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Belize City, Belize, Ministry of Health, 1984. , 54 p. (EPI/84/003)An evaluation of the Expanded Program on Immunization (EPI) in Belize was conducted by the Pan American Health Organization/World Health Organization at the request of the country's Ministry of Health. The evaluation was undertaken to identify obstacles to program implementation, and subsequently provide national managers and decision makers with viable potential solutions. General background information is provided on Belize, with specific mention made of demographic, ethnic, and linguistic characteristics, the health system, and the EPI program in the country. EPI evaluation methodology and vaccination coverage are presented, followed by detailed examination of study findings and recommendations. Achievements, problems, and recommendations are listed for the areas of planning and organizations, management and administration, training, supervision, resources, logistics and the cold chain, delivery strategies, the information and surveillance system, and promotion and community participation. A 23-page chronogram of recommended activities follows, with the report concluding in acknowledgements and annexes.
Health planning and management--requirements for HFA2000 development: report on a working group, Athens, 26-29 September 1983.
[Unpublished] 1984. 18 p. (ICP/SPM 028(1))The purposes of the Working Group, composed of temporary advisers and consultants from 12 Member States of the European Region, were as follows: to examine how the existing health management and planning systems in the European Member States comply with the requirements of Health for All 2000 (HFA2000); and to identify critical areas in the development of health systems and ways of promoting change. In this context, the Group was asked to discuss: existing health planning structures and processes in European Member States, specifically with a view toward longterm outcome and strategic planning; levels of decisionmaking in planning and the balance between centralization and decentralization; the involvement of providers and consumers in the decisionmaking process of health planning; mechanisms for intersectoral involvement and leadership in health development issues; how existing financial mechanisms and budget availability meet the needs of problem-oriented issues and program budgeting; and the consequences of management and planning for health, taking the present economic situation into consideration. In the opinion of the Working Group, the broad policy basis, the strategic goals, and the majority of targets of the HFA2000 strategy for the European Region are widely accepted, but this general agreement does not exclude marked differences in emphasis placed on various aspects of the HFA2000 message in the countries represented at the meetings. A wide variety of steering, planning, and management approaches to the health sector exists in the European Region. Actual management practice varies according to the different balances between formal planning mechanisms and more informal steering and negotiating mechanisms. Issues of centralization and decentralization play an important role in the majority of health planning and management mechanisms and systems in the European Region. These issues contain an essential dilemma of value conflicts that are receiving more and more attention. Basic need orientation, innovative capacity, sufficient flexibility, and community as well as user and provider participation in health development require health planning and management to be closely related to the expressed needs of the population in local communities, in regions, or other "peripheral" levels. The involvement of users, providers, and decisionmakers as well as community participation can contribute considerably to the responsiveness of health planning and management to local needs. Health protection and health development are major objectives in all countries of the European Region. In the Eu ropean Region, the variety of financing mechanisms, budgetary processes, and pricing procedures reflects the various countries' general governmental features. The majority of Member States are at this time passing through a period of economic stringency with zero or even negativve growth tendencies some cases.
British Journal of Family Planning. 1984 Jul; 10(37):37.This editorial takes a broad, international look at the worldwide implications of decisions taken in the United Kingdom (U.K.) and the US with regard to family planning. National authorities, like the U.K. Committee for Safety of Medicines (CSM) of the US Food and Drug Administration, address issues concerning the safety of pharmaceutical products in terms of risk/benefit ratios applicable in their countries. International repercussions of US and U.K. decision making must be considered, especially in the area of pharmaceutical products, where they have an important world leadership role. Much of the adverse publicity of the use of Depo-Provera has focused on the fact that it was not approved for longterm use in the U.K. and the US. It is not equally known that the CSM, IPPF and WHO recommeded approval, but were overruled by the licensing agencies. The controversy caused by the Lancet articles of Professors with family planning doctors. At present several family planning issues in the U.K., such as contraception for minors, have implications for other countries. A campaign is being undertaken to enforce 'Squeal' laws in the U.K. and the US requiring parental consent for their teenagers under 16 to use contraceptives. In some developing countries, urbanization heightens the problem of adolescent sexuality. Carefully designed adolescent programs, stressing the need for adequate counseling, are needed. Many issues of international interest go unnoticed in the U.K. International agencies, like the WHO and UNiCEF, have embarked on a global program to promote lactation both for its benficial effects on an infant's growth and development and for birth spacing effects. It may be of benefit to family planning professionals in the U.K. to pay attention to international activity in such issues.
Grassroots initiatives in developing countries and UNDP project planning and implementation. Summary and recommendations of the SID GRIS Policy Dialogue with UNDP in New York, 3-4 June 1983.
Development: Seeds of Change. 1984; 2:70-2.Some of the concepts of people-based development discussed at the SID GRIS Policy Dialogue are very important. Much benefit can be derived from exchanging information with staff and with resource people from the university sector, grassroots groups, or nongovernment organizations. In terms of field programs, it is important to know the country well to be able to identify and support those entities which benefit from support. Supporting a number of groups with a high potential for participatory development creates a critical mass. Once these grassroots grow, consumer organizations and certain government entities start interacting with one another in a country, and if enough participatory prone groups at different levels are supported a certain synergy is created, which over time builds up to become a dominant thrust in government. It is also important to establish criteria for those programs: what do they do for or with the poorest in the community; and what do they do for the most disadvantaged of disadvantaged groups, women and youths. Advocacy with governments is an obvious role for the UN, possibly by reinforcing those groups in government that are making progress so that they get a sense of reward, enough support through budgetary allocations, and are sustained because the outside world begins to look at them with a certain amount of admiration. There is a whole series of things that can be done in the program planning process to be more effective. It is very clear that local procurement is becoming much more significant. The decentralization of personnel and decision making has become more and more a fact of life in the UN International Children's Emergency Fund, where 75-80% of the staff are now based in the field. Decentralization must continue with more outposting of staff into smaller towns, because they interact with local government and encourage them to plan at that level with the people. There is a move to recruit more social scientists with the grasp of the social elements of development and participation, and more women professionals are also recruited. Staff development and training becomes very different. Grassroots development begins in one's own organization and making that come about can create tension. Budgeting becomes a significant area, and relations with national committees and donor governments require discussion and reeducation.
Fertility and the family: highlights of the issues in the context of the World Population Plan of Action.
In: United Nations. Department of International Economic and Social Affairs. Population Division. Fertility and family. New York, New York, United Nations, 1984. 45-73. (International Conference on Popualtion, 1984; Statements)This paper uses as its organizing principle 5 major themes which run through the sections of the 1974 World Population Plan of Action (WPPA) devoted to fertility and the family. The purpose of this paper it to assure that their discussion is comprehensive and that it reviews all the major research and policy concerns with respect to fertility and the family that have played an important role in the general debate about these issues since 1974. Summerized here are the contributions included in this volumen, as each deals with at least 1 of these issues. The 1st major theme focuses on fertility response to modernization as a facet of the interrelationship between population and development. Discussed are aspects of modernization leading to fertility increases, in particular the reduced incidence and shorter duration of breastfeeding, and those leading to fertility decline, namely the decline in the value of children as a source of labor and old-age support. Freedom of choice, information and education are the principal approaches within which childbearing decision making is discussed. Women's reproductive and economic activity during their life cycle, and the relationship of family types and functions to fertility levels and change are equally addressed. Finally, demographic goals and policy alternatives with respect to fertility change are discussed in terms of a number of policy options: family planning programs, economic incentives and disincentives and more global socioeconomic measures. Although primary attention is given to the problems and policies of developing countries, the special problems of certrain developed countries which view their fertility as too low are also considered. The issues raised in this paper are put forward as an aid to assist in the identification of emderging areas of policy concern and of fruitful new research directions.
In: United Nations. Department of International Economic and Social Affairs. Population Division. Fertility and family. New York, New York, United Nations, 1984. 1-44. (International Conference on Population, 1984; Statements)This volume is comprised of the reports of the 1st of 4 Expert Group Meetings, scheduled in preparation for the 1984 International Conference on Population. Individuals and organizations attending this meeting are listed. The central task of the meeting was to examine critical, high-priority issues relevant to fertility and family and, on that basis, to make recommendations for action that would enhance the effectiveness of and compliance with the World Population Plan of Action, adopted in 1974 at Bucharest. The 1st item on the agenda dealt with ways in which modernization elements in the socio-cultural and economic patterns and institutions of societies alter reproduction. The 2nd topic of discussion was the relationship between family structure and fertility. The view adopted was that family structure could be influenced by a variety of factors that would have implications for fertility (e.g., delayed at marriage, improvements in education). The deliberations on factors influencing choice with respect to childbearing focused upon the complexity of decision making in matters of reproduction. In question, too, was a possible conflict between the acknowledged rights to freedom of choice in respect to childbearing and to the rights and goals of society, as well the acceptability of incentives and disincentives as measures introduced by governments to achieve social goals. The 4th item, reproductive and economic activity of women, was discussed from several perspectives: the amount of reproductive lifetime available to women for productive pursuits other than childbearing; the introduction of social support programs and income-generating opportunities. In the discussion of demographic goals and policy alternatives, the 5th item on the agenda, the policy options considered were family planning programs, incentives and desincentives, social and economic development, and marriage and divorce laws. Particular attention was given to the importance of local institutional settings for the achievement of government policy goals. The Expert Group's recommendations on population policy, family planning, the conditions of women, adolescent fertility, IEC, management and training, international cooperation and areas of research (demographic data, determinants of fertility, operational research and bio-medical) are included in this introduction. Finally, presented in the form of annexes are the agenda for the meeting, the list of documents and the texts of the opening statements.
Ann Arbor, Michigan, University Microfilms International, 1984.  p.One form of international authority proposed by David Mitrany was that of an advisory and coordinating one where both the performance of a task and the means for its accomplishment remain mainly under national control. Mitrany's theoretical framework and its organizational analogue within the UN and national political arenas account for the emergence of a new UN population policy to cope with the rapid global population growth between 1960 and 1974. The most prestigious outcome of this policy was the United Nations Fund for Population Activities (UNFPA), whose centralized contributions came primarily from the US, Japanese, Swedish, and some other west European governments. Its aim is to assist governments in the development of national family planning programs and in related demographic and family planning training and research programs. UNFPA grants went to UN-system agencies, governments, and private organizations. Recipients include India, Pakistan, Egypt, Malaysia, Kenya, Nigeria and Mexico. A mew ideology emerged to support the concept of an interventionist policy to lower the birth rate. That ideology include the responsibility of each government for its own population; an emphasis on social framework for parental choices about family size; and a legitimate role for international assistance. How the UNFPA came into existence is a political process involving government delegations and officials, UN Secretarist staff, and representatives of selected religious and population transnational organizations. It is also a Laswellian social process model of 7 decision-outcomes marking the significant population events and interactions underlying the creation of UNFPA. 6 UN resolutions and 2 decisions by the Secretary-General denominate these decision outcomes. 2 analytic approaches account for these decision outcomes--the Parsonian concept of organized levels (institutional, managerial, and technical) in conjunction with the Laswellian concepts of centralization/decentralization and concentration/decontration, and the concept of coalitions, (legislative and programming). This expanded UN population policy process reveals the interconnectedness of elites and groups in a global network centered at UFPA. (author's modified)
London, England, IPPF, 1984 Feb. 20 p.The promotion of "Male Responsibility for and Practice of Family Planning" was established as a federation-wide Action Area in the IPPF 1982-84 Plan in response to recongizing the need for positive male involvement in family planning programs. Specific identified goals for this action area include the development of programs to educate men about family planning, the need to motivate them to use contraception, and changing the attitudes of male opinion leaders. Implementing the plan and promoting effective male involvement programs are in progress. The Secratariat is undertaking activities to identify Federation and regional strategies and directions and to develop support activities. Program Committee discussion and examination of the issue with subsequent publications are examples of Secretariat involvements. An International Staff Consultation on Male Involvement was held at the IPPF International Office in 1983 to review progress in developing male programs in IPPF; to analyze issues and problems in IPPF programs with regard to men's needs; to examine strategies for increasing male involvement in family planning and to formulate guidelines for program development; and to develop short and longer-term action plans to strengthen male programs within the Federation. The Consultation maded valuable contribution by identifying specific historical, economica, socio-cultural, legal, policy and technological perspectives on male involvement in family planning, as well as providing background papers presented by each participant. Working groups identified and developed a "Strategy for Action of Male Involvement in Family Planning" for the IPPF on 3 strategic levels: policy-makers, service providers and the community. Additionally, Consultation members reviewed audio-visual materials to assess their effectiveness as comunication means. Participants endorsed the need for program review and "strategic planning" by the IPPF. The value in the consultation in examining male programs and in promoting the exchange of ideas within the Federation was affirmed by both the Secretariat and association reoresentativees.
New York, New York, United Nations, 1984. ix, 476 p. (International Conference on Population, 1984; Statements)The Expert Group on Fertility and Family was one of 4 expert groups assigned the task of examining critical, high priority population issues and, on that basis, making recommendations for action that would enhance the effectiveness of and compliance with the World Population Plan of Action. The report of the Expert Group consisted of 6 topics: 1) fertility response to modernization; 2) family structure and fertility; 3) choice with respect to childbearing, 4) reproductive and economic activity of women, 5) goals, policies and technical cooperation, and 6) recommendations. Contained in this report are also selected background papers with discuss in detail fertility determinants such as modernization, fertility decision processes, socioeconomic determinants, infant and child mortality as a ddeterminant of achieved fertility in some developed countries, the World Fertility Survey's contribution to understanding of fertility levels and trends, fertility in relation to family structure, measurement of the impact of population policies and programs on fertility, and techinical cooperation in the field of fertility and the family.
In: International Planned Parenthood Federation [IPPF]. Male involvement in family planning: programme initiatives. London, England, IPPF, . 177-83.The International Labor Organization (ILO) has enlarged its traditional concern and responsibility for labor welfare to encompass the worker's welfare not only at the workplace but also in his living environment. The purpose of this paper is to introduce the ILO's Population/Family Welfare Education Programme. The basic objective of this program is to improve the quality of life of workers and teir families through educational activities aimed at creating an appreciation of interrelations between family income and expenditure, family budgeting and determining of priorities for various needs of the family, including family size. The program is implemented at country level through labor ministries, employers' groups, trade unions, or co-operatives. The program is designed for workers in the organized sector; its content and approach are refined for 4 main sub-groups: male workers, young workers undergoining vocational training, young unmarried female workers, and plantation workers and cooperative members in rural areas. In all cases the ILO program uses existing welfare and educational institutions, and is presented in terms of family level relationships. Once the inter-relationships of needs and resources within the context of the family is considered, it becomes apparent that needs are predominantly determined by family size. To the extent that couples are prepared to regulate their fertility, this decision may be influenced by family decision making. On the other hand, the potential for influencing family resources is limited. Family well-being can thus be seen in terms of family needs, resources and decision making. Workers must therefore be shown that they can determine their family size. This is the basic family welfare education message. It has a distinct ILO flavor about it and has proved to be acceptable to governments, employers, trade union leaders and members.
In: International Planned Parenthood Federation [IPPF]. Male involvement in family planning: programme initiatives. London, England, IPPF, . 9-12.Deliberate involvement of men in family planning matters has only caught on in the Africa Region at the onset of the 1980s. Prior to this, family planning had been of cooperation from their partners, women have sometimes tended to go about family planning matters secretly. Such an approach is undesirable and may have some serious consequences and implications, since family planning involves health matters. Involving men and obtaining their support and commitment to family planning is of crucial importance in the Africa Region, given men's elevated position in African society. The involvement of men in family planning matters will also accelerate the understanding and practice of family planning in general. Regional activities of Family Planning Associations (FPA) in Africa are still in their infancy. A major activity was a Tegional Consultation held in Nairobi, Kenya in February 1983 to formulate appropriate approaches and channels based on actual experiences in a number of countries. This Consultation clearly showed that men could be most profitable reached not as a distinct group but through family life education programs, community education programs and related organizations. Information, materials, approaches and guidelines on male responsibility are being acquired and developed on a continuing basis for distribution to FPAs and Field Offices. A review of FPA activities indicates that practically all FPAs will have some kind of activity aimed at reaching men. However, Anglophone FPAs have greater explicit male orientedd projects than the Francophone ones. Challenges facing this program area will be found in Francophone countriees and countries with concertrations of Muslim culture. Rigid policy and legal systems which favor male domination present anothr challenge. Major efforts, such as small-scale research studies, study visits to successful projects, training in project development and implementation, will be made to enhance the capability of FPAs in devloping and managing projects relating to male involvement in family planning.
In: International Planned Parenthood Federation [IPPF]. Male involvement in family planning: programme initiatives. London, England, IPPF, . 1-8.This introductory paper presents the rationale of male involvement in family planning. 4 major reasons are given: sociological factors point to the importance of male involvement in all stages of contraceptive acceptance; the 2nd reason relates to the role of men as decision makers in matters affecting marital and family life. Experience and research reveal that men's support of, or opposition to, their partner's practice of family planning has a strong impact onn contraceptive usage in many parts of the world. The 3rd reason relates to the limited contraceptive options available for men, which should not, however, deter from efforts at promoting male involvement in family planning. Finally, the 4th reason relates to the encouragement of a better relationship between men and women, through the acceptance of family planning as a joint and equal responsibility. IPPF encourages family planning associations (FPA) to develop and implement education and communication programs aimed at encouraging male support to women in their choice of contraceptive methods, taking on additional family and child rearing responsibilities and using men's leadership role in promoting family planning practice in their communities. A brief review of IPPF's achievements to data shows that there has been no dramatic change in the direction of IPPF's programs towards male-orientated activites; no surge of male clients demanding services. Nonetheless, the amount of fruitful discussion and debate is notable. Perhaps most significant is the stimulus given to activities in IPPF's African and Arab World Regions--2 of the world's most difficult areas in which to bring about male participation in family planning. The 1st 2 years of the IPPF 3-year plan (1982-4) can probably best be described as a period of stimulation and preparation for an accelerated thrust on the part of the Federation to bring about greater male involvement in family planning. Also mentioned here are examples of initiatives, at the FPA level, aimed at reaching and involving men both as acceptors and promoters of family planning. Finally, a number of issues and factors are raised as stimulating questions to guide future action aimed at achieving the Federation's objectives.