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FORUM. 1996 Dec; 12(2):7-8.Community milk distribution posts are places where poor families with children under age 12 years can buy milk at subsidized prices. The centers are run by a social service agency called Liconsa and are located in marginalized neighborhoods around Mexico City. MEXFAM, the International Planned Parenthood Federation affiliate in Mexico, offers health services to women through 25 of these centers. Women who visit milk centers can therefore conveniently have their blood pressure, weight, and height measured; receive vaccines, parasite treatment, diabetes screening, and family planning information; and obtain contraceptive pills, injectables, and condoms while they pick up their milk. Counselors are on site. Referrals for other health services and contraceptive methods are made to the MEXFAM Community Clinic and MEXFAM's Medical Services Center as needed. Each site provides services to approximately 250 women.
In: Gender, health, and sustainable development: a Latin American perspective. Proceedings of a workshop held in Montevideo, Uruguay, 26-29 April 1994, edited by Pandu Wijeyaratne, Janet Hatcher Roberts, Jennifer Kitts, and Lori Jones Arsenault. Ottawa, Canada, International Development Research Centre, 1994 Sep. 19-25.A non-profit, nongovernmental organization, the Paulina Luisa Movement was founded in 1985. It is based in the poor Cerro Largo region of Uruguay. There has been considerable concern for many years over the quality of health care which women receive in public and private health clinics. Health services in Uruguay generally perpetuate the notion that men should be the ultimate authority. In the field of medicine, the male doctor, not the female doctor, holds power and knowledge. These men are usually loathe to establish equal and cooperative relationships with their female patients. In this context, four years ago, the coordinators of the movement began to design a new model for women's health care. Many programs were launched designed to improve health services for women. When HIV/AIDS emerged as a serious heath concern, it was immediately incorporated into the women's health program. This paper describes an HIV/AIDS education intervention project proposed by the Paulina Movement and other nongovernmental organizations to the World Health Organization (WHO) in 1992. The project was approved by the WHO and was developed in 1993 throughout Argentina and Uruguay. Project objectives, methodology, the vulnerability of women to HIV/AIDS, and results are presented. The 82 women involved in the project learned new approaches to avoiding infection with HIV.
PLANNED PARENTHOOD CHALLENGES. 1994; (2):42-4.INPPARES, the International Planned Parenthood Federation affiliate in Peru, has provided family planning and other services to the Peruvian population since 1976. The organization concentrates upon interventions targeted to women of low socioeconomic status. One of the group's most important strategies has been to distribute contraceptives at the community level in rural and peri-urban areas of the country through a network of centers managed by promoters. These promoters are virtually all female. The organization in 1993 supplied 812 distribution centers. Promoters and their supervisors have received training in contraception, basic data recording, community work, and related topics. INPPARES, however, suspected that the quality of the project would be improved if promoters and supervisors were trained about the role of women in the community and their rights and identity as women. The personnel would then be able to better understand the role of contraception and reproductive health in women's lives. To that end, INPPARES in 1992-93 developed a project in coordination with the Manuela Ramos Association, a Peruvian women's organization. A questionnaire was given to forty promoters on issues related to women's roles, values, attitudes, the place of women in society and the family, family planning, sexual relations, and decision making. Their responses pointed to a real need to provide promoters and supervisors with more information through workshops on women in Peruvian society, women's identity and roles, women's sexual rights, and the quality of care in service provision. Four pamphlets were drafted from a seminar of fifty supervisors from both organizations to be used in a series of twelve workshops for 256 promoters. Post-intervention evaluation of the original forty participants confirm the significant effectiveness of both subjects covered and materials used in achieving desired project goals. Four workshops were subsequently held in which project results were presented to 261 promoters. Promoters and supervisors are now using flipcharts and pamphlets in their training activities.
WASHINGTON MEMO. 1992 Nov 12; (17):2-3.In October 1992, the US Food and Drug Administration (FDA) approved Depo-Provera for contraceptive use thus increasing the number of available contraceptives to women. Yet USAID has distributed it through its family planning programs in developing countries for many years. It has been available in the US since 1969 for noncontraceptive purposes such as endometrial cancer treatment. More than >30 million women around the world have used it to prevent conception. Today about 9 million women in 90 countries use it. A reason FDA did not approve Depo-Provera is that some studies revealed a link between it and breast tumors and cervical cancer in animals. More recent research conducted by WHO shows no connection with cervical cancer or ovarian cancer. In fact, it demonstrates Depo-Provera may protect against endometrial cancer. Yet it does indicate an insignificant increased risk of breast cancer in younger women. Some research suggests Depo-Provera may decrease bone density leading to osteoporosis and may increase the risk of having a low birth weight infant if the child is conceived before an injection. Evidence exists that it may lead to longer delays in becoming pregnant than other forms of contraception. Still 70% do conceive within 12 months after the last injection. Each Depo-Provera injection delivers a progestin in a water-based solution over 12 weeks resulting in suppressed ovulation. Its failure rate is <.5%/year, so Depo-Provera is one of the most effective reversible contraceptive available. The most common side effects are menstrual changes and weight gain (5-15 lbs.). Some contraindications include pregnancy, heart or liver disease, and breast cancer. As of November 1992, the FDA had not announced the cost or whether there would be a reduced price for family planning and public health clinics. Women's health and rights advocates plan on monitoring introduction of Depo-Provera to make sure that women have received comprehensive information and were not coerced to use it.
CHILDREN IN FOCUS. 1992 Jan-Mar; 4(1):8.Working class women have always been creative in developing methods of surviving when times get bad. Examples include: earning income from informal sector work, trading in foods stuffs and manufactured items, domestic work. They also alter their consumption patterns by cutting purchases and making do with less, and by planting kitchen gardens. Others relay on remittances from relatives who have migrated to developed nations. Most use multiple strategies to secure the well being of their children and family. These flexible behavior patterns are among the strengths of Caribbean working class women that allow them to deal the harsh realities of poverty. However these strengths have been turned around and used against these women by many governmental and international agencies. The fact that they are able to cope is used to support programs that only perpetuate the situation rather than helping these women to change their lives. These women are caught in a cycle of deprivation, powerlessness, acceptance of hardship, survival strategies, continuing exploitation and continuing deprivation. Because of the actions of such agencies there are 3 basic strategies that should be followed: (1) those designed to ensure day to day maintenance, (2) those designed to determine the elements necessary for longer term solutions, (3) those that challenge negative macroeconomic policies. Strategies must also be distinguished based on those that meet practical gender needs, and those that address strategic gender interests. The importance of this distinction can be seen in the austerity measures which have been central features of most adjustment policies. Policies must be formed in a holistic context that revolve around macro economic issues.
World Education Reports. 1979 Sep; 20:11-3.The Program for the Introduction and Adaptation of Contraceptive Technology de Mexico (PIACT de Mexico) developed a series of pamphlets for use by rural, illiterate, Mexican women. The graphic design and pictorial sequence were the most important features of the pamphlets which answered questions such as where to obtain oral contraceptives and how to use them. The director of the material development must have rapport with the target audience, who should be involved in the content, sequence, and identification of symbols. Content must be limited to important messages. 10 messages can be portrayed in a pamphlet. Nonverbal materials require more time and effort than verbal materials. Several groups of women were asked to arrange the individual messages into the sequence that was most logical to them. In a test of the pamphlet's effectiveness, 700 interviews of illiterate women found that 70% understood 13 pages and 60-70% could interpret the remaining 3. The pamphlet was 16 pages long and printed in black and white. Backgrounds were kept simple, and a combination of photographs of professional models and line drawings told the stories.