Objective: We facilitated a behavior survey on HIV/AIDS and reproductive health related issues among the youth in Granada, Nicaragua, and attempted to increase awareness among various stakeholders and promote partnership between the health and education sectors. Methods: A behavioral survey was conducted among high teen students in Granada. Schools were sampled in collaboration with the educational sector. Results: A total of 689 students participated. At the age of 16 years old, 33.3% of males and 7.2% of females had sexual experience, while 48.1% and 18.5%, respectively, at 18 years old. Only 28.2% of males and 13.3% of females reported condom use at the last non-commerical sex. Discussion: The behavioral survey showed the risky situation among the youth in Granada and their needs.The results were discussed with various stakeholders, including the health and education sectors and students themselves. Behavioral survey can be an effective tool to gain support from the community and stakeholders across the administrative sectors. It is now perceived essential to promote the partnership between the health and education sectors to meet the needs of the youths and to build the capacity among the peer groups for effective response.
A Maternal and Child Health(MCH)handbook was introduced in Indonesia in 1993 to improve the quality of MCH services. BolMong district in the North Sulawesi province, a pilot area for the Japan International Cooperation Agency, started a user-fee system for distributing the handbook. The purpose of this study was to describe the policy-making process, management system, implementation, and outcome of this system. In June 2000, the Local Government instituted a user-fee system; price was set at Rp. 3,500(40 yen). Through continuous efforts of district health officers, all the money collected was used only for reprinting. Midwives collected the money from mothers and turned it in to their health center on a monthly basis, who then sent it to the district office. District health officers monitored and supervised the distribution of the handbooks to maintain the integrity of the system. Payment rate was calculated by dividing the number of pregnant woman paying the book by the number of books distributed. Considering a non-payment rate of 31.8% and an increase in printing cost of 30%, only 47.7% of the initial order could be reprinted. The remaining cost was subsidized by local government. The following three factors were critical in sustaining a user-fee system: strong political commitment by local government, proper supervision of distribution and funds, and simple distribution and management methods.