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Intermediating development assistance in health: prospects for organizing a public/private investment portfolio.
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.
Report of the first meeting of the Scientific Working Group on Viral Diarrhoeas: microbiology, epidemiology, immunology, and vaccine development, Geneva, 1980.
Geneva, Switzerland, WHO, 1980. 11 p.The main function of the Scientific Working Group was to review existing knowledge, designate areas where research was needed, recommended approaches for such research; and prepare a research plan. The Group's five year work plan for research is described, consisting of 3 priority topics: investigations related to viral diarrheas in general, studies of rotavirus diarrhea (recognized by the Group as the most important public health problem among the viral diarrheas at present), and research to determine the possible role as a cause of diarrhea of other viral agents (Norwalk and Norwalk-like agents, adenoviruses, calcivirus, coronavirus, axtrovirus, and other small round viruses). Needed epidemiological studies, clinical studies, and studies of disease resistance and vaccine development are identified. Identification of institutions to undertake research was discussed; priority was given to locating institutions and individuals within the developing world, or those in developed countries which work closely with developing world groups. An application form was reviewed and approved, and some general principles established. A list of participants in the meeting, and the 1st report of the Rotavirus reagents subgroup are appended.
New York, UNFPA, May 1980. 66 p.Review of present status of activities of UNFPA with a view to setting new priorities for support of further UNFPA projects. 106 projects were selected for review, each satisfying the criterion of either addressing women specifically, or having women as the main focus. Of these 68 were selected as being representative of Direct Women's Projects (DWP)--these tended to be research oriented, and included many global projects. 32 were designated Indirect Women's Projects (IWP); these were more training oriented. Both groups were highly likely to be country specific and to have a fair number (29%) of action programs. From a historical perspective, the 2 World Conferences in 1974 and 1975 marked an increase in the number of women funded projects to 47 from a preconference level of 17. The postconference period also emphasized research action, communication and information projects. Part of the thrust during the postconference period was towards involving women more intimately in the national population and development process and to include in its scope the socioeconomic as well as the family status of women. In spite of this progress, the review uncovers the need for development in some areas: 1) basic and applied research on this issue; 2) widening the scope of investigation to include the complex interrelationships of women, population and development; and 3) creation of a data base which ensures easy access to relevant information on projects and findings, for UNFPA as well as agencies, governments and organizations generally.
Report of the First Meeting of the Scientific Working Group on Bacterial Enteric Infections: Microbiology, Epidemiology, Immunology, and Vaccine Development, Geneva, April 1980.
Geneva, Switzerland, WHO, 1980. 17 p.The group developed a five year research plan (1980-84). Topics were given priority based on the following group-established criteria: 1) the extent of the problem to be studied; 2) the chance of its early success given the limited funds available; and 3) the availability of good research workers with an interest in the problem. The epidemiology and microbiology of Vibrio cholerae 01 and Enterotoxigenic Escherichia coli (ETEC) are given first priority for study, as are immunology and vaccine development against cholera and ETEC diarrhoea. The immunology study will involve: 1) identification of protective antigens, 2) tests for antibody measurement and 3) measurement of acquired immunity. Methods of stimulating mucosal immunity are given first priority, as is the testing of existing candidate cholera vaccines such as B-subunit cholera vaccine and living vaccines made from non-toxigenic V. cholerae. Other organisms which will be studied are Campylobaster jejuni (which can account for up to 15% of acute diarrhoea cases in some settings), Salmonella, (including S. typhi), Shigella and Yersinia enterocolitica. Once there is a better understanding of the modes of transmission of the bacterial enteric pathogens, a study of specific cost effective methods of interrupting their transmission through environmental intervention is suggested, with emphasis on modifications in water supply and water usage, defecation practices, and personal and domestic hygiene. Identification of institutions to undertake research, and funding distribution, were also considered.
PUBLIC HEALTH REPORTS. 1980 Sep-Oct; 95(5):422-6.The implications of the eradication of smallpox in the context of epidemiology are presented. Eradication of disease has been conceived since the 1st smallpox vaccination was developed in the 18th century. Since then, attempts to eradicate yellow fever, malaria, yaws and smallpox have been instituted. Most public health professionals have been rightfully skeptical. Indeed, the success with smallpox was fortuitous and achieved only by a narrow margin. It is unlikely that any other disease will be eradicated, lacking the perfect epidemiological characteristics and affordable technology. The key to success with smallpox was the principle of surveillance. This concept has a vigorous developmental history in the discipline of epidemiology, derived from the work of Langmuir and Farr. It involves meticulous data collection, analysis, appropriate action and evaluation. In the case of smallpox, only these techniques permitted the key observations that smallpox vaccination was remarkably durable, and that effective reporting was fundamental for success. The currently popular goal of health for all, through horizontal programs, is contrary to the methods of epidemiology because its objective is vague and meaningless, no specific management structure is envisioned, and no system of surveillance and assessment is in place.
[Unpublished] 1980.  p.This meeting of the ASEAN Heads of Population Program (AHPP) convened to to review and consider the earlier Report of the Experts consisting of the following: Phase I ASEAN Population Program; the Pre-Implementation Meeting Report of the Phase II ASEAN Population Program; interrelationships between and among Phase I and II projects; and the rules and procedures for the implementation of the ASEAN/Australia Population Project. It was generally agreed that the implementation of Phase I has stimulated greater cooperation and collaboration among the member countries in the field of family planning and population through important contacts and exchange of expertise. More ASEAN experts and expertise in the population field have resulted. Though it is too early to assess the impact of these projects, experiences gained in their implementation have already been applied to national programs in most countries. Efforts must be made to maximize the utilization of the findings of these projects, including making available financial and other resources to analyze, disseminate and utilize information. A structured mechanism to sustain and maintain a link between researchers and program managers needs to be designed.
Washington, D.C., Regional Office of the World Health Organization, 1980. x, 189 p. (Official Document No. 173)The World Health Assembly decided in 1977 that the main social target of the Governments and the WHO in the decades ahead should be "the attainment by all the citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life." Subsequently, the World Health Assembly in 1979 urged the member states to define and implement national, regional, and global strategies for attaining the goal of health for all by the year 2000. This monograph reprints UN documents dealing with this goal. The 1st document addresses 2 specific issues, the developments in the health sector in the 1971-1980 decade, and strategies for attaining the goal of health for all by the year 2000. The 2nd document addresses 8 areas of interest; 1) social and environmental aspects of the region of the Americas; 2) evaluation of the 10-year health plan for the Americas; 3) implications of the goal and the new international economic order for the achievement of the objectives; 4) a method for analyzing strategies and developing a primary health care work plan and indicators for evaluating progress towards the goal; 5) objectives for the health and social sectors; 6) regional baseline targets for priority health conditions; 7) summary of revised regional strategies for attaining the goal; 8) national, intercountry, regional, and global implications of the regional strategies. The 3rd and 4th documents are resolutions 20 and 21 of the 27th meeting of the directing council of the Pan American Health Organization. Resolution 20 addresses regional strategies for attaining the goal. Resolution 21 discusses the ad hoc working group to complement the regional strategies.
Peshawar, Pakistan, Pakistan Academy for Rural Development, 1980.Add to my documents.
The study of interrelations between population, resources, environment and development: report to the Economic and Social Council.
In: Interrelations: resources, environment, population and development. New York, N.Y., U.N. Dept. of International Economic and Social Affairs, 1980. 79-106.Add to my documents.
Commonwealth Journal of International Affairs. 1980 Apr; (278):161-166.Add to my documents.
Population and global future, statement made at the First Global Conference on the Future: through the '80s, Toronto, Canada, 21 July 1980.
New York, N.Y., UNFPA, . 6 p. (Speech Series No. 57)The United Nations has always considered population variables to be an integral part of the total development process. UNFPA has developed, in response to national needs, a core program of population assistance which has found universal support and acceptance among the 130 recipient countries and territories. Historically, these are: family planning, population policy formulation and population dynamics. The following emerging trends are foreseeable from country requests and information available to the Fund: 1) migration from rural to urban areas and increased growth in urbanization; 2) an increased proportion of aged which has already created a number of new demands for resources in both developing and developed countries; 3) a move toward enabling women to participate in economic and educational activities; and 4) a need for urgent concern over ecological issues which affect the delicate balance of resources and population.
Women, population and development, statement made at the World Conference of the United Nations Decade for Women: equality, development and peace, Copenhagen, Denmark, 15 July 1980.
New York, N.Y., UNFPA, . 5 p. (Speech Series No. 56)The World Population Plan of Action adopted in Bucharest in 1974 and the World Plan of Action adopted at the Mexico Conference in 1975 had one common goal--the full integration of women in the development process. Women today play a limited role in many national communities. If this role is to be strengthened and expanded, it will be necessary to focus on eliminating discrimination and removing obstacles to their education, training, employment and career advancement. Within this framework, UNFPA has given support to projects in 5 specific areas: 1) education and training in health, nutrition, child care, family planning, and vocational skills; 2) increasing participation of rural women in planning, decision-making and implementation at the community level; 3) income generating activities, such as marketing, social service occupations, and in the legal, educational and political systems; 4) educating women about their social and legal rights; and 5) widening women's access to communication networks. Between 1969 and 1979, approximately US$22 million was provided by UNFPA to projects dealing with the status of women. Projects in areas such as nutrition, maternal and child health services and family planning received more than US$312 million, which constitutes more than 50% of the total UNFPA programs.
The expanding nature of the population field, statement made at the International Seminar on Planned Population Distribution for Development: The Hokkaido experience, Sapporo, Hokkaido, Japan, 19 May 1980.
New York, N.Y., UNFPA, . 11 p. (Speech Series No. 53)Decisions on overall plans and strategies need to be undertaken and implemented by governments, but it is the individuals whose lives are affected by the plans and strategies who must be given adequate knowledge, information and facilities. In this way, they will be able to make meaningful choices. The UNFPA's mandate is: builiding knowledge, promoting planning, promoting human rights aspects of family planning, extending assistance, and coordinating projects supported by the Fund. UNFPA provides assistance in 8 areas: basic data collection, population dynamics, implementation of policies, family planning communication and education, special programs and multisector activities, and formulation and evaluation of population policies. Each project funded by UNFPA is tailored to meet local or special needs. More and more projects are being implemented by governments themselves. UNFPA is now the largest multilateral funding source of population activities. Although clear signs of fertility decline exist, we should not believe the world's population problem has been solved. The majority of developing nations have found their population distribution patterns unfavorable for achieving socioeconomic development goals. Consequently they are concerned with the redistribution of population in a planned manner. Another type of migration which has become an international issue is the problem of refugees from various countries. Large scale migration of population for political reasons is becoming commonplace in the world today. Another problem is growth in urban areas. Yet another concern is the problem of aging caused by the decline of fertility rates and prolongation of life expectancy. It is necessary to discuss these structural changes in population at all levels so appropriate policies, institutions, training facilities, and programs may be developed to deal effectively with these problems in the future.
The food, population and development equation, statement made at Southeastern Dialogue on the Changing World Economy, Atlanta, Georgia, 25 October 1980.
New York, N.Y., UNFPA, . 8 p.The 1st type of assistance asked for from developing countries is the collection of basic data. The 2nd type of program is family planning. Countries must formulate their family planning themselves based on assessment of needs. The 3rd area that has evolved is that of population dynamics--the study of demographic variables and their consequences. The 4th area is the field of communication and education to support family planning and population programs. The 5th area is in population policies. Finally, there is the residual category of special activities concerned with youth, women and the aged. Population, therefore, represents a broad core area of 5 to 6 categories. The UNFPA is a voluntary organization which provides assistance only to developing countries. The projections of the UN indicate that, as a result of efforts in population, there is for the 1st time in the history of mankind a decline in the population growth rate of developing countries. Nevertheless, mankind must be prepared for an additional 2 billion people by the turn of the century. Population efforts in the end must aim at the stabilization of total world numbers to enable individuals to develop to their full capacity and to improve the quality of life for all.
In: Schima ME and Lubell I, ed. Voluntary sterilization: a decade of achievement. Proceedings of the 4th International Conference on Voluntary Sterilization, May 7-10, 1979, Seoul, Korea. New York, Association for Voluntary Sterilization, 1980. 1.Introduction to the proceedings of a conference on voluntary sterilization. Reflects on the accomplishments of the decade of the 1970s, remaining problems and issues, and new ones generated by success. Development of innovative solutions to manpower, funding and transportation problems that hinder delivery of sterilization and family planning education to those in need; grand multiparity as an indication for sterilization; legalization of voluntary sterilization; and the need for improved, inexpensive techniques that are deliverable to remote areas were topics of discussion at the conference. Because of continued growth in acceptance of voluntary sterilization it now offers genuine demographic potential.
Brazzaville, Congo, World Health Organization, Regional Office for Africa, 1980. 16 p. (AFR/EXM/1)In this opening address of the 30th session of the Regional Committee for Africa of the World Health Organization (WHO), Dr. Quenum notes that new program policies already put into action include the substitution of technical cooperation for the idea of assistance, the improvement of managerial processes for health development and the promotion of primary health care to achieve health for all by the year 2000. He asserts that the latter idea is not utopian since regional strategy in Africa, although long-term, has already become a reality and that constant monitoring and evaluation will affect the needed changes. 2 aspects of health planning for Africa which must be kept in mind are unity with present generations and with those of the future. Regarding the correlation between health and politics he states that whereas it is not WHO's place to intrude in a country's government, health policy cannot be developed apart from the society which it is to affect. He asks if WHO must be concerned in the political will voiced by government and their health priorities and replies that it is WHO's duty to respect the political choices of member states of WHO if genuine technical cooperation is to be established peacefully, while concerning itself with social justice. Health must also be considered in developing socioeconomic policy and cannot make a contribution to establishing a new international economic order unless it is firmly integrated into a development process focused on people. Health for all by the year 2000 is a revolutionary idea, the author contends, since it implies radical changes in the delivery of health care involving international solidarity. In many African countries primary health care has gotten off to a good start through administrative reforms or the training of new health development workers, and enthusiasm for such work should not be allowed to dwindle. Knowledge of the primary importance of health should provide the impetus for these projects in order to reach the goal of health for all.
[Morocco: report of Mission on Needs Assessment for Population] Maroc: rapport de Mission sue l'evaluation des besoins d'aide en matiere de population.
New York, UNFPA, June 1980. 111 p. (Report No. 29)In December 1979 a mission sponsored by UNFPA visited Morocco in order to evaluate the need for population assistance. Morocco experiences a high population growth rate, a high rate of malnutrition, infant mortality, and illiteracy, and low availability of health care in rural areas. The economy is in crisis, and population growth undermines the efforts toward development. It is suggested that population policy must be introduced along with social and economic development as part of an integrated development plan. The mission recommends exterior aid in cooperation with the government with the inception of the next Development Plan, and in particular the participation of UNFPA in data collection and research. In addition, the government of Morocco is urged to determine which agency is best suited to coordinate development and population activities, and cooperation with outside agencies.
SOCIAL SCIENCE AND MEDICINE. MEDICAL ECONOMICS. 1980 Jun; 14C(2):67-70.Most of the $.50 to $2 per capita devoted to health expenditures in developing countries is spent on acute curative services and technologies in urban areas, despite the predominantly rural location of their populations and the correlation of their health problems with malnutrition, infectious and parasitic diseases, and inability to limit family size. Present trends away from the "trickle down" approach and toward a strategy of involving the poor majority more directly in development and assuring that they benefit directly from growth and development, and increasing recognition of the interdependence of economic development, nutrition and health, population growth, social patterns, and political instability, are conceptual developments which promise an increased and more effective effort in international health. The major international funding agencies are revising their policies in the direction of supporting "growth from below" and meeting "basic human needs." A major challenge to such efforts is the identification of policy options within development sectors including health that will achieve the goal of providing greater benefits for the poorest strata.
Colombo, Sri Lanka, [Ministry of Plan Implementation?] 1980. 29 p.Speeches delivered by representatives of the 3 major political parties and the remarks of various officials of international donor organizations are presented. The seminar coincided with a visit to Sri Lanka of a UNFPA needs mission. The party representatives were in agreement that population growth in Sri Lanka must be curbed if development is to be achieved, and that all parties must cooperate in implementing population control and family planning programs. Strong support of the Government's Population Policy and Family Planning Programme was voiced. The history of organized family planning in Sri Lanka, ecological limitations of the country, the need to utilize paramedical personnel in service delivery and to establish better service delivery systems were touched upon by several of the speakers.