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Strengthening government capacity for national development and international negotiation: the work of Save the Children Fund in Mozambique.
[Unpublished] 1991. Presented at the Annual Conference of the Development Studies Association, Swansea, England, September 1991. 27 p.This conference paper offers lessons learned by the Save the Children Fund (SCF) regarding work in Mozambique in the course of seven years. SCF began its involvement in Mozambique in late 1984 supporting the government's expanded program of immunization. Objectives were to support essential services by working with the authorities from national through district levels. Models of good practice were assisted at the provincial level in Zambezia. The program diversified in 1986 with the development of policy about orphaned children traumatized by the war. Nutrition, transport, and emergency support followed over the next two years with a great deal of assistance going to the Mozambican emergency structure. The current SCF program has evolved in two major directions: 1) funding, logistical, and technical support at the provincial level to develop models of good practice, and 2) technical assistance at the central government level by experienced expatriate advisors placed within the Ministries of Health and Education along with training for Mozambican counterparts. The ruling government party FRELIMO was seen to be committed to progressive development policies, particularly in primary health care, education, and social welfare. The impact of the strategy on the lives of children was difficult to assess because of the devastation of the country by war and economic decline. A functioning health information system has been developed based on the advice given by computer specialists of SCF. A special focus of SCF's contribution to alternatives to institutional care has been the assessment of the impact of war, violence, and separation on children. This includes the tracing of surviving members of families of orphaned children and reuniting them and teacher training to reconstruct the child's life in school settings. SCF's food security adviser has also contributed substantially to the World Bank Food Security Strategy Paper approved in 1989.
Cholera: ancient scourge on the rise. WHO announces global plan for cholera control. (25 April 1991).
WHO FEATURES. 1991 Apr; (154):1-3.Vibrio cholerae spreads quickly via contaminated water and food, especially in areas with a poor health and sanitation infrastructure. Its enterotoxin induces vomiting and huge amounts of watery diarrhea leading to severe dehydration. 80-90% of cholera victims during an epidemic can use oral rehydration salts. A cholera epidemic is now spreading through Latin America threatening 90-120 million people (started in January 1991), particularly those in urban slums and rural/mountainous areas. As of mid April 1991, there were more than 177,000 new reported cases in 12 countries and 78% of these cases and more than 1200 deaths were limited to 5 countries: Brazil, Chile, Colombia, Ecuador, and Peru, WHO's Global Cholera Control Task Force coordinates global cholera control efforts to prevent deaths in the short term and to support infrastructure development in the long term. Its members are specialists in disease surveillance, case management, water and sanitation, food safety, emergency intervention, and information and education. WHO's Director General is asking for the support of the international community in cholera control activities. These activities' costs are considerable. For example, Peru needs about US$ 60 million in 1992 to fulfill only the most immediate demands of rehabilitation and reconstruction of the infrastructure. Costs of infrastructure capital throughout Latin America is almost US$ 5 thousand million/year over the next 10 years. It is indeed an effective infrastructure which ultimately prevents cholera. Cholera is evidence of inadequate development, so to fight it, we must also fight underdevelopment and poverty.
Review and evaluation of national action taken to give effect to the International Code of Marketing of Breast-Milk Substitutes: report of a technical meeting, The Hague, 30 September - 3 October 1991.
[Unpublished] 1991. 24 p. (WHO/MCH/NUT/91.2)The report of the national actions in marketing breast-milk substitutes includes a review and evaluation summarized in the accompanying annex and the results of a meeting. Participants found the evaluation helpful, that progress had been made, and that the International Code of Marketing of Breast-milk Substitutes must be viewed in a broad context. Lessons learned and recommendations are given for the development and implementation of national measures, as well as the training and education in the health sector, the information to the general public and mothers, monitoring and enforcement, and manufacturers and distributors of products within the scope of the Code. Successful implementation depends on a clear international perspective, on all concerned parties' involvement in development and monitoring, and a continuing commitment to a complex process. Difficulties encountered were lack of 1) political commitment, 2) integration of sectors, and 3) recognition that the Code applied to all counties; there were also questions about the scope of products included in the Code. There is no limit to age group. Partial adoption is not sufficient and has a negative impact. The Code was being ignored in countries moving toward a market economy. Health professionals were unaware of new developments in infant feeding practices. The Code assumes a compatible relationship between manufacturers and health personnel, which is not the case. Manufacturers used mass media and formal and informal educational sectors to disseminate information about their products with the approval of authorities who considered the use consistent with the Code. The expanding international telecommunications systems have proved to be a crippling challenge to some countries without the tools to know how to regulate programming. The feeding bottle is an inappropriate child care symbol for breast feeding, which is frequently found in public places. Monitoring has been uneven. Enforcement is hampered by an absence of, inadequacy in, and inability to apply sanctions. Joint health and industry provisions are weaker than the Code, and marketing strategies do not conform to the Code. Manufacturers apply the Code differently in developed and developing countries. Not enough attention has been paid to feeding or pacifier products. Retail stores sell infant formula next to other infant food products which is misleading.
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.
Amsterdam, Netherlands, WGNRR, 1991. 48 p.This report summarizes the activities of the Women's Global Network for Reproductive Rights (WGNRR), an organization that campaigns to reduce maternal mortality and morbidity, during 1991. In addition to its summary of activities, the report provides examples of local, national, and regional activities which illustrate the efforts of WGNRR's campaign. The report explains that the organization has succeeded in establishing May 28 as the Day of Action for Women's Health. For 1992, WGNRR hopes to make the issue of adolescent mothers the focus of the Day of Action. Having presented excerpts of Martha Rosenberg's paper entitled "Rethinking maternity: a women's task" (presented at the University of Salamanca, Spain on September 1990), the report goes on the describe the work done by WGNRR groups. As an example of a local initiative, the publication discusses the efforts conducted in Tanzania to end sexual harassment. This topic became the focus of the Day of Action. The Tanzania Media Women's Association held a seminar do discuss issues such as rape, media images of women, violence, and harassment in the workplace. The report goes on to describe a national campaign conducted in Chile, a campaign entitled "I am a woman. . . I want to be healthy," which focused on women's demands to humanize health care. For its regional experience, the report discusses accomplishments of the First Regional Workshop on Maternal Mortality, held in Managua in April 1991. The workshop attracted participants from Belize, Costa Rica, the Dominican Republic, Guatemala, Mexico, and Nicaragua. The report also includes an evaluation of the campaign conducted in Lima, Peru. Finally, the report presents excerpts of letters and reports of activities conducted by member groups around the world.
[Descriptive report of the support delivered by the Institute of Nutrition of Central America and Panama (INCAP) to the Ministry of Health, within the National Plan of Child Survival during the period 1985-1989] Informe descriptivo del apoyo proporcionado por el Instituto de Nutricion de Centro America y Panama (INCAP) al Ministerio de Salud, dentro del Plan Nacional de Supervivencia Infantil, durante el periodo 1985 - 1989.
San Salvador, El Salvador, Instituto de Nutricion de Centro America y Panama [INCAP], 1991 Aug. 15 p.The Nutrition Institute of Central America and Panama (INCAP) conducted a retrospective analysis of assistance rendered to different agencies of El Salvador s Ministry of Public Health and Social Assistance during 1985-89 to evaluate its support of the Child Survival Action Plan, identify shortcomings and successes that could guide future planning, and identify future areas of cooperation. Information was obtained from 11 representatives of the different departments. The report describes assistance in training, research, advisory services, and educational materials chronologically by single years during 1985-89 for the agencies of the Ministry: the Maternal-Child Health Department, Nutrition Department, School of Health Training, Epidemiology Unit, and Education Unit, and for 14 nongovernmental organizations (NGOs) belonging to the Intersectorial Committee for Child Survival. The principal achievements were considered to be providing baseline research for planning of educational activities, distribution of 360,000 doses of vitamin A to children aged 1-6 years, providing oral rehydration training centers in two hospitals, training 80% of health personnel in the Eastern region in oral rehydration, introducing the methodology of distance education to local personnel, operationalizing the Diarrhea Control and Oral Rehydration Project in 350 rural and semiurban communities attended by 14 NGOs, and integrating training in oral rehydration into the Social Pediatrics Area of the Bloom Hospital. Since 1987, an average of 280 students in the sixth year of medicine have received training. One of the major limitations was the lack of participation of program coordinators and INCAP consultants in planning. Lack of financing was a problem in some activities.
In: Gender analysis in development planning: a case book, edited by Aruna Rao, Mary B. Anderson, Catherine A. Overholt. West Hartford, Connecticut, Kumarian Press, 1991. 23-31, 101-2. (Kumarian Press Library of Management for Development)This monograph chapter describes the Chandpur Irrigation Project (CIP), which benefits a population of about 700,000 along the east bank of the Meghna River. A circular embankment was constructed to create arable land for agriculture. Pump houses regulate flows of the Dakatia River for irrigation and flood control and drainage into the Meghna River. CIP was begun in 1963 and completed in 1977. CIP aims to improve agricultural production, agricultural employment, and living conditions. A Bangladesh Water Development Board is in charge of operations. Villagers are organized into irrigation groups to facilitate water distribution, operation of pumps, and collection of user fees. CIP allows farmers to grow rice during the summer and winter. Farmers grow two summer rice crops of high yielding varieties. Vegetable gardens were shifted after the irrigation project to home gardens or to outside the irrigation areas. Winter crops include a high yielding variety of rice, vegetables, wheat, spices, pulses, and oil seeds. Households include landless tenants and small, mid-size, and large landowners. All families invest in their children's education. Male labor is in high demand during transplanting, weeding, and harvesting. Female labor is in high demand post-harvest. Male farmers receive 25 takas per day, while females earn 1 kg of rice per day. Diet varies with the wealth of the household; all families had higher food intake after CIP. CIP increased crop yields. Employment of family labor increased by 25% after CIP. Income increased for all types of families. Patterns of food distribution within families did not change.
[Resolution No.] 1991/22. National, regional and international machinery for the advancement of women [30 May 1991].
ECONOMIC AND SOCIAL COUNCIL OFFICIAL RECORDS. 1991; Suppl 1:23-4.This document contains the text of a 1991 UN resolution on the establishment of national, regional and international machinery to promote the advancement of women. After reviewing previous UN action on this issue, the resolution recommended that: 1) all countries establish appropriate machinery for the advancement of women by 1995; 2) governments provide adequate resources to ensure the effective functioning of national machinery; 3) the UN provide technical assistance; 4) countries exchange information on this topic; 5) the UN support such an exchange of information; 6) a UN interregional advisor assist in these and related efforts; 7) technical help be provided to facilitate the preparation of reports for the 1995 World Conference on Women; 8) the UN Secretary-General report on UN activities in this regard to the 36th session of the Commission on the Status of Women; 9) the Secretary-General invite governments to publish pertinent case studies; 10) appropriate sections of the Secretariat be strengthened; 11) governments make accurate information on their national machinery available; 12) governments ensure proper training of staff and include gender-analysis training and information; and 13) the UN report on the effectiveness of these efforts to the World Conference on Women.
DIARIO OFICIAL (SAN SALVADOR). 1991 Sep 27; 312(180):6-7.This Decree creates a National Committee to Ensure the Operation of the Agreements and Operations of the International Conference on Central American Refugees. The Committee is composed of representatives of various El Salvador government agencies and headed by the Vice Minister of Foreign Relations. The following are the functions of the Committee: a) to plan, formulate, and approve projects and to execute them; b) to facilitate the detailed formulation of proposed projects, to work with the United Nations High Commissioner for Refugees and the United Nations Development Program, and to be responsible for the final approval of the projects; c) to establish regular and timely coordination between national agencies and international non-governmental agencies that participate in the planning and/or execution of projects; d) to create support groups at the national level with the participation of national authorities, representatives of cooperating countries, the United Nations High Commissioner for Refugees, the United Nations Development Program, and other interested international agencies and financial institutions and non-governmental organizations; e) to call together these support groups for regular meetings with the goal of ensuring periodic consultation on the supervision, promotion, and mobilization of support and resources; and f) to ensure that the Committee has the necessary resources for the execution of the Plan of Action.
[Unpublished] . 26,  p.In 1991 Norplant was used in 46 countries by more than 1 million women. In 20 countries regulatory approvals for Norplant had been received, including by the US Food and Drug Administration in December, 1990. In 1988 the United Nations Population Fund provided a grant to the Population Council (PC) to expand Norplant to 10 new countries. A Starter Pack of materials was prepared for countries wishing to introduce Norplant. In October 1990 a PC staff associate and a consultant visited Burkina Faso, Mali, and Togo to discuss Norplant preintroduction trials. In both Mali and Togo presentations were made. In May 1991 the regional medical associate received a request to conduct a seminar on Norplant in Burundi. Three physicians were trained in Chile and the PC regional medical associate visited Chile in October 1990 to supervise the first training program. In Bolivia a trial started at the Hospital Obrero No. 1 and services began in September 1990. A project also aimed to compare the acceptability of Norplant with other methods. In Jamaica a study was undertaken to assess the acceptability of Norplant and to plan for its use at 3 clinics, and 5 physicians were trained in its use with 300 women enrolled. Southeastern Asian regional activities in 1990 involved a project training paramedical personnel on Norplant counseling. Three nurse/midwives from each of about 100 hospitals attended a 2-day training session. Nine trained teaching personnel implemented 15 sessions covering 292 nurses and midwives; and 14 visits to provinces for evaluation. India's introduction of Norplant may not be completed in time because of caseload requirements. A preintroduction trial was finalized in April 1991 in Vietnam with about 400 acceptors for 2 years. West Asia and North Africa regional activities concerned consultation in Algeria and plans to introduce Norplant at 2 sites in Rabat, Morocco.
In: Environment: children first, [compiled by] UNICEF. New York, New York, UNICEF, . 3 p..The focus of this article is on the impact of environmental degradation on women and children. The position is taken that the poor in developing countries, most of whom are women and children, are the most vulnerable to environmental disasters and depletion of natural resources. Children are the most susceptible to the effects of environmental degradation in terms of disease, malnourishment, and pollution and toxic chemicals. The task of collecting fuelwood contributes to wastage of time and energy and loss of schooling, health care visits, child care, and food quality. If animal dung or other agricultural products are used as replacement fuel sources, soil nutrient loss results. When land is sufficiently degraded, household food production becomes impossible. Migration as a solution to environmental depletion results in urban slums. One solution is identified as empowerment of communities and satisfaction of basic needs. Social mobilization campaigns are useful for promoting use of latrines and safe sanitation. Promotion of sanitation is facilitated by the inclusion of ideas about privacy and convenience. Oral rehydration therapy and immunization are useful in controlling and preventing disease. A shift to smoke-free, efficient stoves reduces deforestation. Food security problems can be alleviated with improved crop varieties, nitrogen-fixing plants, small-scale irrigation, and appropriate technologies. UNICEF is associated with a people-centered approach, which is considered the most hopeful prospect for preserving the global environment and achieving more equitable and sustainable development.
In: AIDS and women's reproductive health, edited by Lincoln C. Chen, Jaime Sepulveda Amor, and Sheldon J. Segal. New York, New York, Plenum Press, 1991. 151-63.Persons at high risk of sexually acquiring HIV are divided into 2 groups: 1) the primary risk group (prostitutes and their clients, homosexual and bisexual men with multiple partners, and sexually active IV drug users or IVDUs), and 2) the secondary risk group (spouses or boyfriends of female prostitutes, sexual partners of clients of prostitutes, and sexual partners of IVDUs). In the epidemiology of AIDS in high-risk groups, risk factors are genital ulcers caused by chancroid, syphilis, and herpes; lack of circumcision in males; and the presence of other STDs. The US Bureau of Census has compiled an HIV/AIDS surveillance database with over 4300 data entries for Africa. Rates of 50-90% are common among prostitutes in the urban centers of Tanzania, Uganda, Malawi, Rwanda, and Kenya. Thailand has a commercial sex worker population of over 100,000, and HIV prevalence rates of 30% have been reported among some groups. Similar rates have also been found in India. In Haiti and the Caribbean, HIV rates among prostitutes range from 0% to 60%. Strategies for targeted intervention aim at preventing high-risk group from becoming infected; and preventing infected primary risk groups from spreading the infection to secondary groups. To date Family Health International (FHI) has developed over 40 interventions for prostitutes and their partners in 21 countries in Africa, Asia, Latin America, and the Caribbean. The intervention strategies should contain behavior research (to investigate the subculture of prostitution and their clients to induce them to use condoms); AIDS education to modify high-risk behaviors in order to reduce transmission of HIV; STD treatment, control, and prevention at health clinics; condom distribution to target groups; program monitoring and evaluation; and capacity building by training staff to ensure sustainability. Case studies of targeted intervention programs for prostitutes and clients in Zaire, the Philippines, Zimbabwe, and Nigeria are detailed.
IN TOUCH 1991 Jun; 10(99):18-20.The Bangladesh collaborative effort with WHO in strengthening monitoring procedures, developing disease surveillance, and evaluating periodically for the Expanded Program on Immunization (EPI) is discussed. Field data are gathered in periodic reviews and there are routine supervisory visits. The supervisory network i strengthened by the supervision of the consultation with local WHO Divisional Operational Officers. A routine reporting system provides data on immunization coverage by age and dose and number of vaccinations. Each form has 1) the annual targets for eligible women and children, 2) the cumulative vaccinations for the year, and 3) % of the target reached. Wall charts in the Upazila Health Complex and district health office also provide these data. 36 samples surveys have been conducted by local officers trained by WHO experts. 210 children are studied in clusters of 30 to provide 95% accuracy within 10 points of the true value. The vaccination reports are thus validated, and additional information provided on the number of fully immunized children dropout rates, reasons for partial immunization, and source of immunization. Disease surveillance is weak. Annual workshops have been held in 1986-90 to advance correct diagnoses and provide sentinel site data. 15 sentinel hospitals how provide admission data on diphtheria, tetanus, and poliomyelitis cases. Field-based epidemiological teams are being created. These steps are necessary to reach disease prevention goals. Special surveys have been conducted periodically to estimate the magnitude of the problem. In 1983, a lameness survey was conducted. The findings were that 61.3% of the poliomyelitis children became lame at <3 years, and 33% of lameness among 0-4 year olds was caused by poliomyelitis in 1983. A measles survey in 1985 in urban areas found an incidence of 2.6 million <5 years and 45,000 deaths annually. Case fatality was 1.74%. Diarrhea occurred in 38-75.5% of the measles cases; pneumonia in 2.2-11.7%. In 1986 in rural areas, neonatal tetanus had a mortality rate of 41/1000 live births, and 50% of neonatal deaths. In 1989 there was a reduction to 7-12/1000 live births. A computerized EPI information system (CEIS) is in place with computers and equipment at headquarters and in all 4 divisions. Monthly analysis is made at the national level. Current review has revealed high vaccination coverage. The focus for the future must be changed from vaccination coverage (at a cost for 1989-90 of Taka 202 or US$5.79 to disease reduction.
In: Korean experience with population control policy and family planning program management and operation, edited by Nam-Hoon Cho, Hyun-Oak Kim. [Seoul], Korea, Republic of, Korea Institute for Health and Social Affairs, 1991 Sep. 311-27.The Korean experience with collaboration in family planning (FP) is explored in this chapter. Attention is paid to the nature of the decision, external resources (International Planned Parenthood Federation (IPPF) in detail and the following in brief: the UN Economic and Social Commission (UNECOSOC) and the UN Fund for Population Activities (UNFPA), the Population Council of New York (PC), the Swedish International Development Authority (SIDA), the US Agency for International Development (USAID), and the Japanese Organization for International Cooperation (JOICFP)). Suggested criteria for FP projects include, community concern, prevalence, seriousness of unmet need, and manageability, but with external collaboration, consideration should be given to whether domestic resources are insufficient, the priorities of potential donors, expected problems with compliance with the grant, and government commitment to the project. External collaboration can take the form of moral support, technical cooperation, or financial support. The nature of the project as well as the expected achievements of the project need to be identified. Resources may be manpower, facilities, commodities, money, and/or time. The Korean experience with IPPF began with a visit by IPPF in 1960. In 1961, the Planned Parenthood Federation of Korea (PPFK) was accepted as a member of IPPF. Support which began in 1961 has reached over 16 million dollars cumulatively. At present about 25% of support for FP comes form IPPF. The author's experience as a representative of PPFK to IPPF and other groups is described. Tables provide information on commodities supplied by year and dollar amount, and allotment of UNFPA Assistance to Ministries and Institutions between 1973-86 by the number of projects and the dollar amount; types of program activity and dollar amount from UNFPA is also provided.
[Kuching, Malaysia, SFPA, 1991]. ii, 35 p.The Sarawak Family Planning Association's (SFPA's) main focus in 1990 was the strengthening of the Family Planning Clinic Service Program. Although the number of clinics has remained at 8, the number of resupply points increased from 50 in 1989 to 112 in 1990. These resupply points are set up in areas where transportation, financial, or social factors impede the ability of established acceptors to attend the static clinics. In part because of the increased availability of contraceptive services, the number of acceptors increased by 3352 over 1989, to reach 28,996 in 1990. The remaining 31, 847 acceptors in the country are serviced by the Ministry of Health. The SFPA utilizes a "cafeteria approach" to contraceptive choice; methods available are oral contraceptives, IUD, condom, injectable, spermicides, vasectomy, and natural family planning. At SFPA's clinic sites, the pill accounts for 57-93% of total contraceptive acceptance. The physicians at the 8 clinics also provide clients with cervical and breast cancer screening, pregnancy testing, infertility counseling, gynecological examinations and referral, and premarital advice. An extension of the Clinic Service Program, the Community Clinic Extension Family Planning Program, operates in the main towns. Involved in this program are 41 physicians, who distributed largely hormonal forms of contraception to 3587 acceptors, and 76 non-medical workers, who distributed condoms to 289 acceptors. As the major source of family planning information in Sarawak, the SFPA has an extensive IEC program that uses talks, home parties, fieldwork motivation, mass media campaigns, and community meetings to recruit new acceptors. Finally, the Family Life Education Project sought, in 1990, to increase the involvement of young people in determining their own programs and activities.
USAID HIGHLIGHTS. 1991 Fall; 8(3):1-4.This article considers the epidemic proportion of AIDS in developing countries, and discusses the U.S. Agency for International Development's (USAID) reworked and intensified strategy for HIV infection and AIDS prevention and control over the next 5 years. Developing and launching over 650 HIV and AIDS activities in 74 developing countries since 1986, USAID is the world's largest supporter of anti-AIDS programs. Over $91 million in bilateral assistance for HIV and AIDS prevention and control have been committed. USAID has also been the largest supporter of the World Health Organization's Global Program on AIDS since 1986. Interventions have included training peer educators, working to change the norms of sex behavior, and condom promotion. Recognizing that the developing world will increasingly account for an ever larger share of the world's HIV-infected population, USAID announced an intensified program of estimated investment increasing to approximately $400 million over a 5-year period. Strategy include funding for long-term, intensive interventions in 10-15 priority countries, emphasizing the treatment of other sexually transmitted diseases which facilitate the spread of HIV, making AIDS-related policy dialogue an explicit component of the Agency's AIDS program, and augmenting funding to community-based programs aimed at reducing high-risk sexual behaviors. The effect of AIDS upon child survival, adult mortality, urban populations, and socioeconomic development in developing countries is discussed. Program examples are also presented.
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.