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  1. 1
    031138

    WHO Programme in Maternal and Child Health and Family Planning. Report of the second meeting of the WHO Programme Advisory Committee in Maternal and Child Health, Geneva, 21-25 November 1983.

    World Health Organization [WHO]. Division of Family Health. Maternal and Child Health Unit

    [Unpublished] 1984. 95 p. (MCH/84.5)

    The objectives of the 2nd meeting of the Program Advisory Committee (PAC) for the World Health Organization's (WHO's) Program in Maternal and Child Health, including Family Planning (MCH/FP) were to 1) assess the MCH/FP program's achievements since the 1st PAC meeting in June, 1982, 2) determine the level of scientific and financial resources available for the program, and 3) to examine the role of traditional birth attendants (TBAs) in the delivery of MCH/FP services. The committee reviewed the activities and targets of the program's 4 major areas (pregnancy and perinatal care, child health, growth, and development, adolescent health, and family planning and infertility), and developed a series of recommendations for each of these areas. Specific recommendations were also made for each of the major program areas in reference to the analysis and dessimination of information and to the development and use of appropriate health technologies. Upon reviewing the role of TBAs in the delivery of MCH/FP services, PAC recommended that all barriers to TBA utilization be removed and that training for TBAs should be improved and expanded. PAC's examination of financial support for MCH/FP activities revealed that for a sample of 26 countries, the average annual amount allocated to MCH activities was less than US$3/child or woman. This low level of funding must be taken into account when setting program targets. International funding agencies did indicate their willingness to increase funding levels for MCH programs. The appendices included 1) a list of participants, 2) an annotated agenda, 3) detailed information on the proposed activities of the program's headquarters for 1986-87, and 4) a description of the the function, organizational structure, and technical management of the MCH/FP program. Also included in the appendices was an overview of the current status of MCH and a series of tables providing information on infant, child, and maternal health indicators. Specifically, the tables provided information by region and by country on maternal, child, and infant mortality; causes of child deaths; maternal health care coverage; contraceptive prevalence; infant and child malnutrition; the number of low weight births; adolescent health; teenage births; breast feeding prevalence and duration; and the proportion of women and children in the population.
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  2. 2
    046563

    Annual report: 1983.

    Planned Parenthood Federation of America [PPFA]. Family Planning International Assistance [FPIA]

    New York, New York, FPIA, [1984]. 227 p.

    This report summarizes the work of Family Planning International Assistance (FPIA) since its inception in 1971, with particular emphasis on activities carried out in 1983. The report's 6 chapters are focused on the following areas: Africa Regional Report, Asia and Pacific Regional Report, Latin America Regional Report, Inter-Regional Report, Program Management Information, and Fiscal Information. Included in the regional reports are detailed descriptions of activities carried out by country, as well as tables on commodity assistance in 1983. Since 1971, FPIA has provided US$54 million in direct financial support for the operation of more than 300 family planning projects in 51 countries. In addition, family planning commodities (including over 600 million condoms, 120 million cycles of oral contraceptives, and 4 million IUDs) have been shipped to over 3000 institutions in 115 countries. In 1982 alone, 1 million contraceptive clients were served by FPIA-assisted projects. Project assistance accounts for 52% of the total value of FPIA assistance, while commodity assistance comprises another 47%. In 1983, 53% of project assistance funds were allocated to projects in the Asia and Pacific Region, followed by Africa (32%) and Latin America (15%). Of the 1 million new contraceptive acceptors served in 198, 42% selected oral contraceptives, 27% used condoms, and 8% the IUD.
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  3. 3
    268899

    Foreign assistance legislation for fiscal years 1984-85. (Part 1) Hearings before the Committee on Foreign Affairs, House of Representatives, Ninety-eighth Congress, first session, February 8, 15, 16, 22, 23, 24; March 24, 1983.

    United States. Congress. House of Representatives. Committee on Foreign Affairs

    Washington, D.C., Government Printing Office, 1984. 666 p. (Serial No. 18-1870)

    This report of hearings before the House Committee on Foreign Affairs contains reports to the full committee and subcommittees on international security and scientific affairs, Europe and the Middle East, Human Rights and International Organizations, Asian and Pacific Affairs, International Policy and Trade, Western Hemisphere Affairs, and Africa. The committee examined various witnesses on a list of topics that included developing country debt, the world food situation and the promotion of US agricultural export, the fiscal year 1984 security and development corporation program, and the executive branch request for foreign military assistance. The list continues with Peace Corps requests for 1984-85, information in a statement from the acting director of the Agency for International Development, International Monetary Fund resources, and world financial stability, and US interests (particularly regarding developing country debt). The committee examined a series of prepared statements and witnesses discussing foreign aid by type and strategy, and examined the question of "targeted aid" to the extremely poor. Cooperative development, the Peace Corps budget, the ethical issues of military versus development assistance, "food for work" program merits, disaster relief, maternal and child health programs, and finally, an examination of the problem of population. Written statements and responses to committee and witness questions were from the National Association of Manufacturers, US Department of Agriculture, Agency for International Development, Peace Corps, Department of the Treasury, Interreligious Task Force on US food Policy, American Council of Voluntary Agencies for Foreign Service, CARE, the Population Crisis Committee, and the Population Institute.
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  4. 4
    035565

    Social, economic, political, and demographic determinants of development-agency aid to Third World countries.

    Rosenfeld AI

    Ann Arbor, Michigan, University Microfilms International, 1984. xvi, 563 p. (8501088)

    The following dissertation is a report of research on the determinants of economic assistance to the development efforts of 3rd world countries by 6 international agencies including the UN, the US, and the World Bank. With annual data for 109 countries, these agencies' grants and loans were related, by multiple regression, to several socioeconomic variables summarizing the modernization of the nations concerned. Grants and loans of these agencies were also regressed on measures of polity types and political instability in these same analyses. Most socioeconomic variable relationships to fundings of economic development by 2 World Bank branches and 2 UN specialized agencies were in support of a need-for-aid interpretation of these agencies' grant-loan policies. The similar relationships of loans from the 3rd World Bank branch to these economic variables usually supported a credit-worthiness or "good economic performance" emphasis in that World Bank branch's policy on loans. Need for aid and loan credit worthiness were equally important in determining US foreign economic assistance. Polity type and other control variables had small effects on development assistance by the 6 agencies studied. Several of the economic variables' relationships to these agencies' funding were significant, but small; few such relationships were very large. (author's)
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  5. 5
    034829

    Annual report 1984.

    Planned Parenthood Federation of America [PPFA]. Family Planning International Assistance [FPIA]

    New York, New York, FPIA, 1984. 258 p.

    This report summarizes the work of Family Planning International Assistance (FPIA) over the past 13 years, with emphasis on calendar year 1984. A brief overview provides data on 1984 project assistance of all types, followed by greater detail in 3 regional reports for Africa, Asia and the Pacific, and Latin America, a report of interregional projects, program management information, and fiscal information. Each regional report contains an overview, a table showing the value and composition of FPIA assistance by calendar year for 1972-84, and discussions of project assistance, commodity assistance, special grants, and invitational travel. A series of tables in each regional report provides data on the number of active projects by country and calendar year; the number of projects, grants, and modifications awarded by year, classification of current projects in the region; the dollar value and quantities of commodities shipped in 1984 and cumulatively, quantities of selected commodities shipped by calendar year, and commodity assistance to nonproject countries. Country reports within the regional reports provide information on project and commodity assistance for 26 countries in Africa, 17 in Asia and the Pacific, and 12 in Latin America. FPIA programming reached a new high of $18.0 million in project and commodity assistance in 1984, with 118 projects in 37 countries receiving $7.2 million in direct support and 240 agencies in 73 countries receiving $10.6 million in commodity shipments. The cumulative value of FPIA assistance since 1972 totals over $120 million. 1984 project and commodity assistance respectively totalled $2,526,609 and $3,359,158 for Africa, $1,518,908 and $2,645,485 for Asia and the Pacific, and $3,008,663 and $4,560,958 for Latin America, in addition to $184,385 and $12,568 for interregional assistance. The total volume of FPIA assistance between 1972-84 was $19,796,746 for Africa, $46,345,512 for Latin America, $49,354,682 for Asia and the Pacific, and $4,505,798 for interregional assistance. Between 1972-84, FPIA has provided totals of $558,426 for special grants, $784,138 for invitational travel, $57,978,856 for commodity assistance, and $60,681,288 for project assistance. 36% of cumulative commodity assistance has been for condoms, 42% for pills, 8% for other contraceptives, 10% for medical equipment and supplies, 3% for IEC, and 1% for other things. 41% of FPIA assistance has gone to Asia and the Pacific, 39% to Latin America, 16% to Africa, and 4% to interregional programs.
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  6. 6
    199619

    Inventory of population projects in developing countries around the world 1983/84.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, United Nations Fund for Population Activities, [1984]. x, 731 p. (Population Programmes and Projects, v. 2.)

    The eleventh edition of this inventory shows population projects in developing countries that are funded, inaugurated, or carried out by international, bilateral, nongovernmental, or other agencies from January 1, 1983 - June 30, 1984. Projects funded prior to 1983 and still viable are included whenever possible. Listings are by country and then by organization. Budgets are given where known. Each country section also includes basic demographic data and a brief statement on government population policy. Regional and global sections conclude the volume. Neither developed country activities nor projects funded and executed in the same country are listed. Appendices include a bibliography of information sources, a list of addresses, a bibliography of informative newsletters and journals, and an index.
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  7. 7
    031467

    [Health costs and financing and the work of WHO] Cout et financement de la sante et activities de l'OMS.

    Mach EP

    World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(4):339-50.

    This discussion examines the international responses to issues and problems in the cost and financing of the health sector, focusing on the work of the World Health Organization (WHO). It describes the growth of attention to these concerns beginning in the 1970s, reviews methods and applications of financial analysis in greater detail, and summarizes progress to date and the agenda for work. Emphasis is on the developing countries, for they face the most urgent problems regarding costs and financing, and more attention is directed to their needs for support in this area. By the early 1970s it was clear that progress in health development particularly in the most underprivileged countries was unsatisfactory and that changes were needed if services were to have an appreciable impact on the health problems of developing populations. A major study conducted jointly by the UN Children's Fund (UNICEF) and WHO identified several of the critical problems associated with resources. The essential financial concerns requiring attention in connection with primary health service coverage, the need for more equitable distribution of existing resources for health and the priority of resources allocation to peripheral health services were examined in detail by a WHO Study Group on Financing Health Services which met in 1977. Among the problems of health finance, those of the overall lack of funds, the maldistribution of health resources, rising health care costs, and the lack of coordination were found to be particularly important. The Study Group concluded that, despite difficulties, it was possible to collect information of sufficient reliability for planners' needs and at a modest cost, even for the private sector. To help bring this about, it recommended that research centers and universities, in collaboration with national health authorities of their country, devote considerable attention to data collection methods. The reports, studies, and papers prepared at various meetings deal in general with specific aspects of health cost and financing. A major element, and evolving product, of the meetings and studies related to developing countries was a manual on financing health services, originally based on the recommendations of the 1st Study Group meeting. This draft document served as background material for a series of further meetings and was used to guide many of the country financing studies. A number of other health financing manuals were also developed between 1979-81. In its final published form the WHO manual attempts to be relevant to all developing countries. The manual describes health policies and their financial aspects and outlines techniques for data collection. If the recommendations of the 1st Study Group are compared with the achievements recorded thus far, the following facts come to light: many countries have undertaken surveys of health sector financing and resource allocation; increased interest in this subject has been shown by other international organizations; much progress has been made in the development and refinement of methodologies for collecting and using financial data; international activities and country studies have made it possible to provide reports for country leadership; and issues of financial planning and management often appear in medium and longterm plans.
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  8. 8
    030879

    Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.

    United Nations. Department of International Economic and Social Affairs. Population Division

    In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 37-79. (International Conference on Population, 1984.; ST/ESA/SER.A/91)

    This paper reviews the major issues that have emerged in the analysis of mortality and health policy since the 1974 World Population Conference. The 1st part summarizes current mortality conditions in the major world regions and evaluates progress toward achieving the goals of the World Population Plan of Action. It is noted that the current mortality situation is characterized by continued wide disparities between the more developed and less developed regions, especially during the 1st year of life. The 2nd part focuses on the synergistic relationship between health and development, including social, economic, and health inequalities. It is asserted that mortality rates in developing countries are a function of the balance governments select between development strategies favoring capital accumulation and concentrated investments on the 1 hand and strategies oriented toward meeting basic needs and reducing inequalities in income and wealth. Data from developed countries suggest that economic development does not necessarily lead to steady gains in life expectancy. Some variations in mortality may reflect changes in family relationships, especially women's status, that are induced by social and economic development, however. The 3rd part of this paper analyzes the effect of health policies on mortality, including curative and preventive programs and primary health care. The lack of community participation is cited as a key factor in the weak performance of primary health care in many developing countries. In addition, there is strong evidence that the concepts and technologies of modern medicine must be adapted to existing systems of disease prevention and care to gain acceptability. The 4th section, on the implementation of health policies, discusses health care management, planning, and financing. It is noted that successful implementation of health policies is often hindered by scarcity, inadequate allocation, and inefficient utilization of health resources. Finally, more effective means to cope with rising costs of health care are needed.
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  9. 9
    268082

    Public health and community medicine at Loma Linda University.

    Dysinger PW

    In: The Graduate Education of Foreign Physicians in Public Health and Preventive Medicine. The Role of United States Teaching Institutions, edited by Wendy W. Steele and Sally F. Oesterling. Philadelphia, Pennsylvania, Educational Commission for Foreign Medical Graduates, [1984]. 26-28.

    The School of Public Health at Loma Linda University in California was founded in 1967, and as of December 1983 had graduated a total of 1764 students, 187 of whom were physicians. 28 countries and 45 foreign schools were represented in this enrollment. The experience at Loma Linda University is different from many others in that there has been little government sponsorship of foreign medical graduates. Of 89 foreign medical graduates, only 17 were sponsored by the US Agency for International Development or the WHO, and all 17 returned to their home countries where they are making significant contributions in Tanzania, Kenya, Thailand and Indonesia. In 1970, the Loma Linda University School of Public Health developed an evening program in which most of the course work was taught in Los Angeles 1 evening per week over a 2-year period. 10 health officers and a few others completed that program. Their success stimulated extending the program. In 1973 an experimental program teaching a general Master of Public Health (MPH) course to Canadians was initiated. In 1980, Loma Linda University also launched an extended program in the Central American-Caribbean area. In the context of a general program in public health and preventive medicine leading to a Master of Public Health Degree, the curriculum in international health seeks to prepare health workers who will be: trainers of trainers; cross-cultural communicators; managers and supervisors of primary health care services; and practitioners of the integrated approach to community development. Graduates are prepared to deal with sociocultural, environmental and economic barriers. Students not having a professional background in health are required to add an area of concentration to degree requirements. Areas of concentration include: tropical agriculture, environmental health, health administration, health promotion, maternal and child health, nutrition and quantitative methods/health planning. The goal of the International Health Department is to help people help themselves to better health. Loma Linda University has also been involved with schools in Asia, Africa, Latin America and recently in the Philippines. The preventive medicine residency program at Loma Linda is for the 2nd and 3rd years only at the present.
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  10. 10
    029715

    Official development assistance for population activities: a review.

    Herz BK

    Washington, D.C., World Bank, 1984. 153 p. (World Bank Staff Working Papers No. 688; Population and Development Series No. 13)

    The 5 chapters of this document, which traces the sources of assiastance for family planning and other population programs from developed countries and the flow of assistance through principal channel organizations to developing countries, focus on the following: population assistance flows; rationales for population assistance; the shape of population programs; the major channels; and the future of population assistance. Official development assistance for population comes primarily from the US, the Nordic countries, and more recently from the Federal Republic of Germany and Japan. Population assistance is channeled primarily through the UN Fund for Population Assistance (UNFPA), nongovernmental organizations, bilateral programs, and the World Bank. In discussing why developing countries seek and why developed countries provide population assistance, this paper concentrates on official views of how population growth and high fertility affect economic development, environment, maternal and child health, and women's welfare. It explains why some countries are reluctant to seek or provide more population assistance. The paper also analyzes what population assistance does to extend reliable and affordable family planning services and information and to improve understanding of population growth, its causes, and consequences. It summarizes current population policies and family planning programs in major regions of the 3rd world and considers the role of assistance. This paper identifies the comparative advantages of principal organizations providing population assistance, focusing on UNFPA, the major nongovernment organizarions, and the major bilateral programs. Finally, it discusses the evolution of "policy issues" affecting population assistance, particularly donors' concern for "demand" for family planning, cost effectiveness of family planning services, safety, and voluntarism.
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  11. 11
    267640

    The use of indicators of financial resources in the health sector. L'emploi des indicateurs de ressources financieres dans le secteur de la sante.

    Parker DA

    World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(4):450-62.

    This article provides an overview of the application of financial resource indicators in health. The focus is on indicators at the country level, although in certain instances related sub-national indicators are considered as well. 1st the different categories of financial resource indicators are described. The international experience in data collection, and problems of data availability and comparability are reviewed. Although the points addressed are relevant to all countries, the discussion is most applicable to the developing world where health information is limited. Particular attention is given to the design adn use of financial resource indicators in monitoring progress towards the goal of health for all. Finally, the steps that may be taken to increase the contribution of financial resource indicators to the health development process are discussed. Viewed economically, the health sector consists of production and consumption of services which have relatively direct influence on population health status. The different types of resources may be linked to their respective prices to show the financial flows that operate within the health system. The sources and uses of funds are identified. 3 types of financial resource indicators can be identified: health within the national economy, the provision of funds from primary sources and the functional and programmatic uses of funds. The 1st type is concerned with the aggregate availability of funds within the national economy and the fraction of those funds which are allocated to health. The 2nd component relates to the origins of the funds which make up the total health expenditure, under the broad headings of public, private and external sources of health finance. The 3rd type refers to the variety of used to which funds from these sources are put (expressed in terms of function e.g. salaries), program type (e.g. primary health care), or activity (e.g. health education).
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  12. 12
    267239

    The costing of primary health care: report of participation WHO consultation in Nazareth, Ethiopia.

    Stinson W

    [Unpublished] 1984. v, 25 p.

    This meeting was sponsored by the World Health Organization (WHO) with Dr. Wayne S. Stinson participating at WHOs request. The objectives of the informal consultation were: 1) to strengthen national capabilities for undertaking the costing of preimary health care and for the utilization of results for development and management; 2) to exchange experiences on the costing of PHC in different countries; 3) to discuss methodologies used for data collection at the PHC center; and 4) to make recommendations for future work. This consultation is one in a series of costing and financing meetings held by WHO since 1970. The most recent meeting prior to 1983 was an interregional workshop on the cost and financing of primary health care, held in Geneva in December 1980. Papers distributed at that meeting (which have not yet been published) suggest a need for greater understanding of costing principles and technical refinement of methodologies. Judging by the papers presented at the Nazareth workshop, costing efforts have greatly improved since 1980. Representatives from the following countries participated in the Nazareth workshop: Argentina, Botswana, Columbia, Thiopia, Gambia, Kenya, Lesotho, Malawi, Sierra Leone, Sri Lanka, Swaziland, Tanzania, Thailand, Uganda, and Zambia. Some of these reported costing studies. This report consists of a narrative description of the meeting itself followed by a commentary on some of the issues raised. There is then a discussion of Arssi Province and Ethiopia as a whole based on a 1-day field trip. Finally recommendations are given regarding the United States Agency for International Development's (AID's) further PHC costing efforts.
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  13. 13
    026644

    Population growth and economic and social development.

    Clausen AW

    Washington, D.C., World Bank, 1984. 36 p. (International Conference on Population, 1984; Statements)

    In his address to national leaders in Nairobi, Kenya, Clausen expresses his views on population growth and development. Rapid population growth slows development in the developing countries. There is a strong link between population growth rates and the rate of economic and social development. The World Bank is determined to support the struggle against poverty in developing countries. Population growth will mean lower living standards for hundreds of millions of people. Proposals for reducing population growth raise difficult questions about the proper domain of public policy. Clausen presents a historical overview of population growth in the past 2 decades, and discusses the problem of imbalance between natural resources and people, and the effect on the labor force. Rapid population growth creates urban economic and social problems that may be unmanageable. National policy is a means to combat overwhelmingly high fertility, since governments have a duty to society as a whole, both today's generation and future ones. Peoples may be having more children than they actually want because of lack of information or access to fertility control methods. Family planning is a health measure that can significantly reduce infant mortality. A combination of social development and family planning is needed to teduce fertility. Clausen briefly reviews the effect of economic and technological changes on population growth, focusing on how the Bank can support an effective combination of economic and social development with extending and improving family planning and health services. The World Bank offers its support to combat rapid population growth by helping improve understanding through its economic and sector work and through policy dialogue with member countries; by supporting developing strategies that naturally buiild demand for smaller families, especially by improving opportunities in education and income generation; and by helping supply safe, effective and affordable family planning and other basic health services focused on the poor in both urban and rural areas. In the next few years, the Bank intends at least to double its population and related health lending as part of a major effort involving donors and developing countries with a primay focus on Africa and Asia. An effective policy requires the participation of many ministeries and clear direction and support from the highest government levels.
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  14. 14
    027607

    Basic needs or comprehensive development: should UNDP have a development strategy?

    Dell S

    In: Ghosh PK, ed. Third world development: a basic needs approach. Westport, Connecticut, Greenwood Press, 1984. 115-45. (International Development Resource Books No. 13)

    The basic needs approach is critically examined, and the appropriateness of donor agency support for the basic needs approach is questioned. The basic needs approach is plagued by operational problems. It is difficult 1) to define minimum basic need levels, especially if absolute standards are advocated; 2) to measure basic needs; and 3) to implement basic needs programs in such a way as to ensure that only the poorest segments of the population derive benefits and that the benefits remain in the hands of the poor. Basic needs advocates fail to deal with the question of economic growth. They assume that economic growth will continue and ignore the fact that there is a trade-off between satisfying basic needs and investing in growth. They also ignore the issue of trade-offs between fulfilling present and future basic needs. The basic needs approach implies a specific development pattern, and the longterm consequences of this implied development pattern are not sufficiently examined by advocates of the approach. The basic needs approach requires a development pattern that stresses rural development and labor intensive production instead of industrialization, capital intensive production, and growth of the modern sector. Ultimately, the development pattern advocated by this approach will result in an international division of labor between the developing and developed countries which will not improve international marketing conditions for the developing countries since developed countries will not be willing to substantially increase their importation of labor intensive products from the developing countries. Donor agencies need to adopt a cautious attitude toward funding and promoting the basic needs approach. Many developing countries strongly resent the basic needs approach. They feel that donors and the developed countries do not have the right to force them to focus their energies on eradicating poverty. They also fear that the approach is an attempt to reduce financial assistance. Donor agencies lack sufficient expertise to evaluate poverty-oriented programs and to assess the long range impact of many of these programs. In one country, a donor-supported basic needs program to increase agricultural productivity had the unexpected result of reducing the price of agricultural products. Another project aimed at improving living standards in a particular rural community unexpectedly increased property values and, ultimately, led to the migration of the former residents to an urban slum. Furthermore, donor agencies do not have the right to impose development strategies on aid recipients. Development strategies must be formulated by the recipients, and donors should support only those strategies which accord with the development goals of the recipient countries.
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  15. 15
    026339
    Peer Reviewed

    Primary health care will fail if we do not change our approach.

    Chabot HT

    Lancet. 1984 Aug 11; 2(8398):340-1.

    The implementation of primary health care seems seriously hampered because it is not properly handled by many of the international agencies. Initial concern is the haste with which primary health care projects are being established and executed. These projects are expected to improve the health status of the target group within 2-3 years. Almost everywhere health officials are trying to expand primary health care schemes as rapidly as possible and to provide a maximum of the population with village health workers, yet little attention is directed to the structure needed to support the village workers nor to the problems related to their training motivation and financial reward. There is also the tendency to ignore the complex interrelations between the socioeconomic, cultural, and political factors and health improvement in general. A better way of attaining permanent improvement in health is to build slowly, using the local results and positive experiences in primary health care to reinforce the awareness and political organizations of the poor so that they will have more power to demand a shift in money allocation in their favor from their governments. In most countries this is not likely to happen even after the year 2000, and the World Health Organization (WHO) should stop advertising "Health for All by the Year 2000" and call for slow and careful expansion of the primary health care policy. There are some negative aspects to the amount of money available for primary health care. Donors keen to help with primary health care may not see that it needs the assistance of all medical departments to operate effectively. Despite considerable financial investment in primary health care over the past few years, few countries have been able to change their health budgets from hospital-based services to primary health care. The priorities in the ministries of health still seem heavily biased toward the existing curative and urban-based health services. Through primary health care, predominantly Western values are introduced into the countries to be served by the projects. 1 such case is the emphasis on efficiency in establishing and running primary health care projects. The preoccupation with data collection in primary health care is another example of Western influence as is the tendency to plan, in as much detail as possible, the objectives to be met at each stage of a project. A less ambitious approach to a community health care proposal by the government of Giunea-Bissau with less defined objectives would have been preferable, but it is questionable whether the Western donor would have accepted such a "vague proposal.
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  16. 16
    025507

    Population: the UNFPA experience.

    Sadik N

    New York, New York University Press, 1984. 206 p.

    This volume assesses the programming experience of the United Nations Fund for Population Activities (UNFPA) from its establishment in 1969 through 1983, a period during which the Fund supported over 3500 projects in the developing world for a total expenditure exceeding US$1 billion. The objectives of the UNFPA are to assist governments in formulating and implementing a population policy and to promote a fuller understanding of the population aspect of development. The UNFPA has worked with both governments and nongovernmental organizations to implement population programs consistent with cultural values and socioeconomic factors, and its financing of research, training, and action programs has enabled many developing countries to move closer to self-reliance in the field of population. Part 1 of this volume describes the Fund's operational experience in the geographic regions it serves. Part II describes programming assistance in the areas of family planning; information, population education, and communication; data collection; demographic research, training, and population policy; and women, population, and development. Part III suggests future programming outlooks from the regional, substantive, and operational perspectives. Provision of easily accessible, affordable family planning services consistent with prevailing sociocultural norms and potential user preferences is 1 of the Fund's most urgent concerns for the coming period. Greater emphasis on the use of demographic data in development planning and the strengthening of management aspects of population programs are additional goals. Future strategies will have to acknowledge the changing techincal cooperations of developing countries and devise a system where countries can draw on local resources where possible but retain access to international expertise. Compatibility between development projects in health, education, and employment and those in the population field should be sought. An appendix to this volume summarizes the principal demographic indicators for all countries and regions of the world.
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  17. 17
    024814

    FPIA helps expand contraceptive services.

    Groot H

    Planned Parenthood Review. 1984 Spring-Summer; 4(1):18.

    Since the beginning in 1971 of the Planned Parenthood Federation of America's international program, Family Planning International Assistance (FPIA), US$54 million has been contributed in direct financial support for the operation of over 300 family planning programs in 51 countries; over 3000 institutions in 115 countries have been supplied with family planning commodities, including over 600 million condoms, 120 cycles of oral contraceptives, and 4 million IUD; and about 1 million contraceptive clients were served by FPIA funded projects in 1982 aone. Since 1971, however, the world's population has increased from 3.7 billion to around 4.7 billion people. About 85 million people are added to the world each year. There is consensus that without organized family planning programs, today's world population would be even higher. FPIA measures its progress in terms of expanding the availability of contraceptive services in devloping countries. FPIA supported projects have helped make services available in areas previously lacking them, and has helped involve a wide variety of organizations, such as women's groups, youth organizations, and Red Cross Societies, in family planning services. A prime concern of FPIA, which has limited resources, is what happens to projects once FPIA support is terminated. FPIA has been paying attention to local income generation to help projects become more self-supporting and to increas staff members' management skills. The more successful income-generating schemes appear to be directly related to family planning, selling contraceptives and locally produced educational materials, and charging fees for family planning and related medical services and tuition for training courses. FPIA funded to projects use management by objectives (MBO) to help improve management skills. MBO helps grantees improve their ability to set objectives, plan, monitor, report, and do day-to-day project management.
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