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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    [Unpublished] 1984. 95 p. (MCH/84.5)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
    039223

    Report of the fifth meeting of the technical advisory group (Geneva, 12-16 March 1984).

    World Health Organization [WHO]. Programme for Control of Diarrhoeal Diseases

    [Unpublished] 1984. 27 p.

    The current status of the Control of Diarrhoeal Diseases (CDD) Program was reviewed, and activities related to the evaluation of country control programs, the assessment of potential diarrheal disease control interventions, and the program's operational research activities were examined. In the health services component, ciontinued efforts to promote the preparation of plans of operation for national CDD programs is recommended, as is continued use of the national CDD program managers training course. Concern was expressed that the level of use of oral rehydration therapy (ORT) appeared to be modest. Case management was endorsed as the major program strategy. The series of studies on interventions for reducing diarrhea's mortality and morbidity were welcomed. For evaluation purposes, it is recommended that the program develop additional criteria for monitoring increased access to and usage of oral rehydration salts (ORS) and the reduction of diarrheal mortality. Continued accumulaton and publication of information yielded by the program's survey of the impact of ORT in hospitals was recommended. In the research component, the growth of research activities is satisfying. While biomedical aspects have developed well, it might be necessary to relate them gradually to specific control interventions in the future. Further studies of improved ORS formulatons were recommended. High priority should also be given to the promotion of breast feeding, immunization, and water supply and sanitation. The underlying mechanisms that cause the intervention to reduce diarrheal morbidity or mortality should be clarified. Research is recommended on the promotion of personal and domestic hygiene, food hygiene, and improved weaning practices. Emphasis on the development and evaluation of vaccines against the causes of diarrhea is supported. Some changes in the balance of research activities should be made. Epidemiological weak.
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  3. 3
    046113

    Subregional Workshop on Planning, Formulating and Evaluating of MCH-FP/PHC Projects, Nairobi, 15-19 October 1984. Final report.

    World Health Organization [WHO]. Regional Office for Africa

    Brazzaville, Congo, WHO, Regional Office for Africa, 1984. 27 p. (AFR/MCH/81)

    The objective of the Subregional Workshop on Planning, Formulating and Evaluating Maternal and Child Health-Family Planning/Primary Health Care (MCH-FP/PHC) Projects, held in Nairobi, Kenya, during October 1984, was to train national personnel so that they would be prepared to formulate, implement, monitor, and evaluate MCH-FP/PHC projects in the context of primary health care. These proceedings cover the 5 workshop sessions: mandates, roles and activities of the UN Fund for Population Activities (UNFPA) and the World Health Organization (WHO); planning and program development of both the UNFPA and WHO; project formulation and appraisal; practical information and procedures important for both the formulation and implementation of MCH/FP projects by the executing agency; and a project appraisal exercise. Also included is a project formulation exercise and a project monitoring and evaluation exercise. An evaluation of the workshop by participants also is included. Appendixes contain a list of participants, the opening address, the program of work, and reference documents.
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  4. 4
    033841

    General lessons learned from evaluations of MCH/FP projects in Botswana, Malawi, Swaziland and Zambia.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1984 Dec. iv, 41 p.

    4 maternal-child health/family planning (MCH/FP) projects were evaluated by the United Nations Fund for Population Activities (UNFPA) in the Southern Africa Region between 1981-1984. The projects were in Botswana, Malawi, Swaziland and Zambia. An overriding finding at the time of the Evaluation Missions was the acceptance of family planning (child spacing) by all 4 governments, when at the onset of the projects, family planning was either not included in the project documents or was included only as a minor contributant to the MCH programs. The intervention by UNFPA was very important for the acceptance and promotion of family planning activities by the governments. The Evaluation Missions concluded that there were 3 primary reasons for the successful intervention: UNFPA has a broad mandate to provide assistance in MCH and FP, a commitment to development projects in line with the governments' priorities, and the ability to fund projects very quickly, facilitating project implementation. Each of the 4 projects is assessed in terms of population policy changes, MCH/FP program strategy and serive delivery, organization of the MCH/Fp unit, health education, training, evaluation and research systems, and administration and management. Essential factors affecting the project are outlined and recommendations made. The last section discusses general lessons derived from the MCH/FP projects evaluated. 5 areas are identified where similar problems exist to varying degrees in all the projects evaluated. These are: training of medical personnel in FP (the main MCH/FP service provider in these projects was the nurse/midwife); supervision of personnel and the supply and distribution of contraceptives; research and evaluation, especially regarding the sociocultural setting of target populations and the inadequacy of existing service statistics and other sources of data; project monitoring (technical and financial) and finally project execution by the World Health Organization (WHO). Specifically in regard to the recruitment of experts, the provision of supplies and equipment, and the provision of funds for local costs, WHO execution has been deficient.
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  5. 5
    268446

    Report on the evaluation of CPR/80/P14: population education in the secondary schools and teachers training of the People's Republic of China.

    Jayasuria JE; Wayland SR; Swindells H

    New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Nov. iv, 49 p.

    The objectives of the Population Education in Secondary Schools and Teachers Training of the People's Republic of China Projects were to provide the Chinese people, including young students, with the basic knowledge of population science and an understanding of why the Government considers family planning a fundamental national policy and why it is implementing the policy of controlling the number of the population and raising its quality. The 2 distinguishing features of this project are that the target group are middle school students rather than students of all grade levels, and that the existence of an established system for in-service training in the form of pedagogical institutes provides a fast and effective mechanism to introduce population education into the 2ndary school curriculum. The overall assessment of the Mission is that this project has been highly successful. The Mission's main recommendations are: 1) that the United Nations Fund for Population Activities and the Government increase their financial assistance; 2) future objectives be stated in terms that emphasize educational outcomes rather than operational tasks to permit objective monitoring and evaluation; 3) that a moratorium be place on the revision of population education curricula in order to concentrate on its diffusion; 4) that the posters and commentary be considered as a basis for instruction of junior middle school students as well as out-of-school youth and adults; 5) that questions on population content be included in the national examinations for university admission; 6) that a program for pre-service education in population education be initiated to supplement the in-service training; and 7) that substantial attention be given to different modes of training.
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  6. 6
    268445

    Report on the evaluation of UNFPA assistance to the family health programme of Zambia: project ZAM/74/PO2 (February - March 1984).

    Ryder B; Burton J; McWilliam J

    New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Sep. x, 38, [5] p.

    The objective of the Family Health Program of Zambia is to enhance the health and welfare of Zambians, particularly mothers and children, through an increase in coverage of the population served through under-5s clinics, pre- and post-natal services and child spacing activities. The Mission found that the strong points of the project are the increasing commitment of the Government to incorporate family planning activities as an essential component of its family health and primary health care programs; the training and health education components of the program; and the enthusiasm and ability of the Zambian Enrolled Nurse/Midwives in organizing maternal child health/family planning services at service delivery points. Factors which appear to have hindered a more effective project performance have been the restriction on prescribing contraceptives by anyone but physicians; the imbalance in implementation among the project components; the failure to appoint international and national staff to key positions and with a timing that would have enabled staff members to support each other as members of a coordinated team; weak supervision; no research and evaluation activities; transport problems; the lack of use of, and updating of, the project plans; and the absence of a tripartite review early in the project's life to address implementation problems.
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  7. 7
    268444

    Report on the evaluation of UNFPA-sponsored country programme in Democratic Yemen, 1979-1984 and role of women in it.

    El-Sherbiny A; El-Khodary M; Molyneux M; Zouain G; Frieiro L

    New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Apr. xiii, 101 p.

    The United Nations Fund for Population Activities (UNFPA)-sponsored Country Program was the 1st comprehensive effort in the field of population in Democratic Yemen, following earlier sub-sectoral interventions which benefitted from UNFPA assistance. This evaluation covers 1) the country program as such, focusing on the results achieved in terms of building national capacity for formulating and implementing population policies and programs; 2) the 7 component projects, one in data collection and analysis, a maternal child health/family planning project, and 5 in population education for different audiences; and 3) the women's dimension of the program. At the end of the 4th year of implementation, little had been done by the Country Program in terms of institution building and population policy. The program's achievements were hindered by factors such as an extreme shortage of national qualified staff, training facilities, poor program design, insufficient technical leadership and support, as well as unrealistic objectives. The 7 component projects were plagued with similar problems and made only modest acheivements. The Evaluation Mission expressed the view that long term international expertise to serve all projects would have been advisable as well as long term training abroad for a few people who could become leaders/advisors/administrators. In evaluating the role of women, the Mission found that women had participated in the implementation of all the projects evaluated but were mainly to be found in junior positions. The program as a whole contained a substantial portion of women among its direct beneficiaries comprising those who had been trained, employed and targeted as recipients of the services of the projects, although this varied considerably between projects. In general, the Mission was of the view that in the future a country program document should be prepared specifying the long term and immediate objectives for the population program as a whole.
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  8. 8
    268442

    A summary of the report on the evaluation of MEX/79/P04 "Integration of population policy with development plans and programmes".

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1984 Jul. 19, [9] p.

    The objective of this UNFPA project was to build the institutional and methodological base for integration of population policy into and its harmonization with national, sectoral and state policies or socioeconomic development in Mexico. More specifically, the project was to achieve integration of population policy with 6 sectoral plans, 24 state plans and the Master Development Plan within 3 years. Although the Mission considers it an achievement that the project signed agreements with all 31 states and the Federal District, no formal contacts had been made with the 6 sectors. Mexico's National Population Council (CONAPO) coordinated the project. The Mission recommended that support to integration activities be continued on the basis of the experience that has been acquired. Therefore it is necessary 1) to strengthen the activities at the state level; 2) to support the development of methodologies considering the impact of socioeconomic plans and programs on demographic variables and to provide a comprehensive program of international technical experience; 3) to recognize that responses to ad hoc support activities are an important integration instrument for both sectors and states; and 4) to exact greater clarity concerning the role of the project in the National Population Program. A lack of aedquately trained personnel proved to be a continual obstacle to implementation. The Mission recommends that at an early stage in the development of such projects a thorough assessment of the human resource requirements and existing capacity for integration of demographic and socioeconomic variables be made and that, based on this assessment, a specific training strategy be developed and incorporated in the project's design. In addition to training, the project also included research support activities; the outputs, however, were descriptive rather than analytical, which can be traced to both the design and execution of the work plan for research activities. The UNFPA's funding constraints and its management of reduced funds further complicated the project's execution, which suffered from high personnel turnover and lack of coordination of project activities.
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  9. 9
    030872

    [Reconciling censal and inter-censal data and determination of the population base] Conciliacion censal y determinacion de la poblacion base.

    Rincon MJ

    In: Metodos para proyecciones demograficas [compiled by] United Nations. Centro Latinoamericano de Demografia [CELADE]. San Jose, Costa Rica, Centro Latinoamericano de Demografia, 1984 Nov. 13-42. (Centro Latinoamericano de Demografia [CELADE] Series E, No. 1003)

    This work describes procedures used by the Latin American Demographic Center (CELADE) for establishing a base population for projection in quinquennial age groups by means of evaluation of population censuses and reconciliation of demographic data for 2 or more intercensal periods. Demographic reconciliation refers to the array of procedures through which the degree of coverage of successive censuses is evaluated; age and sex distributions resulting from incomplete coverage, differential omission, and poor age reporting are corrected; the demographic dynamics of intercensal periods are made coherent with estimates of mortality, fertility, and migration from all available sources; and a base population for population projection is established. There are no fixed rules for evaluation and reconciliation of census data, because the history and quality of data collection in each country are unique. The compensatory equation, in which 2 or more population censuses are reconciled in regard to fertility, mortality, and international migration in intermediate years usually in terms of age cohorts, is an indispensable tool for demographers in developing countries. The need to add children born in the years between censuses and the different types of errors typifying different age groups means that the process of census reconciliation should be carried out separately for at least 3 age groups: children under 5, the 5-9 year cohort, and those over 10 years of age. The age group 0-4 is often the most seriously underestimated. Because the age group 5-9 years is often the best enumerated in Latin American population censuses, it can serve as the basis for correction of the population aged 0-4. The data required include the population aged 5-9 in single years in the last census, the deaths in children under 10 by year of birth and age at death in single years, and the annual number of births in the 10 years preceding the last census. Data from Panama illustrate that the results of this technique are not always acceptable, in which case correction of the 0-4 cohort may be accomplished by means of correction of births and deaths using indirect methods. Corrections for the 5-9 cohort, if required, can be made in a similar manner to that for the youngest group. Evaluation and correction of errors of omission and misreporting of age of the population over 10 is the most difficult because data sources are most often inadequate, these age groups have the greatest age and sex differentials and poorest age reporting, and are most likely to be effected by emigration. All available data should be utilized to produce a group of alternative estimates for each cohort based on diverse basic data and assumptions about such variables as the sex ratios for age agroups. The most likely values must then be selected or calculated. The process by which census results from 1950-80 were used to estimate the base population for a projection by components in Panama illustrates the procedure used by CELADE.
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  10. 10
    021441
    Peer Reviewed

    A perspective on long-term population growth.

    Demeny PG

    Population and Development Review. 1984 Mar; 10(1):103-26.

    This paper presents some of the results of projections prepared by the World Bank in 1983 for all the world's countries. The projections (presented against a background of recent demographic trends as estimated by the United Nations) trace the approach of each individual country to a stationary state. Implications of the underlying fertility and mortality assumptions are shown mainly in terms of time trends of total population to the year 2100, annual rates of growth, and absolute annual increments. These indices are shown for the largest individual countries, for world regions, and for country groupings according to economic criteria. The detailed predictive performance of such projections is likely to be poor but the projections indicate orders of magnitude characterizing certain aggregate demographic phenomena whose occurrence is highly probable and set clearly interpretable reference points useful in discussing contemporary issues of policy. (author's)
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  11. 11
    029362

    World Health Organization evaluates NORPLANT subdermal implants as effective, reversible, long-term contraceptive. News release.

    Population Council

    New York, Population Council, 1985 Feb 22. 5 p.

    A World Health Organization (WHO) review of animal and human data on Norplant subdermal implants, convened at the request of the United Nations Fund for Population Activities, has determined that this contraceptive system is an "effective and reversible long term method of fertility regulation" and recommended that it be made available through family planning programs. George Zeidenstein, president of the Pouplation Council, which developed the Norplant system, has termed the WHO report "a giant step toward worldwide acceptance and availability." So far, extensive clinical trails have noted no adverse side effects of this contraceptive system, and animal studies on levonorgestrel suggest the drug is safe for use in humans. Clinical trial data on more than 4000 women have indicated continuation rates of 60-95% at the end of the 1st year and about 50% at the end of the 5th year. The annual pregnancy rate is 0.2-1.3/100 women over a 5 year period. Disturbance of the menstrual cycle, including increased frequency and number of bleeding days as well as irregular bleeding or spotting, occurs in the majority of women who use this method; however, bleeding problems tend to diminish with increased duration of use. The Norplant implant system is particularly suitable fo r women who seek extended contraceptive protection but either do not wish to undergo sterilization or who desire a child in the future. Norplant is currently a vailable in Finland and has just been granted registration in Sweden. Over the next 2 years, regulatory approval will be sought in 40 additional countries including the US, where the Norplant system is in clinical trials at 3 sites.
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  12. 12
    267402

    The United Nations' flawed population policy.

    Huessy PR

    Washington, D.C., Heritage Foundation, 1984 Aug 27. 16 p. (Backgrounder No. 376)

    The United Nations' 2nd World Population Conference (Mexico City, 1984) called for greatly expanding funding for family planning assistance worldwide. The United Nations Fund for Population Activities (UNFPA), the conference's chief sponsor, will no doubt receive the largest portion of any assistance increase. UNFPA plays a critical role in population-related programs worldwide. The central debate on population policy should be over the extent and adequacy of the natural resources base and how countries can humanely and voluntarily change family size preferences. In countries like Singapore and South Korea, success has been achieved by combining social and economic incentives to discourage large families. Although couples in developing countries report wanting contraceptive service programs, they also want families of 4 to 6 children. So far UNFPA has been ineffective in changing the population situation. This overview of its activities reveals that UNFPA loses ultimate reponsibility for implementation of many of its own programs. UNFPA does not advocate a reduction in population growth within a single country, but rather helps couples have the number of children they desire. UNFPA's specific population and family programs are divided into functional areas: basic data collection, population change study, formulation and implementation of population policies, support for family planning/maternal child health programs and educational and communication programs. UNFPA stresses the importance of using contraceptives but not of achieving the small family norm. UNFPA's projects in some of the largest less developed nations are described, illustrating how the UN agency spends its assistance funds. From 1971 to 1982, the UNFPA spent almost US $230 million in the 10 largest less developed countries without any significant change in population growth. UNFPA program administrators are far from resolving the serious population problems facing developing countries and generally oblivious to new directions in which population policies should move. No progress will be made until UNFPA recognizes the need to approach the problem from a different perspective, working to change attitudes toward small families.
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  13. 13
    024930

    The urban and city population projections of the United Nations: data, definitions and methods.

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

    In: United Nations. Department of International Economic and Social Affairs. Population projections: methodology of the United Nations. New York, N.Y., United Nations, 1984. 67-74. (Population Studies, No. 83; ST/ESA/SER.A/83)

    This paper draws attention to the large variation in national practices to determine localities and to classify urban populations which has serious implicatons for any projections of urban and city populations, no matter what specific methodology is being used. There are many criteria by whichlocalities can be defined as urban: population size, population density, % labor force in non-agriucltural activities, function of the city, some other unspecified "urban" characteristics or a combination of several of these criteria. Population size is deemed the preferable criterion for designating localities as urban. This criterion is consistent with one of the classic definitions of urbanization: "Urbanization is a process of population concenttration. It proceeds in 2 ways: the multiplication of points of concentration and the increase in size of individual concentration." Population size is also the most widely available criteria for localities. Procedures used by the UN to estimate and project urban and city population are given. The UN utilizes a measure of urbanization called the urban-rural ratio (URR), which is defined as the ratio of the urban to the rural population for a country at a given point in time. While attempts are being made to provide as complete a coverage of cities as possible, no standard guidelines have so far been used to systematically include all cities that will reach 100,000 population during the projection period. It is hoped that detailed discussion of the data and the conceptual and procedural problems will lead users of the estimates and projections to carefully consult the respective sources and definitions when they use these results for comparative purposes.
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