In 1997, the Japan International Cooperation Agency (JICA) started the Community Empowerment Program (CEP) to directly help people at the grassroots level in developing countries. It was created to directly benefit people in developing countries by improving their livelihood and welfare. Under the program, model projects are implemented together with local nongovernmental organizations (NGOs). The Capacity Building for Sustainable Reproductive Health Care Project in Jessore District in Bangladesh, is a pioneer of JICA and NGO cooperation under CEP, and it aims to develop the capacity of service providers to deliver sustainable reproductive health (RH) services in rural areas through community involvement. To achieve this, training for community health promoters (CHPs) is provided to enable them to deliver an Essential Services Package (ESP) of integrated health and RH services to rural beneficiaries. So far, a total of 125 people have been trained, including 75 CHPs, 10 health assistants, and 40 family welfare assistants. Midterm evaluation of the project indicated that the project had pioneered the development of 17 ESP modules and has established the strong potential to link with government programs for future sustainability.
During a study meeting of the Japan International Cooperation Agency's Viet Nam Project, two experts reported on recent visits to the reproductive health project in Nghe An Province, Viet Nam. Dr. Shoko Nagaya made advisory visits to the project in June and November 1998. He observed activities in 7 of the 8 districts covered and 1 of the 11 districts not covered. He was especially interested in the effects of project training on the staff of the 244 Commune Health Centers (CHCs) who oversee prenatal care and delivery. He found that the training of the mobile team members of the District Health Centers (DHCs) resulted in positive supervisory support to the CHCs. He also spoke to key personnel at the provincial Maternal and Child Health and Family Planning Center (MCH/FPC) to encourage them to achieve project sustainability. His overall impression was that the project should be expanded nationwide. Dr. Michiko Chosa made three visits to the project to transfer hospital management techniques to the MCH/FPC. In particular, he taught personnel a five-point Japanese system of making priorities, putting things in order, practicing self-hygiene, cleaning, and creating habits. Chosa found that his efforts were increasingly accepted by the staff, which was eager to become a model for the DHCs and CHCs.
This article presents the speech of Ingar Brueggemann, Director General of the International Planned Parenthood Federation (IPPF) during the 149th Council on Population and Education meeting in October 1, 1999. She discussed the current situation of IPPF, its strategy, and expectations for Beijing+5, the UN review of the Fourth World Conference on Women. It was noted by the IPPF that some issues such as rape, family planning, and female genital mutilation, still need the establishment of legal solutions. Moreover, the Cairo Programme of Action has yet to address five critical areas of concern that relate directly to sexual and reproductive health: poverty, lack of education, lack of appropriate and high quality health care, violence, and human rights. She called for those working in the field to continue to be firm in their actions in order to implement the Cairo Programme of Action, and they have to be first class advocates for issues that Beijing stands for.
China, whose population was 430 million in 1840, is facing a population total of 1.3 billion in 2000. Population increased rapidly in the country during the 1950s, but early efforts at population control were abandoned from the start of the Cultural Revolution in 1966 until the 1970s. Today, the importance of family planning (FP) is recognized throughout Chinese society. With 20 million newborns adding 13 million people to the population each year, controlling the population increase will remain a top priority of China's population policy. Other priorities include 1) increasing the quality of life of the population by improving health, promoting literacy, and developing human resources; 2) facing the impact of population aging; 3) struggling to overcome the poverty experienced by 50 million people; and 4) dealing with the imbalanced sex ratio of newborns. China has been attempting to institute strategies to implement the Program of Action adopted by the 1994 International Conference on Population and Development and is attempting to adopt an integrated approach to population programs that combines FP with development measures and the delivery of multiple services to enhance reproductive health. Since 1984, China has worked with Japan's JOICFP on an Integrated Project that offers FP, maternal and child health services, and parasite control.
This article summarizes statements made by Dr. Nafis Sadik on October 19, 1998, to TICAD II. The address focused on the health challenges that Africa faces. The 1998 population in Africa of 780 million will double to about 1.5 billion in about 25 years. It is likely that this growth will impede socioeconomic development. Quality of life will be reduced by high infant and maternal mortality and high levels of HIV/AIDS. Only a small minority of Africans have access to basic health and reproductive health (RH) services. There are many unwanted births. The impact of HIV/AIDS on women has been very harsh. Life expectancy in some countries has been reduced. 50% of new HIV infections are among young people, who are poorly informed about RH. Health services are not suitable for youth needs. The consequences of early marriage and childbearing are limits to education and employment. Young women face the threat of domestic violence and abuse. Teenagers can be protected against HIV/AIDS and sexually transmitted diseases by institutionalization of sex education. RH needs to stress male responsibility in sexual health and childbearing. Sexual responsibility can be a life-and-death situation. African countries are beginning to integrate population and development policies. African countries need to adopt goals to increase access to RH services and family planning. Access should increase to 20% of population by the year 2000. Integrated programs, empowerment of women in development, male responsibility, and increased literacy should be expanded. UNFPA will continue to give Africa priority through increased resources, staff, and other partnerships.
