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Reaching communities for child health and nutrition: a proposed implementation framework for HH/C IMCI.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 2001.  p. (USAID Contract No. HRN-C-00-99-00007-00; USAID Contract No. FAO-A-00-98-00030-00)The Household and Community component of IMCI (Integrated Management of Childhood Illness) was officially launched as an essential component of the IMCI strategy at the First IMCI Global Review and Coordination Meeting in September 1997. Participants recognized that improving the quality of care at health facilities would not by itself be effective in realizing significant reductions in childhood mortality and morbidity because numerous caretakers do not seek care at facilities. Since that first meeting, several efforts were undertaken to strengthen interagency collaboration for promoting and implementing community approaches to child health and nutrition. (excerpt)
Integrating women's component into population programmes. Report of a training workshop for UNFPA field staff in the Africa and Middle East Regions, Mombasa, Kenya, 18-21 January 1988.
New York, New York, UNFPA, 1988. iv, 12  p.The Mombasa Training Workshop held in 1988 was the first in a series organized to address the problems of women's role in development. The aim was to impart skills and understanding to the UN Population Fund (UNFPA) field staff and to learn ways of integrating women's concerns into population programs. 36 UNFPA field staff from 24 countries participated. The Workshop featured background papers presented by Deryck Onyango-Omuodo and Hilda Mary Tadria who outlined the concerns of integrating women into development and population programs. Christine Oppong spoke about African women's fertility and the link to unequal status and roles. Participants presented short background statements on the status of women and population programs in their respective countries; priorities for support were identified. 5 projects were examined: the 1988 Population Census of Tanzania, demographic training at the University of Zambia, assistance to the Ghana Maternal and Child Health and Family Planning (FP) Program, support for FP based on primary health care in Nigeria, and Population, Human Resources, and Development Planning in Gambia. The workshop was evaluated by participants and recommendations, were made for follow-up. The themes of significance gleaned from the background papers and country reports were 1) the need for more knowledge on women and constraint to women's access to education, employment, and health care. 2) There was also a need for policymakers and planners to be more aware and sensitive to women's issues. 3) Better use of resources in integrating women's concerns into project development was also needed. Ways of improving existing projects were identified, i.e., none of the 5 projects mentioned women as a target group and provision of matrices and checklists was insufficient. Changes in attitudes and perceptions and constant vigilance of women's issues are needed. Project design improvements included local participation, a variety of types of expertise, strengthening women's groups, giving time to an appropriate design, and learning from the past. Suggested directions for UNFPA were given.
Travel to UNICEF / New York to participate in meeting on integrating vitamin A supplementation into immunization programs, January 12-13, 1998.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998. , 6,  p. (Report; USAID Contract No. HRN-C-00-93-00031-00)This report pertains to a consultant meeting in New York City with UNICEF during January 12-13, 1998, to discuss the integration of vitamin A supplementation into immunization programs. One consultant stayed to talk about vitamin A/immunization training materials being developed by BASICS with World Health Organization (WHO) staff and staff from Helen Keller International. The UNICEF meeting included about 35 participants who were mostly WHO and UNICEF headquarters and field staff. There were WHO regional immunization advisers from the Eastern Mediterranean, Southeast Asia, and the Americas. Three staff from USAID and representatives from Canada attended. Several logistics issues arose. Vitamin A supplementation should be introduced at 4-6 months, but the closest immunization contact period is not until after 9 months or before 4 weeks. Second, there is no medical data to ensure that a massive dose of vitamin A would not interfere with DPT effects. It was agreed that the links are helpful but not limited to the Expanded Program of Immunization. The meeting produced a draft paper on background, summary findings, and conclusions and recommendations, which are included in the appendices. It is concluded that many countries already provide vitamin A during immunization contacts. One single recommended strategy does not meet diverse country settings. Additional fieldwork is needed before solidifying strategies. Training should not be delayed. A packaging alternative is to shift to a small squeeze bottle that can be calibrated by size and dose. The mid-level manager's module on vitamin A and EPI continues to be revised.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1997. , 8,  p. (Report; USAID Contract No. HRN-C-00-93-00031-00)This trip report pertains to consultant visits to Niamey (Niger), Bamako (Mali), and Geneva (Switzerland) during June 1 to July 4, 1997, in order to participate in several workshops on integrated management of childhood illnesses (IMCI) in French-speaking African countries. The First Regional IMCI Orientation Workshop, which was held during June 3-4, 1997, in Niamey, was attended by the consultant and a BASICS Regional Director. This workshop included an introduction to IMCI concepts and advocacy for its implementation. The consultant and Regional Director met separately with key decision-makers from Mali, Senegal, Niger, and Togo about IMCI planning. The meeting with Senegal decision-makers aimed to develop a regional IMCI strategy and assess a BASICS role in early implementation. The consultant attended the First IMCI Adaptation Workshop in Mali during June 16-20, 1997. The workshop aimed to adapt the IMCI strategy to Mali; to decide about potential research for adapting the food box; and to help create an adaptation staff with specific jobs and timelines. The consultant attended the WHO IMCI Planning and Adaptation Course in Geneva during June 23 to July 4, 1997. Issues for discussion included planning for IMCI at the country level; the technical basis for adaptation; follow-up after training; and monitoring and evaluation. The World Health Organization is collaborating with 5 countries in Francophone Africa on IMCI implementation. BASICS has 4 trained staff who should be able to provide extensive technical assistance to Francophone and Anglophone African countries and Latin America and the Caribbean.
Informal consultation meeting for IMCI preservice training at the World Health Organization, Geneva, Switzerland, January 25-31, 1998.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998.  p. (Report; USAID Contract No. HRN-C-00-93-3031-00)This trip report pertains to a consultant visit to WHO offices in Geneva, Switzerland, during January 25-31, 1998. The purpose was to participate in informal consultation meetings with WHO's Division of Child Health and Development. Discussion focused on pre-service training for Integrated Management of Childhood Illnesses (IMCI) in medical, nursing, and other health provider teaching institutions. The consultant participated in a one-day introduction to IMCI with others who had not previously received the standard 11-day IMCI course. The consultant also participated in a 3-day consultation with medical and nursing faculty members from 13 developing countries, consultants from developed countries, and the WHO Division of Child Health and Development (CHD) staff. The appendices includes a summary of findings and group recommendations. The consultant met with BASICS and CHD staff and discussed private practitioner quality of care and met with a staff member from the Expanded Program on Immunization to discuss child survival and decentralization. There was some agreement that IMCI pre-service education was desirable and feasible and an appropriate activity for WHO. It is likely that the 11-day IMCI course content will be integrated within subjects in the curriculum and scattered over different years of study. There is a need to develop guidelines for teaching the content of and including readings on the technical background for the IMCI algorithm and methods and for IMCI treatment protocols for diseases and interventions. Materials could be self-study oriented.
WHO informal consultation meeting for IMCI preservice training, Geneva, Switzerland, January 28-30, 1998.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998.  p. (Report; USAID Contract No. HRN-C-00-93-3031-00)This trip report pertains to a consultant visit to WHO offices in Geneva, Switzerland, during January 28-30, 1998. The purpose was to participate in informal consultation meetings with WHO's Division of Child Health and Development. Discussion focused on pre-service training for Integrated Management of Childhood Illness (IMCI) in medical, nursing, and other health provider teaching institutions. The skills and knowledge taught in IMCI courses would be suitable for inclusion in pre-service training programs. Although it was expected that recommendations would result from the meetings, this did not occur. The appendices provide summary documents from small group discussions. It was generally agreed that WHO should continue to support the development of a strategy to and materials for incorporating IMCI into pre-service training for health providers. The referral care guidelines are nearly complete and should be included in any training materials. Participants considered it very important to include core inpatient content, even for providers working in outpatient facilities. Participants thought that pre-service trainers must have someone designated as an effective focus person who can link the child health and community health departments. Change to IMCI-based curricula within schools will be difficult to achieve, but worthwhile. All providers of sick children should be trained to provide standard IMCI care. An adaptation guide for pre-service training materials may be needed. IMCI introductory activities should be implemented country-wide. Experience integrating IMCI into training will indicate how to implement this approach.
Sustainability of the FP-MCH program of NGOs in Bangladesh. Future Search Workshop, July 15-18, 1995, Centre for Development Management, Rajendrapur, Bangladesh.
Dhaka, Bangladesh, Pathfinder International, 1995. , 38, 51 p. (USAID Cooperative Agreement No. 388-0071-A-00-7082-10)This report summarizes the activities of a workshop held July 15-18, 1995, in Bangladesh, on the sustainability of Bangladesh's family planning/maternal-child health (FP/MCH) program among nongovernmental organizations (NGOs). The workshop included representatives of the FP/MCH program, donor agencies, USAID cooperating agencies (CAs), NGOs, family planning clients, and technical experts (64 individuals). The aim was to determine a common vision of sustainability by 2010; to identify common features of this vision; and to identify Action Plans that stakeholders might adopt to ensure the actualization of the vision. The report includes a summary, introduction, objectives, inaugural session notes, technical presentations on USAID's vision, lessons learned from sustainability initiatives in Latin America, sustainability planning approaches and tools, and a future search workshop on sustainability. Stakeholders' evaluations of the workshop were listed in about 16 different statements. The appendices include the agenda, the list of participants, the national vision, USAID's vision, lessons learned from international settings and applicability to Bangladesh, tools to help plan for sustainability, and the workshop evaluation form. Many of the lessons learned were applicable to Bangladesh, with the exception of the question of appropriateness of charging all clients. The Quality-Expansion-Sustainability Management Information System and Management Development Assessment Tool were developed with staff from USAID's CAs in Bangladesh. Eight stakeholders participated in the Future Search Workshop and prepared Action Plans which are included in the appendix. The main features were lower donor dependency, community participation, and cost recovery. Promising features included quality of care, income generation, women's empowerment, collaboration, strengthening management skills, and endowment funds.
International workshop report: Counselling and HIV Infection for Family Planning Associations, 13-17th March, 1989.
[Unpublished] 1989.  p.The International Family Planning Federation's AIDS Prevention Unit sponsored a five-day workshop on counseling and HIV infection for family planning associations (FPAs) at a facility for people with HIV/AIDS in March 1989. The objectives included sharing experiences in counseling on HIV/STDs (sexually transmitted diseases) in family planning programs, examining the integration of sexual health issues into family planning counseling, identifying training needs in interpersonal communication and sexual health issues, sharing approaches to meeting those training needs, and developing an action plan for counseling and sexual health. After introductions on the first day, participants divided into groups to address what they wanted to get out of the workshop, what they wanted to contribute to the workshop, and what their biggest concern is about integrating counseling with AIDS/STDs into their family planning programs. They also shared information on their programs about the status of FPAs in terms of counseling and HIV. The second day involved a name game and role playing to illustrate different levels of communication. Participants also discussed the difference between information, education, and counseling and took part in an exercise geared to trigger facts and feelings. On the third day, the group provided feedback on the facts and feelings discussion trigger, toured the London Lighthouse (the workshop site), and participated in counseling role plays. Activities on the fourth day aimed to process the role plays, to develop counseling skills, and to define sexual health. Participants also played the "safer sex" game. The last day of the workshop involved role plays of exploring the situation, showing materials participants had brought with them and talking about them, future plans, and discussion of the most valuable thing learned at the workshop. Participants also made conclusions and recommendations based on discussions at the workshop.
AMBIO. 1992 Feb; 21(1):112-5.The UN can set standards and provide a framework for collaborative projects, but sustainable development will require the full participation of many sectors of society, both public and private. This review of sustainable development considers the role of UN-sponsored special conferences in the past 20 years, identifies a conceptual tool for assessing options, and suggests a global action plan that radically restructures the UN, based on popular sovereignty. The concern is for the protection of popular rights and welfare that could be ignored by powerful governments and powerful transnational corporations beyond government control; responsibility for the environment, natural resources, technologies, and other global issues cannot be overlooked. The concept is to develop an "international public sector for the management of interdependence" which can correct, as necessary the "international market process and ensure equitable distribution of resources." The Stockholm Conference on the Human Environment in 1972 marked the beginning of special conferences dealing with sustainable development. The UN General Assembly in 1974 adopted a mandate and programs for increasing the pace of economic and social development. In 1980 and 1990 further UN development strategies were adopted. The most recent strategy incorporated much from the Brundtland Commission Report but did not urge the change in attitudes and orientation of political and economic institutions. The Assembly of the World Conservation Union (IUCN) adopted strategies for conservation and development in 1990. Nongovernmental organizations have united to cooperate in the global effort to achieve sustainable development. However, there are 5.4 billion people and an increase of 2 billion expected in 20 years. Bureaucratic rivalry and the inherent weakness of the UN has lead to splintering of objectives and irrelevant decision making. After concept development, which is a noteworthy effort, there must be negotiation with government delegates and policy planners and decision makers. The priorities are to shift from economic development to social development, to shift from maximum use of inappropriate technologies to resource efficient and saving technologies, and integration of population with national environmental strategies.
London, England, International Planned Parenthood Federation [IPPF], 1992 Sep. 93 p.20 participants from 9 sub-Saharan countries and the UK discuss men's negative attitudes towards family planning (the leading obstacle to the success of family planning in Africa) at the November 1991 Workshop on Male Participation in Family Planning in The Gambia. Family planning programs have targeted women for 20 years, but they are starting to see the men's role in making fertility decisions and in transmitting sexually transmitted diseases (STDs). They are trying to find ways to increase men's involvement in promoting family planning and STD prevention. Some recent research in Africa shows that many men already have a positive attitude towards family planning, but there is poor or no positive communication between husband and wife about fertility and sexuality. Some family planning programs (e.g., those in Sierra Leone, Nigeria, Ethiopia, and Zimbabwe) use information, education, and communication (IEC) activities (e.g., audiovisual material, print media, film, workshops, seminars, and songs) to promote men's sexual responsibility. IEC programs do increase knowledge, but do not necessarily change attitudes and practice. Some research indicates that awareness raising must be followed by counseling and peer promotion efforts to effect attitudinal and behavioral change. The sub-Saharan Africa programs must conduct baseline research on attitudes and a needs assessment to determine how to address men's needs. In Zambia, baseline research reveals that a man having 1 faithful partner for a lifetime is deemed negative. Common effective needs assessment methodologies are focus group discussions and individual interviews. Programs have identified various service delivery strategies to meet these needs. They are integration of family planning promotion efforts via AIDS prevention programs, income-generating schemes, employment-based programs, youth programs and peer counseling, male-to-male community-based distribution of condoms, and social marketing. Few programs have been evaluated, mainly because evaluation is not included in the planning process.
IAP-IPA-WHO-UNICEF Workshop on Strategies and Approaches for Women's Health, Child Health and Family Planning for the Decade of Nineties, 22nd-23rd January 1991, Hyderabad.
INDIAN PEDIATRICS. 1991 Dec; 28(12):1481-2.In 1991, health professionals attended a workshop to develop strategies and approaches for women's health, child health, and family planning for the 1990s in Hyderabad, India. The Ministry of Health (MOH) of India should improve and strengthen existing health facilities, manpower, materials, and supplies. It should not continue vertical programs dedicated to 1 disease or a few problems. Instead it should integrate programs. The government must stop allocating more funds to family planning services than to MCH services. It should equally appropriate funds to family planning, family welfare, and MCH. The MOH should implement task force recommendations on minimum prenatal care (1982) and maternal mortality (1987) to strengthen prenatal care, delivery services, and newborn care. Health workers must consider newborns as individuals and allot them their own bed in the hospital. All district and city hospitals should have an intermediate or Level II care nursery to improve neonatal survival. In addition, the country has the means to improve child health services. The most effective means to improve health services and community utilization is training all health workers, revision of basic curricula, and strengthen existing facilities. Family planning professionals should use couple protection time rather than couple protection rate. The should also target certain contraceptives to specific age groups. Mass media can disseminate information to bring about behavioral and social change such as increasing marriage age. Secondary school teachers should teach sex education. Health professionals must look at the total female instead of child, adolescent, pregnant woman, and reproductive health. Integrated Child Development Services should support MCH programs. Operations research should be used to evaluate the many parts of MCH programs. The government needs to promote community participation in MCH services.