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  1. 1

    The National Strategy For Integrating Youth Into Development.

    Yemen. Ministry of Youth and Sports; Boy Scouts and Girls Guides Association; United Nations Population Fund [UNFPA]

    [Sanaa], Yemen, Ministry of Youth and Sports, 1998 Nov. [14] p.

    This policy discusses the National Strategy for Integrating Youth into Development for the Republic of Yemen. It states previous strategy goals and addresses the issues and problems with those and formulates suggested strategic actions that combat those issues.
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  2. 2

    Draft Lisbon Declaration on Youth Policies and Programmes submitted by the Main Committee.

    World Conference of Ministers Responsible for Youth (1998: Lisbon)

    [Unpublished] 1998. [9] p.

    The assembled national youth ministers commit themselves to national youth policies and formulate guidelines in association with youth on the following topics: Participation, Development, Peace, Education, Employment, Health, and Drug & Substance Abuse.
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  3. 3

    IPPF / youth manifesto.

    International Planned Parenthood Federation [IPPF]. Youth Committee

    [London, United Kingdom], IPPF, 1998. [2] p.

    The IPPF / youth manifesto outlines the goals developed by the Youth Committee of IPPF. The goals include: access to information and education on sexuality and SRH services for young people, youth must be able to be active citizens in their society, and young people must be able to have pleasure and confidence in relationships and all aspects of sexuality.
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  4. 4

    IUDs may be safe for women with HIV infection.

    Contraception Report. 1998 Sep; 9(4):[3] p..

    Current recommendations suggest IUDs should not be the first method of choice for women with HIV infection. The World Health Organization and International Planned Parenthood Federation recommend that HIV-infected women not use the IUD for contraception. These recommendations are based upon theoretical concerns about an increased risk of infection and possible increased risk of female-to-male HIV transmission from increased menstrual blood loss. The recommendation also reflects concern about behavioral characteristics that may make some HIV-positive women more susceptible to STDs and PID. Research conducted in Kenya by Family Health International suggests that carefully selected HIV-infected women may safely use the IUD for contraception. Researchers enrolled 649 women who otherwise met eligibility criteria for IUD insertion, including a low risk of STDs. Women came from two family planning clinics in Nairobi, Kenya. (excerpt)
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  5. 5

    Increasing access to IUDs.

    Contraception Report. 1998 Sep; 9(4):[5] p..

    In 1995, the World Health Organization (WHO) released revised medical eligibility criteria guidelines to assist family planning agencies and clinicians prescribe contraceptives. By eliminating overly restrictive barriers to use, WHO hopes to increase access to and use of birth control methods. This article briefly reviews some of the important WHO guidelines concerning intrauterine devices. Introduction WHO researchers evaluated the benefits and risks of using IUDs in healthy women and in women with certain medical conditions or individual characteristics, such as parity and exposure or susceptibility to sexually transmitted diseases. A previous article describes WHO's methods for devising the criteria in detail. Briefly, the eligibility criteria were developed by international experts from many organizations. WHO experts reviewed the medical literature from the past 10 years and devised recommended medical eligibility criteria for different contraceptive methods. One main concern was to address outdated contraindications. WHO notes that "The contraindications for many contraceptives tend to become very rigid, resulting in denial of contraceptive access to many women. Relative contraindications tend to become absolute." (excerpt)
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  6. 6
    Peer Reviewed

    The World Health Organization multinational study of breast-feeding and lactational amenorrhea. II. Factors associated with the length of amenorrhea.

    World Health Organization [WHO]. Task Force on Methods for the Natural Regulation of Fertility

    Fertility and Sterility. 1998 Sep; 70(3):461-471.

    The objective was to determine the relation between infant feeding practices (and other factors) and the duration of postpartum amenorrhea, and to establish whether there are real differences in the duration of postpartum amenorrhea for similar breast-feeding practices in different populations. Design: Prospective, nonexperimental, longitudinal follow-up study. Setting: Five developing and two developed countries. Patient(s): Four thousand one hundred eighteen breast-feeding mothers and their infants. Breast-feeding women collected ongoing information about infant feeding and family planning practices, plus the return of menses. Fortnightly follow-up occurred in the women's homes. A multivariate analysis explored the association between the risk of menses return and 16 infant feeding variables and 11 other characteristics. Ten factors (in addition to center effects) were significantly related to the duration of amenorrhea. Seven of these were infant feeding characteristics and the remaining three were high parity, low body mass index, and a higher frequency of infant illness. The breast-feeding stimulus is strongly linked to the duration of postpartum amenorrhea. Cross-cultural effects also are extremely important and may have caused the variations in feeding, the variation in amenorrhea, or both. (author's)
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  7. 7

    Reaching regional consensus on improved behavioural and serosurveillance for HIV: report from a regional conference in East Africa.

    Pisani E; Carael M

    Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 1998. 12 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/98.9)

    This report documents a regional workshop on surveillance systems for HIV held in Nairobi, Kenya, on 10.13 February 1997. The UNAIDS-funded workshop gathered government epidemiologists, AIDS programme managers, and social scientists from Kenya, Malawi, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe as well as specialists from UNAIDS and other partner institutions. The group aimed to present current data and to work together to suggest practical guidelines for improving HIV surveillance systems in a maturing epidemic. (excerpt)
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  8. 8

    Partnership with the private sector.

    Noehrenberg E

    World Health. 1998 Nov-Dec; 51(6):30.

    The private sector has an important role to play in the global, regional and national response to AIDS. It is in the private sector's own interest to actively combat the expanding epidemic because it affects employees, customers and others in their communities. By working in partnership with the public and nongovernmental sectors, companies can help to make their efforts more effective and bring benefits to all parties concerned. UNAIDS, the Joint UN Programme on HIV/AIDS, is well aware that the fight against AIDS cannot succeed without a broad-based effort involving all members of society, including the private sector. An important part of the mission of UNAIDS is therefore to promote and brokers partnerships among the public, private and nongovernmental sectors of society that can help create a more coordinated, effective and sustainable response to HIV/AIDS. (excerpt)
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  9. 9

    Guide to the strategic planning process for a national response to HIV / AIDS. Introduction.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 1998. 7 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/98.18)

    Strategic planning, as developed in the present guide, defines not only the strategic framework of the national response, i.e. its fundamental principles, broad strategies, and institutional framework, but also the intermediate steps that need to be achieved in order to change the current situation into one that represents the objectives to be reached. In normative--as opposed to strategic--planning, activities are planned according to universal norms that apply to all beneficiaries, irrespective of their conditions or situations. Strategic planning takes an issue's underlying determinants into account, which vary according to the persons concerned (e.g. their social class, religion, culture, gender specificities, etc.) and according to situations that may alter rapidly over time. Strategic planning means adapting norms to a given or changing situation. A strategic plan, therefore, includes a normative as well as a strategic dimension. (excerpt)
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  10. 10

    Towards the creation of strategic partnerships: improving access to drugs for HIV / AIDS. Report of a consultative meeting, 30 June - 2 July 1997, Salle C, WHO, Geneva.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 1998. 20 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/98.40)

    From January 1996, the UNAIDS Secretariat has been in consultation with key players in the pharmaceutical industry, NGOs, people living with HIV, UN, major bilateral donors, country representatives and National AIDS Programme Managers on issues relating to access to drugs for HIV/AIDS. This meeting, held on 30 June to 2 July 1997, was the climax of this consultative process. The meeting brought together people living with HIV/AIDS, NGO representatives, National AIDS Programme Managers and UN representatives. With a modified version of the Search Conference approach, the following questions were raised: What are the current and future issues on access to drugs for HIV/AIDS at country and global levels? What partnerships should be created at country level to address these issues? What should be the content of these partnerships at country level? What should the UN do at global and country level to support these partnerships? To foster regional exchange of experience as well as enhance regional specificity, participants were assigned groups on a regional basis. (excerpt)
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  11. 11

    HIV / AIDS and the workplace: forging innovative business responses. UNAIDS technical update.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 1998 Jul. [9] p. (UNAIDS Best Practice Collection; UNAIDS Technical Update)

    In the early years of the AIDS pandemic, little thought was given to the role that businesses might play in HIV prevention, and the workplace was not seen as a major venue for interventions. Since then, much has been learned about the pandemic and how it should be fought. and in particular that AIDS prevention and care are complex issues requiring a multisectoral approach. The business sector and its workplaces can play a key role in preventing the transmission of HIV, and in caring for and supporting those affected. As the impact of HIV on businesses becomes more visible, business leaders are increasingly seeing the advantages of creating HIV/AIDS programmes for their workplaces -- and, beyond the workplace, for their surrounding communities. (author's)
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  12. 12

    Access to drugs. UNAIDS technical update.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]; World Health Organization [WHO]. Action Programme on Essential Drugs

    Geneva, Switzerland, UNAIDS, 1998 Oct. [12] p. (UNAIDS Best Practice Collection)

    The World Health Organization (WHO) estimates that over one-third of the world's population has no guaranteed access to essential drugs. There are various reasons for this lack of access. Worldwide, the most important is affordability (drugs cost more money than is available to pay for them) but legal, infrastructural, distribution and cultural factors are also serious obstacles. The influence of each of these factors is different from country to country, just as frequencies of diseases also vary greatly. Among its activities aimed at improving drug access in developing countries (including technical services such as help in drug procurement and performance of needs estimates), WHO has drawn up a Model List of Essential Drugs, which is updated every two years. The tenth list (1997) has 308 priority drugs that provide safe, effective treatment for the infectious and chronic diseases which affect the vast majority of the world's population. The drugs are selected on the basis of cost-effectiveness within each drug class (e.g. of the dozens of penicillins only eight appear on the Essential Drugs list). With WHO's encouragement, more than 140 countries have developed their own national essential drug lists taking into account local needs, costs and available resources. (excerpt)
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  13. 13

    Putting HIV / AIDS on the business agenda: UNAIDS point of view.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 1998 Nov. [8] p. (UNAIDS Best Practice Collection; UNAIDS Point of View)

    For too long AIDS prevention and care was pitched to business on health terms by health experts, on the basis that 'dealing with AIDS in the workplace is good for workers'. Initially perceived as a health problem, the health sector was at the forefront of epidemic control efforts. Experience now shows that both management and workers have a stake in the battle against AIDS and that all sectors need to be engaged right at the outset. Unquestionably, in the overall workplace context, management's response is a key element in shaping the level and quality of company interventions. To mobilize the corporate sector's participation in a major way, management must be included as a stakeholder from the planning stage to implementation. Thailand has been relatively successful in drawing support from business, even though this initiative came at a late stage in the development of the epidemic. Thailand's success is based on continuing and determined efforts by the National AIDS Programme and nongovernmental organizations to create opportunities for key business leaders to contribute in a strategic and substantial fashion. Those in the business sector need to be convinced that their participation is essential in making a difference, not only to the larger national endeavour, but also to their businesses. (excerpt)
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  14. 14

    NGO perspectives on access to HIV-related drugs in 13 Latin American and Caribbean countries.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 1998. 32 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/98.25)

    The aim of this document is to point out the most important ways in which NGOs concerned with HIV/ AIDS and with the persons who have this infection in Latin America and the Caribbean help facilitate access to HIV-related drugs. During the XIth Conference on AIDS, the slogan "No greed, access to all!" was heard. The immediate reason was that the new AIDS drugs, the protease inhibitors, had a high price. This does not, of course, mean that access to all other AIDS-related drugs was easy. It was not, and it is not, especially for persons in developing countries. Thus, although lack of access to AIDS-related drugs is an old subject in developing countries, this topic aroused renewed interest when it affected developed countries. Access to treatment has become a global issue and has given rise to a new phase of global solidarity. (excerpt)
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  15. 15

    WHO - UNAIDS - UNICEF Technical Consultation on HIV and Infant Feeding: Implementation of Guidelines. Report of a meeting -- Geneva, 20-22 April 1998.

    World Health Organization [WHO]; Joint United Nations Programme on HIV / AIDS [UNAIDS]; UNICEF

    Geneva, Switzerland, UNAIDS, 1998. [38] p.

    The Guidelines and Guide recognise that: HIV infection can be transmitted through breastfeeding. Appropriate alternatives to breastfeeding should be available and affordable in adequate amounts for women whom testing has shown to be HIV-positive. Breastfeeding is the ideal way to feed the majority of infants. Efforts to protect, promote and support breastfeeding by women who are HIV-negative or of unknown HIV status need to be strengthened; HIV-positive mothers should be enabled to make fully informed decisions about the best way to feed their infants in their particular circumstances. Whatever they decide, they should receive educational, psychosocial and material support to carry out their decision as safely as possible, including access to adequate alternatives to breastfeeding if they so choose; To make fully informed decisions about infant feeding, as well as about other aspects of HIV, mother-to-child transmission (MTCT) and reproductive life, women need to know and accept their HIV status. There is thus an urgent need to increase access to voluntary and confidential counselling and HIV testing (VCT), and to promote its use by women and when possible their partners, before making alternatives to breastfeeding available; An essential priority is primary prevention of HIV infection. Education for all adults of reproductive age, particularly for pregnant and lactating women and their sexual partners, and for young people, needs to be strengthened; Women who are HIV positive need to understand the particular importance of avoiding infection during pregnancy and lactation. (excerpt)
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  16. 16
    Peer Reviewed

    The practice of antenatal care: comparing four study sites in different parts of the world participating in the WHO Antenatal Care Randomised Controlled Trial. [Práctica de controles prenatales: comparación de cuatro centros de estudio en diferentes lugares del mundo que participaron en el Estudio Controlado Aleatorizado de Control Prenatal de la OMS]

    Piaggio G; Ba'aqeel H; Bergsjo P; Carroli G; Farnot U

    Paediatric and Perinatal Epidemiology. 1998; 12 Suppl 2:116-141.

    In the preparation of a randomised controlled trial to evaluate a new programme of antenatal care (ANC) in different parts of the world, we conducted a baseline survey of the ANC procedures in all 53 clinics participating in the trial. There were two components of this survey: (1) description of clinic characteristics and services offered: the staff of each clinic was interviewed and direct observation was made by field supervisors, and (2) the actual use of services by pregnant women attending these clinics: we reviewed a random sample of 2913 clinical histories. The clinical units surveyed were offering most of the activities, screening, laboratory tests and interventions recommended as effective according to the Cochrane Pregnancy and Childbirth Database (PCD), although some of these were not available in some sites. On the other hand, some tests and interventions that are considered not effective according to these criteria are reportedly offered. There was a difference across sites in the availability and offer to low-risk women of vaginal examination, evaluation of pelvic size, dental examination, external version for breech presentation and formal risk score classification, and a notable difference in the type of principal provider of ANC. There was a large variation in the actual use of screening and laboratory tests and interventions that should be offered to all women according to Cochrane PCD criteria: some of these are simply not available in a site; others are available, but only a fraction of women attending the clinics are receiving them. The participating sites all purport to follow the traditional `Western' schedule for ANC, but in three sites we found that a high percentage of women initiate their ANC after the first trimester, and therefore do not have either the recommended minimum number of visits during pregnancy or the minimum first trimester evaluation. It is concluded that the variability and heterogeneity of ANC services provided in the four study sites are disturbing to the profession and cast doubts on the rationale of routine ANC. (author's)
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  17. 17
    Peer Reviewed

    Carob bean juice: a powerful adjunct to oral rehydration solution treatment in diarrheoa.

    Aksit S; Caglayan S; Cukan R; Yaprak I

    Paediatric and Perinatal Epidemiology. 1998 Apr; 12(2):176-181.

    In children, the treatment of acute diarrhoea with the World Health Organization (WHO) standard oral rehydration solution (ORS) provides effective rehydration but does not reduce the severity of diarrhoea. In community practice, carob bean has been used to treat diarrhoeal diseases in Anatolia since ancient times. In order to test clinical antidiarrhoeal effects of carob bean juice (CBJ), 80 children, aged 4±48 months, who were admitted to SSK Tepecik Teaching Hospital with acute diarrhoea and mild or moderate dehydration, were randomly assigned to receive treatment with either standard WHO ORS alone or a combination of standard WHO ORS and CBJ. Three patients were excluded from the study because of excessive vomiting. In the children receiving ORS + CBJ the duration of diarrhoea was shortened by 45%, stool output was reduced by 44% and ORS requirement was decreased by 38% compared with children receiving ORS alone. Weight gain was similar in the two groups at 24 h after the initiation of the study. Hypernatraemia was detected in three patients in the ORS group but in none of those in the ORS + CBJ group. The use of CBJ in combination with ORS did not lead to any clinical metabolic problem. We therefore conclude that CBJ may have a role in the treatment of children's diarrhoea after it has been technologically processed, and that further studies would be justified. (author's)
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  18. 18

    The despotic power of husbands. - Protection of women's rights.

    Perutz MF

    UN Chronicle. 1998 Winter; 35(4):[2] p..

    The Universal Declaration of Human Rights and the enshrinement of its essential rights in international law is one of the great achievement of our civilization. In a large part, we owe their formulation to the great jurist Hersch Lauterpacht, Professor of international law in the University of Cambridge from 1937 to 1954. In 1945, he published a seminal book, An International Bill of the Rights of Man, which became the basis of much that is in the United Nations Declaration and the Conventions that followed it. According to him: "The idea of the inherent rights of man, ultimately superior to the State itself, is the continuous thread in the historical pattern of legal and political thought. In antiquity, their substance has been a denial of the absoluteness of the State and its unconditional claim to obedience; the assertion of the value and freedom of the individual as against the State; the view that the power of the State and of its ruler is derived ultimately from the assent of those who compose the political community; the insistence that there are limits to the power of the State to interfere with man; the right to do what he considers his duty." (excerpt)
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  19. 19

    It comes down to saving lives - refugees.

    Lambsdorff O

    UN Chronicle. 1998 Winter; 35(4):[5] p..

    When, in June 1945, fifty sovereign nations convened in San Francisco to create the United Nations and sign the world Charter, John McCloy - one of America's "Wise Men" and architects of the American Century - was surprised by "the growing sense of Russia vs. the United States" he found at the Conference. A cold war was on the verge of breaking out. Thus, right from its beginning the United Nations has had to face a problem that paralyzes - and sometimes upsets - its daily work. The Organization remains to this day an international body composed of independent sovereign States, with a few States - the five permanent members of the Security Council (China, France, Great Britain, Russia and the United States) - assuming particular responsibilities. In essence and in practice, the United Nations can only fulfill its role within this yet-to-be established "international community", if its Member States respect the covenant they signed and, in particular, commit themselves to fulfilling their "overriding duty to preserve international peace", as Secretary-General Kofi Annan reminded us in a recent speech. Mr Annan further recalled that "the UN is prohibited by its own Charter from intervening in the domestic affairs of its Member States", but [that] the Charter also says that "national sovereignty can be set aside if it stands in the way of the overriding duty to preserve international peace". (excerpt)
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  20. 20

    Working within - women's rights.

    Flor P

    UN Chronicle. 1998 Winter; 35(4):[3] p..

    While the creation of a legal framework which guarantees equal rights for women and men was always regarded as a primary prerequisite for gender equality; it turned out to be far from sufficient, since women and girls face a multitude of constraints imposed by society, not by law. For centuries, societies have created customary rules which, mostly on the basis of sex, class, place of birth, clan or family name, determine to a great extent what role an individual can play. These roles reflect an unwritten social contract within a society on who ought to do what, who rules, who wades, who cares for children, who decides public matters; in short, who occupies a certain space and position in society or in the home. Historically, socially constructed gender roles put women and girls at a disadvantage, denied them equal status with men, restricted their access to income, education and decision-making, and confined their sphere of influence to the home. Today's statistics document the consequences: 70 per cent of the world's poor are women, 2 out of 3 adult illiterates are female. Women are mostly excluded from politics and economic decision-making. Even in Western countries, women hold only approximately 15 per cent of parliamentary seats. Moreover, many women and girls continue to suffer from violence and systematic discrimination. (excerpt)
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  21. 21

    World population nears 6 billion.

    UN Chronicle. 1998 Winter; 35(4):[3] p..

    According to the 1998 revised estimates and projections of the United Nations, the world population currently stands at 5.9 billion persons and is growing at 1.33 per cent per year, an annual net addition of about 78 million people. World population in the mid-twenty-first century is expected to be in the range of 7.3 to 10.7 billion, with a figure of 8.9 billion by the year 2050 considered to be most likely. Global population growth is slowing, thanks to successful family planning programmes. But because of past high fertility, the world population will continue to grow by over 80 million a year for at least the next decade. In mid-1999, the total will pass 6 billion-twice what it was in 1960. More young people than ever are entering their childbearing years. At the same time, the number and proportion of people over 65 are increasing at an unprecedented rate. The rapid growth of these young and old new generations is challenging societies' ability to provide education and health care for the young, and social, medical and financial support for the elderly. (excerpt)
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  22. 22

    Will the circle be unbroken? - includes related article on population assistance to developing countries - child survival programs and fertility decline.

    UN Chronicle. 1998 Winter; 35(4):[4] p..

    The demographic transition which has been under way in the developing countries since the middle of the twentieth century has shown much difference, both in its course and in the factors behind it, from the transition which started two centuries ago in countries that are now developed. In the developed countries, the gradual improvement in living conditions accompanying industrialization and urbanization, coupled with broadening education and sanitation and a growing understanding of the principle of hygiene and nutrition, resulted in progressive gains in child survival and declines in mortality at all ages. These same forces of development were progressively changing attitudes towards reproduction, reducing the demand for children and lowering marital fertility. In the developing countries, there have been unprecedented declines in mortality over a few decades since midcentury. Only sub-Saharan Africa as a whole Ires not yet entered into this phase of demographic transition to a significant extent. A distinguishing feature of this transition has been that declines in mortality and fertility were not accompanying major gains in economic development. (excerpt)
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  23. 23

    Honoured in the breach? Development assistance and human rights.

    Waring M

    UN Chronicle. 1998 Winter; 35(4):[4] p..

    On questions of human rights, the political bodies of the United Nations and nation-State donors frequently override claims of domestic jurisdiction where sovereignty might be invoked. But consider the following case studies. On 22 July 1998, the Emergency Relief Coordinator on United Nations humanitarian policy in Afghanistan cited a discriminatory human fights regime among reasons for the United Nations to restrict its activities to lifesaving assistance only. Four days earlier, the European Commission had suspended funding of all assistance in the Kabul area. An entire village was surrounded by machine-gun-toting men in the national military uniform. Every resident was transported with a few possessions to a 'development project' where, within a few years, they would be more desperate, destitute, hungry and without infrastructural support than they had ever been in the home that their families had known for hundreds of years. This "international aid" programme was euphemistically called "transmigration" where donors were complicit in transgression of fundamental rights "to liberty of movement and of freedom to choose his residency". (excerpt)
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  24. 24

    Addressing HIV: do conferences and papers help? - human immunodeficiency virus. [Faire face au VIH : les conférences et les articles sur ce sujet sont-ils d'une grande aide ? - le virus de l'immunodéficience humaine]

    Weil B

    UN Chronicle. 1998 Fall; 35(3):[4] p..

    My initial reaction to the proposed title of the following article, "Addressing HIV: Do Conferences and Papers Help?," was strong and immediate. I also found myself sitting squarely on both sides of the fence: yes, of course, they help to expand people's minds and abilities to respond effectively to the epidemic, but there is so much wasted time and money involved in organizing most conferences. With the intention of exploring these reactions and putting them in an appropriate context, I decided to poll several colleagues, whom I have worked with, in defining and mobilizing the response to the worldwide human immunodeficiency virus (HIV) epidemic. The feedback I received on my mini-survey, which simply asked respondents to give me their immediate thoughts and feelings about the proposed title, filtered in from Canada, France, Senegal, South Africa and the United States. I have synthesized the general reactions and supplemented them with my own analysis of the question. (excerpt)
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  25. 25
    Peer Reviewed

    Health care reforms and developing countries -- a critical overview.

    Sen K; Koivusalo M

    International Journal of Health Planning and Management. 1998; 13:199-215.

    Although health care reforms have been implemented in both developed and developing countries since the 1980s, there has been little discussion of the historical, social and political contexts in which such reforms have taken place. Health care reforms in developing countries, for instance, have been an integral component of structural adjustment policies, yet scant attention has been paid to these connections nor to their implications. The basic assumptions behind the reforms, and in particular, the ideological underpinnings of health care reorganization, need to be taken into account when considering long-term strategies and policies to provide health services in developing countries. (author's)
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