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Browse POLICY Project (1995-2006) Materials

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List entries are alphabetical by title and contain the title, abstract, language, and then the filename which is hyperlinked and will open in a new browser window. Many files are PDFs but some of the older ones are Word documents.

Peru

  • In the summer of 2003, USAID's Bureau for Latin America and the Caribbean launched regional initiative to determine how contraceptive security in the LAC region could be more effectively addressed and strengthened in light of the phase-out of contraceptive donations. The initiative, which is being implemented by the POLICY and DELIVER Projects, commenced in July 2003 with a Regional Meeting in Managua, Nicaragua. Seventy representatives from governments, nongovernmental organizations, UNFPA, and USAID from nine Latin American countries came together to discuss and share their country's experiences with donor phase-out and efforts to achieve contraceptive security. The meeting was followed by two-week country assessments in Bolivia, Honduras, Nicaragua, Paraguay, and Peru, which were conducted between September 2003 and May 2004. Each assessment resulted in a full assessment report and an accompanying summary of country-level findings. Findings in each country were also presented to stakeholders at the end of each assessment. A regional report describes the findings at the regional level and makes recommendations for regional contraceptive security initiatives.
    English
    Peru_CS_Eng.pdf
  • In the summer of 2003, USAID's Bureau for Latin America and the Caribbean launched regional initiative to determine how contraceptive security in the LAC region could be more effectively addressed and strengthened in light of the phase-out of contraceptive donations. The initiative, which is being implemented by the POLICY and DELIVER Projects, commenced in July 2003 with a Regional Meeting in Managua, Nicaragua. Seventy representatives from governments, nongovernmental organizations, UNFPA, and USAID from nine Latin American countries came together to discuss and share their country's experiences with donor phase-out and efforts to achieve contraceptive security. The meeting was followed by two-week country assessments in Bolivia, Honduras, Nicaragua, Paraguay, and Peru, which were conducted between September 2003 and May 2004. Each assessment resulted in a full assessment report and an accompanying summary of country-level findings. Findings in each country were also presented to stakeholders at the end of each assessment. A regional report describes the findings at the regional level and makes recommendations for regional contraceptive security initiatives.
    Spanish
    Peru_CS_SP.pdf
  • English
    SPARHCS-Peru.doc
  • The term “safe motherhood” refers to efforts to prevent maternal and infant death and disability through improved access to healthcare and other supportive services (White Ribbon Alliance, 2005). Sadly, women in the developing world experience a 1 in 61 lifetime risk of dying from pregnancy- or childbirth-related complications (World Health Organization, 2003). This is compared to a 1 in 2,800 lifetime risk for their counterparts in developed countries. Common causes of maternal and neonatal mortality and morbidity are excessive bleeding, obstructed labor, infections, and hypertensive disorders. They can occur suddenly, often with little warning. However, negative outcomes can be greatly reduced with proper nutrition throughout the pregnancy, skilled assistance at delivery, and access to regular antenatal checkups, emergency obstetric care, and postpartum care. Effective operational policies are essential for ensuring access to maternal health services, especially for underserved and hard-to-reach populations. Operational policies are the rules, regulations, codes, guidelines, and administrative norms that governments and organizations use to translate laws, policies, and resources into programs and services on the ground (Cross et al., 2001). These policies and guidelines affect all aspects of service quality and accessibility. Examples of operational barriers include unreliable supplies of medicines, unnecessary restrictions on the types of services that can be performed by various healthcare providers, high user fees for services, and inconsistent resource allocation and staffing plans that neglect rural health facilities.
    English
    Safe Motherhood Brief 2 HQP.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Peru_MNPI.pdf
  • English
    2005Peru.pdf
  • User fees are gaining widespread use in government health programs as a means of alleviating pressure on constrained budgets as demand for services increases. Concerns that fees reduce access to services among the poor have led to the promotion of fee exemption mechanisms in order to protect those unable to pay for services. The exemptions, however, may not effectively ensure access among the poor because (1) informal fees and other costs associated with seeking and receiving services are not alleviated by most exemption mechanisms and (2) exemption mechanisms are poorly implemented. The low proportion of formal fees to total costs to the consumer and the unpredictable nature of informal fees and other costs of access may actually work against formal fee exemption mechanisms. Even though little is known about how well fee and waiver mechanisms function for maternal health services, it is important to understand whether exemption mechanisms alone hold promise for protecting access for the poor or whether the mechanisms need to be supplemented with other strategies. This study was conducted simultaneously in five countries: Egypt, India (Uttaranchal), Kenya, Peru, and Vietnam. The objectives were to survey actual costs to consumers for antenatal and delivery care; survey current fee and waiver mechanisms; assess the degree to which these mechanisms function; assess the degree to which informal costs to consumers constitute a barrier to service; and review current policies and practices regarding the setting of fees and the collection, retention, and use of revenue.
    English
    WPS16.pdf
  • This four-page policy brief describes how advocacy efforts by civil society groups and a coalition of youth-focused nongovernmental organizations have helped ensure the implementation of the youth policy guidelines and how they played a key role in the approval of specific guidelines on adolescent health.
    English
    Peru country brief.pdf
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    Spanish
    op-02es.pdf
  • The 1994 ICPD intensified the worldwide focus on reproductive health policies and programs. Officials in many countries have worked to adopt the recommendations in the ICPD Programme of Action and to shift their population policies and programs from an emphasis on achieving demographic targets for reduced population growth to a focus on improving the reproductive health of their population. This paper presents information from case studies carried out in Bangladesh, India, Nepal, Jordan, Ghana, Senegal, Jamaica, and Peru to assess each nation's process and progress in moving toward a reproductive health focus. The case studies show that within their unique social, cultural, and programmatic contexts, the eight countries have made significant progress in placing reproductive health on the national health agenda. All countries have adopted the ICPD definition of reproductive health either entirely or in part. Policy dialogue has occurred at the highest levels in all countries. The countries have also achieved considerable progress in broadening participation in reproductive health policymaking. Bangladesh, Senegal, and Ghana have been particularly effective in involving NGOs and civil society organizations in policy and program development. In some of the other countries, however, the level of participation and political support for reproductive health may not be sufficient to advance easily to the next crucial stage of implementation. The case studies indicate almost uniformly that countries are grappling with the issues of setting priorities, financing, and implementing reproductive health interventions. Bangladesh has made the greatest progress in these areas while India, Nepal, Ghana, Senegal, Jamaica, and Peru are beginning to take steps toward implementation of reproductive health activities. Jordan continues to focus primarily on family planning. Several challenges face these countries as they continue to implement reproductive heath programs. These challenges include improving knowledge and support of reproductive health programs among stakeholders; planning for integration and decentralized services; strengthening human resources; improving quality of care; addressing legal, regulatory, and social issues; clarifying the role of donors; and maintaining a long-term perspective regarding the implementation of the ICPD agenda. Despite many encouraging signs, limited progress has been achieved in actually implementing the Programme of Action; this finding is neither surprising nor unexpected. It took more than a generation to achieve the widespread adoption and implementation of family planning programs worldwide, and that task is far from complete. The key to continuing progress lies in setting priorities, developing budgets, phasing-in improvements, and crafting strategies for implementation of reproductive health interventions.
    English
    op-02.pdf
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    French
    op-02fr.pdf
  • This brief examines the extent to which the 1994 ICPD has shaped reproductive health policies and programs in Bangladesh, Ghana, India, Jamaica, Jordan, Nepal, Peru, and Senegal. Within their unique social, cultural, and programmatic contexts, the eight countries have made significant progress in placing reproductive health on their respective national health policy agendas. The progress illustrated by the case studies is a logical beginning for defining and adopting reproductive health policies and principles, while building political and popular support. However, whereas well-established reproductive health services, such as family planning and maternal and child health, have remained high priorities, the case studies indicate that a continued effort will be required to place more sensitive issues, such as gender-based violence and reproductive rights, on the policy agenda. In addition, in some countries, a greater level of participation and political support for reproductive health may need to be cultivated before the countries are able to advance to the next crucial stage of implementation. Countries also need sufficient financial resources to implement the expanded reproductive health programs and services envisioned by the ICPD—resources that most respondents suggested were not immediately forthcoming.
    English
    pm-05.pdf
  • The POLICY Project (POLICY) provided a focused technical assistance package between September 2002 and June 2004 in Peru to help identify and eliminate operational barriers that stand in the way of access to safe delivery care for low-income women, particularly in areas with high maternal mortality. Our research and analysis identified barriers to delivery care. Key stakeholders at both the regional and national levels assessed the most significant barriers as follows: the severe lack of financial resources and absence of appropriate personnel at health establishments; multifaceted problems with the implementation of the Integrated Health Insurance (SIS) resulting in poor quality services that clients must pay for; and lack of respect for local cultural practices and customs at health facilities that serve as a disincentive for women seeking institutional care for their deliveries.
    English
    Peru_CP_final.pdf