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In: Tradition and transition: NGOs respond to AIDS in Africa, edited by Mary Anne Mercer, Sally J. Scott. Baltimore, Maryland, Johns Hopkins School of Public Health, Institute for International Programs, 1991 Jun. 15-22.Many people at risk of HIV infection are changing their behavior drastically when they are referred for HIV testing, as a result of more access to information. Featured as a theme for World AIDS Day, women are particularly vulnerable, since they have less power than men to influence their interpersonal relationships. Women with HIV/AIDS often are asked to make the unrealistic decision to avoid childbearing, but the status of a women in Africa depends on her reproductive ability. The traditional role of women as caregivers both as professional health workers, or in home care, is critical in HIV/AIDS disease. Preservation of the health of the 5-14 age group, who is uninfected, is a priority. Adolescents must be specially targeted in preventive counseling on the consequences of early sexual activity such as teenage pregnancies and sexually transmitted diseases. Sex education in the schools should start at a much earlier age. Studies in Zimbabwe show that women are being infected 5-10 years earlier than men, and there are even cases in 15, 16, and 17 year old women. Most HIV-infected people are afraid of being ostracized or fired from jobs. Women have lost their jobs when their HIV status became known, although the Minister of Health has issued a directive that HIV infection is not a valid reason for discharging an employee. Women are especially vulnerable because they may be rejected by their families and their partners, while having small children who also may be infected. Empowerment of women is needed so that destructive relationships do not continue only because of economic dependence. Ministries of Health, Labor, and Social Welfare need to develop strategies with NGOs to cope with demand to find resources for increasing numbers of desperate people. Community-based care is ideal, and positive trends are emerging to combat the destructive effects of AIDS that divide families leaving the most vulnerable uncared for.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (746):1-89.A World Health Organization (WHO) Study Group on Community-based Education of Health Personnel met during November 1985 to clarify the meaning of the term community-based education, to determine its implications, to suggest how to put it into practice, and to recommend ways of fostering it. This report of the meeting defines terms and covers the following: the rationale of community-based education (a historical account, underlying principles, 6 reasons in support of community-based education, the organization of community-based educational programs, major problems and constraints, and quantitative and qualitative considerations); and the principles and issues (educational principles and issues, coordination between the health and educational systems, the intersectoral approach, community involvement, the health team, the competency-based learning approach, problem-based learning, performance assessment, and recapitulation of the action to be taken in implementing a community-based educational program). Recommendations to the WHO are included along with recommendations on how to start a community-based educational program and on how to foster an understanding of the concept of community-based education. An educational program, or curriculum, can be termed community-based if, for its entire duration, it consists of an appropriate number of learning activities in a balanced variety of educational settings, i.e., in both the community and a diversity of health care services at all levels. Participation in community-based educational activities gives the students a sense of social responsibility, enables the students to relate theoretical knowledge to practical training and makes them better prepared for life and their future integration into the working environment, helps to break down barriers between trained professionals and the lay public and to establish closer communication between educational institutions and the communities they serve, helps to keep the educational process current, helps students to acquire competency in areas relevant to community health needs, and is a powerful means of improving the quality of the community health services. A clear organizational design is needed to create a community-based educational program.
Social Science and Medicine. 1985; 21(1):41-53.This paper explores the emergence of an international fad aiding and monitoring community participation efforts and projects its future outcome based on lessons from previous experiences in other than the health sector. The analysis suggests that the promotion of community participation was based in all cases on 2 false assumptions. 1) The value system of the peasantry and of the poor urban dwellers had been misunderstood by academicians and experts, particularly by US social scientists, who believed that the traditional values of the poor were the main obstacle for social development and for health improvement. However, the precolumbian forms of organization that traditional societies had been able to maintain throughout the centuries were not only compatible with development but had many of the characteristics of modernity: the tequio guelagetza minga and even the cargo system stress collective work, cooperation, communal land ownership and egalitarianism. 2) Another misjudgement was the claim that the peasantry was disorganized and incapable of effective collective action. In Latin America historical facts do not support this contention. A few examples from more recent history show the responsiveness and organizational capabilities of rural populations. The Peasant Leagues in Northeastern Brazil under the leadership of Juliao is perhaps 1 of the best known example. The question is thus raised as to why international and foreign assistance continues to pressure and finance programs for community organization and/or participation. It is suggested that the experience in Latin America (except perhaps Cuba and Nicaragua) indicates that community participation has produced additional exploitation of the poor by extracting free labor, that it has contributed to the cultural deprivation of the poor, and has contributed to political violence by the ousting and suppression of leaders and the destruction of grassroots organizations. Information presented on community participation in health programs in Latin America illustrates that they have followed closely the ideology and steps of community participation in other sectors. A country by country examination indicates that health participation programs in Latin America in spite of promotional efforts by international agencies, have not succeeded. The real international motivation for participation programs was the need to legitimeize political systems compatible with US political values. Through symbolic participation, international agencies had in mind the legitimation of low quality care for the poor, also known as primary health care and the generation of much needed support from the masses for the liberal democracies and authoritatrian regimes of the region. Primary health care delivery can be successful without community participation, in contradiction to what international agencies and governments maintain.
Paris, France, UNESCO, Education Sector, Division for the Promotion of Quality Education, Section for Education for an Improved Quality of Life, 2006. 38 p. (ED-2006/WS/13)This report presents the key points and recommendations that emerged over the course of a two day Technical Consultation on HIV and AIDS Treatment Education held in Paris, France, November 22-23, 2005. The Consultation was co-sponsored by the United Nations Educational, Scientific, and Cultural Organization (UNESCO) and the World Health Organization (WHO), and aimed to: Review the current status of treatment education at the global country and community levels and "take stock" of experiences, lessons learned, and good practices in treatment education; Identify needs in the realm of treatment education, with a focus at this Consultation on treatment literacy and community preparedness; Develop an action framework with key priorities for work in the near future for the various partners, including UN agencies, national authorities and civil society, taking into consideration the value added of each and encouraging joint programming; and Identify how the UNESCO-led EDUCAIDS Initiative and the UNAIDS-led campaign on «Universal Access to Prevention, Treatment and Care» can contribute to treatment education. (excerpt)
Expanding the field of inquiry: a cross-country study of higher education institutions' responses to HIV and AIDS.
Paris, France, UNESCO, 2006 Mar. 73 p. (ED-2006/WS/25; CLD 27584)This report compares, analyses, and summarises findings from twelve case studies commissioned by the United Nations Education, Scientific, and Cultural Organization (UNESCO) in higher education institutions in Brazil, Burkina Faso, China, Democratic Republic of the Congo (DRC), Dominican Republic, Haiti, Jamaica, Lebanon, Lesotho, Suriname, Thailand, and Viet Nam. It aims to deepen the understanding of the impact of HIV and AIDS on tertiary institutions and the institutional response to the epidemic in different social and cultural contexts, at varying stages of the epidemic, and in different regions of the world. The overall objective is to identify relevant and appropriate actions that higher education institutions worldwide can take to prevent the further spread of HIV, to manage the impact of HIV and AIDS on the higher education sector, and to mitigate the effects of HIV and AIDS on individuals, campuses, and communities. Specific focus includes: Institutional HIV and AIDS policies and plans; Leadership on HIV and AIDS; Education related to HIV and AIDS (including pre- and in-service training, formal and nonformal education); HIV and AIDS research; Partnerships and networks; HIV and AIDS programmes and services; and Community outreach. (excerpt)
New York Times on the Web. 2002 Mar 4;  p..In India, the death of a 2-year old boy named Wahidur and some 30 other children has halted the vitamin A campaign supported by UN International Children's Emergency Fund. Rumors spread that the vitamin A supplementation has caused the death, causing fear among the people. However, investigation by public health officials revealed that it was not vitamin A that killed many of the children but rather by common sickness like diarrhea and pneumonia. In addition, laboratory tests determined that the vitamin syrup met all the standards. Studies have shown that vitamin A sharply reduces the chances of death of many malnourished youngsters in developing countries due to diarrhea, measles and other diseases. It also helps prevent blindness. According to Dr. Alfred Sommer, an epidemiologist and dean of the Bloomberg School of Public Health at John Hopkins University, an estimated tens of thousands of Indian children would die needlessly if the vitamin A campaign is not restored.
[New York, New York], Population Council, Frontiers in Reproductive Health, 2007 Jul.  p.Progress in the initial stages of the documentation process can be slow, though it gathers momentum over time. Successful communication channels such as email are important for maintaining the momentum. Familiarity with applying the GRIPP framework and process and having existing networks in the field adds value to the product. An initial lack of knowledge about stakeholders can slow down the documentation process. However, the documentation process can help discover who these stakeholders are and the usefulness of the study to them. Case study information is much easier to recall and richer when the research is still current or only recently concluded. A snowballing effect, which results in getting more stakeholder perspectives than originally thought, can occur during the process. A study may have clinical and social and other dimensions, which have very different processes and outcomes with relation to a given research study. Each needs to be followed up in order to fully understand the utilisation and effectiveness of the research. A well-positioned facilitator may be the best placed to assume a neutral position and document the research process. Many of the obstacles in relation to the documentation process that were encountered could be overcome if researchers built the documentation process into their research schedule. (excerpt)
East African Standard. 2002 Dec 14;  p..United Nations Children's Fund (Unicef) has asked the Government to take urgent action to protect children against increasing HIV/Aids infection. And Unicef has expressed concern that over 50 per cent of orphans in Kenya are out of school. Unicef Kenya Officer in charge of Hiv/Aids Unit, Ms Margaret Kyenka Isabirye, said four out of every ten children born to HIV positive mothers are infected. (excerpt)
BBC News. World Edition. 2002 Dec 9;  p..Villagers in parts of Western Africa have come up with an ingenious way of helping pregnant women get to hospital. They place yellow flags on the side of major roads to literally flag down passing truck drivers. The drivers transport the women to hospital, which can sometimes be hundreds of miles away. (excerpt)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S66-S71.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) Asian site was New Delhi, India. Its sample was drawn from 58 affluent neighborhoods in South Delhi. This community was selected to facilitate the recruitment of children who had at least one parent with 17 or more years of education, a key factor associated with unconstrained child growth in this setting. A door-to-door survey was conducted to identify pregnant women whose newborns were subsequently screened for eligibility for the longitudinal study, and children aged 18 to 71 months for the cross-sectional component of the study. A total of 111,084 households were visited over an 18-month period. Newborns were screened at birth at 73 sites. The large number of birthing facilities used by this community, the geographically extensive study area, and difficulties in securing support of pediatricians and obstetricians for the feeding recommendations of the study were among the unique challenges faced by the implementation of the MGRS protocol at this site. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S53-S59.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) South American site was Pelotas, Brazil. The sample for the longitudinal component was drawn from three hospitals that account for approximately 90% of the city's deliveries. The cross-sectional sample was drawn from a community survey based on households that participated in the longitudinal sample. One of the criteria for site selection was the availability of a large, community based sample of children whose growth was unconstrained by socioeconomic conditions. Local work done in 1993 demonstrated that children of families with incomes at least six times the minimum wage had a stunting rate of 2.5%. Special public relations and implementation activities were designed to promote the acceptance of the study by the community and its successful completion. Among the major challenges of the site were serving as the MGRS pilot site, low baseline breastfeeding initiation and maintenance rates, and reluctance among pediatricians to acknowledge the relevance of current infant feeding recommendations to higher socioeconomic groups. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S60-S65.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) African site was Accra, Ghana. Its sample was drawn from 10 affluent residential areas where earlier research had demonstrated the presence of a child subpopulation with unconstrained growth. This subpopulation could be identified on the basis of the father's education and household income. The subjects for the longitudinal study were enrolled from 25 hospitals and delivery facilities that accounted for 80% of the study area's births. The cross-sectional sample was recruited at 117 day-care centers used by more than 80% of the targeted subpopulation. Public relations efforts were mounted to promote the study in the community. The large number of facilities involved in the longitudinal and cross-sectional components, the relatively large geographic area covered by the study, and the difficulties of working in a densely populated urban area presented special challenges. Conversely, the high rates of breastfeeding and general support for this practice greatly facilitated the implementation of the MGRS protocol. (author's)
Increasing the relevance of education for health professionals. Report of a WHO Study Group on Problem-Solving Education for the Health Professions.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1993; (838):i-iv, 1-29.A consideration of current practices in problem-solving education for the health professions was the agenda of a World Health Organization (WHO) Study Group convened in Geneva, Switzerland, in October 1992. The group widened its concerns to provide a general outline of how health professional educational institutions (HPEIs) can influence health care delivery by redefining and expanding their role into the domain of health policy and service delivery. The committee's report presents information on such educational innovations as problem-based learning, student-centered education, community-based education, and community-oriented education. The effects of these innovations can be measured in terms of outcomes for the individual and outcomes for the HPEI, which include effects on the HPEIs themselves and effects on the community health sector. The report discusses 1) creating links with new partners by identifying and solving priority health problems in and with the community, 2) working in the community, 3) shaping health policy through the appropriate use of pharmaceuticals, 4) the effective use of health personnel, 5) the rational allocation of human resources, and 6) health-related legislation. The group addressed strategies for change as they apply to health systems and (HPEIs) including such barriers to changes as fear of a loss of control, failure to align innovation with the perceived needs of the HPEI or service, specific behavior on the part of innovators which jeopardized the change process, fear that change will erode professional excellence or undermine the reward system, and security considerations. Strategies for changes include encouraging broad participation, ensuring that all participating constituencies benefit, maintaining links with other innovative programs, and encouraging participation through a reward system. Organization and practical issues addressed in the committee report include factors involved with getting started, resource needs for curricular development, selecting community sites, and creating favorable administrative structures. The committee recommended that HPEIs review their mission statements, establish partnerships in the community, conduct action research, shift resources to health systems research, ensure the relevance of educational programs, evaluate programs in terms of their impact practice, ensure the use of problem-based learning techniques, and support longterm evaluation. WHO member states were advised to provide incentives and remove unnecessary barriers to collaboration, to use the potential of HPEIs to improve the health sector, to provide financial and administrative support for action research, and to ensure that research findings guide policy development. Finally, the group recommended that WHO encourage the development of guidelines and models to support action research, collaborate with HPEIs which express an interest in developing pilot collaborative projects, and encourage research efforts in HPEIs which have begun such collaboration.
Manila, World Health Organization, Nov. 1976. 72 p.Add to my documents.
Dacca, Bangladesh, Directorate of Population Control and Family Planning Research, Evaluation, Statistics and Planning Wing, April 1977. 30 p.Upon completion of a report on Research Inventory and Analysis of Family Planning Communication Research in Bangladesh, the convenor of Task Force II proposed a study on Family Planning Communication Audience, a top priority study, as documented by the Task Force II in its report submitted earlier to the government. The objectives of this study are to: 1) examine if 2 steps or a multi-step communication model is in operation in Bangladesh; 2) determine which of the media has the largest audience; 3) determine the contribution of each of the mass media in disseminating the family planning message; and 4) determine socioeconomic characteristics of various media audiences. The sample design included exposure to 5 mass media: newspapers, television, radio, audiovisual van, and village bard. The study shows that: 1) both groups of respondents (male and female) have been exposed to the mass media in varying degrees, but that the audiences, after receiving the message, did not keep it confined to themselves; 2) the 2 and 3 step model of communication is in operation in the sample population; 3) in terms of exposure, the data show that radio had larger audiences among both male and female respondents; 4) newspapers, radio, and television audiences differ from the audiences of the other 2 media--village bard, and audiovisual van--in the following areas: education, age, income, and parity. Recommendations are made for further development of family planning communication programs through the mass media: 1) More news, advertisements, pictures, and features printed in the daily newspapers "Ittefaq," and "Dainik Bangla," which are widely read by rural populations; 2) installation of radios and television sets at public sites will enable public service announcements on family planning to be viewed; 3) the musical drama, "Jatragan," by the village bard is highly effective in delivering the family planning message; 4) future studies should include control groups for each of the 5 media audiences; and 5) since women cannot join men in viewing the audiovisual van performances, special arrangement should be made for them.
Cambridge, Mass., Harvard Institute for International Development, Dec. 1975. 53 p. (Development Discussion Paper No. 9)Add to my documents.
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S78-S83.The World Health Organization (WHO) Multicentre Growth Study (MGRS) Middle East site was Muscat, Oman. A survey in Muscat found that children in households with monthly incomes of at least 800 Omani Rials and at least four years of maternal education experienced unconstrained growth. The longitudinal study sample was recruited from two hospitals that account for over 90% of the city's births; the cross-sectional sample was drawn from the national Child Health Register. Residents of all districts in Muscat within the catchment area of the two hospitals were included except Quriyat, a remote district of the governorate. Among the particular challenges of the site were relatively high refusal rates, difficulty in securing adherence to the protocol's feeding recommendations, locating children selected for the cross-sectional component of the study, and securing the cooperation of the children's fathers. These and other challenges were overcome through specific team building and public relations activities that permitted the successful implementation of the MGRS protocol. (author's)