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  1. 1

    The Bamako initiative [letter].

    Ofosu-Amaah S

    Lancet. 1989 Jan 21; 1(8630):162.

    This letter was written in defense of a November 19, 1988 editorial discussing the Bamako Initiative. The writer, who works for UNICEF, has been working, with WHO, on the Initiative for the past year. In addition, he taught and practiced pediatrics in Ghana for 25 years. He claims the idea of "free" health services has undermined traditional African practice and confused the debate about fairness and community responsibility. UNICEF and WHO feel that increased community involvement and contribution to costs will strengthen Primary Health Care and maternal and child health systems. Acknowledged difficulties of the program, such as equity, management, foreign currency, and drug orientation are being addressed. Research and experience in community financing for health in Africa is felt to provide a solid basis for proceeding with the Bamako Initiative.
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  2. 2

    The experience of the Association for Voluntary Sterilization in supporting vasectomy programs.

    Jezowski TW; Ahmad JS

    [Unpublished] 1982. Paper prepared for Conference on Vasectomy, Colombo, Sri Lanka, Oct. 4-7, 1982. 21 p.

    Discusses the factors responsible for the decline of male acceptance of vasectomy over the past decade. The Association for Voluntary Sterilization (AVS) is a nonprofit organization working in the United States which helps funding of similar programs in other developed and developing countries. Reasons for the decline of vasectomy acceptance include the lack of attention paid to male sterilization in countries with family planning programs, the introduction of new technology for female sterilization, the introduction of new effective methods of contraception, and the exaggerated sexual role of the male and the need to protect his virility. The author reviews successful vasectomy programs and finds that, to be successful, a program should have strong leadership, a focussed design, clinic hours that would not interfere with patients' working schedules, and should pay attention to the needs of men, e.g., emphasizing that vasectomy does not cause impotency. The program should also have a community-based orientation, since all the services are not hospital-based and can be brought to the client's home, thereby emphasizing the minor nature of the surgery. AVS believes that vasectomy as a means of family planning can be effective. It is safe, inexpensive, simple, and deliverable. A special fund was allocated in 1983 to stimulate the development of several pilot and demonstration projects in a variety of countries.
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  3. 3

    Sex work and HIV / AIDS. UNAIDS technical update. [Prostitución y VIH/SIDA. Actualización técnica de ONUSIDA]

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2002 Jun. 19 p. (UNAIDS Best Practice Collection; UNAIDS Technical Update)

    This Technical Update focuses on the challenges involved in the protection of sex workers (and, subsequently, the general population) from HIV infection, and discusses the key elements of various effective interventions. Significantly higher rates of HIV infection have been documented among sex workers and their clients, compared with most other population groups. Though sex work is often a significant means of HIV infection entering the general population, studies indicate that sex workers are among those most likely to respond positively to HIV/STI prevention programmes—for example, by increasing their use of condoms with clients. This document explores the many issues involved in providing care and support for sex workers, preventing entry into sex work, and reducing risk and vulnerability through programmes at the individual, community and government levels. (author's)
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  4. 4

    Increasing access to HIV testing and counselling. Report of a WHO Consultation, 19–21 November 2002, Geneva, Switzerland.

    World Health Organization [WHO] Consultation on Increasing Access to HIV Testing and Counselling (2002: Geneva)

    Geneva, Switzerland, WHO, 2003. 30 p.

    In November 2002, WHO convened a larger consultation to consider strategies to increase access to HIV testing and counselling. Those at the Consultation reconfirmed the commitment to voluntary HIV testing and counselling and explored new modalities by which to ensure informed consent as access to HIV testing and counselling expands in a variety of settings. In this context, the participants urged that HIV testing and counselling be offered as standard best practice in the provision of prevention, care and treatment services whenever testing and counselling can benefit the health and well-being of those affected by HIV/AIDS. This report summarizes the main conclusions reached at this Consultation. (excerpt)
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  5. 5

    The last whole earth, do-or-die vasectomy initiative.

    [Unpublished] 1988 Oct 14. [3] p.

    This concept paper discusses an initiative planned for 1989-91 to redirect family planning (FP) program efforts so that vasectomy increasingly becomes of a method choice. The availability and acceptance of vasectomy is considerably less than for female sterilization. It is thought that the reason for the decline in numbers of vasectomy may be unfamiliarity with the method and lack of knowledge on the part of doctors of the best methods to use when performing vasectomies. Internationally, there has been concern about increasing the role of the male in FP. New developments such as increased vasectomy use in Africa and other unlikely countries suggest that this is an appropriate time to begin this initiative. The Chinese "no scalpel technique" has been recognized as having distinct advantages over other techniques. The WHO has produced a program and technical guide on vasectomy services for FP program managers. The objectives are 1) to introduce the Chinese method systematically through training activities; with the cooperation of the Chinese; 2) to set up demonstration projects in vasectomy services in several countries where vasectomy is not available; 3) to develop and conduct operations research projects on the best way of introducing vasectomy services; 4) to encourage clinical research on factors affecting safety, effectiveness, and satisfaction; 5) to promote dialogue on vasectomy at country and regional and international levels; and 6) to encourage donor agencies to become involved in the effort. The plan for action is to be implemented in 3 stages during a period of 3 years and is directed toward solving unanswered questions, which will be generated during an idea generation period. The approach will be multidisciplinary and will involve service and training programs, social science research, and clinical research. Other agencies must be involved. An international symposium will occur at the end of the period to relate and synthesize the experiences of the preceding 3 years. Phase I will generate ideas at, for instance, the World Fertility Rio meeting. Phase II will involve implementation, and phase III the analysis and synthesis of the experiences.
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  6. 6

    Project appraisal document on a proposed International Development Association credit in an amount of US$24 million to the Islamic Republic of Mauritania for a health sector investment project. [Document d'évaluation de projet : proposition de crédit d'un montant de 24 millions de dollars US à l'Association Internationale pour le Développement à la République Islamique de Mauritanie en vue d'un projet d'investissement dans le secteur sanitaire]

    World Bank. Africa Region

    Washington, D.C., World Bank, Africa Region, 1998 Feb 24. 24, [86] p. (Report No. 17396-MR)

    This project appraisal document presents the proposed international development association credit in an amount of US$ 24 million to the Islamic Republic of Mauritania for a health sector investment project. The overall objective of the Program is to improve the health status of the population in general (and of underserved groups in particular) through the provision of more accessible and affordable quality health services. Specifically, the Program aimed to improve health services quality and coverage; improve health sector's financing and performance; mitigate the effects of major public health problems; and promote social action and create an environment conducive to health. This document is outlined into nine sections which covers the topics on project development objective; strategic context; project description summary; project rationale; summary project analyses; sustainability and risks; main credit conditions; readiness for implementation; and compliance with bank policies. Several annexes are also included in this document.
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