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Towards developing a community based monitoring system on the social and economic impact of AIDS in East and Central Africa.
[Unpublished] 1991. 4,  p.Proposed is a short-term, initial study of the potential of a community-based system to monitor the social and economic impact of acquired immunodeficiency syndrome (AIDS) in Eastern and Central Africa. The study was requested by the United Nations Development Program (UNDP). Its initial phase, which will be conducted in the UK, will consist of a literature review and preparation of a proposal for a pilot project. Particular emphasis will be placed on poor households in which family survival is threatened by the death from AIDS of an economically active adult. Assessed will be the extent to which a community-based monitoring system can aid households and communities in coping with the excess mortality created by AIDS and also provide information to national leaders that can be used to guide the formulation of national AIDS policy. Components of such a monitoring system are the regular collection of data, processing of the data into a form where they can be used as the basis for initiating actions, and definition of a set of interventions. Such an activity assumes the existence of both institutions that can collect and process the data and agencies capable of initiating interventions. Examples of successful monitoring systems exist in the areas of food security and child malnutrition. Their success appears to have been based on the availability of data at the points where action is to be taken, involvement of existing community institutions, a convergence of community and external agency objectives, and a common perception of problems and their relative importance. The pilot project is expected to involve a small number of areas in one or two countries of East and Central Africa with a high incidence of AIDS.
New York, New York, UNFPA, . , 33 p.A United Nations Fund for Population Activities (UNFPA) mission to Albania in 1989 attempted to identify the country's priority population issues and goals. Albania, a socialist country, has made many accomplishments, including an administrative structure that extends down to the village level, no foreign debt, universal literacy, a low death rate (5.4/1000), and involvement of women in development. At the same time, the country has the highest birth rate in Europe (25.5/1000), a high incidence of illegal abortion, lack of access to modern methods of contraception, and inadequate technology in areas such as medical equipment and data collection. Albania's population policy is aimed at maintaining the birth rate at its current level, reducing morality, and lowering the abortion rate by 50% by 1995. Goals for the health sector include increasing life expectancy, reducing infant and maternal mortality, improving the quality of health services, and decreasing the gap between the standard of living in rural and urban areas. Family planning is not allowed except for health reasons. Depending on trends in the total fertility rate, Albania's population in the year 2025 could be as low as 4.6 million or as high as 5.4 million. Albania has expressed an interest in collaborating with UN agencies in technical cooperation projects. The UNFPA mission recommended that support should be provided for the creation of a population database and analysis system for the Government's 1991-95 development plan. Also recommended was support to the Enver Hoxha University's program of strengthening the teaching of population dynamics and demographic research. Other recommendations included activities to strengthen maternal care/child spacing activities, IEC projects, and to raise the status of women.
ECONOMIC AND SOCIAL COUNCIL OFFICIAL RECORDS. 1991; (Suppl 1):37-9.This document contains the text of a 1991 UN resolution on the UN's work program in the field of population. After reviewing previous UN action on this issue and stressing the relationship between population and development, the resolution notes with satisfaction the progress made in implementing the population work program to date and makes the following specific requests of the Secretary-General: 1) to continue to give monitoring world population trends and policies high priority; 2) to continue working on specified issues; 3) to give priority to strengthening multilateral technical cooperation in specified areas; and 4) subject to the availability of funds, to study the needs of developing countries for skilled human resources in the field of population. In addition, the resolution reemphasizes the importance of maintaining the population program and strengthening coordination among various UN agencies and departments and among member states and appropriate intergovernmental, nongovernmental, and national organizations.
ECONOMIC AND SOCIAL COUNCIL OFFICIAL RECORDS. 1991; Suppl 1:24-5.This document contains the text of a 1991 UN resolution on refugee and displaced women and children. After reviewing previous UN action on this issue, the resolution recommends that: 1) member states cooperate with UN agencies and nongovernmental organizations to address the root cases of refugee migrations; 2) women and children be protected from violence and abuse; 3) the specific needs of refugee women and children be considered in planning; 4) refugee women be given sufficient information to make decisions on their own future; 5) women and, when possible, children, be given access to individual identification documents; 6) refugee women participate fully in the assessment of their needs and in the planning and implementation of programs; 7) the UN Secretary-General review the ability of its organizations to address the situation of refugee women and children; and 8) international organizations increase their capacity to respond to the needs of refugee women and children through greater coordination of efforts. The resolution commends member states which receive large numbers of refugees and asks the international community to share the resulting burden and further recommends that all pertinent organizations adopt an appropriate policy on refugee women and children, female field staff be recruited, staff be trained to increase awareness of the issues related to refugee of women and children and skills for planning appropriate actions, and the collection of refugee statistics be disaggregated by age and gender.
New York, New York, UNFPA, . v, 36 p. (Report)The former government of Romania sought to maintain existing population and accelerate population growth by restricting migration, increasing fertility, and reducing mortality. The provision and use of family planning (FP) were subject to restrictions and penalties beginning in 1986, the legal marriage age for females was lowered to 15 years, and incentives were provided to bolster fertility. These and other government policies have contributed to existing environmental pollution, poor housing, insufficient food, and major health problems in the country. To progress against population-related problems, Romania most urgently needs to gather reliable population and socioeconomic data for planning purposes, establish the ability to formulate population policy and undertake related activities, rehabilitate the health system and introduce modern FP methods, education health personnel and the public about FP methods, promote awareness of the need for population education, and establish that women's interests are served in government policy and action. These topics, recommendations, and the role of foreign assistance are discussed in turn.
The household survey as a tool for policy change: lessons from the Jamaican Survey of Living Conditions.
Washington, D.C., World Bank, 1991. viii, 48 p. (Living Standards Measurement Study [LSMS] Working Paper No. 80)The Jamaican Survey of Living conditions (SLC), which is scheduled as a semiannual survey, was initiated during 1988/89 to monitor the Human Resources Program (HRDP). The multisectoral aim was to provide household data for analysis of the effects of government policies on living conditions of the population. As a Living Standards Measurement Study (LSMS, SLC was a small, but in-depth instrument with a narrow focus and emphasis on policy impact, i.e., capable of determining who the poor are and their responses to policy changes. LSMS surveys are flexible and can be adapted to the policy issues of importance in any country. Results can be provided quickly. The SLC was a household questionnaire, which eliminated data available from the LSMS; the SLC sample used a random 33% of the Labor Force Survey (LFS) sample and followed the LFS by a month. Between the 1st and 2nd rounds of the SLC, a training and transfer program was begun to gradually assure Jamaican staff sustainability. A key feature of skills transfer was a tutorial approach. Discussion focused on the nature of the survey, similarities to the LSMS, the adaptations made to the SLC, and the history of the development of the survey. The survey provided information on the distribution of welfare and sectoral data on health, education, and nutrition. Strategic choices were made which account for SLC's success; the lessons learned were thought to be of value to other countries involved in living standards research and policy directives. The concreteness of purpose was a strategy which appealed to both policy makers and technicians. Timeliness was traded with quality of data, which contributed to immediate policy relevance, enhanced the training functions, and allowed for refinements. The disadvantages were that good results could block further detailed work; quality issues might be compromised. Other strategies discussed were the adaptation to the existing environment, gradual training of staff, the close cooperation between several agencies, multiple analysis prospects for government staff and academics, and the extensive use of World Bank staff in the initial effort. Costs to Jamaica were low compared to other LSMS surveys, but World Bank costs were high in staff time and travel. The cost of replication for other countries will depend on existing infrastructure, sample size, and local prices.
New York, New York, United Nations, 1991. xiv, 120 p. (Social Statistics and Indicators Series K No. 8; ST/ESA/STAT/SER.K/8)5 UN agencies worked together to develop this statistical source book to generate awareness of women's status, to guide policy, to stimulate action, and to monitor progress toward improvements. The data clearly show that obvious differences between the worlds of men and women are women's role as childbearer and their almost complete responsibility for family care and household management. Overall, women have gained more control over their reproduction, but their responsibility to their family's survival and their own increased. Women tend to be the providers of last resort for families and themselves, often in hostile conditions. Women have more access to economic opportunities and accept greater economic roles, yet their economic employment often consists of subsistence agriculture and services with low productivity, is separate from men's work, and unequal to men's work. Economists do not consider much of the work women do as having any economic value so they do not even measure it. The beginning of each chapter states the core messages in 4-5 sentences. Each chapter consists of text accompanied by charts, tables, and/or regional stories. The 1st chapter covers women, families, and households. The 2nd chapter addresses the public life and leadership of women. Education and training dominate chapter 3. Health and childbearing are the topics of chapter 4 while housing, settlements, and the environment comprise chapter 5. The book concludes with a chapter on women's employment and the economy. The annexes include strategies for the advancement of women decided upon in Nairobi, Kenya in 1985, the text of the Convention on the Elimination of All Forms of Discrimination against Women, and geographical groupings of countries and areas. During the 1990s, we must invest in women to realize equitable and sustainable development.
Rapid anthropologic assessment: applications to the measurement of maternal and child mortality, morbidity and health care.
[Unpublished] 1991. Presented at the International Union for the Scientific Study of Population [IUSSP] Committee on Population and Health and Cairo University Institute of Statistical Studies and Research, Center for Applied Demography Seminar on Measurement of Maternal and Child Mortality, Morbidity and Health Care: Interdisciplinary Approaches, Cairo, Egypt, November 4-7, 1991. 14 p.University Nations University (UNU) leaders requested rapid anthropological assessment procedures (RAP) guidelines in the early 1980s to examine health-seeking behavior in 16 developing countries. They were not content with the expense, time, and poor accuracy of standard survey techniques to study health care. UNU project researchers studies 42 communities in these countries. They used triangulation to assess the validity of their data and found the data to be accurate. RAP involves applied medical anthropologists and other social scientists with appropriate training to pass about 6 weeks in a community where a supposed effective primary health care (PHC) programs operates to learn the household and community perspective on PHC services. 6 weeks constitute a long time for health planners and policymakers, but for anthropologists this time period tends to be too. Yet the required time hinges on the amount and complexity of data needed. It is important that the anthropologists and/or other social scientists already know the language and the culture because they interview biomedical and indigenous health providers. RAP depends on limited objectives and on existing data and prior research. Research designers should modify the limited objectives or data collection guidelines to fit each culture and each project. RAP data collection techniques include formal and informal interviews, conversations, observation, participant observation, focus groups, and data collection from secondary sources. Indeed researchers should be able to adapt these various techniques during the project. Obstacles which RAP research designers must consider are: some anthropologists do not feel at ease with RAP; not all cultures are comfortable with an outsider coming into their community asking questions, thus highlighting the importance of using an anthropologist already known and trusted in the community; and the topic may not be appropriate for discussion in a community.
Ann Arbor, Michigan, University Microfilms International, 1991. vii, 266 p. (Order No. 9116069)The effectiveness of official development assistance in responding to health problems in recipient countries may be examined in terms of 1) the results of specific aid-supported projects, 2) the degree to which the activities have contributed to recipients' institutional capacity, and 3) the impact of aid on national policy and the broader development process. A review of the literature indicates a number of conceptual and practical constraints to assessing health aid effectiveness. Numerous health projects have been evaluated and issues of sustainability have been studied, but relatively little is known about the systemic effects of health aid. The experience of Nigeria is analyzed between the mid-1970s and the late 1980s. In the 1970s, Nigeria's income rose substantially from oil revenues, and a national program was undertaken to increase the provision of basic health services. The program did not achieve its immediate objectives, and health sector problems were exacerbated by the decline of national income during the 1980s. Since 1987, a progressive national primary healthcare policy has been in place. Aid has been given to Nigeria in comparatively small amounts per capita. Among the major donors, WHO, UNICEF, and, most recently, the World Bank, have assisted the development of general health services, while USAID, UNFPA, and the Ford Foundation have aided the health sector with the principal objective of promoting family planning. 3 projects are examined as case studies. They are: a model of family health clinics for maternal and child care; a largescale research project for health and family planning services; and a national immunization program. The effectiveness of each was constrained initially by limited coordination among donors and by the lack of a supportive policy framework. The 1st 2 of these projects developed service delivery models that have been reflected in the national health strategy. The immunization program has reached nationwide coverage, although with uncertain systemic impact. Overall, aid is seen as having made a marginal but significant contribution to health development in Nigeria,a primarily through the demonstration of new service delivery approaches and the improvement of management capacity. (author's)
New York, New York, UNFPA, . 31 p.The UN Population Fund (UNFPA) knows the linkages between women's status and execution of sustainable development initiatives. This booklet has taken the next step and explains how to include women in development, especially population initiatives. Women specific projects are 1 primary approach to realize women's participation. They include projects designed to improve their situation (education, skill development, training, or economic activities) or those designed to increase awareness of women's issues among policy makers, the media, and the public. These projects are often successful in motivating women to use family planning services. The 2nd approach involves mainstreaming women into development projects in all work plan categories. This approach provides women opportunities to work with men, to draft policy, and to take part in national development and is pivotal to the long term success of population efforts. One must 1st recognize obstacles to designing projects and programs that include women, however. 1 such obstacle is few discussions with women to learn their perceptions of national priorities and needs. The booklet features how one can be an advocate for maternal-child health/family planning (MCH/FP) and information, education, and communication (IEC) programs, research, policy, planning, special programs (e.g., those that train women in environmental management), and basic data collection and analysis. For example, statistics that prove that demand for family planning services exceed supply of those services allows an advocate to promote MCH/FP programs. UNFPA also recommends a gender impact statement be prepared for all development projects. For IEC programs, it may include questions about specific cultural, legal, financial and time constraints for females in having full access to education and how a project may change these traditional obstacles.