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PubMedDate not supplied

Trouble on tap.

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Africa↗
PubMedDate not supplied

House okays $330 million for population.

A total of $330 million for international population assistance has been approved by the US House of Representatives in the foreign operations appropriations bill for fiscal 1993. The legislation, which includes $20 million for the UNFPA, is expected to be considered by the Senate in the late summer or early autumn. The bill stipulated that the amount earmarked for UNFPA must be used solely for the provision of FDA-approved contraceptives and related logistics. Other restrictions placed on the funds specify that; none of the funds may be used in the People's Republic of China; they must be placed in a separate account and not co-mingled with any other funds; they may not be use to carry out any program, project or activity disapproved by the US Ambassador to the UN; the full amount must be refunded if UNFPA provides more than $57 million for its 5-year family planning program in china that began in 1990 and for which funds already have been committed. Once the largest donor to UNFPA, the US government has not contributed to the Fund since 1985 after the Reagan Administration and antifamily planning forces in Congress lashed out against UNFPA for its support of the allegedly coercive Chinese national family planning program. 2 USAID probes were unable to trace UNFPA funds to the forced abortions the Chinese government program was charged with encouraging and carrying out. Nevertheless, after Congress approved the 1989 foreign operations bill with $15 million earmarked for UNFPA, President Bush vetoed the measure. In his veto message, the President said that UNFPA "participates in and strongly defends the program of a particular foreign government which relies heavily upon compulsory abortion." Pointing out that UNFPA has received no US assistance since 1985 "precisely because of its involvement in this coercive abortion policy," Bush said the 1989 bill represented "a radical and unwarranted change in policy." Although the President failed to name the country that "relies heavily upon compulsory abortion" congressional opponents of refunding UNFPA singled out China as that country. The Chinese government has repeatedly issued official denials that force or coercion are involved in its population policy or programs. Meanwhile, the Bush administration has been pushing hard for Congress to grant most favored nation trade status to China, UNFPA is the largest multilateral agency providing population assistance to developing countries. But Dr. Nafis Sadik, executive director of the Fund, says that "requests for assistance from all regions have mounted to a level that can no longer be met by our organization." She pointed out that the demand for UNFPA support already exceeds the Fund's resources by $500 million. Additionally, she said, many countries--particularly in sub-Saharan Africa--want to expand their current population programs, and new requests are coming from the Commonwealth of Independent States, the Baltic States, and Eastern Europe. More than 100 countries contribute to UNFPA, but most of the Fund's resources are derived from a handful of donors--Japan, the Netherlands, Norway, Finland, Germany, Sweden, Denmark, the United Kingdom, and Canada.

Abortion, Induced↗
PubMed1998

Rehabilitation of the expanded programme on immunization in Sudan following a poliomyelitis outbreak.

In 1993 a large outbreak of paralytic poliomyelitis occurred in Sudan as a result of an accumulation of large numbers of susceptible children that was accelerated by faltering immunization services. The extent of the outbreak led to the rapid rehabilitation of Sudan's Expanded Programme on Immunization (EPI); the government began financing vaccine purchase, operational aspects of EPI were decentralized, vaccine delivery was changed from a mobile to a fixed-site strategy, a solar cold chain network was installed, inservice training was resuscitated, and social mobilization was enhanced. National immunization days (NIDs) for poliomyelitis eradication were conducted throughout the country, including the southern states during a cease fire in areas of conflict. Measles immunization coverage was increased by offering measles vaccine during the second round of NIDs and subsequently through routine immunization services. Supplemental tetanus toxoid immunization of women of child-bearing age began in three provinces at high risk for neonatal tetanus. From 1994 to 1996 reported immunization coverage increased and the incidence of all EPI target diseases fell. Trends in coverage, disease incidence, financing, and the implementation of WHO-recommended disease-control strategies suggest that more sustainable immunization services have been re-established in Sudan.

Adult↗
PubMed1990

Demographic change and social security: some elements of a complex relationship.

"This paper gives an overview [of] some central aspects of the highly complex topic...[of] understanding effects of structural changes in demography and economy on social security." The impact of an aging population on health and pension schemes is discussed. Changes in retirement ages and labor force participation and the restructuring of public expenditures are explored as possible solutions to government financial problems. The geographical focus is on developed countries.

Adult↗
PubMed1999

A pragmatic intervention to promote condom use by female sex workers in Thailand.

An overview is presented of a multifaceted intervention to promote consistent condom use by female commercial sex workers in Thailand, in the context of the government's 100% condom use policy for preventing spread of human immunodeficiency virus (HIV) infection. The project is described with reference to a succession of stages including pre-programme needs assessment, intervention design, implementation and evaluation. The key elements of the intervention were video scenarios and discussions coordinated by health personnel, and video-depicted open-ended narratives aimed at helping sex workers to explore their personal and work-related dilemmas and concerns. A core objective was to enhance sex workers' self-esteem and perceived future with a view to strengthening their motivation to take preventive action against HIV infection. The intervention was evaluated using a combination of qualitative (process evaluation) and quantitative (outcome) methods. The outcome evaluation was undertaken using a pretest, post-test intervention and control group quasi-experimental design. There were significant increases in consistent condom use among the intervention groups but not among the controls. Pragmatic stability is advocated for the Thai sex industry and recommendations are offered for good quality HIV prevention activities.

Adolescent↗
PubMed2001

Reinventing the government role in pharmacotherapy.

Governments face enormous challenges in managing escalating expenditures under their prescription drug plans while providing access to new, cost effective therapies. Strategies to address cost pressures must be considered carefully, however, to ensure the achievement of optimum health outcomes. Alberta has adopted an inclusive approach in addressing utilization and cost issues through a variety of advisory processes and initiatives supported by the Minister of Health and Wellness. The Expert Committee on Drug Evaluation and Therapeutics advises the Minister on Alberta's government-sponsored drug programs and related policy matters. The Alberta Management Committee on Drug Utilization, co-chaired by the Alberta Medical Association and the Pharmacists Association of Alberta, is mandated to oversee the implementation of a number of drug utilization initiatives. The Pharmaceutical Information Network is the cornerstone project of Alberta Wellnet, supported by a unique multistakeholder task force that includes physicians, pharmacists, representatives from health regions and government. Recent successful program launches in Alberta include a palliative drug program, trial prescription program and the multiple sclerosis drug program. Successes in Alberta reinforce the importance of government's role in achieving optimum pharmacotherapy. This role can only be undertaken in collaboration with key stakeholders.

Canada↗