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Participation in World Health Organization technical briefings, Geneva, Switzerland, October 13-24, 1997.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1997.  p. (Report; USAID Contract No. HRN-C-00-93-00031-00)This trip report pertains to a consultant visit to the World Health Organization's Technical Briefings on Child Health and Development and Immunization in Geneva, Switzerland, during October 13-24, 1997. Three BASICS technical officers, 2 operations officers, a regional child survival advisor, and a regional immunization coordinator attended the technical briefings. The aim was to allow BASICS staff to obtain an up-to-date overview of the 2 divisions' programs, approaches, and methods that are used in planning and management in developing countries. The briefings provided an opportunity for BASICS staff to meet WHO staff, discuss activities of mutual interest, and obtain technical materials. The workshop included lectures by WHO staff and some problem-solving exercises in small groups. Discussions occurred during presentations and in separate meetings. Other participants included members of government agencies, universities, multilateral organizations, and nongovernmental organizations worldwide. Appendices provide a full list of conference participants by name and organization or agency also provide the schedule of activities.
Inter-Agency Working Group on Participation meetings hosted by UNDP, September 17-18, 1996, New York City, NY.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1996.  p. (Report; USAID Contract No. HRN-00-93-00031-00)This report pertains to BASICS participation at a meeting of the Interagency Learning Group on Participation (IGP) hosted by the UN Development Program in New York City, on September 17-18, 1996. Participants included UNICEF, the World Bank, Overseas Development Assistance, Asian Development Bank, USAID, and other international organizations. This was the first time that BASICS was included in the meetings to share their community participatory experiences and to explore opportunities for collaboration. The meeting was the third of its kind. IGP is a voluntary group without a budget who represent multilateral, bilateral, and nongovernmental organizations (NGOs). The IGP is concerned with institutional change and creating awareness of the value of participatory approaches; training and country-level capacity building; information and dissemination; and monitoring and evaluation. The UNDP administrator emphasized the need to focus on more information disclosure for donors and NGOs, the context of increasing decentralization, legal frameworks for the empowerment of women, and the importance of democratization. Most of the presentations focused on the internal institutional constraints to promoting and implementing participation in the field. The logical framework approach does not lend itself to participatory development. UNICEF ran workshops in 3 countries on how to use a more participatory manner in country programs, but after 6 months trainees still had difficulty with applications. Internal policies and procedures, lack of tools for monitoring, a need to change staff attitudes, specific country context, and institutional capacity to identify and work with the right partners were all problems. An NGO in India, cautioned against too much participation. Smaller plenary discussions focused on dealing with conflict, outcomes, redistribution of power, the public good, and village logbooks.
POPULATION HEADLINERS. 1998 Mar-Apr; (263):1-2.This article summarizes the recommendations of a high level meeting, to review the implementation of the action plan of the 1994 International Conference on Population and Development (ICPD), organized by UNFPA and ESCAP. Participants reviewed the progress to date on plans that were adopted at the 1994 ICPD and included in the Bali Declaration. Participants included delegates from 30 countries in the ESCAP region. Participants recommended that governments adjust their population policies to account for increasing globalization and emerging demographic, economic, and social issues. Governments should cooperate with nongovernmental organizations and international agencies regionally. These meetings should address the consequences of globalization that include high levels of international migration, both legal and illegal. Government should promote activities that strengthen the family and must contend with challenges to new values and roles of family members. The participants made recommendations for achieving the goals of the 1994 ICPD and the Bali Declaration. Youth should receive reproductive health services and become involved in the planning, management, and implementation of youth programs. Governments must also provide the option for full participation of civil society in all stages of development. Participants drafted a resolution seeking greater international funding and a constant flow of domestic resources for programs. Regional diversity is a constraint to unified program efforts. The draft resolution will be voted on at the April 1998 annual meeting. Recommendations will comprise ESCAP input to the preparations for the global ICPD + 5 Meeting scheduled for 1999.
Informal consultation meeting for IMCI preservice training at the World Health Organization, Geneva, Switzerland, January 25-31, 1998.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998.  p. (Report; USAID Contract No. HRN-C-00-93-3031-00)This trip report pertains to a consultant visit to WHO offices in Geneva, Switzerland, during January 25-31, 1998. The purpose was to participate in informal consultation meetings with WHO's Division of Child Health and Development. Discussion focused on pre-service training for Integrated Management of Childhood Illnesses (IMCI) in medical, nursing, and other health provider teaching institutions. The consultant participated in a one-day introduction to IMCI with others who had not previously received the standard 11-day IMCI course. The consultant also participated in a 3-day consultation with medical and nursing faculty members from 13 developing countries, consultants from developed countries, and the WHO Division of Child Health and Development (CHD) staff. The appendices includes a summary of findings and group recommendations. The consultant met with BASICS and CHD staff and discussed private practitioner quality of care and met with a staff member from the Expanded Program on Immunization to discuss child survival and decentralization. There was some agreement that IMCI pre-service education was desirable and feasible and an appropriate activity for WHO. It is likely that the 11-day IMCI course content will be integrated within subjects in the curriculum and scattered over different years of study. There is a need to develop guidelines for teaching the content of and including readings on the technical background for the IMCI algorithm and methods and for IMCI treatment protocols for diseases and interventions. Materials could be self-study oriented.
WHO informal consultation meeting for IMCI preservice training, Geneva, Switzerland, January 28-30, 1998.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998.  p. (Report; USAID Contract No. HRN-C-00-93-3031-00)This trip report pertains to a consultant visit to WHO offices in Geneva, Switzerland, during January 28-30, 1998. The purpose was to participate in informal consultation meetings with WHO's Division of Child Health and Development. Discussion focused on pre-service training for Integrated Management of Childhood Illness (IMCI) in medical, nursing, and other health provider teaching institutions. The skills and knowledge taught in IMCI courses would be suitable for inclusion in pre-service training programs. Although it was expected that recommendations would result from the meetings, this did not occur. The appendices provide summary documents from small group discussions. It was generally agreed that WHO should continue to support the development of a strategy to and materials for incorporating IMCI into pre-service training for health providers. The referral care guidelines are nearly complete and should be included in any training materials. Participants considered it very important to include core inpatient content, even for providers working in outpatient facilities. Participants thought that pre-service trainers must have someone designated as an effective focus person who can link the child health and community health departments. Change to IMCI-based curricula within schools will be difficult to achieve, but worthwhile. All providers of sick children should be trained to provide standard IMCI care. An adaptation guide for pre-service training materials may be needed. IMCI introductory activities should be implemented country-wide. Experience integrating IMCI into training will indicate how to implement this approach.
Planning for a multi-site study of health careseeking behavior in relation to IMCI, November 4-11, 1997.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1997.  p. (Report; USAID Contract No. HRN-C-00-93-00031-00)This trip report pertains to a 1-week workshop held during November 4-11, 1997. The purpose of the workshop was to plan a study of healthcare-seeking behavior in Mexico, Ghana, and Sri Lanka. The study would develop a community and facility link as part of the WHO Integrated Management of Childhood Illness (IMCI) initiative. The theoretical framework identifies four types of maternal behavior (recognition, labeling, resorting to care, and compliance) and four types of channels (paid community health workers, volunteer health workers, mother support groups, and informal support from family and others). Project funding would be supplied by WHO. BASICS has the opportunity to collaborate with WHO and the London School of Hygiene and Tropical Medicine on the study, which is highly relevant to its work with behavior change and IMCI. The workshop was attended by about 18 persons and included teams from the three study sites. The workshop included presentations, plenary discussions, and small group sessions. The organizing committee prepared a review of the literature on healthcare-seeking behavior, evaluation techniques, WHO protocols for multi-center studies, targets, and budgets. Representatives from the sites prepared an overview of health conditions at their sites and some ideas for the study plan and intervention. The subgroups developed specific draft study plans, which were presented to the plenary. Final proposals are due in Geneva by November 30, 1998. BASICS will develop a review of mother support groups and provide position papers to sites.
Sustainable ORS use in West Africa through private-public partnership, January 18-28, 1998, Abidjan, Cote d'Ivoire, Dakar, Senegal.
Arlington, Virginia, Partnership for Child Health Care, Basic Support for Institutionalizing Child Survival [BASICS], 1998. , 16,  p. (Report; USAID Contract No. HRN-Q-06-93-00032-00; USAID Contract No. HRN-C-00-93-00031-00)This trip report pertains to travel to Abidjan and Dakar, Senegal, during January 18-28, 1998, for the purpose of organizing and facilitating a consensus meeting between the partners in the West Africa ORS (oral rehydration solution) Initiative. The consensus meeting report includes an overview of the regional strategy, the perspectives of the Population Services International (PSI) and the Rhone-Poulenc Rorer (RPR), and status reports for Cote d'Ivoire, Cameroon, and Burkina Faso. The report discusses the price debate and promotional materials. The report consultant also briefed the USAID and local BASICS staff in Dakar on the results of the consensus meeting and implications for the initiative in Senegal. The consultant met with Senegal Ministry of Health staff, RPR-Dakar, and the company that was conducting market research on demand for ORS. The initiative aimed to establish a commercial sector partnership to ensure sustainable supply and promotion of ORS. The consensus meeting was undertaken to discuss the progress to date, and necessary next steps among central, regional, and country level staff from PSI and RPR. A memorandum of understanding that would specify objectives, roles, and responsibilities of partners was signed in December 1997, for a 10-year period. UNICEF was informed that the commercial sector initiative was meant to create demand among those with disposable income and not meant to serve the poorest of the poor. The initiative was part of an integrated national strategy for program sustainability that would allow governments to reallocate limited resources to better serve the needy.
SAFE MOTHERHOOD. 1997; (24):3.This article identifies key features of a June 1997 seminar held among delegates from French-speaking African countries on the World Health Organization's Mother-Baby Package. This package aims to strengthen, integrate, and speed up national efforts to reduce maternal and neonatal mortality in developing countries. Multidisciplinary teams met in subregions. The first group met in Ouagadougou, Burkina Faso; another group met a week later in Libreville, Gabon. WHO's Regional Office for Africa organized the meetings. Participants included representatives from UNDP, UNICEF, and UNFPA and representatives from Algeria, Angola, Benin, Burkina Faso, Burundi, Cameroon, Chad, Comoros, Equatorial Guinea, Gabon, Guinea Bissau, Madagascar, Mali, Mauritania, Niger, Senegal, and Togo. The meetings were conducted in French. Some participants pointed out the needs of countries that recently emerged from periods of armed conflict. It was understood that a minimum level of political stability was required in order for health systems to function effectively and to reduce maternal deaths. Countries are trying to restore health services to be able to respond to obstetric emergencies at any time or place. Information was provided on country-specific experiences with initiatives and problems, such as lack of funding and human resources. Midwife skills are particularly deficient at the local level. Some participants viewed a reproductive health emphasis as slowing safe motherhood efforts, while some viewed reproductive health as the foundation for safe motherhood and a way to strengthen support. Participants agreed on methods of mobilizing resources, identifying appropriate indicators, and collaborating intersectorally. They were committed to using World Health Day 1998 as a way to focus national celebrations on safe motherhood.
Highlights from the Third Annual Inter-Agency Working Group on FGM Meeting, Cairo, Egypt, November, 1996.
[Unpublished] 1996. 13 p.In November 1996, more than 34 representatives from 20 organizations attended the Third Annual Inter-Agency Working Group meeting on female genital mutilation (FGM) in Cairo, Egypt. After opening remarks by the Chairperson of the Task Force on FGM in Egypt and the Egyptian Under Secretary of the Ministry of Health and Population, other discussions placed FGM in the larger context of women's human rights, reviewed the background of the Global Action Against FGM Project and the goals of the Inter-Agency Working Group, and provided an overview of the activities of RAINBO (Research, Action, and Information Network for Bodily Integrity of Women). A report was then given of a research workshop organized by RAINBO and the Egyptian Task Force on FGM immediately prior to the Working Group meeting. It was noted that data from the recent Demographic and Health Survey revealed an FGM prevalence rate of 97% in Egypt, and areas requiring more research were highlighted. Discussion following this presentation included mention of qualitative methods used in a recent study in Sierra Leone and recent research in the Sudan that led to recommended intervention strategies. During the second day of the Working Group meeting, participants provided a preview of the work of the Egyptian Task Force Against FGM; a description of RAINBO's effort to develop training of trainers reproductive health and FGM materials; and summaries of the work of nongovernmental organizations, private foundations, UN agencies, and bilateral donors. This meeting report ends with a list of participants.
Bethesda, Maryland, Sisterhood is Global Institute, 1996. , xiv, 168 p.This manual presents a multidimensional framework that allows grassroots Muslim women from various backgrounds to examine the relationship between their basic human rights as inscribed in major international documents and their culture. The introduction contains the manual's objective and background, the major international sources of women's rights, the major premises upon which the manual is based, the theoretical framework of the communication model (involving a communicator, an audience, a medium, and a message), the general structure of the model, and a note to facilitators. The next section presents the learning exercises that can be used by facilitators and participants to discuss women's rights 1) within the family; 2) to autonomy in family planning decisions; 3) to bodily integrity; 4) to subsistence; 5) to education and learning; 6) to employment and fair compensation; 7) to privacy, religious beliefs, and free expression; 8) during times of conflict; and 9) to political participation. Section 3 contains a workshop and facilitator evaluation form. Appendices contain auxiliary material such as relevant religious passages, descriptions of the first heroines of Islam, samples of Arabic proverbs concerning women, the text of international human rights instruments, and a list of various human rights and women's organizations in selected Muslim societies. The manual ends with an annotated bibliography.
FAMILY PLANNING NEWS. 1996; 12(2):2.This article is based on a speech presented at an International Planned Parenthood Federation (IPPF) seminar to volunteers and staff. The speech was given by the secretary general of the IPPF, Mrs. Ingar Brueggemann. She stressed that complacency was not appropriate. The concepts of sexual and reproductive health need to be implemented. IPPF must act as the conscience of the people and the voice for the underprivileged. IPPF must ensure that governments understand the concept of reproductive health and its importance. IPPF's "Vision 2000" published in 1992 emphasizes the empowerment of women, a focus on youth needs, reductions in unsafe abortion, prevention of sexually transmitted diseases, greater attention to safe motherhood, and increased programs in sexual and reproductive health. All women must have the basic right to make free and informed choices regarding their sexual and reproductive health and the satisfaction of unmet need for quality family planning services and sexual and reproductive health services, particularly for the disadvantaged groups in society. Africa has the greatest needs. Estimated maternal mortality is over 600 maternal deaths per 100,000 live births. The maternal death rate in some countries may be close to 1200 per 100,000 live births. Africa also practices female genital mutilation, and the practice is widespread. Average life expectancy is around 50 years of age. The average African modern contraceptive use rate is about 10%. Botswana, Kenya, and Zimbabwe have recently made progress in rapidly increasing the modern contraceptive use rates. Africa may also have about 66% of the world's HIV/AIDS cases. Funding will be needed to advance programs in sexual and reproductive health. However, the shift of funds from supporting one soldier would pay for the education of 100 children. The cost of one jet fighter would pay for equipping 50,000 village pharmacies.
[Unpublished] .  p.This document relays 10 lessons learned in providing communication technical assistance in programs designed to eradicate female genital mutilation (FGM). 1) The community must identify FGM as an issue they are interested in working on, and the local implementing agency must request technical assistance. 2) Agencies providing technical assistance to FGM eradication programs must avoid high visibility. 3) Technical assistance is most appropriately given by local staff living and working in the particular country. 4) International agencies should strengthen the skill base of their local counterparts so the local groups can acquire the necessary communication skills to work toward eradication. 5) The local implementing organization must conduct research to guide the intervention and the target communities must be involved in designing the interventions. 6) Interventions must be very local in nature and design. 7) Workshops provide good settings for providing technical assistance and training. 8) Local-level project staff need assistance in skills training and individual-level support to deal with their sense that they are betraying their own culture. 9) Skills training helps local staff work through individual behavior change issues in order to help communities adopt behavior changes. 10) The process of behavior change takes time and requires continuity. Donors and local implementing agencies must understand that it may take as long as a generation to eradicate FGM.
Sustainability of the FP-MCH program of NGOs in Bangladesh. Future Search Workshop, July 15-18, 1995, Centre for Development Management, Rajendrapur, Bangladesh.
Dhaka, Bangladesh, Pathfinder International, 1995. , 38, 51 p. (USAID Cooperative Agreement No. 388-0071-A-00-7082-10)This report summarizes the activities of a workshop held July 15-18, 1995, in Bangladesh, on the sustainability of Bangladesh's family planning/maternal-child health (FP/MCH) program among nongovernmental organizations (NGOs). The workshop included representatives of the FP/MCH program, donor agencies, USAID cooperating agencies (CAs), NGOs, family planning clients, and technical experts (64 individuals). The aim was to determine a common vision of sustainability by 2010; to identify common features of this vision; and to identify Action Plans that stakeholders might adopt to ensure the actualization of the vision. The report includes a summary, introduction, objectives, inaugural session notes, technical presentations on USAID's vision, lessons learned from sustainability initiatives in Latin America, sustainability planning approaches and tools, and a future search workshop on sustainability. Stakeholders' evaluations of the workshop were listed in about 16 different statements. The appendices include the agenda, the list of participants, the national vision, USAID's vision, lessons learned from international settings and applicability to Bangladesh, tools to help plan for sustainability, and the workshop evaluation form. Many of the lessons learned were applicable to Bangladesh, with the exception of the question of appropriateness of charging all clients. The Quality-Expansion-Sustainability Management Information System and Management Development Assessment Tool were developed with staff from USAID's CAs in Bangladesh. Eight stakeholders participated in the Future Search Workshop and prepared Action Plans which are included in the appendix. The main features were lower donor dependency, community participation, and cost recovery. Promising features included quality of care, income generation, women's empowerment, collaboration, strengthening management skills, and endowment funds.
African Journal of Reproductive Health. 1997 Mar; 1(1):97-9.Since 1994, a series of workshops, held under the auspices of the World Health Organization, has led to creation of an operational network in southern Africa, which would foster rational use of country, regional, and international resources to strengthen national health development in areas of common interest. A recent workshop considered country needs in the development of policies and programs to integrate reproductive health services within primary health care and the need to develop networks to support reproductive health services, training, research, and advocacy. This workshop resulted in the following: 1) endorsement of the concept of reproductive and sexual health; 2) a commitment to foster this understanding of reproductive health at the country level and to identify needs and strategies to address the needs; 3) a recommendation that national authorities adjust existing programs to reflect a reproductive and sexual health perspective; 4) agreement that in-country networking and coordination must be strengthened; 5) a recommendation that global, regional, and national collaboration should increase; and 6) a recommendation that all efforts should be made to strengthen networking. This workshop has resulted in significant reproductive health activity in the region.
HIV / AIDS workshop: community-based prevention and control strategies, Volume II. Khon Kaen, Thailand, November 15-26, 1993. Report.
Woking, England, Plan International, 1993. , 61 p.This report contains the proceedings of the portion of a 1993 HIV/AIDS workshop held in Thailand dealing with community-based prevention and control strategies. The report opens by identifying PLAN international's identity, vision, and mission. The next section reviews PLAN's policy on children directly or indirectly affected by HIV/AIDS. Section 3 brings perspectives from Burkina Faso, India, Kenya, Thailand, and Zimbabwe to the problem of home care, and section 4 applies perspectives from Indonesia, Kenya, the Philippines, Senegal, and Zimbabwe to the evaluation of health education interventions. Section 5 presents a commentary on planning, monitoring, and evaluating PLAN's AIDS programming, and section 6 summarizes a group discussion on possible future actions that PLAN should take. The seventh section of the report contains profiles of the HIV/AIDS situation in Burkina Faso, India, Indonesia, Kenya, the Philippines, Senegal, Thailand, and Zimbabwe. The report ends with a description of the collaboration between the Family AIDS Caring Trust and PLAN International in Zimbabwe.
Report of the Technical consultation on Female Genital Mutilation, 27-29 March 1996, Addis Ababa, Ethiopia.
New York, New York, UNFPA, 1996. 36 p.This report presents a summary of the discourse among 58 participants from 25 countries, international nongovernmental organizations (NGOs), UN agencies, and African organizations, who attended the Technical Consultation on Female Genital Mutilation during March 1996 in Addis Ababa, Ethiopia. The meeting was sponsored and organized by the UNFPA. About 85-115 million girls and women have undergone female genital mutilation (FGM), and at least 2 million are at risk. Reproductive and sexual health are affected over the entire life course by FGM. Despite the seriousness of the issue, there are major gaps in knowledge about the extent of the problem and the nature of successful interventions. Expressed concern has not reached the level of legal change or programs for promoting the abandonment of the practice. Dr. Leila Mehra reviewed the main features of FGM, UN policies, and the implications for operations research. Dr. Nahid Toubia gave an assessment of approaches to FGM from a reproductive health, human rights, and historical perspective. The World Health Organization Working Group emphasized the importance of including all physical, psychological, and human rights aspects of FGM in the definition. Dr. Mehra indicated that circumcisers, government policymakers, and NGOs should be targeted. Country-specific presentations focused on Ghana, Burkina Faso, Kenya, Sudan, Uganda, Senegal, and Ethiopia. Participants generally agreed that circumcisers need alternative sources of income and that resistance is widespread. Parents need to be educated. Communities need sex education. Men's and women's groups need to be mobilized to stop FGM. Ms. Ana Angarita proposed a model of the determinants of FGM and potential areas for intervention and summarized the initiatives taken and constraints. Dr. Hamid Rushwan proposed a framework for integrating FGM eradication into three UNFPA program areas.
SAFE MOTHERHOOD. 1996; (20):10.During a 1994 workshop sponsored by the World Health Organization and the International Federation of Gynaecology and Obstetrics (FIGO), participants discussed 1) women's right to family planning information, education, and services; 2) women's right to a choice of options and to voluntary decisions concerning their health; and 3) the link between women's rights and women's health. Participants noted that obstetricians and gynecologists must expand their role to become women's advocates and must insure that women's rights to informed choice and informed consent are protected. Women should participate as equals in the planning, implementation, and evaluation of policies which affect them so that they can make fully informed decisions. The workshop produced the following recommendations: 1) FIGO should discourage practices that abuse women's rights to information and education on the procedures and treatments they face; 2) adolescents should receive reproductive health information, counseling, and services; 3) obstetricians and gynecologists should be trained in communication and counseling skills; and 4) national societies of obstetricians and gynecologists should encourage the provision of comprehensive reproductive health services, discourage female genital mutilation, and encourage provision of counseling for female victims of violence.
UNFPA COUNTRY SUPPORT TEAM FOR EAST AND SOUTH-EAST ASIA NEWSLETTER. 1996 Aug; 4(2):11-2.This news brief identifies workshops and meetings related to the implementation of the ICPD Program of Action in Thailand and some changes in Thai policy and program direction. The 8th National Economic and Social Development Plan for 1997-2001 uses a people-centered human development approach. The Plan emphasizes extending compulsory primary education to 9 years for all children initially and eventually to 12 years. The second major change is to accelerate the extension of primary health care in rural areas and to carry out a Five-Year National AIDS Prevention and Control plan. The new Plan aims to promote family planning in target groups with high fertility, to improve the quality of family planning methods and services, to promote small family size among target groups, to improve quality of life and community self-sufficiency, to promote family planning as a means of ensuring healthy children and improved quality of life, and to promote the development of agricultural industry in rural areas. The government priority will be to develop rural areas, the skills of rural residents, and small and medium sized cities, in order to slow the flow of migration from rural to large urban areas. Local administration will be upgraded and directed to solving environmental problems. The Plan aims to expand social services and to train rural people to meet the needs of the labor market. Several workshops and seminars were conducted during 1995 and 1996 that related to reproductive health and reproductive rights. In 1994, and shortly following the ICPD, Thailand government officials, members of nongovernmental groups, UN representatives, and media staff participated in seminars on the implementation of the ICPD Plan of Action in Thailand and seminars on Thailand's population and development program.
Summary report of: Updating Service Delivery Guidelines and Practices: a Workshop on Recent Recommendations and Experiences, Guatemala City, Guatemala, March 6, 1995.
Research Triangle Park, North Carolina, Family Health International [FHI], 1995 Aug. , 26 p. (MAQ: Maximizing Access and Quality)In March 1995, Family Health International (FHI), JHPIEGO Corporation, and seven collaborating agencies hosted an international workshop in Guatemala City so 60 family planning specialists from 23 countries could discuss how national guidelines for the use of contraceptives can be developed and implemented that are universally agreed upon and accepted. This workshop was held because a key obstacle of achieving high-quality family planning services is the lack of such guidelines. The participants reviewed the international recommendations developed by USAID and the World Health Organization (WHO). They also discussed the merits of the guidelines principle and learned from the pioneering countries in this initiative. The pioneering countries were presented in Session II as country case studies and included Mexico, Tanzania, and Turkey. The first session addressed the international initiative to update service delivery guidelines and practices, specifically how medical barriers stand in the way, and the WHO and USAID guidance documents. Session III involved working groups on contraception for young adults, contraception in postpartum care, contraception in postabortion care, progestin-only methods, and client perspectives. Participants suggested that the workshop be adapted into an easily replicated format to introduce the guidelines worldwide. The next step would be to translate the documents into national guidelines and convert them into changes in practice. One way would be to publish training materials for all levels of family planning providers. JHPIEGO has already published a user-friendly pocket guide in five languages to simplify the USAID and WHO documents. FHI has developed Contraceptive Technology Modules to educate policymakers and providers on the latest scientific information. JHPIEGO and FHI have created expert slides to accompany the modules.
Verbal autopsies for maternal deaths. World Health Organization workshop, held at the London School of Hygiene and Tropical Medicine, 10-13 January 1994, London, U.K.
Geneva, Switzerland, World Health Organization [WHO], Division of Family Health, 1995. , 36 p. (WHO/FHE/MSM/95.15)The Safe Motherhood Programme of the World Health Organization convened a workshop in 1994 so that investigators from around the world could share their experience in the use of verbal autopsies (postmortem interviews of the relatives and/or neighbors of the deceased) to determine the cause of maternal death and move towards a consensus of what should constitute verbal autopsy methods. Workshop outcomes included the following: 1) a determination that the postmortem interview should consist of verbal autopsy, verbal determination of the nonclinical causes of death, and verbal reporting of background characteristics; 2) agreement that the classification of direct causes of maternal death may be single, dual, or a combination of single and multiple; 3) development of a comprehensive list of the signs and symptoms of obstetric/medical causes of maternal death (direct and indirect); 4) agreement that verbal autopsies should be conducted for all deaths of women of reproductive age to determine early pregnancy deaths; 5) determination that the future development of flowcharts would be valuable for identifying and coding causes of maternal death; 6) identification of information to be included in all questionnaires; and 7) consideration of specific aspects of data collection (requirements for interviewers, respondents, getting information from health providers, the recall period, and validation of specific aspects). Appended to this report are 1) a list of participants, 2) flowcharts for causes of maternal death, 3) suggestions for questions to be asked, 4) suggestions for a questionnaire, and 5) a summary of selected studies that used lay reporting to identify causes of death.
JOICFP NEWS. 1996 Feb; (260):5.The UNFPA-supported project on development and distribution of information, education, and communication (IEC) materials in support of improving women's health and status was evaluated at a workshop held in Tokyo in December 13-15, 1995. The 1992-95 cycle of the project was analyzed by experts from Bangladesh, China, India, Indonesia, Malaysia, Nepal, the Philippines, and Vietnam plus three experts from the UNFPA/Country Support Team. The workshop also made it possible for the experts to identify needs as well as effective utilization of existing IEC materials. It was suggested that a nongovernmental organization be established for the distribution and effective use of these materials. The workshop mostly reviewed the print and audiovisual materials. Videos were also evaluated. The materials were found useful for the targeted region. Among other subregional issues it was noted that youth needs were inadequately addressed as they related to sexually transmitted diseases (STDs), unwanted pregnancy, risk of maternal mortality and morbidity, low birth weight, and premature birth. Although the women of the region comprise one-third of the world's population, 70% of the global annual maternal mortality of 500,000 occurs in the subregion. IEC materials should also target adolescents and their support groups. Other needs were also outlined: the expansion of educational opportunities for women, the promotion of employment, the involvement of men, and the training of personnel. The strategies used in the cycle helped strengthen self-reliance through information and experience sharing. The focus on women should be continued with more attention paid to adolescents and young adults, including males. Women's health issues should be expanded to include menopause, reproductive tract infections, STDs, HIV/AIDS prevention, and legal rights including abortion. The production of IEC materials should be identified through research and analysis of existing materials, focus group discussions, or field visits.
Geneva, Switzerland, WHO, 1988. vi, 158 p.This report in 1988 summarizes the progress made toward attainment of the goals set forth at the International Conference on Primary Health Care in Alma-Ata, USSR, in 1978. Policies changed immediately within the World Health Organization (WHO) and priorities slowly shifted within member nations. This report summarizes relevant papers, ideas, comments, and questions pertaining to the 1988 conference in Riga that followed-up the problems and prospects of Alma Ata. This volume is organized into four units: background to Alma Ata and the address of the Director General of WHO in 1978, background to Riga and its progress and failures, the Forty-First World Health Assembly addresses and a technical discussion on leadership development, and future agendas and recommendations. The resolutions passed in 1988 by the World Health Assembly on Health for All are included in the annexes. Over the ten year period since Alma Ata, there was evidence of the guidance provided to the health and development community worldwide by the ethical principles, political imperatives, and technical directions established at Alma Ata. The concept of Health for All was incorporated in part or fully by a variety of individuals ranging from policy makers to school children. The concept was influential in developed and developing countries and was accepted by poorer countries in formulating their national and regional strategies. The survival of Health For All (HFA) is attributed to the ethical, political, social, and technical elements of the effort. The purpose of HFA is to provide a conceptual structure for thinking about multiple and related problems and guiding decisions about priorities and actions. One outcome has been the development of monitoring and reporting procedures for gauging progress. Targets, but not principles, are expected to shift over time. The 1988 assessment of statistical indicators is that progress has been too slow and may be stagnating. Progress was made in health system development and use of new technologies, but problems persisted that were resistant to the solutions during 1978-88: high maternal and under five mortality rates and population growth and ecosystem instability. These problems affect the poor and most vulnerable people, are difficult to solve, and require new responses from WHO.
In: Learning about sexuality: a practical beginning, edited by Sondra Zeidenstein and Kirsten Moore. New York, New York, Population Council, 1996. 363-79.IPPF's AIDS Prevention Unit (APU) conducted HIV prevention training workshops for key staff of family planning associations (FPAs) in West Africa. The experience of these workshops and the findings of a 1992 needs assessment among selected FPAs have articulated the nature of the gap between clients' needs and social norms and providers' values in relation to sexual behavior. This chapter of the book entitled Learning about Sexuality: A Practical Beginning examines how sexual options to minimize the risk of HIV infection (condom use, abstinence, fidelity within marriage, and nonpenetrative sex) correspond with the realities of the attitudes and sexual lives of different client groups. It also addresses how effective these options are in preventing HIV/AIDS. Another discussion revolves around the extent providers help clients determine the best HIV prevention strategy for themselves. The book also covers whether providers help clients overcome gender inequalities that place them at risk of HIV infection or reinforce gender stereotypes. Significant obstacles among the work of the APU include providers' long-standing attitudes, biases, and perception; consideration of counseling and education as if the clients can freely decide what to do about sex; providers' concern for social and moral well-being of clients; and conflict between contraceptive targets and the mandate to provide clients with the information needed to make informed choices about reproductive and sexual health. The book provides four steps to address these obstacles and to change the behavior of both FPA staff and clients in order to close the gap between their goals and perception: structured sessions on gender issues in FPA staff training and actively challenge gender discrimination and attitudes that result in sexual ill health; structured activities on religion, traditional sexual culture, and sexual health in FPA staff training; pilot projects that test the feasibility of FPAs using a participatory community development approach in sexual health; and network with groups that have resources to address some underlying determinants of sexual health.
Arlington, Virginia, Partnership for Child Health Care, 1995. , 5,  p. (Trip Report; BASICS Technical Directive: 000 AF 53 020; USAID Contract No. HRN-6006-C-00-3031-00)The World Health Organization (WHO)/Africa Regional Office organized a six-day meeting during August 21-26, 1995, with the following objectives: to upgrade the skills of selected national malaria control program managers so that they can perform as consultants for other countries in the region; to familiarize participants with issues related to planning, monitoring, and evaluation of malaria control activities; to brief participants on recent developments concerning the Regional Malaria Control Strategy; and to finalize the preparation of workshops for malaria control program managers in Kenya for East Africa, in Zimbabwe for Southern Africa, and in Ghana for West Africa. The meetings were conducted in both plenary session and small working group sessions. 16 national malaria control program managers and WHO epidemiologists from 15 anglophone countries participated. The purpose of the BASICS Technical Officer's attendance, trip activities, discussions, conclusions, and follow-up activities are presented, followed by a list of participants and facilitators.
Report on WHO's first course to train consultants for Management of Childhood Illness, Addis Ababa, Ethiopia, November 13 to December 2, 1995.
Arlington, Virginia, Partnership for Child Health Care, 1995.  p. (Trip Report; BASICS Technical Directive: 000 HT 53 014; USAID Contract No. HRN-6006-C-00-3031-00)The World Health Organization's Division of Diarrheal and Acute Respiratory Disease Control (WHO-CDR) and its partners have prepared the Management of Childhood Illness course, which trains health workers in optimal outpatient management of the leading causes of child death: pneumonia, diarrhea, malnutrition, measles, and malaria. During November 13-24, 1995, WHO-CDR held a training course in Addis Ababa, Ethiopia, for consultants in Management of Childhood Illness. Following the course, a subset of the consultants participated in a series of workshops on preparations for introducing the course and adapting it to correspond to national policies. WHO-CDR has officially released the materials for training in integrated outpatient management of childhood illness. They include the training materials for participants, the Course Director's Guide, the Facilitator's Guides, three videos, a paper entitled Where Referral Is Not Possible, the Adaptation Guide, and a document entitled Initial Planning by Countries for Integrated Management of Childhood Illness. Preparation needs for use of the course include adaptation of the course to correspond to national policies, organization of training sites, and training of highly qualified facilitators. Complementary training materials are needed for health workers with less formal education, for instruction in inpatient management, and for training private-for-profit health workers. Training must correspond to system-wide changes (e.g., in drug supply and in supervision). The project must extend to the home and community to improve the care for sick children. Training specialists, communications specialists, public health managers, policy makers, and parents of sick children need to be included so as to expand understanding of and support for the initiative in order to complete the unfinished tasks.