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PubMed1997

A campaign against violence: USAID / Kenya funds "Breaking the Silence".

From November 25 to December 10, 1996, USAID/Kenya supported 16 days of activism against gender violence. Called "Breaking the Silence," this annual national campaign was aimed at raising awareness of the rising level of violence against women in Kenya. At meeting places around the country, the campaign, organized by the Coalition on Violence Against Women/Kenya and partially funded by USAID/Kenya, brought together hundreds of participants for a dialogue about gender-based violence. Speakers sought to debunk the myths surrounding violence, including the tendency to blame the victims of gender violence. Victims of violence described their treatment at the hands of abusers. Information brochures discussing domestic battery, wife killing, incest, and other forms of violence against women were distributed. USAID/Kenya has provided funding for this coalition since 1995.

Africa↗
PubMed2006

Veterinary medicine educational requirements to meet the needs of the US Agency for International Development.

The US Agency for International Development (USAID) works within the overall purpose of US foreign assistance to improve the lives of the citizens of the developing world. Through partnerships with other agencies, organizations, and governments, and using its field offices around the world, USAID strives to develop local capacity and thus build sustainable development. Two specific USAID programs pertinent to veterinary medicine are global health and agriculture. In the area of global health, veterinarians can aid USAID's work to improve the quality, availability, and use of essential health services that specifically target maternal and child health, HIV/AIDS, family planning and reproductive health, infectious diseases, environmental health, nutrition, and other life-saving areas. The challenge of making the agricultural sector in a developing country more productive is a critical one for USAID and a clear area for input from the veterinary profession. Animal agriculture is the largest single sector of agricultural economies in most developing countries, and livestock remains a critical component of poverty alleviation. There are educational requirements that benefit anyone working at USAID and can be met prior to admittance to a DVM program, as part of a DVM curriculum, or in post-graduate training/employment, such as proficiency in a foreign language; environmental sciences background; familiarity with accounting and management techniques; expertise in foreign animal diseases, zoonotic diseases, epidemiology, food safety, and nutrition, as well as the application to human health of those areas; an advanced degree such as an MPH; and management experience. Appropriately trained veterinarians can make enormous contributions to USAID's global efforts to improve the health and agriculture sectors of developing nations.

Agriculture↗
PubMed1995

POPs less widely used.

Progestin-only pills (POPs) are less widely used and available than combined pills. For example, the U.S. Agency for International Development (USAID) shipped only 3 million packets of POPs worldwide in 1994, compared with 62 million packets of combined pills, according to Mark Rilling, program analyst with USAID's Office of Population. While USAID considers POPs to be an acceptable contraceptive option for some women and intends to continue providing them, the worldwide market for them is small, Rilling says. The London-based International Planned Parenthood Federation (IPPF) reports a similar trend. IPPF shipped 16 times more combined pills than POPs during 1994, says Dr. Carlos Huezo, the organization's medical director. New efforts to clarify the role of progestin-only pills may make them more acceptable. For example, new studies have provided additional evidence that POPs do not harm breastfed infants whose mothers use them. A new label that reflects these findings, and clarifies other distinctions from combined pills, is being developed for POPs by the U.S. Food and Drug Administration, based on a draft developed by FHI. The pills also are being more actively promoted among some family planning organizations, and may prove useful for community-based distribution.

Contraception↗
PubMed1995

Interaction of condom design and user techniques and condom acceptability.

In 1991, the source of public sector condom supplies in an African country changed from USAID to WHO. Following a complaint, the two types of condoms were sampled and compared. Laboratory tests indicated that the new-style condoms were of adequate quality, but a number of differences were noted between the two types. Complaints that the condoms were short and broke frequently could not be reconciled with measurements. Lubricant quantities on the WHO-supplied condoms were found to be lower than on the USAID condoms, but still within the range found on the commercial market. Also, the WHO condoms were marginally narrower and thicker. WHO asked the authors to conduct field interviews to seek reasons for the reported problems. These revealed that the relative dissatisfaction with the WHO condoms was largely confined to a group of sex workers in a follow-up programme conducted by two educators funded by a European agency. The instructions for use being given by the educators magnified the risk of incorrect application of the condom. Design changes to the WHO condoms (regarding lubricant, size and thickness) were subsequently made to minimise the chance of wrong use.

Africa↗
PubMed1997

International family planning funds will be expedited.

With a 53-46 vote on February 25, the Senate approved a resolution to speed up the release of funding to the US Agency for International Development (USAID) for its overseas family planning programs. The resolution, which had been passed by the House on February 13 (see RFN VI/2), will make money budgeted for fiscal year 1997 available on March 1, 4 months earlier than originally scheduled. Under the omnibus budget bill approved at the end of September 1996, funding was to have been withheld until July 1--a full 9 months into the fiscal year--unless President Clinton made a finding that the delay was harming the functioning of the US family planning program. Based on a report from USAID, which found that the delay would cause at least 17 programs around the world to suspend their services and result in significant and permanent damage to US population-control efforts, President Clinton issued the finding in support of moving up the release of funds. The Senate did not consider a House-passed provision that would have barred family planning programs that receive US money from providing abortions, even if they paid for the procedures through other sources of funding.

Americas↗
PubMed2005

Community environmental health assessment strengthens environmental public health services in the Peruvian Amazon.

In December 1999, the Centers for Disease Control and Prevention (CDC) and the Cooperative for Assistance and Relief Everywhere, Peru Country Office (CARE Peru), initiated the Urban Environmental Health Project (SAU, in Spanish) to strengthen environmental public health services in urban and periurban settlements in Peru. The project received funding from the Woodruff Foundation as part of the CARE-CDC Health Initiative (CCHI). The "Protocol for Assessing Community Excellence in Environmental Health" (PACE EH) guided the development of a community environmental public health assessment (CEHA) process in Cardozo, a settlement in Iquitos, Peru. The project developed a three-phase process that merged scientific understanding and community perception about local environmental health problems. In phase 1, local environmental health technicians assisted the community in understanding environmental health conditions in Cardozo and selecting priorities. During phase 2, local technicians assessed the community-selected priorities: water and sanitation. Results from recent water quality assessments revealed that 82% (9 of 11) of samples from shallow dug wells, 18% (2 of 11) from deeper drilled wells, and 61% (11/18) from household drinking containers were positive for thermotolerant coliforms. Phase 3 activities produced an action plan and an intervention to mitigate health problems associated with inadequate water and sanitation services in the Cardozo community. As a result of the CEHA process, CARE Peru obtained funding from the United States Agency for International Development (USAID) to develop and implement an environmental health risk monitoring system and the proposed water and sewage intervention in the settlement. CDC continues to provide technical assistance to the local environmental health services groups in Iquitos through an agreement with CARE Peru as part of the USAID-funded Urban Environmental Health Models Project (MUSA). Technical assistance activities and the development of the environmental health risk monitoring system have helped to strengthen the local environmental public health services delivery system.

Community-Institutional Relations↗
PubMed1999

Use of sexually transmitted disease risk assessment algorithms for selection of intrauterine device candidates.

Sexually transmitted diseases (STD) are an important contraindication for intrauterine device (IUD) insertion. Nevertheless, laboratory testing for STD is not possible in many settings. The objective of this study is to evaluate the use of risk assessment algorithms to predict STD and subsequent IUD-related complications among IUD candidates. Among 615 IUD users in Kenya, the following algorithms were evaluated: 1) an STD algorithm based on US Agency for International Development (USAID) Technical Working Group guidelines: 2) a Centers for Disease Control and Prevention (CDC) algorithm for management of chlamydia; and 3) a data-derived algorithm modeled from study data. Algorithms were evaluated for prediction of chlamydial and gonococcal infection at 1 month and complications (pelvic inflammatory disease [PID], IUD removals, and IUD expulsions) over 4 months. Women with STD were more likely to develop complications than women without STD (19% vs 6%; risk ratio = 2.9; 95% CI 1.3-6.5). For STD prediction, the USAID algorithm was 75% sensitive and 48% specific, with a positive likelihood ratio (LR+) of 1.4. The CDC algorithm was 44% sensitive and 72% specific, LR+ = 1.6. The data-derived algorithm was 91% sensitive and 56% specific, with LR+ = 2.0 and LR- = 0.2. Category-specific LR for this algorithm identified women with very low (< 1%) and very high (29%) infection probabilities. The data-derived algorithm was also the best predictor of IUD-related complications. These results suggest that use of STD algorithms may improve selection of IUD users. Women at high risk for STD could be counseled to avoid IUD, whereas women at moderate risk should be monitored closely and counseled to use condoms.

Adult↗
PubMed2004

Power and politics in international funding for reproductive health: the US Global Gag Rule.

Since 2001, the US government has used its power as a leading donor to family planning programmes to pursue policies in conflict with global agreements on reproductive rights. Prominent among these policies is the Mexico City Policy (or Global Gag Rule), which restricts non-governmental organisations (NGOs) in developing countries that receive USAID family planning funding from engaging in most abortion-related activities, even with their own funds. This paper reviews the history and political origins of the Gag Rule under several Republican party presidents. The Gag Rule has not achieved an overall reduction in abortions; rather, where it has disrupted family planning services, the policy is more likely to have increased the number of abortions. This paper concludes that the Gag Rule is a radical intrusion on the rights and autonomy of recipients of US funding. Regardless of whether or not it is rescinded in the future, the underlying issues in the politics of US reproductive health assistance are likely to persist. NGOs that wish to free themselves from the constraints it imposes must find the means to end their dependence on USAID funding, including turning to other donors. NGOs should also take the lead in opposing policies such as the Gag Rule that violate global agreements.

Ambulatory Care Facilities↗
PubMed1999

The results framework--an innovative tool for program planning and evaluation.

This article constitutes a case study of the development and implementation of the "results framework," an innovative planning and evaluation tool that is rapidly becoming a standard requirement for United States Agency for International Development (USAID) projects. The framework is used in a USAID-funded regional initiative for HIV/AIDS prevention in Central America. This new program evaluation and monitoring tool provides many advantages over traditional evaluation approaches that use outside consultants to provide midterm and end-of-project evaluations. The results-framework process, which spans the life of the project, provides an opportunity for program staff, donors, partners, and evaluators to work as a team to collect and use rich, longitudinal data for project planning, implementation, and evaluation purposes.

Central America↗