ideas and efforts of salt producers, governmental decision-makers, and program and organization managers seeking to evaluate the essential elements of such quality assurance systems and to recommend which steps should be taken. The 27 workshop participants from several different fields and organizations therefore examined production problems, sales monitoring concerns at both the wholesale and retail levels, standards and their application, laboratory analyses, and policy development. Workshop participants came from South Africa, Bangladesh, Canada, Denmark, Eritrea, the US, Ghana, Guatemala, India, Pakistan, Holland, Philippines, Tanzania, and Thailand. Recommendations are presented.
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  13. 13

    A review of the USAID grant to UNICEF for EPI in Uganda, and a follow up visit on strengthening disease surveillance in Uganda, 29 May - 6 June 1997.

    Weeks M

    Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1997. [3], 8, [45] p. (Report; USAID Contract No. HRN-C-00-93-00031-00)

    This report presents the key observations and recommendations of a Basic Support for Institutionalizing Child Survival (BASICS) review of a US Agency for International Development (USAID) grant to UNICEF for the Uganda National Expanded Programme on Immunization (UNEPI). To date, UNEPI's disease surveillance plan has focused almost entirely on acute flaccid paralysis. The need remains for more activities and surveillance concerning measles and neonatal tetanus. The government of Uganda's decentralization process and UNICEF's Community Capacity Building project provide potential for increasing awareness of EPI diseases and improving their detection and reporting. However, UNEPI must first ensure that District Health Teams are prepared, both technically and financially, for responding to reports of EPI diseases. It is recommended that UNEPI continue the revision of its work plan and budget for disease surveillance to include all activities and funding needs for measles and neonatal tetanus as well as the district operational costs. Where possible, UNEPI should provide a facilitator during any Ministry of Health surveillance training to ensure that EPI-related content is adequately covered. Establishment of a reliable, sustainable EPI disease surveillance system in Uganda will contribute to the development of such systems in other African countries.
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  14. 14

    Summary report of: Updating Service Delivery Guidelines and Practices: a Workshop on Recent Recommendations and Experiences, Guatemala City, Guatemala, March 6, 1995.

    Keller S

    Research Triangle Park, North Carolina, Family Health International [FHI], 1995 Aug. [2], 26 p. (MAQ: Maximizing Access and Quality)

    In March 1995, Family Health International (FHI), JHPIEGO Corporation, and seven collaborating agencies hosted an international workshop in Guatemala City so 60 family planning specialists from 23 countries could discuss how national guidelines for the use of contraceptives can be developed and implemented that are universally agreed upon and accepted. This workshop was held because a key obstacle of achieving high-quality family planning services is the lack of such guidelines. The participants reviewed the international recommendations developed by USAID and the World Health Organization (WHO). They also discussed the merits of the guidelines principle and learned from the pioneering countries in this initiative. The pioneering countries were presented in Session II as country case studies and included Mexico, Tanzania, and Turkey. The first session addressed the international initiative to update service delivery guidelines and practices, specifically how medical barriers stand in the way, and the WHO and USAID guidance documents. Session III involved working groups on contraception for young adults, contraception in postpartum care, contraception in postabortion care, progestin-only methods, and client perspectives. Participants suggested that the workshop be adapted into an easily replicated format to introduce the guidelines worldwide. The next step would be to translate the documents into national guidelines and convert them into changes in practice. One way would be to publish training materials for all levels of family planning providers. JHPIEGO has already published a user-friendly pocket guide in five languages to simplify the USAID and WHO documents. FHI has developed Contraceptive Technology Modules to educate policymakers and providers on the latest scientific information. JHPIEGO and FHI have created expert slides to accompany the modules.
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  15. 15

    Technical support to the Expanded Program on Immunization, Ecuador.

    Steinglass R

    [Unpublished] 1989. [4], 16, [27] p. (USAID Contract No. DPE-5927-C-00-5068-00)

    The Ministry of Public Health (MSP) and external agencies participating in Ecuador's Expanded Program on Immunization (EPI) decided in 1987 that a field-oriented supervisor was needed to help improve the implementation of immunization service delivery at operational levels. Dr. Jose Litardo was therefore retained as EPI Field Coordinator to offer technical support including 2 short-term visits annually from REACH headquarters. The 1st visit was January 11-22, 1989, during which detailed discussions were had with USAID, the Ministry of Public Health (MSP), PAHO, and UNICEF staff; a 3-day field trip within Cotopaxi Province also took place so that EPI supervisory techniques could be demonstrated, strengths and weaknesses in the EPI identified, and recommendations formulated. It was found that the MSP needs technical, managerial, administrative, and logistic support for its EPI at provincial and canton health area levels as it continues to extend its regionalization of health services. More personnel like the REACH EPI Field Coordinator will be needed. It was also found that the program has been slack in meeting routine demand for immunization services; the prevention of neonatal tetanus has been overlooked relative to other EPI target diseases; many norms in use Ecuador do not reflect internationally accepted WHO EPI policies; third doses of vaccine are not completed before age 12 months in many areas; and training in the management and supervision of the cold chain is needed. REACH supports the MSP's decision to assign Litardo to Esmeraldas in 1989. Recommendations are provided on regionalization, delivery strategies, EPI norms, monitoring immunization coverage, supervision, the cold chain, and research.
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  16. 16

    Study of sustainability for the National Family Planning Board in Jamaica.

    Clyde ME; Levy TD; Bennett J

    [Unpublished] 1992 Apr 2. iv, 37, [24] p. (PN-ABL-448)

    The family planning (FP) program sponsored by the National Family Planning Board (NFPB) of Jamaica has proved a successful example to other countries in the Caribbean. New challenges, however, face the Board and the Jamaican government. Specifically, the government wishes to realize replacement fertility by the year 2000; USAID/Kingston will phase out assistance for FP over the period 1993-98, while the UNFPA and the World Bank will also reduce support; the high use of supply methods such as the pill and condom is less efficient than the use of longterm methods; and legal, economic, regulatory, and other operational barriers exist that constrain FP program expansion. A new implementation strategy is therefore needed to address these problems. The NFPB is the best suited body to develop and implement this strategy. Accordingly, it should work to garner the support of and a partnership with the public and private sectors to mobilize resources for FP. Instead of being the primary provider of FP for all consumers, the public sector must start providing for users who cannot pay for services and leave those who can pay to the private sector. This approach will diversify the burden of financing services while expanding the pool of service providers. Recommendations and next steps for the NFPB are offered in the areas of population targets to be served; the role and function of the NFPB to reach and serve various targets; and how to sustain beyond the cessation of donor inputs.
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  17. 17

    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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  18. 18

    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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  19. 19

    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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  20. 20
    Peer Reviewed

    Maternal anthropometry for prediction of pregnancy outcomes: memorandum from a USAID/WHO/PAHO/MotherCare meeting.

    Krasovec K; Anderson MA


    The memorandum is an abbreviated version of a prepared report on maternal anthropometry which summarizes the general recommendations of a consensus of 50 experts on field applications and priority research issues in developing countries. Consensus was reached at a meeting on Maternal Anthropometry for Prediction of Pregnancy Outcomes held in Washington, D.C. in April 1990. 15 general recommendations are identified for field applications and research priorities. Specific recommendations differentiating field applications from research priorities are provided for prepregnancy weight, weight gain in pregnancy, height, arm circumference, and weight for height and body mass index. For example, the discussion of arm circumference indicates that it is useful as an indicator of maternal nutritional status in nonpregnant women because of its correlation with maternal weight or weight for height. During pregnancy, it is useful as a screen for risk of low birth weight (LBW) and late fetal and infant mortality. Maternal arm circumference has been found to be stable during pregnancy in developing countries and is independent of gestational age. Field applications involve the use 1) to assess the nutritional status of pregnant and nonpregnant women, 2) to screen women at risk of poor maternal stores postpartum because it reflects maternal fat and lean tissue stores, for instance, 3) to screen women and refer to facilities for a more thorough assessment of nutritional risk, and 4) to assess the extent of undernutrition in an area, particularly for surveillance. Community level workers, especially birth attendants (TBA's) should be trained and have access to arm circumference tapes. The technology is simple enough also for use by women in the home. Cutoff points for assessing biological risk are fairly consistent across developing country populations, and range between 21-23.5 cm. Routine monitoring during pregnancy is not necessary because the changes are too small to detect. Where prepregnancy weight is unavailable and weight is monitored, arm circumference may serve as a proxy for prepregnancy weight. All women of childbearing age should be measured. Research priorities are to explore the functional significance with women of difference body compositions (fat versus lean upper arm), the relationship to pregnancy related outcomes, arm changes relative to stages throughout the reproductive period and to weight changes, different instruments such as color-coded tapes or 1 tape for arm measurement and uterine height, combinations of different measurements, the relationship with prepregnancy weight, and the development of arm circumference in weight gain charts as a proxy for prepregnancy weight.
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  21. 21

    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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  22. 22

    Evaluation of Matching Grant II to International Planned Parenthood Federation / Western Hemisphere Region (IPPF/WHR) (1987-1992).

    Wickham R; Miller R; Rizo A; Wexler DB

    Arlington, Virginia, DUAL and Associates, Population Technical Assistance Project [POPTECH], 1991 Jul 26. xii, 48, [25] p. (Report No. 90-078-116; USAID Contract No. DPE-3043-G-SS-7062-00)

    This is a mid-term review of a matching grant given to the International Planned Parenthood Federation/Western Hemisphere Region (IPPF/WHR) by USAID's Office of Population for 1987-1991. The grant covers projects in Brazil, Colombia, Mexico and 9 smaller countries, and 4 regional activities, commodities, technical assistance, management information systems (MIS), and evaluation support. The goal of the grant was to reach new acceptors with quality services, to exert leadership of public sector providers, and to improve internal management. The goals in the 3 large nations are to focus on pockets of need or inadequate service or method mix. The goals of attracting 2.8 million new acceptors, improving services, making detailed plans and keeping strict financial reports have been met. The most serious problem was the lack of a regional evaluation of goal evaluation, the real cost of contraception, and impediments to contraceptive use. There were also difficulties in forwarding funds at the beginning of the FPA's year, and in sending in agency workplans on time. Better communication structures could probably remedy this. It is recommended that the matching grant be renewed in 1992.
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  23. 23

    Operational issues in developing A.I.D. policy reform programs.

    Vondal P

    Washington, D.C., Agency for International Development, 1989 Oct. vii, 38 p. (A.I.D. Program Evaluation Discussion Paper No. 28)

    This paper discusses the operational issues in the US Agency for International Development's (AID) strategy for developing sustainable economic growth in developing countries. The complexity of this task involves planning, designing, and negotiating policy reform for programs. The topics covered in this report include: 1) approaches to selecting policy reform objectives; 2) analytical requirements for designing programs; 3) coordination with the International Monetary Fund and the World Bank (WB); 4) design of conditionality; 5) use of AID resources in packaging reforms; 6) sources of AID influence for obtaining negotiation agreements; and 7) negotiation strategies and styles. The content of this report is based on responses to questionnaires sent to all past and present AID Mission directors and program officers involved in overseeing policy negotiations for economic reform; interviews conducted in Washington D.C., and a review of selected AID and WB documents. The manner in which USAID plans, designs and negotiates policy reform programs has major implications for: 1) amount of support the program will have from host government; 2) implementation of the program by the host government; 3) the sustainability of the reform program; and 4) the level of relationship between the US and the host government. Program and political success has been demonstrated when efforts are made that stress collaboration, consensus-building, flexibility, sensitivity to cross-cultural differences and appreciation of country political and economic situations. (Author's modified).
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  24. 24

    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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  25. 25

    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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