Population, health, and nutrition : annual operational review for fiscal 1992

Population, health, and nutrition (PHN) lending decreased in fiscal 1992 from the record levels of fiscal 1991, in both the amount and the number of operations. Lending amounted to $961.6 million for 16 projects, compared with$1,567.6 million for 28 projects in fiscal 1991. This temporary dip in PHN lending is attributable largely to pipeline factors. Fiscal 1993 lending is projected to recapture if not exceed the fiscal 1991 level, and projections for fiscal 1993 and fiscal 1995 are for a continued increase in lending volume. PHN projects approved in fiscal 1992 have been responsive to the World Bank's objective of poverty alleviation. Collectively, fiscal 1992 projects cover the essential features of good poverty work but the depth and quality of poverty work varies across projects. Drawing from the good practices observed and lessons recorded in this year's portfolio, the review offers the following suggestions, among others, for strengthening PHN interventions to alleviate poverty: poverty information and monitoring must be accompanied by dissemination and sensitization activities to strengthen national understanding of poverty-related issues and national commitment to resolving them through the proper policy; community involvement in project design and development requires clearly defined and carefully designed institutional and procedural mechanisms, and a concerted effort to make them work; it is essential that PHN sector work identify poor and vulnerable groups and assess their needs and demands for basic health, family planning, and nutrition services; and even the most demand-driven project designs targeted to clearly identified poverty groups require promotional activities to ensure that these groups participate in and benefit from project initiatives. Health lending is now a decade old, and many innovations in PHN lending have emerged only in the past four or five years. This review demonstrates that good practices and new and promising ideas - well worth emulating - are scattered across PHN work. Overall, PHN work is moving in the right direction and the quality of work is generally seen to be improving. Welcome trends (which should be encouraged and reinforced) include serious attention to the poorest, most vulnerable populations, growing consideration of the demand of target groups, and increased attention to monitoring and evaluation of sector performance.Health Monitoring&Evaluation,Health Economics&Finance,Banks&Banking Reform,Poverty Monitoring&Analysis,Urban Services to the Poor

Population, health, and nutrition : fiscal 1991 sector review

The theme of this year's annual sector review blends two special topics: poverty alleviation and the development of management and institutional capacity. Based on a review of project experience, both within and outside of the population, health and nutrition (PHN) sector, this report distills lessons that should assist task managers in the design and implementation of interventions to develop poverty-sensitive management and institutional capacity in the PHN sector. The Bank's ability to strengthen institutions, especially those needed to alleviate poverty, are constrained by the number and the skills mix of PHN staff, by the absence of standards and guidelines for analyzing and addressing institutional and management issues, and by too little time to spend on institutional and management issues. Therefore, the sector review recommends : a) improving the sector staff not only in numbers but in access to guidelines and training; b) revising Bank priorities and practices to ensure that enough time is spent on supervision and on upstream diagnostic work; c) grounding PHN policies in a macroeconomic and multisectoral framework oriented toward growth with poverty reduction, together with a sound strategy for building institutions and the capacity to implement and manage policy; and d) seeking more creative use of Bank instruments through a review and assessment of the best use of lending instruments for PHN sector interventions.Banks&Banking Reform,Poverty Assessment,Urban Services to the Poor,Health Monitoring&Evaluation,Health Economics&Finance

Le Forum, Vol. 41 No. 1

https://digitalcommons.library.umaine.edu/francoamericain_forum/1090/thumbnail.jp

Perception du contexte linguistique et culturel minoritaire sur le vécu de la grossesse

International audienceFrom a public health perspective, the follow-up of women during pregnancy and the perinatal period requires quality communication and health services that take into account the context in which these women live. However, challenges related to access to health services in French in a minority situation have been documented in recent research. The objective of this pilot study is to better understand the perceptions, the lived experiences and the needs of pregnant Francophone women living in Canada within a linguistic minority context. Given the exploratory nature of the inquiry, a mixed method descriptive study was conducted in Alberta and New Brunswick, whose populations are 2% and 33% Francophone, respectively. Two semi-structured interviews and a series of validated questionnaires were administered to 21 pregnant women during the third trimester of pregnancy and at six weeks postnatal. Based on the questionnaires, a descriptive analysis documented participants' characteristics, and qualitative interviews were transcribed, coded and analyzed through an inductive process by four independent readers to uncover key themes related to the participants' experiences. Most of the women were bilingual and language in which health services were received did not appear to be a major issue for them, except during times of stress and at critical periods of the pregnancy. In contrast, almost one third of the women reported being unsatisfied with services they had received and attributed this dissatisfaction to gaps in French language services. Women prefer to receive health services in their mother tongue, however services are delivered in English most of the time. Participants report that during times of stress and emergency, communication in French is essential to a quality follow-up of patients. Linguistic and cultural congruence seems to be a key factor for quality care during pregnancy. A comparative study would assist in better ascertaining the relative impact of language on Francophone women's lived experiences during pregnancy.OBJECTIF : Dans une perspective de santé publique, le suivi de grossesse et la période périnatale exigent une communication de qualité et des servicesde santé qui tiennent compte du contexte dans lequel ces femmes évoluent. Or, des défis d’accès aux services de santé en français en situationminoritaire au Canada ont été documentés. Cette étude pilote a pour objectif de mieux cerner les perceptions et le vécu de femmes enceintesfrancophones vivant au Canada dans un contexte linguistique minoritaire.MÉTHODES : Étant donné la nature exploratoire du questionnement, une étude descriptive alliant des méthodes quantitative et qualitative a été mis en oeuvre en Alberta et au Nouveau-Brunswick, dont les populations sont de 2 % et 33 % francophones, respectivement. Deux entrevues semi-structurées et une série de questionnaires ont été administrées auprès de 21 femmes enceintes au début du troisième trimestre de grossesse et à six semaines après la naissance. Une analyse descriptive des questionnaires a permis de dresser le profil et les caractéristiques des participantes, et les entrevues qualitatives,transcrites, codées et analysées de façon inductive par quatre lecteurs indépendants, ont fait ressortir plusieurs thèmes clés en rapport avec leursexpériences.RÉSULTATS : La plupart des participantes se sont dites bilingues et la langue ne semble pas avoir été un enjeu majeur dans l’évaluation des services desanté reçus sauf en situation de stress et lors de certaines périodes critiques de la grossesse et de l’accouchement. Par contre, près d’un tiers desparticipants se disent insatisfaites des services de santé reçus et l’insuffisance de suivi en français est mentionnée comme un des facteurs contribuant àcette insatisfaction.CONCLUSION : Les services de santé sont préférés dans la langue maternelle des femmes mais reçus dans la langue de la majorité la plupart du temps.En situation de stress ou de complication de grossesse, les témoignages des participantes semblent indiquer que la communication en français est unfacteur essentiel d’un suivi de grossesse de qualité. Une étude comparative permettrait de mieux distinguer l’impact spécifique de la langue dansl’expérience vécue des femmes enceintes

Dictionnaire

ACTION FRANÇAISE (1917-1928) / ACTION NATIONALE (1933- ) Lancée une dizaine d’années après l’affaire Dreyfus, L’Action française (AF) de Montréal existe toujours sous le titre L’Action nationale (AN). C’est dire la place de la revue pour l’histoire des intellectuels, d’autant plus qu’au-delà de La Revue canadienne (1864-1922) et des journaux nationalistes du début du siècle – Le Nationaliste (1903) d’Olivar Asselin*, L’Action (1911-1916) de Jules Fournier*, Le Devoir (1910) d’Henri Bourassa* ..

Dictionnaire des intellectuel.les au Québec

Qui connaît vraiment les intellectuel.les hors du cercle restreint des historiens et des littéraires ? Quelle mémoire avons-nous de celles et ceux qui, au Québec, eurent recours à la parole comme « mode d'action » ? Qui, comme Hubert Aquin, entreprirent et entreprennent encore de « comprendre dangereusement » la culture et la société de leur époque, remuant idées et images, bousculant pouvoirs et doxa ? Ce dictionnaire est conçu pour combler les lacunes d'une mémoire collective quelque peu défaillante, mais aussi pour donner envie de lire ou de relire les textes de ces femmes et hommes passionnés par les idées, qui ont contribué - et qui contribuent toujours - à bâtir la société québécoise. On y trouvera les noms de celles et ceux qui, depuis trois siècles, interviennent sur la place publique et soulèvent des questions d'intérêt civique et politique à propos d'enjeux collectifs importants ; de celles et ceux qui promeuvent ou incarnent la liberté de parole et la défendent contre différents pouvoirs et structures organisationnelles