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Integrating oral rehydration therapy into community action programs: what role for private voluntary organizations?
Washington, D. C., CEFPA, 1980. 42 p.A workshop, sponsored by the Centre for Population Activities, the National Council for International Health, and the Pan American Health Organization, meet in 1980 to discuss the use of ORT (oral rehydration therapy) in health and development programs and to determine how private and voluntary organizations could be encouraged to become involved in efforts to extend ORT availability. ORT is a technique for reducing dehydration in patients suffering from prolonged diarrhea. Diarrhea related dehydration is a serious problem among children in developing countries, especially among malnourished children. In 1975, 5 million children under 5 years of age died from diarrhea in Latin America, Africa, and Asia. The therapy consists of administering a solution of sodium chloride, sodium bicarbonate, potassium chloride, glucose, and water to the patient in order to balance the composition of body fluid. Initially the solution had to be administered intravenously at a treatment center; however, the solution can now be administered orally to mildly or moderately dehydrated patients by the patient's family in the home setting. The solution is given to the patient frequently and amount is determined by the patient's thirst for the solution. Packets containing enough dry ingredients to mix with 1 liter of water are now available. These packets can be centrally or locally manufactured. The solution can be mixed at health centers upon request, or the packets can be distributed directly to family members who are then taught how to mix and administer the solution. Various community action programs can incorporate an ORT component. Personnel in these community action programs, working at all organizational levels, should receive training in ORT. Community workers should receive intensive training so that they in turn can teach families in the community to use the therapy. The programs should use all available communication channels to send out accurate messages about ORT. The program should also organize the distribution of the packets and develop evaluation procedures for the ORT program component. WHO, UNICEF, USAID, and the National Council for International Health provide various forms of assistance to governments or to private and voluntary organizations interested in developing ORT programs.
San Francisco, San Francisco Press, 1974. 292 p.Despite its high effectiveness, lack of side effects, ease of use, and low cost, condom utilization has declined in the U.S. from 30% of contracepting couples in 1955 to 15% in 1970. The present status of the condom, actions needed to facilitate its increased availability and acceptance, and research required to improve understanding of factors affecting its use are reviewed in the proceedings of a conference on the condom sponsored by the Battelle Population Study Center in 1973. It is concluded that condom use in the U.S. is not meeting its potential. Factors affecting its underutilization include negative attitudes among the medical and family planning professions; state laws restricting sales outlets, display, and advertising; inapplicable testing standards; the National Association of Broadcasters' ban on contraceptive advertising; media's reluctance to carry condom ads; manufacturer's hesitancy to widen the range of products and use aggressive marketing techniques; and physical properties of the condom itself. Further, the condom has an image problem, tending to be associated with venereal disease and prostitution and regarded as a hassle to use and an impediment to sexual sensation. Innovative, broad-based marketing and sales through a variety of outlets have been key to effective widespread condom usage in England, Japan, and Sweden. Such campaigns could be directed toward couples who cannot or will not use other methods and teenagers whose unplanned, sporadic sexual activity lends itself to condom use. Other means of increasing U.S. condom utilization include repealing state and local laws restricting condom sales to pharmacies and limiting open display; removing the ban on contraceptive advertising and changing the attitude of the media; using educational programs to correct erroneous images; and developing support for condom distribution in family planning programs. Also possible is modifying the extreme stringency of condom standards. Thinner condoms could increase usage without significantly affecting failure rates. More research is needed on condom use-effectiveness in potential user populations and in preventing venereal disease transmission; the effects of condom shape, thickness, and lubrication on consumer acceptance; reactions to condom advertising; and the point at which an acceptable level of utilization has been achieved.
Draft report of a meeting of specialists in contraceptive distribution, London, September 28-30, 1973. (London, IPPF, 1973), 65 p.A report of a meeting of specialists in contraceptive distribution held in London in September 1973 is presented. The specialists represented most of the community-based distribution schemes outside the People's Republic of China. They unanimously agreed that these schemes are capable of involving millions who are not reached by the existing programs. The meeting recommended that the International Planned Parenthood Federation (IPPF) take the lead in the formation of groups to work in community-based contraceptive distribution. The programs are discussed in terms of: 1) organizational structure; 2) staff; 3) contracted skills; 4) distribution chain; 5) depot holders; 6) contraceptives; 7) promotion,; and 8) program results. The possible aims of any program to distribute supplies and resources are discussed. Criteria for judging the appropriateness of an organization for carrying out the tasks are given. 5 options for the future with their advantages and disadvantages are discussed. They are: 1) no new initiative; 2) activities confined to the IPPF; 3) organizations linked to the IPPF; 4) supplementation of the resources of an appropriate existing organization; and 5) a new organization.
Population Reports. Series A: Oral Contraceptives. 1974 Apr; (1): p.This report provides data on worldwide distribution of oral contraceptives (OCs) over the last decade. Marketing figures and information on government and international distribution programs were provided by AID, the Swedish International Development Authority, UNICEF, and IPPF. It is noted that in at least 5 developed countries (Canada, Australia, West Germany, the Netherlands, and New Zealand) 25% or more of all women aged 15-44 are regularly purchasing OCs from pharmacies. If women receiving supplies from family planning programs are included, the U.S. and the United Kingdom are now close to the 20% level. The highest usage rate is in the Netherlands where nearly 30% of the fecund women bought OCs regularly in 1972 and 37% in the first half of 1973. The hazards of OCs publicized in 1969 and 1970 caused noticeably reduced purchases. In Australia 15-22% of the women taking OCs discontinued their use following adverse reports. By 1971 when further evaluations put earlier warnings into a more reassuring perspective and lower dosage formulations became available, sales in developed countries substantially exceeded previous levels.