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  1. 1
    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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  2. 2
    037920

    How to estimate chloroquine requirements for the first time.

    World Health Organization [WHO]. Expanded Programme on Immunization [EPI]

    Geneva, Switzerland, WHO, EPI, 1984 Oct. 14 p. (Logistics and Cold Chain for Primary Health Care 7; EPI/LOG/84/7)

    The objective of this module is to enable the users to estimate the 1st requirement for chloroquine tablets. This could be for a new health center or an existing center receiving chloroquine tablets for the 1st time. The 5 steps are as follows: estimate the size of the target population; estimate the incidence of malaria; estimate the coverage; decide on the standard treatment; and calculate the amount of chloroquine tablets needed for the 1st month's supply. Exercises are included.
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  3. 3
    037918

    The cold chain game.

    World Health Organization [WHO]. Expanded Programme on Immunization [EPI]

    Geneva, Switzerland, WHO, EPI, 1984. 24 p. (Logistics and Cold Chain for Primary Health Care 12; EPI/LOG/84/12)

    This booklet is a guide for those who already have played the cold chain game, a game for teaching logistics for primary health care, and who want to organize their own game. The cold chain game was developed originally by the Expanded Program on Immunization (EPI) as a method of teaching people how to distribute vaccine effectively. In this booklet, the game has been adapted to teach how to distribute chloroquine tablets as well as vaccines. The cold chain game is designed for 5-10 people or 11-20 people depending on how it is organized. 2 or 3 supervisors are needed, one to direct the game and the others to assist the participants. The game's purpose is learning. The players learn by discovering the problems of trying to manage a cold chain and solving thse problems by themselves. The players take on the roles of cold chain workers, storekeepers, supervisors and learn the complex nature of these tasks. This booklet describes what the game is designed to teach, how to set up the game, how to run the game, and how to devise one's own cold chain game.
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  4. 4
    037916

    How to distribute supplies.

    World Health Organization [WHO]. Expanded Programme on Immunization [EPI]

    Geneva, Switzerland, WHO, EPI, 1984 Oct. 12 p. (Logistics and Cold Chain for Primary Health Care 3; EPI/LOG/84/3)

    This booklet considers 4 important aspects of good distribution of supplies: decide a delivery interval; decide a delivery method; choose the transport; and make a timetable. In a system that works well, supplies never run out, there is never too much of any supply, the expiration date is never passed, the cost of the distribution is as low as possible; and in the case of vaccines, they are kept cold all the time. The design of a good delivery depends on: what storage facilities exist; what transport exists; how many people can be trained in the different skills needed; what volume and weight of supplies need to be delivered; and many other factors that only can be decided locally. It is necessary to estimate the volume and the weight of the supplies required in order to make a decision about the distribution means. There are 2 ways of distributing supplies: collection and delivery. In many places, both methods are used. There are 3 types of transport that may be chosen: public, project vehicle, and hired vehicle. The type of transport is not limited to motor vehicles. Boats, trains, carts, bicycles, and walking may be used. In certain cases, it may be justified to use domestic air service. However the distribution system is planned, it is important to make a timetable so that it will operate regularly and properly. The module includes diagrams and exercises.
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  5. 5
    034513

    An analysis of the nature and level of adolescent fertility programming in developing countries.

    Center for Population Options. International Clearinghouse on Adolescent Fertility

    [Unpublished] 1984 Jun. 10, [13] p.

    105 developing country projects dealing primarily or exclusively with adolescent fertility were analyzed in an attempt to determine the nature and level of adolescent fertility programming in the developing world. There were 37 projects in Asia, 21 in Sub-Saharan Africa, 8 in North Africa and the Middle East, 22 in the Caribbean, and 17 in Latin America. About 27% of the programs were exclusively urban, 16% exclusively rural, and the remainder operated in both rural and urban settings. Various types of organizations sponsored projects, but the majority were sponsored by International Planned Parenthood Federation affiliates and other private organizations. There were marked regional differences in sponsorship. Only 11 of the 105 programs were conducted by government agencies, but 14 programs received some support from national governments and local governments also sometimes contributed support. Family life education for both in and out of school youth was the predominant project activity in 66 of the 105 projects. 20 projects focused on training of professionals in family life education such as educators, counselors, and health personnel. Curricula primarily concentrated on sex education, responsible parenthood, the importance of delayed 1st birth and child spacing, and general population concerns. 25 projects conduct youth training sessions and teach teams to serve as peer counselors and cators, motivating their peers toward acceptance of family planning and the small family and providing accurate information on sexuality. About 21 projects have a specific counseling component, with most counseling services teaching family planning, distributing condoms, or referring clients to clinics. Only 16 projects had as a stated objective provision for adolescents of diagnostic or clinical health services related to contraceptive use, family planning, or venereal disease. 18 projects offered training in vocational or income-generating skills integrated with family planning, sex education, and family life education. Over 20 projects described educational materials preparation and production as an activity. Innovative approaches observed in the 105 projects included adoption of the multiservice center concept, integration of family planning education with self-help initiatives to improve young women's socioeconomic status, participation of adolescents in program decision making, and innovative promotional activities. Factors contributing to program success identified by project staff include conducting a needs assessment survey, securing parental and community support, solid funding, a flexible program design, skilled personnel, availability of adequate materials, good cooperation with other community agencies, active participation of young people in planning and running the program, good publicity, and use of innovative teaching methods. Projects are increasingly tending toward less formal kinds of communication in family life education.
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  6. 6
    032447

    Oral rehydration salts: an analysis of AID's options.

    Elliott V

    [Columbia Maryland], Westinghouse Electric Corporation, Public Applied Systems, 1984 Sep. 26, [13] p. (Contract No. PDC-1406-I-02-4062-00, W.0.2; Project No. 936-5939-12)

    Westinghouse Health Systems, under a US Agency for International Development (USAID) contract, ass ssed the global supply and demand of oral rehydration salts (ORS) and developed a set of recommendations concerning USAID's future role as a supplier of ORS. 1.5 billion ORS packets (assuming each packet is equivalent to 1 liter of ORS solution) would be required to treat all ORS treatable cases of diarrhea which occur annually among the world's children under 5 years of age. Currently, about 200 million packets are manufactured/year. In 1983, international sources supplied slightly less than 37 million packets, and the remaining packets were produced by local or in-country manufacturers. UN Children's Fund (UNICEF), which currently provides 81% of the international supply, contracts with private firms to manufacture ORS and then distributes the packets to developing countries, either at cost or free of charge. UNICEF purchases the packets for about US$.04-US$.05. USAID provides about 12.3% of the international supply. Prior to 1981, USAID distributed UNICEF packets. Since 1981, USAID has distributed ORS packets manufactured by the US firm of Jianas Brothers. USAID must pay a relatively high price for the packets (US$.08-US$.09) since the manufacturer is required to produce the packets on an as needed basis. Other international suppliers of ORS include the International Dispensary Association, the Swedish International Development Authority, the International Red Cross, and the World Health Organization. Currently, 38 developing countries manufacture and distrubute their own ORS products. These findings indicate that there is a need to increase the supply of ORS; however, the supply and demand in the future is unpredictable. Factors which may alter the supply and demand in the future include 1) the development of superior alternative formulations and different type of ORS products, 2) a reduction in the incidence of diarrhea due to improved environmental conditions or the development of a vaccine for diarrhea, 3) increased production of ORS in developing countries, 4) increased commercial sector involvement in the production and sale of ORS products, and 5) the use of more effective marketing techniques and more efficient distribution systems for ORS products. USAID options as a future supplier of ORS include 1) purchasing and distributing UNICEF packets; 2) contracting with a US firm to develop a central procurement system, similar to USAID's current contraceptive procurement system; 3) contracting with the a US firm to establish a ORS stockpile of a specified amount; 4) promoting private and public sector production of ORS within developing countries; 5) including ORS as 1 of the commodities available to all USAID assisted countries. The investigators recommended that USAID should contribute toward increasing the global supply of ORS; however, given the unpredictability of the ORS demand and supply, USAID should adopt a short-term and flexible strategy. This strategy precludes the establishment of a central procurement system; instead, USAID should contract a private firm to establish an ORS stockpile and to fill orders from the stockpile. Consideration should be given to altering the ORS packets size and to alternative ORS presentations. USAID should also promote the production of quality ORS products within developing countries and continue to support research on other diarrhea intervention strategies. This report also discusses some of the problems involved in manufacturing and packaging ORS. The appendices contain 1) a WHO and UNICEF statement on the ORS formulation made with citrate instead of bicarbonate, 2) a list of developing countries which manufacture ORS, and 3) statistical information on distribution of ORS by international sources.
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  7. 7
    119388

    The decision makers. [editorial]

    Senanayake P

    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.
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  8. 8
    267012

    Application of WHO Essential Drugs in practice.

    Gotnik MH; Faber DB

    Tropical Doctor. 1984 Jan; 14(1):8.

    Enormous problems in developing countries concerning drug supply, such as inadequate control of money spent on drugs, insufficient government supervision of the importation and distribution of drugs, dumping, and so on, prompted the World Health Organization to set up an expert committee to compile a list of drugs which would provide adequate health care. This Essential Drug list is intended to extend the accessibility of the most necessary drugs to those populations whose basic health needs could not be met by the existing supply system. In cooperation with Medicus Mundi Nederland the use of this basic list is investigated in a population of medical doctors in Africa, sent out by Medicus Mundi. Investigated were: actual use of the essential drug; use of other drugs in the same pharmacotherapeutical group; priority; availability; and suppliers. In addition, insight into a number of other factors, such as the number of patients, beds, stocklists, local production, and supply of information, was obtained. The total number of patients in the combined areas was about 3,500,000. It was found that 3% of WHO's suggested drugs were not used at all, 22 essential drugs were used by only 5% of the doctors, and 41 essential drugs were used by more than 95% of the doctors. In the 1979 Revised List 25 drugs had been added and 10 deleted, compared with the 1st list, although it should be remembered that the differences were not always great. Several essential drugs mentioned for the 1st time in the Revised List are little used. Some complementary drugs scored better than the essential drugs from the same group. A number of drugs not mentioned in the List of Essential Drugs have a high priority. The results of the inquiry will be useful to evaluate the list further.
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  9. 9
    267011

    On a national drug policy for Bangladesh.

    Islam N

    Tropical Doctor. 1984 Jan; 14(1):3-7.

    On April 27, 1982 the Ministry of Health of the government of Bangladesh, set up an 8-man expert committee to evaluate all the registered pharmaceutical products presently available, and to formulate a draft National Drug Policy. Objectives are: 1) to provide support for ensuring quality and availability of drugs; 2) to reduce drug prices; 3) to eliminate useless, nonessential, and harmful drugs from the market; 4) to promote local production of finished drugs; 5) to ensure coordination among government branches; 6) to develop a drug monitoring and information system; 7) to promote the scientific development and application of unani, ayurvedic, and homeopathic medicines; 8) to improve the standard of hospital and retail pharmacies; and 9) to insure good manufacturing practices. 16 criteria were agreed on as guidelines for evaluating the drugs on the country's market. Drugs in Bangladesh have been classified into 3 categories. The 1st is drugs that are positively harmful. They should be banned immediately and withdrawn from the market. There are 265 locally manufactured drugs and 40 imported drugs in this category. The 2nd, drugs to be slightly reformulated by eliminating some of their requirements. There are 134 drugs in this category. The 3rd is drugs that do not conform to 1 or more of the 16 criteria/guidelines. There are over 500 drugs in this category. The new drug policy will produce a saving of 800 million taka (US $32.4 million). Drug supply in Bangladesh is a problem. The public sector distributes 20% of the total. In the private sector, drugs are supplied through import and local production. Investment for research by the pharmaceutical companies is essential. The principles laid down by the International Federation of Pharmaceutical Manufacturers Associations for the supply of good medicine needs to be put into practice.
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