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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.
[Unpublished] 1984. 95 p. (MCH/84.5)The objectives of the 2nd meeting of the Program Advisory Committee (PAC) for the World Health Organization's (WHO's) Program in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.
[Unpublished] 1984. 51 p.This listing of research projects funded since 1980 by WHO's Diarrhoeal Diseases Control Programme, is arranged by project title, investigator and annual budget allocations. Project titles are listed by Scientific Working Grouping (SWG) and include research on bacterial enteric infections; parasitic diarrheas; viral diarrheas; drug development and management of acute diarrheas; global and regional groups and research strengthening activities. SWG projects are furthermore divided by geographical region: African, American, Eastern Medierranean, European, Southeast Asian and Western Pacific. The priority area for research within each SWG is specified.
New York, New York, FPIA, . 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.
[Institutions of youth promotion and services in La Paz, Bolivia: an analytical-descriptive study] Las instituciones de promocion y servicio a la juventud en La Paz, Bolivia. Un estudio analitico-descriptivo.
La Paz, Bolivia, Centro de Investigaciones Sociales, . 104 p. (Estudios de Recursos Humanos No. 8)This work presents the results of an evaluation of 30 institutions in La Paz, Bolivia, which offer recreational, nonformal educational, training, and sports programs to young people. The 1st chapter provides theoretical background on the psychological, social, and sexual problems and tasks of adolescents in modern societies. The 2nd chapter briefly discusses the roles of the family, friendships, and organizations in the development of adolescents, and briefly describes the goals, programs, and financing of 17 of the 20 organizations studied. 21 of the 30 had formal legal status. 16 of the organizations were public and 13 were private. 7 were national in scope and 15 had international ties. 2 were for women only, 23 were for both sexes, and 5 included children. The primary program objectives were educational in 11 cases, cultural in 8, and sports and religious in 5 cases each. 24 of the organizations reported that they fulfilled their objectives and 5 that they possibly did so. 9 of the organizations had vertical patterns of authority, 16 had horizontal, and 5 had other types. 26 reported that their personnel were qualified. 21 were financed by member contributions, 5 by donations, and 1 by parental contributions. 21 reported that attendance was normal and 5 that there was little participation or interest among members. None of the organizations provided more than very superficial sex education programs, although 26 organizations indicated their belief that sex education is important. 12 of the organizations had professionals on their staffs and 17 had volunteers only. 19 reported they had sufficient manpower and 2 that they did not. The material resources of the organizations were scarce; only 6 had their own meeting places. 15 relied on financing by members, 8 had governmental help or received donations from nonmembers, and 4 had international assistance.
EPI in the Americas. Report to the Global Advisory Group Meeting, Alexandria, Egypt, 22-26 October 1984.
[Unpublished] 1984. 15 p.This discussion of the Expanded Program on Immunization (EPI) in the Americas covers training, the cold chain, the Pan American Health Organization's (PAHO) Revolving Fund for the purchase of vaccines and related supplies, evaluation, subregional meetings and setting of 1985 targets, progress to date and 1984-85 activities, and information dissemination. All countries in the Region of the Americas are committed to the implementation of the EPI as an essential strategy to achieve health for all by 2000. During 1983, over 2000 health workers were trained in program formulation, implementation, and evaluation through workshops held in Argentina, Brazil, Cuba, El Salvador, and Uruguay. From the time EPI training activities were launched in early 1979 through 3rd quarter 1984, it is estimated that at least 15,000 health workers have attended these workshops. Over 12,000 EPI modules have been distributed in the Region, either directly by the EPI or through the PAHO Textbooks Program. The Regional Focal Point for the EPI cold chain in Cali, Colombia, continues to provide testing services for the identification of suitable equipment for the storage and transport of vaccines. The evaluation of solar refrigeration equipment is being emphasized increasingly. PAHO's Revolving Fund for the purchase of vaccines and related supplies received strong support from the UN International Children's Emergency Fund (UNICEF), which contributed US $500,000, and the government of the US, which contributed $1,686,000 to the fund's capitalization. These contributions raise the capitalization level to US $4,531,112. Most countries are gearing their activities toward the increase of immunization coverage, particularly to the high-risk groups of children under 1 year of age and pregnant women. To evaluate these programs, PAHO has developed and tested a comprehensive multidisciplinary methodology for this purpose. Since November 1980, 18 countries have conducted comprehensive EPI evaluations. 6 countries also have had followup evaluations to assess the extent to which the recommendations from the 1st evaluation were implemented. At each subregional meeting, participants met in small discussion groups to review each other's work plans and discuss appropriate targets for the next 2 years. Immunization coverage has improved considerably in the Americas over the last several years. Figure 2 plots the incidence rates of polio, tetanus, diphtheria, whooping cough, and measles from 1970-83 in the 20 countries which make up the Latin American subregion. If all countries meet their 1985 targets, immunization coverages for DPT and polio will range from 60-100%, with most countries attaining coverages of over 80%. For measles, 1985 targets range from 50-95%, and from 70-99% for BCG. The main vehicle for dissemination of information is the "EPI Newsletter," which publishes information on program development and epidemiology of the EPI diseases.
Expanded Programme of Immunization Eastern Mediterranean Region. A report for the EPI Global Advisory Group Meeting, Alexandria, 21-25 October 1984.
[Unpublished] 1984. 10,  p. (EPI/GAG/84/WP.7.a)The strategy adopted by the Members States of the Eastern Mediterranean Region (EMR) to achieve the objective of the promotion of the Expanded Program of Immunization (EPI) through primary health care (PHC) concentrates on strengthening synergistic integration of EPI with other services. Activities have been planned and implemented or are being implemented at the Regional Office and at the country level. 21 countries of the Region now have either a full-time or part-time manager or an EPI focal point. This is a considerable development, for in 1982 there were EPI managers in 9 countries. Except for 3 countries, all national EPI managers/focal points have received senior level training in EPI. At delivery points, vaccination is performed to a large extent by multipurpose health workers, but full-time vaccinators are available in about 6 countries. All field workers have received training at their respective regional levels. Limited financial resources continue to be 1 of the primary constraints of the program in the Region. Plans to resolve this problem include: counteracting wastage factors; close collaboration with the UN International Children's Emergency Fund (UNICEF) and other international agencies at the country level to standardize approaches and avoid overlap; tapping regional and international voluntary agencies to increase their contributions; and increased use of associate experts, UN volunteers, and national technical staff. The overall information system is to some extent weak and suffers from irregularity and a lack of continuity. Regular reports are received from 9 countries which have World Health Organization staff. Repeated requests from other countries yield incomplete and at times contradicting data. Research efforts are directed towards operational areas, and research in strategies, integration, community, and surveillance areas is being encouraged.
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.
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.
Implementation of action area four ("Meeting the Needs of Young People") of the IPPF three year plan 1985-87.
[Unpublished] 1984 Dec. 11,  p. (PC/3.85/4)The objective of this paper is to assist the Central Council of the International Planned Parenthood Federation (IPPF) in monitoring the implementation of the IPPF 1985-87 plan. Baseline information is provided on all 1985 youth projects proposed by grant receiving family planning associations (FPAs) in their 1985-87 Three Year Plans. Detailed analysis was confined to the 67 FPA 1985-87 Three Year Plans received at the International Office by September 1984. This number covers most of the Associations in the region; the exception is the Western Hemisphere where several of their plans arrived in London too late to be included in the analysis. For nongrant receiving Associations, summary information was extracted from regional bureau sources and a list of youth activities in these countries is shown in an appendix. A summary of 1985 youth activities supported by the IPPF Secretariat at both regional and international level is shown in a 2nd appendix. To provide the necessary background to an analysis of 1985 youth projects, all strategies proposed by FPAs in their 1985-87 Plans were examined. A total of 360 strategies were classified according to their main purpose. A further classification into 14 categories was then used to demonstrate their relationship to the IPPFs 1985-87 Action Areas. Information about the purpose of youth projects, the types of activity carried out, and whether the project was new or ongoing was also extracted from the FPA Plans. For the 67 FPAs whose Three Year Plans were reviewed, a total of 360 strategies were proposed for the 1985-87 period. The largest number of strategies were concerned with providing family planning services; male involvement was the least mentioned. A total of 34 FPAs specifically mentioned young people in their list of strategies. A further 17 FPAs proposed youth projects but did not as yet devote a special youth strategy for them. Taking into account all regions, a total of 51 Associations in 1985 intended to spend almost $2 million implementing 169 youth projects. The projects fell into 4 main types: family life and population education; training; increasing awareness of issues affecting young people; and family planning services. The number of new youth projects in 1985 varies from region to region, the highest number being in Africa. FPAs still have much to do to meet the new objective of involving parents and the community in preparing young people for responsible sexuality and family life.
New York, New York, United Nations Fund for Population Activities, . 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.
[Health costs and financing and the work of WHO] Cout et financement de la sante et activities de l'OMS.
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.
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.
London, Eng., International Planned Parenthood Federation, 1984. 32 p.Add to my documents.
The use of indicators of financial resources in the health sector. L'emploi des indicateurs de ressources financieres dans le secteur de la sante.
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).
[Unpublished] 1984. Paper presented at the NCIH 11th Annual International Health Conference, Arlington, Virginia, Jun 11-13, 1984. 19 p. (NCIH 11th Annual International Health Conference Paper)This article discusses the relative merits of various maternal and child health interventions and programs. The Center for Population and Family Health (CPFH) has been studying international resources for maternal and child health (MCH), including family planning (FP) at the request of the Maternal and Child Health Program of the World Health Organization. A questionnaire was sent to 100s of donor agencies, including multilateral, bilateral and governmental agencies (NGOs). Data were obtained from the Development Assistance Committee (DAC) of the Organization for Economic Cooperation and Development which collects information on development cooperation from 17 developed countries. Despite its limitations, this study indicates important program implications. Over US$37 billion in official (government) development funds were disbursed in 1981, 73% of which came from DAC members. Of DAC members, the United States provides the largest amount of official development funding (US$5.8 billion in 1981). Nongovernmental funds for 1981 are estimated to be over US$2 billion. 6% of bilateral commitments for funding from DAC countries were for health in 1981, amounting to US$1.3 billion. The median allocations of funding to the sectors and programs of interest in various geographical regions are shown, indicating that in African countries a much smaller proportion of total development funding is allocated to health and population than in Asia or Latin America. Overall, about 10% of the reported international funding was allocated to health and population. In the last year or 2 numerous family planning projects (often integrated with health services) have been initiated in Africa. More money is available per eligible person in Africa than in other regions both for health and population services and for MCH/FP services because African countries have small populations compared to those in Asia and Latin America. For all regions, the US$s/per person eligible for services is very low. Only for all health and population services in Africa is there over US$1 available per person. In recent years a large proportion of agencies have increased funding of MCH/FP. 46 of 53 agencies indicated they would consider increasing funding. The priority of possible services should be considered carefully if they are to reach the vast number of women and children needing services in developing countries.
Jakarta, Indonesia, U.S. Agency for International Development, Office of Population and Health, 1984 Jun. 32 p.This booklet, intended to provide a brief introduction to the Indonesian Family Planning Program and US Agency for International Development (USAID) assistance to this program, describes Indonesia's population problem, population policy and government goals, population strategy, and results. The data were compiled from numerous sources, including the National Family Planning Coordinating Board and USAID Office of Population and Health. Based on Indonesian census figures, the annual average rate of population growth was 2.3% during the 1971-80 period. USAID currently projects a decrease in the average annual rate of natural increase to 1.6% during the 1980-90 period and to 1.1% during the 1990-2000 period. The population policy goal is to institutionalize the small, happy, prosperous family norm. The strategy is to reduce significantly the rate of population growth through the family planning program and related population policies, to ameliorate population maldistribution through transmigration programs, and to improve socioeconomic conditions for all citizens through expanded development programs. The family planning target is to reduce the crude birthrate to 22/1000 population by March 1991. This represents a 50% reduction in the crude birthrate over the 1971-91 period. In 1970, the total of new family planning acceptors was 53,103 in Java-Bali; in 1984 3,895,120. For the Outer Islands I, acceptors numbered 117,875 in 1975 and 1,009,852 in 1984. For Outer Islands II, the acceptors numbered 56,705 in 1975 and 341,212 in 1984. The percent of married women 15-44 using modern contraceptives increased from 2% in 1972 to 58% in 1984. In Java-Bali, 32% of married women aged 15-44 were oral contraceptive (OC) users as of March 1984; 16% were IUD users, 2% condom users, 6% injectable acceptors, and 2% acceptors of other methods. For Outer Islands I, 33% were OC users, 8% IUD acceptors, 4% condom users, 3% injectable acceptors, and 2% acceptors of other methods. In the Outer Islands II, 12% were OC acceptors as of March 1984, 5% IUD acceptors, 1% condom users, 4% injectable acceptors, and 1% acceptors of other methods.
Address to the Board of Governors, the World Bank and International Finance Corporation, Washington, D.C., September 24, 1984.
Washington, D.C., World Bank, 1984. 27 p.Although progress toward economic recovery has been made in the past year, serious economic problems still plague many of the poorest nations, and many middle income countries are painfully struggling with the effects of economic recession. Increased international cooperation is urgently needed to solve the economic problems of the developing countries. The World Bank's activities during the past year are reviewed, and its goals for the future delineated. During 1984, major efforts were directed toward helping the poorest nations, and especially sub-Saharan African nations. Nternation Development Association (IDA) credits amounted to US$3.6 billion, and 93% of all IDA loans were made to countries with per capita incomes under US$410. A number of combined IDA and International Bank for Reconstruction and Development (IBRD) loans were made to low income nations. IBRD loans totaled US$11.9 billion in 1984. The International Finance Corporation approved of US$700 million in gross investment and $2.5 billion in project costs. Unfortunately, during the coming year only US$3 billion in IDA funds will be available, but efforts are being made to obtain supplemental concessional funds. The Board of Governors approved of an US$8.4 billion increase in the capital base of IBRD and of an increase of $650 million in the capital base of IFC. During the coming year, a high priority will be placed on assisting low income countries. Conditions in developing countries may worsen during the late 1980s. The economic prospects of the developing countries will depend to a large degree on whether the industrialized nations are willing to undertake needed reforms. 3 major goals which must be accomplished during the next few years are 1) an improvement in the economic performance and economic policies of all countries, 2) a reduction in protectionist trade policies, and 3) an increase in capital flow. In middle income countries, the World Bank will continue the trend toward policy-based lending and promote adjustment measures that reflect policy and institutional reform. Low income countries need to be assured of a constant flow of capital as they undertake the difficult task of alleviating poverty in their countries. Concessional assistance for African countries will be given top priority. An action program directed toward helping these countries calls for 1) the development of a national rehabilitation center; 2) increased donor support, flexibility, and coordination; 3) the allocation of funds for maintaining and operating projects representing previous investments; and 4) the maintenance of a net capital flow at 1980-82 levels. The support of the World Bank's shareholders will be necessary prerequisite for fulfilling these goals.
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.
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)
Report on developments and activities related to population information during the decade since the convening of the World Population Conference, Bucharest, 1974.
New York, United Nations, 1984 Jun. vi, 52 p. (POPIN Bulletin No. 5 ISEA/POPIN/5)A summary of developments in the population information field during the decade 1974-84 is presented. Progress has been made in improving population services that are available to world users. "Population Index" and direct access to computerized on-line services and POPLINE printouts are available in the US and 13 other countries through a cooperating network of institutions. POPLINE services are also available free of charge to requestors from developing countries. Regional Bibliographic efforts are DOCPAL for Latin America. PIDSA for Africa, ADOPT and EBIS/PROFILE. Much of the funding and support for population information activities comes from 4 major sources: 1) UN Fund for Population Activities (UNFPA): 2) US Agency for International Development (USAID); 3) International Development Research Centre (IRDC): and 4) the Government of Australia. There are important philosophical distinctions in the support provided by these sources. Duplication of effort is to be avoided. Many agencies need to develop an institutional memory. They are creating computerized data bases on funded projects. The creation of these data bases is a major priority for regional population information services that serve developing countries. Costs of developing these information services are prohibitive; however, it is important to see them in their proper perspective. Many governments are reluctant to commit funds for these activites. Common standards should be adopted for population information. Knowledge and use of available services should be increased. The importance os back-up services is apparent. Hard-copy reproductions of items in data bases should be included. This report is primarily descriptive rather than evaluative. However, given the increase in population distribution and changes in government attitudes over the importance of population matters, the main tasks for the next decade should be to build on these foundations; to insure effective and efficient use of services; to share experience and knowledge through POPIN and other networks; and to demonstrate to governments the valuable role of information programs in developing national population programs.
[Unpublished] 1984. i, 15, 5 p.This report ist presented in response to a United States Agency for International Development (USAID) /Sri Lanka request for a review of the population and family planning program in the country and for recommentdations on the future role of UASID in support of the Sri Lanka program. It is intended to help the USAID Mission to make decisions regarding both the substance of population program assistance and the manner in which it is provided. The central recommendation is that the Mission undertake bilateral support of both public and private sector programs as soon as possible. This report is organized into 3 parts: 1)a brief overview of the demographic situation; 2) a review of the present national program, both public and private; and 3) recommendations for future program directions. The report was prepared during a 3-week visit to Sri Lanka. The relatively high rate of population growth will become an even greater factor in Sri Lanka's development equation than it has been in the past, and unless there is a significant and rapid decrease in fertility, population growth will diminish development prospeccts for the remainder of the century. USAID currently provides about US$0.5 to US$0.7 million of annual support to Sri Lanka family planning services programs through 9 intermediaries. This does not include the annual assistance provided by the United Nations Fund for Population Activites and International Planned Parenthood Federation which total approximately US$1.5 million. The Family Health Bureau of the Ministry of Health is responsible for managing the Government's family planning program. The Family Planning Association of Sri Lanka currently manages 2 large family planning service projects. USAID should begin high-level discussions in earnest with the Sri Lanka government.
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.
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.
Sex education and family planning services for adolescents in Latin America: the example of El Camino in Guatemala.
[Unpublished] 1984. ix, 54,  p.This report examines the organizational development of Centro del Adolescente "El Camino," an adolescent multipurpose center which offers sex education and family planning services in Guatemala City. The project is funded by the Pathfinder Fund through a US Agency for International Development (USAID) population grant from 1979 through 1984. Information about the need for adolescent services in Guatemala is summarized, as is the organizational history of El Camino and the characteristics of youngg people who came there, as well as other program models and philosophies of sex education in Guatemala City. Centro del Adolescente "El Camino" represents the efforts of a private family planning organization to develop a balanced approach to serving adolescents: providing effective education and contraceptives but also recognizing that Guatemalan teenagers have other equally pressing needs, including counseling, health care, recreation and vocational training. The major administrative issue faced by El Camino was the concern of its external funding sources that an adolescent multipurpose center was too expensive a mechanism for contraceptive distribution purposes. A series of institutional relationships was negotiated. Professionals, university students, and younger secondary students were involved. Issues of fiscal accountability, or the cost-effectiveness of such multipurpose adolescent centers, require consideration of the goals of international funding agencies in relation to those of the society in question. Recommendations depend on whether the goal is that of a short-term contraception distribution program with specific measurable objectives, or that of a long-range investment in changing a society's attitudes about sex education for children and youth and the and the provision of appropriate contraceptive services to sexually active adolescents. Appendixes are attached. (author's modified)
Shared sexual responsibility: a strategy for male involvement in United States Family Planning clinics.
In: International Planned Parenthood Federation [IPPF]. Male involvement in family planning: programme initiatives. London, England, IPPF, . 167-76.Reviewed here are the efforts of the Planned Parenthood affiliates in the United States, showing that their focus is on female contraception. The author argues that if family planning is to be seen as a basic human right, then far more attention needs to be given to shared sexual responsibility. Although major strides have been made through federal grants and education programs, the history of meaningful male involvement has been a feeble one. It is argues that the alarming rate of teenage pregnancies, the falling statistics in vasectomy services across the country and the overall image of family planning programs, are indicative of the need for a new strategy. The little research data that is available shows that the earlier young men and boys are reached with accurate sexuality information, the more successful family planning and education services will be. The most successful sex education programs seem to be those which see sexuality education as a life-long process. More recently, research has concluded that programs working with parents and children are by far the most successful in ensuring ongoing dialogue and most meaningful behavior change. An important strategy for reaching males, partucularly with condoms, is to build on current strength in reaching female populations. Active promotion of vasectomy services, increased availability of comdom products suitably packaged and promoted, and attention-getting public service announcements, have combined to help change the image of a family planning program too often thought of as exclusively female. A representative sample of educational materials for men is included in the appendix.