JOICFP NEWS NO. 248 FEBRUARY 1995
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- JOICFP NEWS NO. 248 FEBRUARY 1995
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ISSN 0911-0755
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STATION
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Quality Care for Community-based FP/MCH
Asian regional workshop focuses
on providing quality services at
the community level
The experiences of the Family Planning
Association of Nepal (FPAN) fueled discussion
and helped participants identify key factors on
'ity care for community-based family
h .ning/maternal and child health (FP/MCH)
at an Asian regional workshop. The non
governmental organization (NGO). which
operates an outreach system of health-care
units, offered insights into the effectiveness of
providing quality services in rural communities
where clinic-based services are not available.
The Regional Workshop on Quality Care
for Community-based FP/MCH in Asia was
held in Kathmandu, Nepal, from December 4 9. Organized by FPAN in cooperation with
JOICFP, the workshop was attended by
representatives of counterpart organizations in
ft
:
“
Az
Participants discuss quality care.
the four countries of Bangladesh, Laos, Nepal
and the Philippines implementing the UNFPAsupported Sustainable Community-based FP/
MCH Project with Special Focus on Women.
Representatives of China and Vietnam and
resource persons from Mexico and Japan also
attended the event. The workshop drew a total
of 40 participants.
The workshop was aimed at providing
participants with effective strategies for
promoting quality care for community-based
FP/MCH activities based on the Nepalese
experience. The
event also provided
an opportunity for
participants to share
experiences and to
develop strategies
for project
sustainability and to
identify strategies
and action plans
suitable for their
particular country
situations.
The participants
A participant talks to local women.
were introduced to
the Japanese
experience in
community-based FP/MCH by JOICFP Deputy Laos, while a participant from China
Executive Director Yasuo Kon. Highlighting
commented on the high motivation of the
the importance of quality care, Kon offered
villages to contribute to the cost-recovery
practical strategies for raising quality and
scheme. He added that by paying nominal fees,
achieving self-reliant services.
the villagers had access to drugs and services
To complement the presentations,
that may not be available through the
the workshop included field trips to
government free of charge.
the three areas of Panchkhal, Sunsari
In recommendations made at the end of the
and Morang where the project is being workshop, participants outlined various steps
implemented in 26 villages. During
necessary for achieving quality care in a
the field trip, participants noted the
community-based FP/MCH project. In
strong community involvement and
particular, they called for specific indicators to
1 support of the village leaders. They
be identified for monitoring services and
were also impressed by the community activities and urged the development of
people’s awareness of services
community-based monitoring systems for
provided under the project.
services and activities, and income-generating
Commenting on the project, a
programs. Training and orientation was
Philippine participant said that despite recommended for all levels to improve the
the geographical and cultural difficulties, FPAN skills and attitudes of health-care workers and
had succeeded in promoting fee-charged
to emphasize the client-oriented approach.
The participants also called for the
services towards project sustainability.
A Vietnamese participant welcomed the
development of potential income-generating
opportunity to learn about FPAN’s cost
activities to ensure sustainability such as the
recovery scheme and said that he would like to
implementation of cost-sharing, service fees
institutionalize a similar system in his country.
and revolving funds. The equal involvement
He also praised the high-quality training for
and participation of both men and women at the
midwives and nurses under the project.
policy and implementation levels was stressed
The NGO-government collaboration and
by the group, which also recommended that
high quality of services provided at outreach
essential FP/MCH equipment and training on
clinics in Nepal impressed representatives from its use be provided.
9/
1
Asia
vX
Nepal Project on Track
Participants prepare reports.
Community representatives of 26 villages
of Nepal compared achievements made in the
promotion of family planning/maternal and
child health (FP/MCH) and exchanged
experiences at the Second National Workshop
on Sustainable Community-based FP/MCH
Project with Special Focus on Women. At the
workshop, held in Sunsari District from
Sunsari staff explain their service implementation
to Panchkhal staff.
December 12 -14, the representatives presented
firsthand reports on project progress including
FP/MCH statistics. The event was opened by
the chairman of district development
committee, Ram Bahadur Basnet and insights
into quality of care were provided by Dr. K. K.
Misra, officer, UNFPA East Region.
The event was attended by 80 people from
the six project villages in Sunsari and five
recently developed project villages in Morang.
Representatives of the 15 project villages in
Panchkhal also attended. The participants
included the chairperson of the village health
committee, mothers’ club representatives and
members of the local steering committees.
The reports were presented by the health
committee chairperson of each village and
included such statistics as infant and maternal
mortality rates and
numbers of reproductive
couples. The set format
inspired active discussions
on ways to improve
service provision. The
reports indicated progress
made in project villages
over the last year. For the
new project area of
Morang, the reports
covered progress made
since May 1994, when the
project was launched.
One of the most lively
topics was that of maternal
mortality. None of the pregnancies in project
areas monitored under the project had resulted
in maternal mortality. However, project staff
noted that there were maternal deaths in the
project areas among women who were not
covered by services. The participants discussed
causes and ways to better reach women in all
the villages with ante-natal services.
A Kunii Award of US$1,000 was
also presented for promotion of
women’s status and health care in
Panchkhal. The workshop also included
a trip to Bhaluwa village in Sunsari for
firsthand observation of project activities.
The field trip complemented the very
practical approach of the workshop which
served to highlight the need to include
women more directly in project planning.
The event was closed by Ganesh M.
Shresta, chairman of the local project
steering committee.
Japanese share know-how
A team of 18 Japanese visited
Panchkhal on December 18. The group, a
mixture of individuals concerned with
social improvement programs, included
experts on alternative energy sources and
environmental pollution. The team
provided advice on wind generation and
conducted water analysis. They also
participated a seminar on prevention of
environmental pollution and application of
appropriate energy technologies in
Kathmandu on December 19.
I
South-to-South
Exchanges
The sharing of applicable exchanges among
developing countries is catching on as a
practical means to promote mutual
development. One recent example of this
South-to-South cooperation is the visit of
Subama Shresta, project coordinator, Family
Planning Association of Nepal (FPAN) to
Indonesia. Shresta, who serves as project
coordinator of the Sustainable Community
based Family Planning/Matemal and Child
Health (FP/MCH) Project with Special Focus
on Women, learned insights into the selfsustaining activities of Yayasan Kusuma Buana
(YKB) in Jakarta while in Indonesia from
November 10-12.
Shresta was particularly interested in the
keys of YKB’s successful school health project
under which its MCH clinics are providing
parasite control (PC) services on a fee-charged
basis along with health education activities to
school students. Shresta observed the mass PC
activities and learned how the activities not
only contribute to self-reliance of YKB’s
activities, but serve as an entry point to the
promotion of other health-care activities such as
FP and MCH.
Meanwhile, James Chipipa, acting head,
Parasitology Unit, Tropical Diseases Research
Center, Zambia, also benefited from YKB’s
experiences during a visit from November
28 - 30. Chipipa, is a member of the National
Steering Committee of JOICFP’s Integrated
Project in Zambia and is responsible for the
parasitology aspect of the project. Prior to
visiting Indonesia, Chipipa attended the 18th
APCO Regional Training Course, held in
Bangkok, Thailand.
The Asian experience was particularly
appropriate for the IP in Zambia. Launched 10
years ago, the project is now gearing towards
self-reliance. The 1995 work plan for the IP
incorporates a school health program targeting
3,000 students. Funds raised by the activities
will be used to create a revolving fund, while
the school health program will serve as a
springboard to broaden FP/MCH education
among teachers and parents.
Following creation of the work plan,
Chipipa expressed confidence that the Asian
experience will work in Africa. Once the
Zambian activities yield results, similar school
health projects will be set up in other African
countries under the IP.
JOICFP NEWS, February 1995
Asia
Bangladesh’s Silent Revolution
A movement called the “silent revolution”
is spreading among rural women in Bangladesh
living in or near the areas where the Integrated
Family Development Program is being
implemented. Emboldened by the success of
collective action encouraged under the
program, women are coming out of their homes
to join hands with other women in economic
A woman spins to earn income.
and health-care related activities. As word of
the program spreads among the rural women,
the silent revolution is moving from out of the
program areas to embrace women in
I
■ Q
s
Delegates of IPPF, the Family
Planning Association of B angladesh
(FPAB) and JOICFP discussed the role
that non-governmental organizations can
play in women’s empowerment following
the International Conference on
Population and Development (ICPD) in
Cairo in 1994 at a meeting in Dhaka,
Bangladesh, on November 26. (From
left, front), Pramila Senanayake, assistant
secretary general, IPPF; Dr. Indira
Kapoor, director, South Asian Division,
IPPF; Kazi Anisur Rahman, honorary
secretary general, FPAB; Dr. Fred Sai,
president, IPPF; Alamgir Kabir,
president, FPAB; and Yasuo Kon, deputy
executive director, JOICFP.
JOICFP NEWS, February 1995
surrounding areas.
The program inspiring these
women is being implemented by
the Family Planning Association
of Bangladesh (FPAB) through
JOICFP under the UNFPAsupported regional Sustainable
Community-based Family
Planning/Maternal and Child
Health (FP/MCH) Project with
Young girls sing a health education song.
Special Focus on Women.
Achievements of the program were
highlighted at the Workshop on
Sustainability of Integrated Family
In just two years, the program has won the
Development Program, organized by the FPAB
endorsement of the men in the communities,
in Comilla from November 30 - December 1.
which traditionally hold the power in rural
areas. Men serving in the advisory committees
The workshop was attended by 70
representatives of the two project areas of Feni
are cooperating with the 48 mothers’ clubs
District and Narsingdi District. Most of the
actively involved in program activities such as
participants were women who work at the
health education and income generation.
grassroots as field coordinators, medical
Through the program, men have come to
officers, supervisors, family development
recognize the benefits that women’s
volunteers, and members of the steering
empowerment brings to the family and
committees and advisory committees.
community at large. The program’s success in
Bangladesh, a densely populated country
gaining male support for women’s
with a low GNP, has achieved considerable
empowerment continues to give women the
success in its FP programs. In 20 years, the
confidence to come out of their homes and join
population growth rate has dropped to 2% from the silent revolution that is spreading
3%; the total fertility rate has dropped to 4 from throughout the country.
7; and the contraceptive
prevalence rate has increased from
7% to 45%. These achievements
reflect the efforts of government,
non-governmental organizations
(NGOs) and international
organizations. Despite the gains,
however, the population of the
country continues to grow. If the
current growth rate is maintained,
the country’s population will
double in 35 years.
JOICFP’s program, which was
Hirofumi Ando
launched in 1993, aims to increase
FP acceptance in rural
Dr. Hirofumi Ando, deputy executive director,
communities by promoting it in
UNFPA, spoke about the achievements of the
concert with other activities that
International Conference on Population and
Development (ICPD), held in Cairo in 1994, at a
benefit the grassroots people,
particularly rural women. Women
meeting held at JOICFP on December 19. In the talks
with JOICFP staff, Ando provided an outline of the
are being encouraged to take a
more active role in economic
efforts required of UN organizations, governments
activities under the project which
and non-governmental organizations to implement the
involves FP/MCH, parasite
Program of Action. He also spoke about the future
control, income-generating
perspectives in the field of population and the role of
activities and non-formal
UNFPA.
education.
3
Ecuador
Speaking the Language of
Adolescents
Adolescent health was high on the agenda
of the National Seminar on Communication for
Adolescents, held in Quito, Ecuador, on
January 11. Noting that unwanted pregnancy
and HIV/AIDS infection among young people
are major health concerns of Ecuador, the
participants sought ways to communicate with
this high-risk group. The seminar focused on
developing an integrated approach to adolescent
health education using the films jointly
produced by the Mexican Foundation for
Family Planning (MEXFAM) and JOICFP.
Organized by UNFPA, the Ecuadorian
Association of Family Welfare (APROFE) and
JOICFP, the seminar attracted 140
representatives of over 40 public and non
governmental organizations (NGOs). Most
participants were those directly working with
young people including young peer counselors.
In opening remarks, Dr. Paolo Marangoni,
executive director, APROFE, and Dr. Mario
Vergara, national program officer, UNFPA, both
stressed that it is necessary to promote
adolescent health education at the community
level to tackle the problems of this group.
The seminar included
presentations from several resource
persons including a representative of
the U.S. Centers for Disease Control
f 16?
who provided data on adolescent
sexual behavior gained through
surveys taken in Latin American
Resource persons (front) exchange information
countries including Ecuador. She
with participants.
commented that while teenagers are
sexually active, adequate information
and services are not available.
The seminar wound up with a presentation
The effectiveness of involving adolescents
by a MEXFAM representative on the NGO’s
in production of I EC materials was emphasized “Gente Joven” adolescent health program under
by a UNFPA consultant who explained about
which educators or promoters are sent to plar~~
the production of an innovative poster
where young people gather such as schools a
developed with young people. Participants
enterprises. Participants learned about the role
were then introduced to a pilot adolescent
played by the MEXFAM/JOICFP films to
health program of APROFE which has been
facilitate communication. The participants,
utilizing peer counselors since 1990 to convey
who saw two of the films, commented that they
messages on a range of issues. Insights into a
were effective communication tools for
communication program that is tailored to meet Ecuador.
the needs of an ethnically diverse audience
To follow up on the seminar, APROFE will
were also provided by a representative of the
be organizing workshops for people working in
Family Planning Association of Guatemala
the area of adolescent health education to assist
(APROFAM).
them to use the films effectively.
A Reputation for Quality Care
SALl
Since APROFE was established over 30
years ago, the organization has earned a
reputation for quality services. Under the
guidance of Dr. Paolo Marangoni, executive
director, the IPPF affiliate has done much to
make FP and reproductive health services
available to the women of Ecuador with an
innovative community-based approach that
integrates education and activities to empower
women. APROFE’s services are both clinic
based and outreach. It operates 20 clinics, three
pap smear laboratories, 12 clinic laboratories
and one mobile clinic. This NGO also uses a
boat to reach some groups.
The most popular contraceptive methods in
Ecuador are female sterilization, the IUD and
the oral contraceptive pill. To obtain the pill,
women need only go to a pharmacy where they
can receive it without prescription or medical
attention. At APROFE’s clinics, however, the
most popular method among family planning
(FP) acceptors is the IUD. According to
APROFE, since this method requires the
services of medical personnel, the clients
feel reassured that they are receiving
medical attention and quality services.
APROFE further earns its reputation for
quality of care by providing clients with
information and counseling on all
contraceptive methods.
APROFE has one of the oldest programs
in Latin America dedicated to women. Based
in a marginal area of the most populated city of
Ecuador, Guayaquil, the program is aimed at
raising the status of women. It involves
training in traditional crafts to assist women to
earn income and more recently incorporates
self-esteem workshops, education on gender
and rights, and the provision of FP information
and services. The program covers about 1,000
women annually.
Through its efforts to provide quality of
4
Dr. Paolo Marangoni (left) introduces the
outreach services provided by the mobile clinic.
care and to serve women at the community
level, APROFE has earned the distinction of
being the most prominent NGO providing FP
services. According to the 1994 survey by the
Center for Development and Population
Activities (CEDPA), the national contraceptive
prevalence rate of Ecuador is 56.4% (1994). Of
these acceptors, 37.8% are served by the
Ministry of Public Health; 26.3% by private
doctors; 16.4% by pharmacies; and 13.2% by
APROFE.
JOICFP NEWS, February 1995
Japan
Women Look Towards Beijing
A remarkably large number of people
turned out for the last international event held
by Japan’s Network for Women’s Health, Cairo
’94, which was scheduled to disband in January
1995. Despite the Monday afternoon timing of
the symposium at the busy year-end on
December 19, some 500 people attended the
event including officials of the Ministry of
Foreign Affairs and UNFPA.
The International Symposium on
Environment, Population and Reproductive
Rights was held in cooperation with JOICFP
and related organizations under the theme of
“Voice from Cairo to Beijing.” It was aimed at
building on the momentum of the International
Conference on Population and Development
2PD) held in Cairo in 1994 toward this year’s
UN Fourth World Conference on Women in
Beijing, China. Opening remarks were
provided by Japanese family planning pioneer
and women’s rights advocate, Shidzue Kato,
president, Family Planning Federation of Japan,
and vice president, JOICFP.
A notable feature of the meeting was the
shared understanding of the main achievements
of Cairo, namely the recognition of
reproductive health and rights. The
symposium focused on a much broader
approach to reproductive rights, going
beyond fertility regulation to embrace
all the aspects of a woman’s life
US
connected to population and
IB
environment issues.
7
s__ ?___ 1
The network, a Japanese non
governmental organization (NGO),
>4 view of the panelists.
was set up with a one-year time limit
ahead of the ICPD. The members
agreed to disband the network after it
fulfilled its objectives of creating solidarity
Egypt and Singapore were highlighted by the
among women of the North and South; playing
panelists who discussed common problems and
an advocacy role for Cairo; and for promoting
sought solutions related to the empowerment of
the roles of NGOs and women in official
women and reproductive rights. Another topic
development assistance (ODA). The network,
of discussion was the need to improve ODA to
however, may reorganize to continue activities
ensure that benefits reach the grassroots.
in the future.
Panelists ended their discussion with a call for
The symposium served to smooth the
more solidarity among women.
ongoing dialog on the essence of the Program
During the free discussion time, members
of Action of Cairo — reproductive health and
of the audience expressed concern about the
rights —towards the conference in Beijing.
situation of women in Japan and urged revision
The panel discussion featured representatives of of the Eugenic Protection Law and
five NGOs, three of which were from overseas.
authorization of the low-dose oral contraceptive
The situations of women in the Philippines,
pill, especially to answer needs of adolescents.
F?
Ministry of Foreign Affairs officials discuss
the GII.
on December 20 at its office in Tokyo. The
meeting served as a forum for sharing
information on the government’s activities
under the GII, specifically the two project
JOICFP NEWS, February 1995
cd
A
H
GOs in Touch with GII Progress
The Japanese Ministry of Foreign Affairs
tMOFA) held its second meeting with
presentatives of Japanese non-governmental
organizations (NGOs) concerning the Global
Issues Initiative (GII) on Population and AIDS
5
formulation missions that were sent to the
Philippines and Indonesia, and to Egypt at the
end of last year. It was attended by some 30
NGO representatives.
The meeting began with reports of the two
missions. These were followed by a question
and answer session on the missions and on
NGO involvement in official development
assistance (ODA) under the GII.
A report on the meetings held with NGOs
in the Philippines and Indonesia was provided
by JOICFP Program Officer Kiyoko Ikegami,
who took part in the mission. These meetings,
she noted, were effective for gaining a fuller
understanding of the local situations and the
grassroots needs in the two countries.
An outline of possible projects for the two
countries was provided by Masafumi Kuroki,
director. Research and Programming Division,
Economic Cooperation Bureau, MOFA.
Objecting to the lack of projects
specifically targeting women, the NGO
5
L
s
I
representatives also noted that all members of
the Egypt mission were men.
The representatives agreed on the
importance of bringing women’s perspectives to
project formulation by including them in
missions, especially in Islamic countries such
as Egypt where women feel freer to discuss
family planning needs with other women.
To further the process of NGO-government
dialog on GII, the participants recommended
that such meetings be held on a regular basis in
the future and inlcude officials of the Ministry
of Health and Welfare, a ministry that is
directly involved in AIDS and population
issues. The representatives also urged that an
integrated approach directly involving NGOs be
pursued by the government to tackle the issues
population and AIDS to enhance effectiveness
of Japanese ODA.
The ministry is planning to send project
formulation missions to Pakistan, Bangladesh
and India after April. The MOFA officials also
announced that project formulation for Kenya
was also being conducted locally through the
Japanese Embassy in Nairobi.
Asia
A Balanced View of
Urbanization in Asia
Administrators from four Asian countries
taking part in an urban policy course in Kobe,
Japan, were reminded of both the negative and
positive aspects of the rapidly expanding
phenomenon of urbanization in Asia. This
approach to urbanization echoed the balanced
view taken by the Program of Action, adopted
fK!
lift
The visitors listen to an explanation of city
planning.
at the International Conference on Population
and Development in Cairo in 1994.
The First Group Training Course on
Integrated Urban Policy was held from
November 14 - December 15 at the Asian
Urban Information Center of Kobe (AUICK).
It was attended by seven participants
from Indonesia, the Philippines,
Thailand and Vietnam. The program,
the first of its kind funded jointly by
AUICK and UNFPA, was aimed at
introducing participants to the
experience of Japanese cities such as
Kobe to assist them to solve a wide
scope of urban problems. The event also
fostered network building among medium-sized
Asian cities including Kobe and UNFPA.
Founded with UNFPA support in 1989,
AUICK has been engaged in the study and
research of urban problems facing Asian cities.
The training focused on middle-ranking
city administrators actively involved in urban
problem-solving. The course provided an
understanding of policies, statistics, family
planning and citizen participation in Japanese
cities and offered insights into Kobe’s problems
and their solutions. The training served to
stimulate participants to seek solutions for their
own cities and provided analytical resources for
problem solving.
The course included input from UNFPA
with the contributions from Ian Howie, country
Participants observe garbage collection.
director, China, Mongolia and the Democratic
People’s Republic of Korea; Jyoti Shankar
Singh, director, Technical and Evaluation
Division; and Dr. Hirofumi Ando, deputy
executive director.
To complement the East and Southeast
Asian focus of the 1994 training, another
course is planned to be held this year focusing
on South Asia.
Condolences for Kobe
JOICFP expresses its condolences to
the people of Kobe following the major
earthquake on January 17,1995.
Mega-cities of the 21st Century
Jyoti Shankar Singh, director, Technical
and Evaluation Division, UNFPA, spoke at the
First Group Training Course on Integrated
Urban Policy in Kobe on November 23. Below
are highlights of his statement.
The last decade of the 20th century will go
down in history as the decade in which the
world experienced the largest absolute increase
in its population. Altogether, the world’s
population will increase by some 2.6 billion
people over these 30 years.
Most of the increase will be in the cities
and towns. In Asia (excluding Japan), for
example, in the late 1960s urban growth stood
at over 3% per annum, with rural growth about
a percentage point lower. Currently, the urban
rate has increased to around 4% annual growth,
but net growth in rural areas has lessened to
only about 1 % annually.
The world as a whole is growing inexorably
more urban. Sometime before the year 2005,
around 10 years from today, the world’s
population will pass the 50% level of
urbanization and after another 10 years the
developing countries as a group will pass this
milestone. Asia, along with Africa, remain the
two least urbanized regions. Only one out of
every three Asians today lives in a city, so the
inevitable growth in urbanization will likely
continue at an even higher pace in Asia than is
true for the developing world as a whole.
One result of urban concentration is the rise
of mega-cities. The UN estimates that in the
year 2010 there will be 21 mega-cities in the
Third World with populations above 10 million,
14 of them in Asia.
The ICPD adopted the Program of Action
which gives us guidance for future
programmatic action in many areas related to
population and development.
6
Jyoti Singh (left) at the training course.
Compared to previous documents, the
Program of Action contains a more balanced
treatment of urbanization, emphasizing its
positive aspects as well as its negative
consequences.
The Program of Action also demonstrates a
global concern for how urban settlements
impact on the environment. One of the
principal recommendations urges countries to
assure that mechanisms for urban management
are opened to wider participation by all
population groups.
JOICFP NEWS, February 1995
which should be sufficient to allow those
readers interested to be able to pursue the
matter further with OMNI at ILSI Research
Foundation, 1126 Sixteenth Street, N.W.,
Washington, D.C. 20036 (fone 202 659 0074 fax
202 659 8654). It should be pointed out that the
deadlines for receipt of proposals may have
passed by the time this Bulletin is published
and received, but it is always possible that
these deadlines may have been extended. It is
perhaps appropriate to point out that the
notices were received only a short time before
the deadlines and that in the case of research
that is of worldwide interest it is important for
sufficient time to be allowed for workers in
distant places, where the problems exist, to be
able to respond.
QUALITY ASSURANCE AND CONTROL
SYSTEM FOR VITAMIN A, IRON, OR
IODINE FORTIFIED FOOD
Specific Research Questions
OMNI Research seeks to determine the
necessary components for a simple,
economical, practical, yet effective quality
assurance system for micronutrient fortification
programs. Beginning with fortification
programs currently in operation, OMNI
Research is seeking proposals that will
document the crucial components of quality
assurance and control systems and test
improvements in such systems. The goal is the
development of a set of minimum requirements
for an effective QAC system. Examples of
questions to be addressed in response to this
request for proposals include:
1. What are the components of successful
existing micronutrient fortification programs
in developing countries?
- What are appropriate cost control steps
that can be implemented efficiently and
safely without jeopardizing the
effectiveness of the QAC system?
- What are the critical control points that
might adversely affect the fortified
product? How can these points best be
monitored? What are appropriate sampling
methods?
2. What modifications can be implemented
that will improve the effectiveness of the
QAC system within the necessary cost
constraints?
3 What then are the minimum requirements
for an effective yet economical QAC system?
Award Criteria
OMNI Research will fund 1-2 grants in response
to this request for proposals, based on the
following criteria:
• Successful proposal must demonstrate
knowledge of the necessary successful
components of food fortification programs in
a developing country, including government
regulatory requirements, if any.
• Successful proposal must develop criteria
for a quality assurance control system for a
fortification program that is effective in
improving micronutrient status. The impact
of the fortification program must be
addressed.
• The micronutrients to be addressed through
fortification are vitamin A, iron or iodine.
• Successful applicant should address the cost
benefit for the whole distribution chain from
the food production facility to the consumer.
• Collaboration with food manufacturers and
appropriate government agencies is
desirable.
• Successful applicant must propose a project
that can realistically be completed within 18
months of receiving the award. Proposal
budget, including indirect costs, should not
exceed US $75,000
DEVELOPMENT AND VALIDATION OF
METHODS FOR MICRONUTRIENT (IODINE,
IRON, VITAMIN A) ASSESSMENT OF
COMMUNITIES
Specific Research Questions
Proposals should be designed to develop
and/or validate a method of micronutrient
assessment that can answer one or more of the
following questions:
1. Is there a vitamin A, iron, or iodine
deficiency problem within specified areas or
population groups? If so, what is the
magnitude, severity, and distribution of the
deficiency and which areas or population
groups are at greatest risk? How reliable are
the assessment data generated using the
proposed method?
2. What are the causes of the deficiency?
3. What kind of intervention is needed and how
can an appropriate intervention be
designed?
4. What assessment indices can be used to
monitor and evaluate the progress and
impact of an intervention? How precise are
these indices?
5. How does the proposed method agree with
the existing reference indices?
Award Criteria
OMNI Research will fund 1-2 grants in response
to this request for proposals, based on the
following criteria:
• The successful proposal should emphasize
the potential innovative impact of its findings
on global micronutrient malnutrition.
3
6
project and gave the women an economical
service and incentive. Groups of women form
savings groups and have access to micro
credit; providing they produce gardens. The
programme is concluding and we are handing
both the equipment and creditline over to the
women.
Children from weaning age to 5-6 yrs old are
eating the daily requirement as beta-carotene
with no fuss in the form of Leaf Nutrient
Concentrate produced by their mothers. Most
are of the opinion that it tastes terrible, but we
camouflage the taste in a porridge with natural
brown sugar. "Find Your Feet", 37-39 Great
Guildford Street, London SEI OES, UK have
excellent information packs on the process.
NOTES AND NEWS
Sight and Life, Annual Report 1993 and vol 9,
no. 2, June 1994 (Task Force Sight and Life,
F. Hoffmann-La Roche Ltd, CH-4002 Basel,
Switzerland). The annual report describes
support for research in Nepal and Indonesia,
intervention programmes in Ghana, Kenya,
India and Niger and fortraining and education
in Indonesia and Guatemala. The latest issue of
Sight and Life gives an account of the Fifth
General Assembly of the IAPB held in Berlin,
May 1994 and an elective period by an
Aberdeen medical student spent in a small
town in India.
Carotenoid News, vol 4, no. 2, August 1994
(from CARIG, department of Human Nutrition &
Dietetics, University of Illinois at Chicago, 1919
W. Taylor St., M/C 517, Chicago, IL 60612, USA).
(Ed. This newsletter, full of information on
meetings on carotenoids and titles of recent
papers on the subject was kindly sent to me by
my friend Michael Meguid, Professor of
Surgery and Head of the Nutrition Support
Service at the Medical Sciences Center, 750
East Adams Street, Syracuse, NY 13210, USA.
Incidentally, he is editor of an excellent
bimonthly journal "Nutrition" which some of
you may wish to obtain).
ADV Antioxidant Vitamins Newsletter a quarterly update on beta-carotene, vitamin C
and vitamin E (from F. Hoffmann-La Roche,
contact Dr Lillian Langseth, FACN, Lyda
Associates Inc., P.O. Box 700, Palisades, NY
10964, USA).
Community Eye Health, vol 6, issue no. 12,
1993 (ICEH, Institute of Ophthalmology, Bath
Street, London EC1V 9EL, UK). Of special
interest in this issue are articles on health
education and on the causes of blindness in
western province of Cameroon. ICEH runs
courses of differing length and level throughout
the year and the most up-to-date details of
these are given with this Bulletin. Full
particulars may be obtained from the Courses
Promotions Officer at ICEH (tel: 44 71 608 6898,
fax: 44 71 250 3207).
SOW News, no. 11, mid 1994 (Dr John B.
Mason, Technical Secretary, ACC/SCN, c/o WHO
Headquarters, Avenue Appia, 20, CH-1211
Geneva 27, Switzerland). This latest 70 page
issue is a mine of useful information of all kinds
in the field of international nutrition. The theme
of "Maternal and Child Nutrition" is covered in
a series often articles, including "Vitamin A
Deficiency in the Mother-Infant Dyad" by
Rebecca J. Stolzfus.
Dietary Fiber, bibliography and reviews, an
international newsletter on carbohydrates, fiber
and health (Dr A. R. Leeds, Department of
Nutrition, King's College, London W8 7AH, UK).
Vol 1, no. 3,1993.
Dialogue on Diarrhoea, issues 56, 57,
March-May, June-August 1994. (AHRTAG,
1 London Bridge Street, London SEI 9SG, UK).
Topics of special interest are food hygiene,
improved cookstoves, urban families' nutrition,
and zinc-diarrhoea link.
Contact, a bimonthly publication of the
World Council of Churches (150 rue de Ferney,
1211 Geneva 2, Switzerland). Issues no. 136
(writing about health), no. 137 (coordinating
agencies) and no. 138 (community action for
health).
Health Action, issue 8, March-May 1994
(AHRTAG see above). Continuing education for
primary health care is the topic and in issue 9,
June-August it is paying for health care.
NCR Bulletin, July-December 1993
(Nutrition Center of the Philippines, P.O. Box
1858, MCPO, Makati, Metro Manila,
Philippines). Two articles in this issue are of
special interest to readers; an account of a
meeting focussing on Strategies for Vitamin A
Deficiency Control held in Ottawa in July 1993
and a report on micronutrient deficiencies
incuding vitamin A deficiency in the
Philippines. The editorial, commenting on a
regional meeting of WHO-UNEP on education
for promotion for supportive environment for
health held in November 1993 epitomised the
thoughts of most health workers - "In the
Philippines we certainly have to work harder.
The prevailing high rate of population growth,
with its concommitant blights of poverty,
disease, congestion, and filth, especially in
urban areas, continues to stress the need for
safe water, sanitation, efficient garbage
collection and disposal and easing of industrial
and traffic pollution".
Nutrition News, vol 15, no. 3, July 1994
(National Institute of Nutrition, Tarnaka,
Hyderabad 500 007, India). The current topic is
'nitrate and N-nitrosamines as plausible factors
in cancer'; research highlights are also
included.
NFI Bulletin, vol 15, no. 3, July 1994
(Nutrition Foundation of India, B-37 Gulmohar
Park, New Delhi, India). Contains articles on
micronutrient deficiencies and lathyrism.
Asia
Effective IEC
Approaches for Asia
Workshop participants view
innovative IEC materials made
from prototypes
Participants of an IEC workshop held in
Katmandu on December 9 were introduced to
three innovative IEC materials developed for
China with funds from UNFPA/JOICFP. The
workshop served as a follow-up to the first such
event held in Kuala Lumpur in February 1993
and the second in Tokyo in November 1993.
The first workshop focused on printed
educational materials for pre-adolescent girls
d the second was aimed at the production of
^eo scripts for women’s health.
Two materials developed by the Shanghai
JOICFP staff demonstrate the Magnel apron
prototype to the audience.
iu.emational Center for Population
Communication, China (SICPC) under the
guidance of the State Family Planning
Commission of China were presented at the
workshop. Wang Zhong, deputy director and
secretary general, SICPC, introduced the
participants to the eight different types of “Rose
Cards” (menstrual record cards) produced for
pre-adolescent girls and two videos, one for
STD prevention and the other for AIDS
prevention. Prior to the workshop, the STD
video was broadcast nationwide on China
Central TV, while the AIDS video was
broadcast on World AIDS Day on December 1
in Shanghai and Yunnan.
Aimed at encouraging girls to accept and
better understand their reproductive cycles, the
menstrual record cards have been distributed to
young girls in Shanghai who have provided
feedback that is being used to finalize the
JOICFP NEWS, February 1995
regional workshop on quality care
for community-BASED FP/MCH IN ASIA
DECEMBER 4 "9, 1994
materials. The cards were
produced from several
prototypes created at the
Kuala Lumpur workshop and
with information from a
knowledge, attitude and
practice survey conducted on
Alfonso Lopez explains the Gente Joven program for
adolescents in Mexico.
school girls in Shanghai.
To highlight the
important part that menstruation
plays in a woman’s life, Wang commented that
education has on women’s health has developed
Chinese women experience menstrual cycles
a variety of effective strategies and IEC
for an average of 36.5 years. This figure means materials for tackling issues related to the
that each woman menstruates for an average of health education of young people.
2,500 - 3,500 days or for seven to eight years,
During his presentation, Lopez emphasized
he said. Since menstruation is such a major
the effectiveness of peer counseling,
factor in a woman’s life, she should
commenting that adolescents find it easier to
understand how to protect her health
talk with someone their own age. Lopez also
during this time, he added.
used role plays to assist participants to
Wang compared the level of
understand the approach of the Gente Joven
understanding of menstruation among
program for young people.
young women in Japan and China, noting
In the third part of the workshop, JOICFP
that the more information women had, the
presented a video developed under the IEC
more likely they were to have a positive
project by a Vietnamese non-governmental
attitude about their reproductive cycles.
organization. Entitled Drops of Rain, the video
He added that the cards were designed to
seeks to raise women’s self-esteem. Another
make young women more aware and thus
recent JOICFP-produced entitled A New Profile
encourage them to accept menstruation as
a natural and not negative phenomenon.
The SICPC will be mass-producing
modified cards this year for sale after the
initial card distribution received a very
positive response from parents, he said.
Wang also introduced the two videos
developed by the SICPC. The STD prevention
video went on sale in September 1994 and sold
600 copies in three months. Commenting on
the success of the video, Wang said that such
materials were badly needed to prevent STDs.
“It is a good investment in women’s
reproductive health,” he said.
Wang Zhong displays the menstruation
The second part of the workshop focused
record cards for pre-adolescent girls.
on the experiences of the Mexican Foundation
for Family Planning (MEXFAM). which has
been promoting an adolescent health program
ofAsia was also presented.
entitled “Gente Joven.” The outline was
Participants were also given a
presented by MEXFAM Executive Director
demonstration of a prototype for a new version
Alfonso Lopez.
of the educational Magnel Kit. Participants
The Latin American experiences were
were asked to comment on the material, which
welcomed by the participants from Asia where
consists of an apron and parts for reproductive
adolescent health problems are a serious, yet
health education. The apron, if developed will
not prioritized issue. MEXFAM. having
be simpler, cheaper and more easy to carry than
recognized the impact that adolescent health
the Magnel Kit.
1J
7
VOICE OF VOICES
By Chojiro Kunii
Inspiration from Desperation
When World War II came to an end, I had
no money, no skills and no job. The only thing
that I felt I had a flair for was literature, but I
doubted that this would be a practical way to
make a living.
By chance I happened to visit Dr. Makoto
Koizumi. He was a professor of the Medical
faculty of Keio University and was an expert in
parasitology. He was also famous for having
introduced the theory of evolution to Japan.
Dr. Koizumi was an interesting person to
talk to. He was well-read, having studied the
Manyoshu, Japan’s oldest collection of poems,
and the works of Ueda Shusei, a writer of the
DIARY
18th century. The doctor was also a writer
himself, having contributed many essays on
Japan’s mythical water sprite, the kappa, to
various publications.
During my visit, we discussed many things,
from the rural poverty of Japan, to China’s
nation-building efforts under Mao Tse Tung
who had led a revolution to liberate farmers
after centuries of hardship. We also talked
about rural environments and the health of
farming populations.
At that time in Japan’s history, about 80%
of the population were suffering from parasite
infection. It was seriously affecting the way
they conducted their lives. I spoke about the
need for parasite control in Japan to Dr.
Koizumi. He gave me an encouraging laugh,
which inspired me to do something about it.
I was not trained as a medical professional
and was not cut out for medical work. My
inclination was to get involved in literature.
o
o
yOICT^P ‘Women's health and Status Series
C)
________ A New Animated Film_________
- Agnes Aristiarini Iswari, journalist, Daily
()
Compass, Indonesia, visited JOICFP to
o
interview JOICFP Chairman Chojiro Kunii
o
while in Japan from Nov. 25 - 27.
o
-JOICFP Program Officer Kiyoko Ikegami o
was in the Philippines and Indonesia as a
o
member of a government project formulation o
mission under the Global Issues Initiative for
Population and AIDS from Nov. 20 - Dec. 3. O
- Dr. Andrew Mason, director, East-West
C)
Center, visited JOICFP on Dec. 9 to
O
exchange information. He was accompanied o
by Yoshiaki Okunishi, population program 9
()
researcher.
()
-Alfonso Lopez, executive director,
9
Mexican Foundation for Family Planning
o
(MEXFAM), was in Japan Dec. 11 - 15 to
o
exchange information with government
Q
officials, preventive health and medical
o
institutions, and a MCCOBA member city.
o
-Dr. Hirofumi Ando, deputy executive
o
director, UNFPA, visited JOICFP to
o
exchange information on Dec. 19.
o
- JOICFP Deputy Executive Director Yasuo o
Kon and program officers Aiko lijima and
Ryoichi Suzuki were in Bangladesh from
Nov. 25 - Dec. 2 for the National Workshop
of the Integrated Family Development
Program and project monitoring. They
traveled to Nepal to attend the Regional
Workshop on Quality Care for Community
based FP/MCH in Asia, held Dec. 4 - 8, and
the IEC Seminar, held Dec. 9. They were
joined by program officers Sumie Ishii,
Yukio Honma and Ryoko Nishida. Nishida
traveled from Thailand where she stayed
from Dec. 1 - 2 to hold discussions with
ESCAP on the regional project on popula
tion aging. lijima stayed on in Nepal until
Dec. 22 to attend the National Workshop.
Ishii traveled to Thailand after Nepal where
she stayed from Dec. 11 -14 to exchange
information with government officials,
UNFPA and PDA.
- JOICFP Program Officer Hiroshi
Taniguchi was in Turkey for interviews
related to Integration magazine from
Dec. 10-24.
Twin Lotus
13 min., Color/English, Chinese
A newly-wed couple is just beginning to live
together in a beautiful riverside district in southern
China. One day the wife collapses from illness
while at work.
Women today must learn about their bodies and
be intent upon maintaining their health so they can
lead more self-reliant lives.
This film, from the Women's Health and Status
Series, is a Japan-China joint production that uses
an animation technique based on a traditional
paper-cutting method.
Distributed by
Sakura Motion Picture Co., Ltd.
Yoyogi Center Bldg., 57-1 Yoyogi 1-chome
Shibuyo-ku, Tokyo 151, Jopor
Tel: 81-3-33206311/Fox: 81-3-332O7666
Telex: J34799 ITCINBTH
16mm-VTR (Beta, VHS/NTSC, PAL, SECAM)
JOICFP NEWS is a monthly newsletter published by
the Japanese Organization for International
Cooperation in Family Planning, Inc. (JOICFP).
New Japanese Publication
I
I
I
However, the meeting with Dr. Koizumi
changed my outlook. Since so many Japanese
were suffering from parasite infection, I
decided to put preventive health measures into
practice in the field.
This is how I began my parasite
examination and treatment activities with the
students of Kyobashi Elementary School in
Tokyo. The response from students amazed
me. They were delighted to be rid of Ascaris
and hookworm infections.
Their enthusiasm gave me confidence to
begin my career in parasite prevention. With
the fees I collected from the testing and
provision of medicines, I was able to earn a
living and gradually expand the activities to
include a variety of preventive health-care
services.
My experience taught me an invaluable
lesson. When you are driven to the wall, you
may find a truly innovative means to overcome
your problems.
The fifth volume of JOICFP Chairman Chojiro Kunii’s series of books
entitled Humanistic Family Planning was published in December 1994.
Written by Kunii, this Japanese-language edition is a collection of theses,
reports and essays mainly related to the integrated approach to family planning
promotion. Most of the work included in the book was written during the
1970s and 1980s.
8
I]
JOICFP NEWS welcomes your comments,
suggestions and contributions. Please mail to:
JOICFP NEWS
Hoken Kaikan Bekkan
1-1, Ichigaya Sadohara-cho
Shinjuku-ku, Tokyo 162 Japan
Phone: 81-3-3268-5875
Facsimile: 81-3-3235-7090
JOICFP NEWS, February 1995
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