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Proceedings of the Caribbean Regional Conference "Operations Research: Key to Management and Policy", Dover Convention Centre, St. Lawrence, Barbados, May 31 - June 2, 1989.
[New York, New York], Population Council, 1989. 19,  p.Objectives, proceedings, and conclusions of a Caribbean regional conference on operations research (OR) in maternal-child health and family planning programs (FP/MCH) are summarized. Sponsored by the Population Council, USAID, and UNICEF, participants included policy makers, program managers, service providers, and representatives from international agencies in health and family planning from Antigua and Barbuda, Barbados, Dominica, Grenada, Jamaica, Mexico, St. Kitts-Nevis, St. Lucia, St. Vincent and the Grenadines, Trinidad and Tobago, and the U.S. The conference was held with hopes of contributing to the legitimization of OR as a management tool, and helping to develop a network of program directors and researchers interested in using OR for program improvement. Specifically, participants were called upon to review the progress and results of recent regional OR projects, analyze the utilization of these projects by policy makers and program managers, highlight regional quality of care, and establish directions for future projects in the region. Overall, the conference contributed to the dissemination and documentation of OR, and provided a forum in which to identify important service, research, and policy issues for the future. OR can improve FP/MCH services, and make positive contributions to the social impact of these programs. The unmet need of teenagers and men and structural adjustment were identified as issues of concern. Strategies will need to be developed to maintain currently high levels of contraceptive prevalence, while responding to the needs of special groups, with OR expected to focus on the quality of care especially in education and counseling, and screening and user follow-up. The technical competence of service providers and follow-up mechanisms are both in need of improvement, while stronger institutional and management capabilities should be developed through training and human resource development.
Program report [of the Central America regional seminar-workshop entitled] New Focuses of Family Planning Program Administration: Analysis of Contraceptive Prevalence Surveys and Other Program Data, [held in] Antigua, Guatemala, May 25-30, 1980.
[Washington, D.C., CEFPA, 1980.] 30 p. (Contract AID/pha-c-1187)This report 1) presents a summary of the planning process of the seminar-workshop in family planning held in Antigua, Guatemala from May 25-30, 1980; 2) reviews program content and training methodology; and 3) provides feedback on the evaluation of the program and in-country follow-up responses to the workshop. Negotiations were made between the Centre for Population Activities (CEFPA) officials, USAID (U.S. Agency for International Development) population/health officials, and family planning officials from each participating country to elicit program suggestions and support. The ensuing communication process facilitated the development of the program in many ways, including: 1) program design, which incorporated in-country family planning program needs, suggested workshop topics, and country-specific requests for workshop objective; 2) participant selection; and 3) USAID mission commitment. The workshop aimed to provide an opportunity for leaders of family planning and related programs to make an intelligent and effective use of data available to them. The training methodology consisted of structured small-group exercises. Program content included: 1) contraceptive prevalence survey case exercise, which aims to identify problem areas and need in the delivery of family planning and maternal child health services as a tool in assessing progress towards family planning goals; 2) other data sources available to family planning program managers, including World Fertility Survey data and program service statistics; 3) program alternatives in the form of mini-workshops on such topics as logistics management, improving clinic efficiency, primary health and family planning, adolescent fertility, and voluntary sterilization; and 4) program planning, which enables participants to interpret data and apply them in the planning process. In evaluating the workshop, a majority of the participants reported that the workshop and their own personal objectives were either completely or almost completely achieved, and they also indicated that more workshops at the regional and national levels should be conducted.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1997. , 14,  p. (Report; USAID Contract No. HRN-C-00-93-00031-00)This report pertains to a consultant visit to Mali, during November 15-22, 1997, to plan a radio training workshop. The workshop was requested as a follow-up to a BASICS regional workshop for radio health messages held in Burkina Faso, in June 1997. The aim of the visit was to decide on an operational plan to deliver health messages aimed at behavioral change, as construed by USAID. The consultants studied the mass media context in Mali, and planned a training workshop for radio journalists and health personnel on an appropriate child health topic. Mali has a thriving independent radio network and a good degree of communal listening to the radio. Health agencies have prioritized the most important child health need as maternal and infant malnutrition and nutritional practices that are harmful to child health. High infant mortality is attributed to withholding of fluids in cases of infant diarrhea and delayed breast feeding. About 50% of mothers are anemic. Meetings were held with many radio-related persons in Bamako, in order to determine the extent and focus of the training need. The family health director of the Ministry of Health (DSF) suggested targeting participants beyond the BASICS area. DSF is BASICS' key partner and one that has contact with 2 local radio stations. Meetings included child health and IEC specialists with USAID/Bamako, which supports 64 community radios outside Bamako. USAID has contacts with major supporters of radio. Meetings were held with people from Plan International, UNICEF, PANOS Institute, Groupe Pivot, SOMARC, World Vision, CNIECS, and potential collaborators.
Summary report of: Updating Service Delivery Guidelines and Practices: a Workshop on Recent Recommendations and Experiences, Guatemala City, Guatemala, March 6, 1995.
Research Triangle Park, North Carolina, Family Health International [FHI], 1995 Aug. , 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.
Arlington, Virginia, Management Sciences for Health, Technologies for Primary Health Care [PRITECH], 1992. , 36 p. (USAID Contract No. DPE-5969-Z-00-7064-00)The Technologies for Primary Health Care Project (PRITECH) in Madagascar was begun in April 1992, in collaboration with the Ministry of Health (MOH), UNICEF, and WHO to reduce diarrhea-related morbidity and mortality in children under 5 years old. Consultants visited Madagascar in 1992 to plan PRITECH activities for 1993 and to analyze the oral rehydration salt (ORS) marketing situation. The ORS market assessment included a market analysis of pharmaceutical producers, distributors, and outlets. Key issues identified were the continuous supply, availability, accessibility, and correct use of ORS. Based on this assessment, preliminary marketing recommendations were to maintain local production by renegotiating agreements on the supply of raw materials and then to find a new and sustainable supply when demand outstrips supply in 1994. To develop a revised 1993 work plan and administrative arrangements for PRITECH activities, PRITECH consultants met with MOH officials, visited MOH facilities, and reported on collaboration efforts with UNICEF. In 1993, PRITECH will focus on the development of the National Control of Diarrheal Disease (CDD) program and establish 2 CDD Documentation Centers. PRITECH's original scope of work has been revised since 1992, but the 4 main objectives remain: 1) to increase the number of health care providers who can manage diarrheal disease and use ORS; 2) to develop an information, education, and communication (IEC) strategy; 3) to increase ORS demand, production, and availability; and 4) to increase the effectiveness and efficiency of the CDD program implementation. In the first quarter of 1993, PRITECH-supported MOH training activities included an IEC Strategy/ORS Promotion Plan Workshop, a Diarrhea Training Workshop, and third country training for CDD staff in Cameroon and Geneva. The administrative issues remaining to be settled before PRITECH start-up include: 1) procurement of vehicles (Jeep Cherokees), 2) establishment of a bank account, and 3) purchasing equipment, including photocopiers, a slide projector, overhead projector, computer, and printer. Plans for followup training include an IEC workshop and a Diarrhea Training Unit workshop. A revised calendar of activities, schedule of visits, list of people contacted, workshop participant lists, and delivery order scope of work description are presented.
[Unpublished] 1989. , 16,  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.
National Program on the Control of Diarrheal Diseases. Report of the Joint MOH / WHO / UNICEF / USAID Comprehensive Program Review, 28 January to 11 February, 1985.
Manila, Philippines, Ministry of Health, 1985. v, 36 p.In early 1985, representatives of the Philippines Ministry of Health, WHO, UNICEF, and USAID visited health facilities (barangay health stations to hospitals) and used data from 9106 households (11,131 children under 5 years old) in the provinces of La Union, Bohol, and Bukidnon in the Philippines, to evaluate implementation and effect of the National Program on the Control of Diarrheal Diseases (CDD). 10.8% of the children had had diarrhea within the last 2 weeks. Mean diarrhea episode/child/year stood at 2.8. Mean infant mortality was 62.3/1000 live births (35.8 in La Union to 94 in Bukidnon). Diarrhea-related mortality for all children studied ranged from 3 in La Union to 18.3 in Bukidnon (mean = 8.6). Between 1978 and 1982, the diarrhea-related mortality rate for all of the Philippines fell from 2.1 to 1, presumably due to the CDD Program. Diarrhea was the leading cause of death in Bukidnon (21.3%), but in La Union and Bohol, it was the 5th leading cause of death (6.6% and 10.3%, respectively). 33% of children with diarrhea received oral rehydration solution (ORS), 12% did not receive any treatment, and 72% received herbs, antibiotics, or antidiarrheals. Many of the children receiving ORS also received other treatments. 86% of mothers were familiar with ORS and 73% of them had used it. 92% would use it again. 84% would buy it from stores, if sold. Government health facilities tended to use ORS and to prescribe it for diarrhea cases. Most facilities had successfully promoted breast feeding. The supply of ORS packets in most facilities was good. Almost all health personnel had received ORT training. Some recommendations included promotion of non-ORT strategies (e.g., hand-washing and food safety), conducting research (e.g., to identify suitable fluids and foods for home-based oral rehydration therapy, and regular monitoring and evaluation of the CDD Program.
[Unpublished] . 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.
Baltimore, Maryland, JHPIEGO, 1987. iii, 23 p.The Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) is a private, non-profit corporation affiliated with the Johns Hopkins University, and funded by the U.S. Agency for International Development (USAID). It aims to increase the availability of improved reproductive health services and the number of skilled and knowledgeable health professionals in developing countries, especially in the area of family planning. JHPIEGO has supported educational programs for over 55,000 health care professionals and students from 122 countries since 1974. In 1987, it supported 46 programs for 12, 981 participants in 26 countries. 12,821 were trained in-country, 160 attended regional programs open to professionals seeking training not offered domestically, and an additional 122 studies at the JHPIEGO educational center in Baltimore for an eventual total of 13,103 trainees. 1,719 participants were from Africa, 541 from Asia, 10,426 from Latin America and the caribbean, and 417 from the Near East. Additional accomplishments include the creation of a slide/lecture set on contraception and reproductive health for distribution to selected health care leaders with teaching responsibilities in developing countries. A French translation is being developed. Proceedings from a conference co-sponsored with the World Health Organization, Reproductive Health Education and Technology: Issues and Future Directions, should also be published in Fall, 1988. The report comprehensively describes training objectives and activities for the 4 regions and the educational center, and discusses program evaluation. It further presents training and program support statistics, trends, a financial report, and supporting figures and tables.
Arlington, Virginia, Management Sciences for Health, Technologies for Primary Health Care [PRITECH], 1991.  p. (USAID Contract No. DPE-5969-Z-00-7064-00)Representatives from several nongovernmental organizations visited Uganda in February-March 1991 to help the Control of Diarrheal Disease (CCD) program bolster its ability to advance case management, training, and supervision of health care professionals. Specifically, the team focussed its activities on determining a strategy to create a national level diarrhea training unit (DTU) centered around case management for medical officers, interns and residents, medical students, and nurses. Similarly, it participated in developing a strategy for training traditional healers in diarrhea case management and for inservice training for health inspectors (preventive health workers). The team presented a generic model for a training/support system to the DTU faculty and CDD program manager. The model centered on what needs to be done to ensure that the local clinic health worker manages diarrhea cases properly and instructs mothers effectively to manage diarrhea. Further, in addition to comprehensive case management, content included interpersonal communication at all levels supplemented by supervision and training skills. It encouraged a participatory approach for training. In addition, it strongly encouraged the DTU faculty and CDD program staff to follow up on training activities such as supporting trainees and reinforcing skills learned in the training course. The team met with relevant government, university, and donor representatives to learn more about existing or proposed CDD activities. Further, the CDD program asked team members to assist informally in the surveyor training session for the WHO/CDD Health Facilities Survey. The team also spoke to WHO/CDD staff about its plans and future activities. WHO/CDD was concerned that training in interpersonal skills not weaken the quality of training in diarrhea case management.
Plan of action for the control of diarrheal diseases in the region of the Americas. Interagency Coordinating Committee for the Control of Diarrheal Diseases (ICC/CDD). Plan de accion para el control de las enfermedades diarreicas en la region de las Americas.
[Unpublished] . , 32, , 32 p.The American made remarkable strides in reducing diarrheal mortality and morbidity during the 1980s. All of the nations here had in place a control of diarrheal diseases (CDD) program or CDD activities by early 1989. 1 goal for CDD projects in the region included ORS availability to 80% of all children <5 years old. 17 nations even produced their own oral rehydration solution (ORS). This contributed to the fact that more countries proportionally produced ORS in the Americas than in any other region. Still diarrhea continued to be 1 of the 3 leading causes of death and illness in children <5 years old in most countries in the Americas. Accordingly an Interagency Coordinating Committee (ICC/CDD) Task Force composed of representatives from PAHO, UNICEF, and USAID formed in 1989 to develop a framework for the region and countries to follow in designing plans of action. Each country in the Americas should foster effective cooperation among all organizations involved in CDD activities within that country. If an interagency process, e.g., child survival programs, already exists, the country should include the CDD program into it. National ICC/CDDs should define policies and prepare the plan of action incorporating both technical and financial support from the public and private sectors. They must also coordinate CDD training activities, especially those emphasizing correct case management. Further they should concur on communication projects and coordinate message development and relations with the mass media. These committees must also recognize problems, develop solutions, foster research, and amend national CDD programs as needed. PAHO is the technical secretariat for the regional ICC/CDD which works to foster optimum cooperation among PAHO, UNICEF, and USAID thereby providing maximum assistance to these programs.
Child survival and development toward Health for All: roles and strategies for Asia-Pacific universities.
ASIA-PACIFIC JOURNAL OF PUBLIC HEALTH. 1989; 3(2):118-28.The child survival and development movement in relation to universities in the Asia-Pacific region were the subject of recent discussions of medical practitioners and academics. There are 14 million deaths of children that could be avoided if they could benefit from immunizations, pure water, sanitation, nutrition, and oral rehydration therapy. Also there is a large loss of physical and mental ability. Many international agencies have helped improved children's health and survival, and life expectancy has risen 40% in the last 40 years. In countries such as China, India, Pakistan, Thailand, and Indonesia there has been an exceptional achievement in child survival and development. In many developing countries health services have been patterned after western medical systems that promote treatment rather than prevention. Universities' role in relation to these problems has been the conducting of research, providing instruction, education, and training. The areas of success are in vaccine development and mass communications research. New roles can be taken in technical assistance and introduction of technology in planning and evaluation. There are also possibilities in the pooling of information and resources to help in child survival and development. In long range strategies and roles, universities can use conventional methods. In midrange areas the universities can use new modes and share and interact with governments and international organizations. In the short term they can use the less conventional methods and follow the leadership of the international organizations. In short term, universities can provide help in planning of national campaigns, provide resources, and participate in evaluations of campaigns. In the mid-range they can be involved in joint initiatives in operations research, specialized training, and clinical trials. In the long range universities are best suited to conventional research, training, laboratory science and technology development.
Draft team member contributions to mid-term evaluation of the Population and Family Planning Project (608-0171) in Morocco.
[Unpublished] 1988 Mar. 13 p.The draft team member contributions to the mid-term evaluation of the population and family planning project in Morocco examine current progress and address future needs. Increased awareness of at least 1 method of family planning was attributed to a USAID-funded project. But, problems of access, religious constraints, and lack of method-specific media campaigns need to be addressed. An increased effort to direct promotion efforts toward men is needed, as a prior immunization program showed that the husband was a key factor in encouraging mothers to bring their children to be vaccinated. Because the local health worker plays a critical role at the community level, training and support for these workers should be emphasized. Media-specific and audience-specific campaigns, by the government and private sector, should focus on the most cost-effective means of reaching the provincial level population. Donor organizations (such as UNICEF, UNFPA and USAID) should address the IEC needs identified by the central health education office, whose role and supporting functions need to be strengthened. Content of family planning materials must be method-specific, using a systematic methodology to address problems of inappropriateness, inadequate contraceptive mix, and lack of field worker training materials. Improved distribution methods for existing materials, as well as increased use of television and mass media are viable options. Using the community more effectively by encouraging leader motivation and instituting incentives could help to improve promotional and distributional activities at the provincial level. An evaluation of training needs revealed that the workshop method of training may be overemphasized, and most health workers expressed a desire for lengthened training. The private sector could be sensitized to public health issues and needs and, in conjunction with out of country technical assistance, produce effective social marketing of contraceptives within the Moroccan context. Coordination with other donors would be beneficial, with the exchange of documents and meetings between the groups.
In: Conference for Identification of Unmet Needs in Family Health Care in Anglophone Africa, 1979, London. Report of the Conference. [London, ICM and USAID, 1979]. 5 p..In this report of the Conference for Identification of Unmet Needs in Family Health Care in Anglophone Africa, meeting in London in 1979, objectives were reviewed and shortcomings of health care were outlined. Objectives included the following: giving leaders the opportunity to state their unmet needs in their own country in the field of maternal and child health and family planning; identifying the role of rural health personnel within such programs; and recommending individual midwives capable of implementing in-country programs aimed at meeting the needs. Adequate financial resources were considered to be the primary constraint against development of comprehensive health care services. Generally, there were insufficient facilities to meet the needs of the populations and overcrowding was often encountered. Maldistribution of facilities and services brought a concentration of available care in the urban areas and deficiencies in the rural areas. The scope of maternal and child health care in most countries left room for improvement. Health education, with emphasis on community participation, had been begun in many countries but required strengthening. Every country delegate thought that their health services were unduly concentrated in the urban areas and that the rural areas were neglected. No country had sufficient health personnel at any level, and equipment was scanty and frequently out-of-date. There was a growing realization of the need for the involvement of the community in all aspects of health care delivery. Points highlighted during discussions following presentations included approaches to establishing primary bealth care projects, with the identification, training and utilization of village level workers who were selected by the villages and who would work in their villages following training. The wide variety of care provided by traditional birth attendants highlight the need for training to be based on a spot description of the tasks they would be expected to perform. There were family planning programs in all of the countries, and the majority involved the midwives in some aspect of the program.
Unpublished, U.N. Development Programme memorandum, July 1970. 16 pAdd to my documents.
Chapel Hill, N.C.; University of North Carolina, Carolina Population Center, 32 p., December 1969The greatest challenge for America today is the world's population growth; both external and internal strains caused by this affect American life. Knowledge of family planning programs is quite adequate, however, financial support is usually scanty, and the important matter is to apply what is known. The amount and kind of help needed by the developing nations exceed the present capapcity (in terms of personnel, technical expertise, and funds) of assistance by the U.S. A ten year global population program is proposed. Suggested aims for this program include: a) drastic reduction of birth rates in high fertility countries, b) development of international mechanisms to achieve and maintain norms of low population growth, c) creation of major agency to provide funds through other channels, and d) demonstration of sincerity abroad by developing strong domestic policies.
[Unpublished] 1982. 19 p.The Integrated Population and Development Planning project (IPDP) has led to many diverse activities in 22 countries. The project consists of technical assistance, training, and research which have been evaluated insofar as each contributes to the objectives of the project. One part of the evaluation examines the Mauritania Human Resources Planning Model, Thailand Cost Benefit Analysis, the relationship between IPDP and The Futures Group, the role of the African Regional Office in Lome, Togo, and the quality of staffing of the IPDP; the 2nd part deals with project management issues. The following recommendations are made: 1) future activities should be concentrated in no more than 10 countries, 2) a special workshop should be convened to reexamine the entire issue of population and development policy, particularly as it related to sub-Saharan Africa, 3) future conferences should be planned as workshops or as short courses and be oriented towards mid-level staff, 4) no new research should be solicited, 5) technical assistance should be available not only to ministries of planning but to other ministries as well, 6) mini-courses should be developed in computer science, demography, statistics, and the economics of population in host countries, and individuals sent to short-term courses in the region or, if preferable, in the U.S., 7) the IPDP core staff should be maintained at its 1981/82 strength over the remaining term of the project, 8) present activities should be continued and adequately financed so that real impact on population policy may be achieved, and 9) the US Agency for International Development/Washington Contract Office should review internal procedures to expedite contractor requests for consultant approval.
Horizons. 1983 Apr; 2(4):14-20.In Honduras and the Gambia the US Agency for International Development's (AID's) Bureau for Science and Technology and its contractors, working with the Ministry of Health in each country and drawing upon experts in health communications, anthropology, and behavioral psychology, have developed a health education methodology that integrates mass media and health providers. The project uses radio, graphics, and the training of village health workers to teach mothers how to treat and prevent diarrheal dehydration. The World Health Organization (WHO) and the AID assisted International Center for Diarrheal Disease Research in Bangladesh, have demonstrated that lost body fluid and electrolytes can be replaced with an orally administered solution. The treatment is known as ORT, oral rehydration therapy. AID efforts in Honduras and Gambia are showing that semi-literate persons, contacted primarily through the mass media, can be taught to mix and administer ORT. The campaign also includes a number of preventive measures. The Gambian government chose to use ORT packets prepared according to the WHO formula at health centers as a backup to the similar home mix solution. Honduras chose to package their own ORT salts, following the WHO formula, for use both at health centers and in the home. In Gambia the Ministry of Health created a national contest which kicked off with the distribution of 200,000 copies of a flyer carrying mixing instructions to nearly 2000 Gambian villages. Repeated radio announcements in Gambia's 2 major languages told mothers to gather and listen to contest instructions. The radio announcer led listeners through each panel of the color coded flyer which told them how to mix and administer ORT. 11,000 women attended the 72 village contests. Of the 6580 who entered the mixing competition, 1440 won a chance to compete and 1097 won prizes for correct mixing. After 8 months of campaign activities, the number of mothers who reported using a sugar-salt solution to treat their children's diarrhea rose from 3% to 48% (within the sample of some 750 households). The number of women who could recite the formula jumped from 1% to 64%. In Honduras a keynote poster for the campaign that featured a loving mother was distributed simultaneously with the airing of the 1st phase of the radio spots and programs. Within a year 93% of the mothers knew that the radio campaign was promoting Litrosol, the name of the locally packaged ORT salts; 71% could recite the radio jingle stressing the administration of liquid during diarrhea, and 42% knew that Litrosol prevented dehydration. 49% of all mothers in the sample had tried Litrosol at least once during the campaign.
World Health Forum. 1983; 4(2):157-61.In developing countries, the delivery of basic health care services is often hampered by communications problems. A pilot project in Guyana, involving 2-way radio in 9 medex (medical extension) locations, was funded by USAID (United States Aid for International Development). A training manual was prepared, and a training workshop provided the medex workers with practical experience in using the radios. The 2-way radios have facilitated arrangements for the transport of goods, hastened arrangements for leave, and shortened delays in correspondence and other administrative matters. Communication links enable rural health workers to treat patients with the advice of a doctor and allow doctors to monitor patient progress. Remote medex workers report that regular radio contacts with their colleagues have lessened their sense of isolation, boosted their morale, and helped build their confidence. 1 important element of the project was the training given to the field workers in proper use of the radio and in basic maintenance. Another key to the success of the system appears to be the strength and professionalism of the medex organization itself. Satellite systems may eventually prove to be the most cost effective means of providing rural telephone and broadcasting services and may also be designed to include dedicated medical communications networks at very little additional cost.
Washington, D.C., USAID, Bureau for Program and Policy Coordination, 1982 Dec. 13 p. (A.I.D. Policy Paper)Human resources development, necessary for the growth of overall productivity and efficient use of human capital, is a longterm process that is integral to all aspects of national development. Broad agreement exists among development agencies that assisting countries to establish more efficient systems of education, to control their recurrent cost and administrative burdens, and to relate them more effectively to employment opportunities and trained manpower needs are essential components of effective development strategies. The development strategies of the US Agency for International Development (USAID) stress efforts to raise levels of basic education and relate technical training to employment opportunities as adjuncts of programs to apply science and technology to development efforts, rely on market mechanisms and the private sector to stimulate economic development, strengthen institutions important in development processes, and reinforce efforts of local leaders to address their development problems and administer local resources. Schooling for children aged 6-14, vocational education and functional skills training for adolescents and self-employed adults, and technical skills training for wage employment are among USAID priorities. USAID policy is to focus 1st on problems of resource utilization and internal efficiency, in the expectation that such an approach will lead over time to improved access and more broadly based distribution of educational opportunities. Most nonenrolled children or those whose educational experience is cut short by grade repetition, examination failure, or dropout, are poor, rural, or female, and those who are all 3 usually have the least opportunity. Measures are thus needed to increase the proportions of children who successfully complete at least primary schooling. USAID will focus its assitance to educational and training systems on increasing the efficiency of educational resource utilization, increasing the quantitative and qualitative outputs of training and educational investments, and increasing the effectiveness of the educational and training systems to support economic and social development goals. USAID will seek to promote the participation of communities in the establishment and maintenance of schools and the involvement of employers in the implementation ot technical training programs.