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Health and AIDS Newsletter, December 2001
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Adapting to Change Learning Program
DECEMBER 2001

In This Issue:

  1. Letter from Arlette Campbell White
  2. Update on New Regional Partnership in LAC and first Network of Partners Meeting, Mexico City
  3. The Fourth Adapting to Change Global Core Course, 19-30 August 2002, Turin, Italy
  4. Feedback from Participants in the 2001 Adapting to Change Global Core Course
  5. Adapting to Change UNFPA Staff Course on Reproductive Health and Health Sector Reform, Turin, Italy, 3-7 December 2001
  6. S’adapter au Changement: Population, Santé de la Reproduction, Réforme du Secteur de la Santé, Abidjan, Cote d’Ivoire
  7. New Readings and Announcements
    • “Impact of the proximate determinants on the future course of fertility in sub-Saharan Africa”
    • "Rethinking Differences and Rights in Sexual and Reproductive Health"
    • "Guide to European Population Assistance" - A Resource for Grant-Seekers
    • "Challenges and Lessons Learned" - A Fact Sheet on Monitoring and Evaluation in a Sexual and Reproductive Health Context
  8. How to Subscribe/Unsubscribe

    I. Letter from Arlette Campbell White

    Dear Friends,
    Welcome to this edition of the Adapting to Change Electronic Newsletter. We have had an exciting and busy time since our last newsletter. We are pleased to announce the formation of a new regional partnership in the Latin America and Caribbean region. Other exciting news is that our global Core Course, which usually takes place in Washington, will be offered in Europe next year, in Turin, Italy. We are moving ahead with our second Francophone Core Course in cooperation with the Francophone Network and plan to expand to Anglophone Africa in the coming months.

    A lso in this issue, we showcase a recent paper on fertility in sub-Saharan African co-authored by John May, Senior Population Specialist, Africa Region, the World Bank. John is also one of the coordinators for the Bank’s Thematic Group on Population and Reproductive Health. Best wishes for a happy, prosperous and peaceful New Year! Warm regards,
    Arlette Campbell White and the Adapting to Change Program Team

    II. Update on New Regional Partnership in LAC and the first Network of Parners Meeting, Mexico City

    The Adapting to Change Program is a capacity building program that aims to strengthen human and institutional capacity in both knowledge of and training in population, reproductive health, health sector reform, gender and related issues. The Program builds regional capacity by organizing regional and international organizations into a network of partner institutions with the aim of building regional and institutional capacity in the above areas. The Program’s first regional partnership, the Network of African Partners in Population and Reproductive Health, has been active in Francophone Africa since its inception in 1999. After a curriculum development workshop and a training of trainers workshop, the Network offered its first Francophone Core Course in January 2001, with plans for two more in 2002. The second Francophone Core Course will take place 21 January - 1 February in Abidjan, Ivory Coast (see our website, http://www.worldbank.org/wbi/healthandaids/).

    We are delighted to report that we are now well on the way to establishing a second such network of partners for Latin America. In collaboration with the Pan American Health Organization (PAHO) and the Latin America and Caribbean (LAC) regional unit of the United Nations Fund for Population Activities (UNFPA), the Adapting to Change Program co-convened a workshop in Mexico City, 14-16 November 2001. The workshop's objective was to explore interest in a LAC regional learning program on reproductive health and health sector reform. Prior to this three-day partnership meeting, four other meetings had been held in Washington and New York among representatives of donor/development agencies and training institutions interested in collaborating to improve and coordinate reproductive health training and networking in LAC, particularly in the context of health sector reform. Staff from the three agencies attended this partnership meeting, together with participants from Mexico’s Fundación Mexicana para la Salud (FUNSALUD) and Instituto Nacional de Salud Pública; the Universidad Peruana Cayetano Heredia and Universidad del Pacífico, Peru; Facultad de Salud Pública, Universidad de São Paulo, Brazil; Centro de Estudios de Estado y Sociedad (CEDES), Argentina; Red de Salud de las Mujeres Latino Americanas y del Caribe (RSMLAC), Chile; Canadian International Development Agency (CIDA); and regional representatives from the MacArthur and Ford Foundations, PROFAMILIA (Columbia), Population Council, EngenderHealth, International Planned Parenthood Foundation (IPPF), Centre for Development and Population Activities (CEDPA) and Management Sciences for Health (MSH). Other potential partners who were unable to attend, including the Inter-American Development Bank (IADB) and South-South Partners in Population and Development, also expressed their interest in joining the network. Topics addressed included a discussion of regional needs for capacity building and policy development on the intersection between sexual and reproductive health and rights, the interest of potential partners in adapting WBI's learning program on reproductive health and health reform to address these needs, the content and form that a LAC learning program should take, the administrative and financial arrangements for the partnership, and a workplan for the first year (2002) of the partnership. The group recommended that the program start with a two-week pilot course during the autumn of 2002 aimed at country teams of six to seven participants from seven countries (Bolivia, Dominican Republic, Ecuador, Guatemala, Honduras, Nicaragua and Peru). Criteria for selection of countries for the pilot include the stage of their reform process (early), the opportunity for success in incorporating sexual and reproductive health (SRH) in the design of reforms, and the level of commitment by governments, donors, and civil society organizations. In addition, representation will be invited from countries (e.g. Chile and Colombia) where reforms are more advanced and whose experiences with the intersection of SRH and reforms could be shared. An additional seven countries were proposed for a second course. It was agreed that the regional learning program will be supported by a network of organizations, including those present at the meeting and others who have expressed interest and are willing to commit resources and expertise to the effort. The network will be managed by a steering committee of seven to eight members. The steering committee will select one of the partner institutions to act as its secretariat and to manage the first phase of the learning program. Next steps include: (i) completion of a report on the workshop (including terms of reference for the steering committee and secretariat) by its conveners (UNFPA, PAHO and WBI) by mid-December; (ii) issue a request for proposals from organizations interested in taking on the role of the secretariat and selection of the secretariat by end January, 2002; (iii) preparation of case materials (March to June 2002); (iv) design of the pilot by the secretariat and steering committee, including a training of trainers workshop in June, 2002; (v) selection of participants (June to September, 2002); and (vi) offering of the first pilot in October-November, 2002. For more information please contact Gilles Dussault (Email: gdussault@worldbank.org, tel. (1) 202 473 8709, fax (1) 202 522 0638) and see our website at: http://www.worldbank.org/wbi/healthandaids/

    III. The Fourth Adapting to Change Global Core Course, 19-30 August 2002, Turin, Italy

    The Adapting to Change Global Core Course on Population, Reproductive Health and Health Sector Reform will take place 19-30 August 2002 in Turin, Italy, at the ILO Training Center. This will be the first time that the Global Core Course has been offered outside Washington, D.C. and for a two-week period. By adapting the course to a shorter period, and moving it to a more central location with less expensive accommodation costs, we hope that the new venue will make it easier and less expensive for participants to attend. The overall goal of the training is to improve population and reproductive health outcomes in client countries by strengthening the skills and capacity of key actors to make their population and reproductive health programs more efficient, equitable and financially sustainable. The course objectives are to increase participants’:
    • Understanding of how the changing international and national policy environment impacts on their work in population and reproductive health;
    • Knowledge and skills that they will use to deliver population and reproductive health services in their country in more efficient and equitable ways;
    • Strategic thinking and ability to ensure that health sector reforms help rather than hinder improvements in population and reproductive health outcomes in their countries; and
    • Capacity to develop action plans that apply course material, knowledge and tools to an issue they face currently in their work.

    The course is designed for senior government officials, particularly from ministries of Health, Education, Women’s Affairs, Labor, Population and Welfare, and Finance and/or Planning, as well as representatives of NGOs, private sector organizations, the donor community, and others working in the field of population, reproductive health and health sector reform, including World Bank staff.

    The course brochure and application form will be available in early January. For more information please contact Ms. Laurence Sage, Admissions Officer, World Bank Institute, at lsage@worldbank.org 

    IV. Feedback from Participants in the 2001 Adapting to Change Global Core Course

    As reported in the last issue, the Third Annual Adapting to Change Global Core Course on Population, Reproductive Health and Health Sector Reform took place from 10-27 September and was attended by 65 participants from 29 countries. Representatives from ministries of health, universities, and nongovernmental organizations, donor and partner institutions participated, including CIDA, UNDP, UNFPA, UNICEF, USAID and the World Bank. All these participants brought their skills, experiences and wisdom together through their impressive and active participation, which contributed significantly to the success of the course.

    Participants were asked if they would recommend this course to someone else, and what they would like a potential participant to know: “I will tell them it is very important when they are ready to shift from MCH to RH. The course is not technical, but more of a policy nature. It really helps in implementing RH and population issues. I found it to be very educational - you learn a lot and meet people of different professional expertise.” -- Anna Able-Thomas, Ministry of Health, The Gambia “The course is a cutting-edge course, taught by a world class faculty with access to the latest technical advancements. It is very relevant to personnel from the health and related sectors, both public and private, from developing countries. It integrates reproductive health, health sector reform, poverty alleviation and gender.” -- Folarin Adebayo Olowu, The Center for Developoment and Population Activities (CEDPA), Nigeria “I would emphasize the framework of the course – the Pathways to Reproductive Health Outcomes, and especially the role of households/communities – which shows how better outcomes need the collaboration of other sectors.” --Doris Mawuse Aglobitse, Department of Women, Ministry of Women and Children Affairs, Ghana “This course has been an eye opener. I especially liked learning about Sector Wide Approaches (SWAps) and links to the Pathways framework, focusing on the disadvantaged/poor, so that s/he benefits as opposed to the rich. The best thing about the course is that participants and facilitators share experiences from all the countries represented.” -- Joyce Nyasulu, Ministry of Health and Population, Malawi “It helps participants to know about the key issues and processes in ‘reform’ and how they could be implemented. The best thing about the course is that it gave participants the opportunity to learn from policy reform process being undertaken in some developing countries and the pros and cons and alternative options if one wants to have a successful reform on key policies.” -- Haddas Wolde Giorgis, Centre for Human Environment, Ethiopia “This course provides a comprehensive understanding of how to address reproductive health issues. Moreover, it provides extensive knowledge regarding health reform initiatives.” -- Rand Tawfieq Salman Jarallah, American Near East Refugee Aid (ANERA), West Bank & Gaza “Nobody had taken time to explain to me and many others that are new in the system (MOHP) about current changes in health sector reform. So this was a great opportunity for me to learn some of these things. Being one of the key persons at district level in implementing government policies, I feel I am now better equipped to forge ahead.” -- Haldon Yohane Njikho, Ministry of Health, Malawi “This course gives a great overview of major issues and background information concerning reproductive health in ever changing international health reform settings. Interacting with talented and experienced presenters – and more than 50 participants from around the world – was an eye-opening opportunity and a lot of fun.” -- Laura Hoemeke, USAID-Benin “Those who are planning reproductive health programs or projects should take this course to understand all the steps and issues that should be taken into consideration during the planning phase. This course helped me to understand the importance of linking the potential agenda with the realities.” -- Janik Bouchard, Canadian International Development Agency (CIDA), Canada

    V. Adapting to Change UNFPA Staff Course on Reproductive Health and Health Sector Reform, Turin, Italy, 3-7 December 2001

    We offered a global course on Reproductive Health and Health Sector Reform for 35 UNFPA Representatives, Deputy and Assistant Representatives, Country Support Team staff and National Program Officers and headquarters staff in Turin, Italy, 3-7 December 2001. How did this course differ from the core content of the three week Adapting to Change programme? Existing materials were tailored and new content was developed to expand discussion of sector wide programming approaches (SWAps), as well as strengthen UNFPA staff understanding of results-based management and the programming cycle process. Presenters included experts such as Steve Sinding, recently named Director-General of IPPF, Carla AbouZahr from WHO, Adrienne Brown from the UK Institute for Health Sector Development, and Barbara McPake from the London School of Hygiene and Tropical Medicine. Several sessions were delivered by resource persons through video conference from DC and New York.

    Sonia de Heckadon, UNFPA Assistant Representative for Panama, said of the course: “It was excellent. The presenters and the content are top quality – I can truthfully say that it is one of the best trainings I have attended in my 11 years with the Fund. Its real value lies in the way it presents the bigger picture – that enables us to see how our particular interests fit into the health system as a whole. It has really made me think at a much-needed policy level. For example, I am developing an adolescent RH project in Guatemala; now I can do so with a much better understanding of the environment in which the project will be developed. I can take into account the potential impact of the reforms and make allowances accordingly; and so on.” This successful pilot paves the way for a series of further training events tailored to the needs of UNFPA and other UN agencies. For more information please contact Tom Merrick at tmerrick@worldbank.orgor Neela Jayaratnam at jayaratnam@unfpa.org. You can also get information on the course, including the concept paper, curriculum and materials from the link on our website, http://www.worldbank.org/wbi/healthandaids/

    VI. S'adapter au Changement: Population, Santé de la Reproduction, Réforme du Secteur de la Santé, Abidjan, Cote d'Ivoire

    The second Francophone Africa Adapting to Change Core Course on Population, Reproductive Health and Health Sector Reform will take place 21 January - 1 February in Abidjan, Ivory Coast. This course will be conducted in French. It is organized in collaboration with the Francophone Network of African Partners in Population and Reproductive Health.

    The course objectives are to improve population and reproductive health outcomes in Francophone Africa by:
    • providing participants with an understanding of the changing national and international policy and program environment for their work in population and reproductive health;
    • sharing knowledge and tools that help participants effectively deliver reproductive health services in their countries; and
    • informing participants working in health systems about how the delivery of reproductive health is influenced, and can be supported by, health sector reforms.

    The Francophone Network is managed by a Coordinating Committee and Secretariat with the aim of building regional and institutional capacity in the areas of population, reproductive health and health sector reform. The Coordinating Committee is chaired by Professor Issakha Diallo of the Institut de Santé et Développement (ISED) at the Université Cheikh Anta Diop, Sénégal. The Secretariat is led by the Centre d'Etudes de la Famille Africaine (CEFA), Togo, and the Centre Africain d'Etudes Supérieures en Gestion (CESAG), Sénégal.

    The course is designed for French-speaking West and Central African public and private sector professionals involved in the financing, planning, implementation, and evaluation of reproductive health services in WB client countries; staff from the WB, donor agencies, international organizations, and NGOs who are working with countries to implement the reproductive health approach called for in the ICPD Programme of Action; trainers from regionally-based training and research institutions working in population and reproductive health who conduct training in this area, and wish to strengthen their capacity to do so; and academics and researchers working in the areas of reproductive health, public administration, or the social sectors. If you would like information on this course or to be considered as an applicant please contact Mamadou Dicko (mdicko@cefa.café.tg) or Issakha Diallo (idiallo@ised.sn). Alternatively, you can access our website at http://www.worldbank.org/wbi/healthandaids/  and download the brochure and application form.

    VII. New Readings and Announcements

    “Impact of the proximate determinants on the future course of fertility in sub-Saharan Africa”
    by J. Guengant, Demographer at the Institut de recherche pour le développement (IRD), Niger, and J. F. May, Senior Population Specialist, Africa Region, presented at the United Nations Population Division meeting on Prospects for Fertility Decline in High Fertility Countries held in New York from 9-11 July 2001.
    This paper focuses on the proximate determinants of fertility to assess the future prospects for fertility decline in sub-Saharan Africa (SSA). The paper contends that sub-Saharan fertility will not necessarily decline as rapidly as it has been experienced elsewhere in the world. Among the findings we noted:

    • the intermediate proximate determinants of fertility (e.g. education, employment prospects, etc.) are far from favorable in SSA and will not help trigger a rapid fertility decline in the continent;
    • the HIV/AIDS epidemic will have an impact on fertility (through unfecundability) but this impact is probably less important than expected since overall fertility levels are still very high;
    • contraceptive method mix (modern and traditional) is a crucial factor since traditional and folk methods are ineffective to achieve rapidly substantial decreases in fertility;
    • unless effective family planning programs are put in place to respond to existing and/or implicit demand, induced abortion rates will increase, with detrimental effects on maternal mortality levels;
    • the programmatic commitment of African leadership and donors toward the family planning needs in SSA must be rekindled; and
    • the broad reproductive health agenda adopted in Cairo must not dilute the focus on family planning needs, especially in countries that have not started their fertility transition and/or are only at incipient stages.

    Work done by Jean-Pierre Guengant prior to this paper has led the UN Population Division to change its assumptions for fertility decline in SSA (see the publication World Population Prospects: The 2000 Revision, available on their website at: http://www.un.org/esa/population/unpop.htm) You may download a copy of the paper, soon to be published in the Population Bulletin of the United Nations, from our website at: http://www.worldbank.org/wbi/healthandaids/  under Library.

    Rethinking Differences and Rights in Sexual and Reproductive Health
    published by Family Health International in collaboration with the Center for Information and Development of Women (CIDEM), La Paz, Bolivia. This manual, developed with support from the USAID, promotes an approach to sexual and reproductive health care that recognizes different needs and perspectives within a context of respect for the rights and dignity of men and women. It is designed to provide health professionals with a framework for examining the quality of care, including the quality of human relations, technical quality, and quality of administration and management of health services. The training steps outlined in the manual aim to:
    • Create opportunities for reflection and action in the field of gender-sensitive quality care;
    • Provide basic tools that providers can use in their everyday practice: key concepts, techniques and practices, and criteria for implementing quality care; and
    • Develop capacity for critical analysis that permits participants to use key concepts and criteria to recognize, analyze and respond to users' realities and institutional practices.

    The publication is available online at http://www.fhi.org/. Limited quantities of the manual are available from FHI in English and Spanish at no cost to developing country health agencies. For more information, please contact: publications@fhi.org

    "Guide to European Population Assistance" - A Resource for Grant-Seekers The third and fully updated editions of the "Guide to European Population Assistance" (with the support of the Wallace Global Fund) and "Tips & Tricks on how to apply for the European Commission’s Budget Lines for Sustainable Development" (supported by the Gates Foundation) have just been published. The guide has been compiled primarily to provide governmental and NGOs in developing countries with practical and user-friendly access to the different funding instruments in Europe for potential support in the field of sexual and reproductive health, population and sustainable development. The publications provide a source of detailed and annually updated information on funding lines from the European Commission. The Tips & Tricks gives contact information, a review of financial information and, most importantly, detailed information about how to submit a proposal and how to apply for funding in 29 categories including aid for population and reproductive health, HIV/AIDS, and integrating gender issues, among others. To see the online versions go to: http://www.eurongos.org/guide.htm and http://www.eurongos.org/resources/tips/. To obtain a hard copy, please contact Nicole van Heugten, Project Co-ordinator, International Programmes, German Foundation for World Population (DSW), Rue de la Concorde 53, B - 1050 Brussels (Belgium), Phone/Fax: + 32 2 502 36 26 Internet: www.dsw-online.de. E-mail: nicole.vanheugten@dsw-hannover.de

    "Challenges and Lessons Learned" – A Fact Sheet on Monitoring and Evaluation in a Sexual and Reproductive Health Context This fact sheet was completed for the EC/UNFPA Initiative for Reproductive Health in Asia (RHI) by Megan Douthwaite and Ronald Horstman of the London School of Hygiene and Tropical Medicine (LSHTM) and the Netherlands Interdisciplinary Demographic Institute (NIDI). It gives an overview of experiences from the implementation of the Regional Dimension Project "Monitoring and Evaluation", housed within the RHI. It addresses such questions as: How do you measure the value of a specific reproductive health (RH) programme? What indicates the value of NGO interventions in the field of RH? What is the difference between monitoring and evaluating? An online version of the fact sheet is available at: http://www.asia-initiative.org/ or for a printed copy please contact:rhi_info@asia-initiative.org

    VIII. How to Subscribe/Unsubscribe

    Please circulate this message to other interested people and encourage them to register for their own copy by sending email to join-reprohealth@lists.worldbank.org. This newsletter, as well as previous issues, is also available on the Web at http://www.worldbank.org/wbi/healthandaids/  in PDF format.

    Thank you for your interest in the Adapting to Change Program. This newsletter is published bi-monthly. We welcome your comments and suggestions. Please send them to lraney@worldbank.org



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