CMOP-E Case Study Example

CMOP-E Case Study Example Mrs. B is a 54 year old woman diagnosed with schizophrenia. After being stabilized with medication and receiving treatment, she struggled with finding and maintaining employment but eventually found a job as a sales associate. Recently, she was referred to see the OT because she was beginning to feel dissatisfied with her job and wanted to explore other options. In the past, she worked 4 or 5 day shifts a week; however, currently, her employer was giving her fewer shifts per week. Her shifts were in the evening, which made it difficult for her to spend time with family. She felt stressed because her employer was expecting her to complete more tasks but did not give her adequate time to complete them. She was also having interpersonal problems with her co-workers which added to the stress. She also indicated that she wanted to expand her social network as she felt that she had few friends. The OT provided her with resources that would assist with vocational readiness. To assist with e xpanding her social circle, the OT provided Mrs. B with a website that connected people based on interests. Using the above case study, this paper will discuss how the CMOP-E relates to OT practice. The focus of this paper is on the interaction between occupation and environment. CMOP-E Models provide OTs with a framework to gather information about the individual and to plan interventions. The Canadian Model of Occupational Performance (CMOP) is based on a set of values and beliefs concerning occupation, person, environment, and client-centered practice (Hagedorn, 2001). A central construct of this model is that the client is involved in the process of determining needs and planning action; the therapists role is to enable this process and enable clients to engage in occupation (Hagedorn, 2001). The CMOP is an interactive model showing relationships between person, environment, and occupation (See Figure 1, part A) (Townsend Polatajko, 2007, p. 23). In the CMOP, the person, represented as a triangle, has three components cognitive, physical and affective, with spirituality at the core (Townsend Polatajko, 2007). The model shows that occupation connects the person and the environment (Townsend Polatajko, 2007). The key components of occupation include self-care, productivity and leisure (Townsend Polatajko, 2007). A critical review of the CMOP led to the portrayal of a trans-sectional view (see Figure 1, part B) (Townsend Polatajko, 2007, p. 23). The trans-sectional view of the CMOP can be used to show that occupation is of central interest and delimits the OTs concern with persons and environments. The transverse view with occupation front and centre presents occupation as OTs core domain of interest, showing that OTs are primarily concerned with human occupation, and the connections with the occupational person and the occupational influences of the environment; those aspects of person or environment that are not related to occupation are beyond OTs scope (Townsend Polatajko, 2007, p. 23 24). OTs need to consider the actual performance of an occupation and the level of importance it holds or the degree of satisfaction it brings to the individual, family, group or organization. OTs also need to consider the potential and possibilities for occupational engagement that is allowed by the oc cupation-person-environment interactions. CMOP is now CMOP-E with the added word engagement to extend the occupational perspective (Townsend Polatajko, 2007, p. 24, 28). Environment The environment in the CMOP is the context in which an individual performs occupations and includes physical, social, cultural, and institutional elements (Cole Tufano, 2008). The physical environment includes natural and built factors. This may include home, classroom, workplace, or natural environments (Cole Tufano, 2008). Social environment is composed of social groups such as family, coworkers, and community organizations (Cole Tufano, 2008). The social environment is the source of personal relationships (Duncan, 2006). Cultural environment may overlap with social environment and include religious, ethnic, and political factors which can affect the opportunities for, and barriers to, participation (Cole Tufano, 2008). The institutional environment includes the political and social systems that affect the number of opportunities present and provides rules and limits to an individuals occupations (Cole Tufano, 2008). Occupation The definition of occupation is (excerpted from Enabling Occupation, CAOT, 1997): Occupation refers to groups of activities and tasks of everyday life, named, organized, and given value and meaning by individuals and a culture. Occupation is everything people do to occupy themselves, including looking after themselves (self-care), enjoying life (leisure), and contributing to the social and economic fabric of their communities (productivity). (Townsend Polatajko, 2007, p. 17) The area of self-care encompasses all the tasks an individual goes through in a day to take care of oneself. Personal care includes basic activities of daily living, such as bathing, dressing, or personal hygiene. Self-care also includes instrumental activities of daily living, such as budgeting, driving, or grocery shopping (Radomski Latham, 2008). Productivity refers to an individuals economic contribution to society through paid and unpaid work. Some examples of productivity include paid employment, volunteer work, childcare, and homemaking (Radomski Latham, 2008). Leisure is activities that are completed voluntarily, intrinsically motivating and for enjoyment (Radomski Latham, 2008). Leisure activities may include quiet activities, such as reading, or active leisure such as sports, and socialization. (Randomski Latham, 2008). Application in Practice In the case study, the interaction between the occupations of productivity and leisure and the environment is evident. Mrs. Bs satisfaction in her productivity was influenced by the social environment of her job. Her strained relationship with her co-worker affected her job satisfaction and stress level. Having time constraints placed on her by her employer to complete certain tasks also increased her stress. Sparks and Cooper (1999) conducted a study to investigate the influence of seven job characteristics on mental and physical health. Results of the study showed that the quality of the social environment in the workplace is associated with stress. Mrs. B.s leisure was also affected by her productivity and social environment. Mrs. B. had limited time to spend with her family when she was scheduled to work evening shifts. Working in the evenings limited her opportunities to meet new people and expand her social network. Leisure is important because it allows an individual to have a balanced life. Research has shown that a balance between work and family predicts well-being and overall quality of life. (Greenhaus, Collins, Shaw, 2003) The cultural environment also affected Mrs. Bs productivity. Schizophrenia or mental illnesses by their nature lack visibility; therefore, encouraging the stigmatization of individuals with a mental illness (Copeland, 2009). In addition, society expects these individuals to work. This affected Mrs. B. because the expectation placed on her from society was that she should be working. The impact of the institutional environment on Mrs. Bs productivity is that the Government of Alberta requires individuals to meet certain conditions in order to be eligible for financial and health-related assistance programs, such as Assured Income for the Severely Handicapped (AISH) and Alberta Works. Some of the eligibility criteria for AISH are: must have a severe handicap that is permanent and substantially limits ability to earn a living, and income or income of cohabiting partner must not exceed the limits allowed under the program (Assured Income for the Severely Handicapped, AISH, n.d.). The institutional environment required Mrs. B to work because she did not qualify for AISH or Alberta Works. Mrs. B.s physical work environment was not addressed; however, looking at the work environment would be beneficial because it affects a persons job satisfaction. Some elements that may affect job satisfaction include the effect of lighting, noise levels, and floor configuration and furniture layout (Vischer, 2007). Leather, Pyrgas, Beale, and Lawrence (1998) conducted a study that examined the direct and indirect effects of windows in the workplace on job satisfaction, intention to quit, and general well-being. Results from the study showed a significant direct effect for sunlight penetration on all three factors. Self-care was also not addressed by the OT; however, it could be concluded that it did not have an effect on Mrs. Bs productivity. She was observed to have dressed appropriately and was well kept. It could be assumed that it was not an explicitly stated criterion for Mrs. B to demonstrate proper self-care before engaging in productivity with the OT. Self-care is a component that is important to address in productivity because an individual is usually interacting with others when working or volunteering. Being able to maintain proper self-care allows the individual to be socially accepted. Proper self-care also allows the individual to make a good first impression during job interviews and throughout his or her time as an employee. Conclusion The CMOP-E is a theoretical model that illustrates how occupational performance evolves from the interactions among the person, environment, and occupation. It provides OTs with a clear conceptual framework for thinking about the person throughout the occupational process. The CMOP-E with a person at its centre, demonstrates OTs client-centered practice. The application of the CMOP-E to Mrs. Bs case study demonstrates the dynamic and interdependent relationships between all aspects of environment and occupation. Through applying this model to Mrs. Bs case study, it is evident that practice is strongly based in theory.

On the Backs of Blacks and Sorrowful Black Death Is Not a Hot Ticket :: Sorrowful Black Death Is Not a Hot Ticket Essays

On the Backs of Blacks and Sorrowful Black Death Is Not a Hot Ticket      Ã‚  Ã‚  Ã‚   In both Toni Morrison's "On the backs of blacks" and bell hooks' "Sorrowful Black Death Is Not a Hot Ticket" the authors attempt to analyze the role and treatment of blacks in motion pictures. Morrison's essay deals with what she calls "race talk", and defines as "the explicit insertion into everyday life of racial signs and symbols that have no meaning other than pressing African Americans to the lowest level racial hierarchy" (Morrison, 1993). Hooks' essay similarly analyses the issue of death for blacks in movies to which she concludes "that there can be no serious representation of death and dying when the characters are African-Americans." (hooks) In both these essays there are huge errors made in their thinking, and their analyzation.      Hooks, in her opening paragraphs attempts to compare the portrayal of black vs. white death in films. In her comparison she blows all future credibility with critical readers by using examples that obviously don't have any baring on the point she is trying to make. The example she gives for a white death is that of Tom Hank's character in Philadelphia, a homosexual lawyer with AIDS who had taken his firm to court because of their bad treatment towards him because of his disease. For this case she points out that "even before tickets are brought and seats are taken, everyone knows that tears are in order." (hooks) Hooks then goes on to explain that "There is no grief, no remembrance" for the deaths of blacks.   She uses the film The bodyguard for her example of black death, citing the scene where "the sister of Rachel Marron (Whitney Houston) is accidentally assassinated by the killer she has hired" to kill her own sister (Hooks). These two examples have nothing in c ommon. The character in Philadelphia deserved sympathy when he died because he was treated unfairly for a condition he had no control of. The character in The Bodyguard neither deserved nor received recognition for one reason. It had nothing to do with her blackness, that was a non-issue, it was because she was a murderer who in an ironic twist was murdered by the assassin she had hired.

Robert and the Dog :: Essays Papers

Robert and the Dog Ken Saro-Wiwa's short story "Robert and the Dog" tells about a steward and his master and mistress, the main character is the steward: Robert. To understand the character Robert, one must look a bit at his background. Ken Saro-Wiwa has left several clues in the text that can tell us a lot about this. Before Robert was employed by the young medical doctor, he had worked for several different households. It is indicated in the text that these had not been as pleasant a workplace as with the young doctor. It seems that Robert had been used to his employers' shouting and losing their tempers. And never calling him by his first name. Also the gratitude Robert feels towards his new employer, for his mere politeness, indicates that Robert is not accustomed to gestures of this sort. All this shows how Robert probably has been degraded and suppressed throughout his whole life. Later in the story Saro-Wiwa tells that Robert never misses a chance to exercise the power he has over his family. This type of pathological behaviour is common among people with an inferiority complex, something Robert is very likely to have attained, due to the treatment he has received. Later when the dog is introduced to the story, Robert has enlightenment and reveals to us and to himself his place in the hierarchy. He had always thought himself above them, but now discovers he is down with the dogs. This shattering blow to his self-image makes him aware of his own feelings and features. When his master throws him a treat or a kind word, he "wags his tail" and feels indefinite gratitude, just like a dog. He does his master's bidding with a heartfelt glee, just like a dog. And he loves his master above all else, just like Bingo, the dog. The revelation causes hatred to swell his servant mind, at length resulting in Robert taking a step up the hierarchical ladder, and the tragic pr emature death of Bingo, the dog. Ken Saro-Wiwa's short story about Robert and the dog Bingo also portrays a culture clash that not everybody thinks about, the view of the pets. In our rich western world pets are not uncommon. A lot of people have them, and among the most popular are dogs. Pets or "house animals" are nothing new, man has for the last 15 000 years kept animals as companions.

Enviromnetal Degradation as a Result of Overpopulation :: Environment Pollution Research Papers

Enviromnetal Degradation as a Result of Overpopulation Introduction There are simply too many people on our planet, and the population is not showing any signs of slowing down. This is having disastrous effects on our environment. There are too many implications and interrelationships to discuss in this paper, but the three substances that our earth consists of: land, water and air, are being destroyed. Our forests are being cut down at an alarming rate, bearing enormous impacts on the health of earth. Our oceans and seas are being polluted and overfished. Our atmosphere is injected with increasing amounts of carbon dioxide, which hurts the entire planet. All of these problems can be traced to our vast, rapidly expanding population, which has stressed our world far too greatly. Our Population In 1994, the world population was 5 602 800 000. This population had a doubling time of only forty-one years (De Blij and Muller, 1994, p.527). The massive amount of people has had highly destructive impacts on the earth’s environment. These impacts occur on two levels: global and local. On the global level, there is the accumulation of green house gases that deplete the ozone layer, the extinction of species, and a global food shortage. On the local level, there is erosion of soils (and the loss of vegetation), the depletion of water supply, and toxification of the air and water. The earth is dynamic though, all of these aspects are interrelated, and no one impact is completely isolated. All of these destructive elements can be traced to our enormous population. As the population increases, so do all of the economic, social, and technological impacts. The concept of momentum of population growth is one that must be considered. It states that areas with traditionally high fertility rates will have a very young structure age. Thus, a decrease in the fertility rate will still result in a greater absolute number of births, as there are more potential mothers. Populations are very slow in adjusting to decreases in fertility rates. This is especially frightening when considering that South Asia has a population of 1 204 600 000 (and a doubling time of thirty two years), Subsaharan Africa has 528 000 000 (doubling time: thirty one years), and North Africa/Southwest Asia has 448 100 000 (doubling time: twenty seven years) (De Blij and Muller, 1994, p. 529-531)and all of these areas have traditionally high fertility rates.

Motivation in the Play Essay

Villains and why they do their villainy is always justified or explained in any literary work. Even those childhood fairy tales with the villain’s formulaic and predictable evil deeds will always do things that have a purpose or will do those things because they were compelled to do it caused by a negative feeling: jealousy, revenge, envy, greed, a childhood without someone to love them or support them, etc. William Shakespeare’s plays are not an exemption to this case as he even creates characters that are capable of not only of evil; they embody evil in their totality as a person—if you may call them that. An example of this would be Iago, touted as the most villainous of all villains in the literary world because of the simple reason that he was guiltless, conscienceless and definitely purposeless in his strategic deeds that destroyed Othello and the people close to the tragic hero. This analysis will focus on this villain and scrutinize his character, villainy and most of all, his purpose (or the lack thereof) on why he did the things he has done that aimlessly ended to other people’s lives. In fact, there is already an answer to this query for Iago is just plain evil, nothing less and definitely more. His motivation lies in the fact that he wants to end other people’s happiness and takes simple delight in causing other people pain and grief which makes him not just a villain but a very mysterious and most terrifying one. In Othello, the Moor of Venice, a man’s capacity to do evil is magnified as Iago is overcome with rage as Othello gives a position to another less qualified man that was originally intended for Iago. Iago takes this in deep and plots against Othello, a Moor in Venice that holds such high position, influential power and great riches. Iago uses jealousy to destroy Othello and the people around him by making it appear that Othello’s loyal wife, Desdemona, is having an affair with another man. In rage, Othello kills his own wife and when he realizes that it was all Iago’s evil plan, he kills himself out of grief and guilt. Iago confesses to no one and does not explain his actions; instead, he keeps mum about what he has done and the purpose in them. Thus, as the play concludes, it is only the audience who are witnesses to Iago’s malice and the extent of his wickedness—but there is a possibility that Iago also leads the audience into believing that they know the entire truth when in fact, he has been dishonest the whole time to everyone—even that of the audience. Iago acts as the villain in the play even if he was not really the one who did the bad deeds. He is the sole villain because he was the master plotter in the whole thing that even innocent people like Roderigo and Emilia were implicated as bad people when they were not wholly that capable of evil. Roderigo and Emilia were simply pawns to his plans and he used them and easily discarded them. In the book of Dobbs & Wells entitled The Oxford Companion to Shakespeare, they sum up the villainy of Iago (and pretty much, the entire play) in a few words: He skilfully convinces Othello that his wife Desdemona has been adulterous with Cassio. He wounds Cassio, murders Roderigo, whom he has involved in his plots, and also kills his own wife Emilia. (211) The extent of Iago’s villainy does not merely end in his acts and plans but in an entirely different context and case because his villainy was unjustified and unexplainable. He did not have a purpose and an aim in ruining Othello’s life and soul. For even if it seems that Iago was motivated by the anger he felt over Othello’s passing over the position that was rightfully his to another man that was very much unqualified (according to Iago that is), it still seems not enough motive. In the first part of the play (act I, scene i), Iago insists that he does hate Othello and does a lengthy monologue on why he hates the Moor. However, it can be later learned that maybe Iago was not really motivated by that trivial act done by Othello since Iago has never really revealed the real reason on why he hates Othello. This is because in the same act, he declares that he will never say what he feels and thinks because it is dangerous and it is laughable: For when my outward action doth demonstrate / The native act and figure of my heart In compliment extern, ’tis not long after / But I will wear my heart upon my sleeve For daws to peck at. I am not what I am. (Shakespeare 1. 1. 63-7) His supposed reason on hating Othello may not be his true reason for the vendetta he so chillingly instills on the Moor because Iago will never disclose his real reasons. Thus, even though Iago was transparent with his feelings and thoughts to the audience and some characters like Roderigo and Emilia, he actually lied to everyone since he could never â€Å"wear his heart† on his sleeve. Moreover, even if the rage he felt over Othello’s actions propelled him to do/plan such things, it was not enough to completely destroy the life of one man and the lives around that man. To think that Iago even killed his own wife with his own hands—without a second thought on doing it or a guilt overcoming afterwards. As what Dobbs & Wells wrote, Iago was a â€Å"motiveless evil† and that lack of motivation in him makes him a superior proponent of evil (211). In conclusion, Iago is most villainous not just because of the things he has done but also because of the lack of motivation in them, the absence of purpose, the incapacity to be guilty over the success of his evil plans and most of all, the mockery he throws to the characters and the audience at the end of the play with his silence. This silence is eerie as it has a purpose—to make everyone shiver at what other havoc and damnation he could have done with that evil mind of his. Works Cited Dobson, Michael and Wells, Stanley. â€Å"Iago†. The Oxford Companion to Shakespeare. New York: Oxford University Press, Inc. , 2001. 211. Shakespeare, William. â€Å"Othello, the Moor of Venice†. Ed. Russ McDonald. New York: Penguin Group, 2001. Print.

The World of Business

The world of business today requires that companies place their performance on an operation aspect so that all channels may perform to their best and lead to productive interdependence within the organization. The human resource management portfolio is of great importance to each firm because it guides its decisions and how it functions within them. When the firm employs good Human Resource Manager, there are high chances of performance in productivity, costs and quality of products and overall efficiency. Hence, a firm should adopt the quality HRM to enjoy its benefits as well as have an advantage in solving any risks that may have come up before. Its HRM pedagogies will eventually provide a platform, through which it attracts, retains and trains its existing assets with the highest value. On the other hand, without human contribution, there would be no appreciated management. In this precept, for good performance of any organization, it requires motivation, engagement, and satisfaction of the human aspect to operate efficiently and smoothly. Job satisfaction is consequently determined so that customer satisfaction may also be measured. This is because employee dissatisfaction in their job may lead to the provision of inadequate services, which may eventually lead to customer dissatisfaction as well. Hence, it is the responsibility of the human resource as a labor-intensive industry to sensitize on the delivery of excellent services to clients so that maximum customer satisfaction may be achieved as a result. When managing any project, a well stipulated project goals and objective must be outlined by the HRM. The manager should keenly look at how the objectives will be realized and outlining how the resources needed to achieve the goals. He plays a very important role is implementing good plans for the project alongside taking risks that ensures the project does well. A good manager identifies all the competing demands from various stakeholders and ensuring that a commonality of purpose is realized. He is an instrumental person in an organization because he schedules the entire plan, he encourages teamwork, maximizes available resources, manages change and good quality of output. He is also responsible for evaluating the progress and the performance of an organization. Therefore, the presence of human resource is very essential within any organization.A good manager brings high performance to an organization. Good performance is the ultimate measure of a well doing organization. The manager must be empowered to take appropriate decisions that contribute to the well being of the organization. He uses the authority and the power bestowed upon him to make decision on how to allocate available resources. He does the same on administration, communication, technological choices and any other matter that pertain the project that may need his attention. In so doing, there will be high performance in within the set up. High performance on the other hand makes the clients have the intrinsic drive to attain their services from the firm. Most of the client will bestow their trust on the services provided because of good leadership. It also makes the company have good relationship working relationship with other neighboring organizations and with the workers themselves. Because of the competition in today`s market, current organizations need good management without which they are subjected to failure. In this plinth, the purpose of this assignment is to securitize the appropriate pedagogical approaches that the resource manager can employ within the organization to improve on the organizational output. Good performance of the organization depend on various aspects like motivation, job security, compensation, good working environment, advancement in line of duties among many other factors.2.0 DiscussionDefinitions of Performance Management and High Performance Work According to Martha Lagace (2009), companies that record high performance are actually led by their original founder members or by their transformational. In this case, they are people who can be responsible of any crisis that occurs in the company and attend to it appropriately. They are able to achieve high standards of commitments from all the stakeholders within the organization. In so doing, the firms retains the clients for a very long period of time, the employees are care for well because they have good working environment, and investors are attracted to venture into the firm because of good production. This illustration is supported by Michael Beer, the Cahners-Rabb Professor in the School of Business Administration, Emertus by saying that such firms attain excellence for long period of time. Companies with good performance output have positive contribution to the customers the employees, investors and the community at large. They also grow by outlining their idiosyncratic capabilities in order to make them move into wider markets to attain products and services and geographical locations for their firms. According to Gong, Law, Chang and Xin (2009), high performance work system represents a detailed, incorporated and systematic approach where the human resource manager works tirelessly to ensure that all the set goals and objectives are met. He ensures that he utilizes the resources, manpower, and any other available material to meet the satisfaction of the firm. In this dictum, evaluation of high performance of work is extensively examined because it their outermost priority. According to the definition, the employees are very instrumental in realizing the set objective of the firm. They are treated with a lot of dignity and decorum because they solicit all ways possible to ensure that there is maximization of profit within the firm. Any institutional factor or environment as a context that may affect or influence high performance of the firm is looked into with a lot of keenness. The firms also provide good geographical location, which are at central places to be accessed by the clients most of the time. An example of a case study in Chinese gives empirical results that firm with HPWS connection is mediated by the adaptive aptitude. Also, the effect of high performance work system on firms with adaptive capability is more strong that the firms within an institutional sector. Therefore, the location of the firm matters a lot as far as high performance is concerned. A similar description is explained by The Management of Engineering and Technology (2002), a methodical approach used by organization to attain high production standards. Through the process, the company aims at achieving effective operational skills, innovation, and high quality results for their customers. They work tirelessly to ensure that the clients get the best goods and services and they are retrained most of the time. In this case, there are five organizational practices that are keenly looked into to ensure that the high performance is realized. The first one being good leadership, empowerment of the employees, pioneering in human resource management, good measuring of performance and ensuring employees have good knowledge in whatever thing they are doing. In this regard, the firm is assured of attaining high performance since the clients will be served with high quality of products and services all the time.3.0 Performance Management Conceptual FrameworkMost of the managers think that filling report is the most important aspect in attaining good performance. However much this might be necessary, attaining high performance entails a lot. All too often, performance management if not looked into, sometimes become the weakest link within the chain of management, therefore, the managers should put a lot of considerations into it. The figure below shows some of the important aspect that the managers of organizations should look into to ensure high performance is realized. From the framework, a lot of derivations can be madePerformance management system depend on the factors like evaluating performance standards, measuring performance of the employees, reporting the progress to the topmost leadership and improving the quality of the products.3.1 Goal Setting TheoryEdwin Locke defines goal setting theory of motivation as the goal set by the organization to be directly proportional to performance. When the goals set are directly adhered to under proper management, the performance has to be positive by a great margin. In simple words, goals set enable the employer to give the appropriate directions to the employees. Employees on the other hand, are enticed to work extra hard to achieve the goals laid. The readiness to work towards attaining the set goals is the driving force in motivation. Goals set act as motivational factors to the employees and the employer; hence, they work in tandem to achieve them. High goals set are more motivating than easy, all-purpose and hazy goals because they are easily attained. Edwin and Gary, 2015, gives clarity that the goals set must be SMART; Specific, Measurable, Achievable, Realistic and can be achieved within a given Time-bound. Specific goals give best results and it is easier to measure and appreciate because it inspires one in achieving the set objectives.Nevertheless, the goal setting theory has its pros and cons. Some of the pro`s is that it provides a constructive way of evaluating workers performance and commitment. It also gives appropriate feedback on the progress made by the organization. Another advantage is point a clear ladder of coordination between the workers and gives proper channel of communication. In addition, it defines structured goals that help in the managers in realizing the objective of the organization. On the same plinth, the theory has it weakness. The conflict between the organizational skills may lead to disagreement between the stakeholders if the matter is not solved with care. The theory may not work well in institutions with low goals, where the goals are not well defined because the managers do aim higher. On the same not, it may demoralize the performance of the employees because they are not motivate to work extra hard. When the goals are not well defined and challenging, the employees work reluctantly because there is nothing to challenge them. There is no convincing evidence that goal setting theory satisfies the members. When the members are not satisfied with the job they do, there is high likelihood that they can run away from the job. Also, when the employer is not satisfied, there will be managerial problems which may eventually lead to the decline of the organization. Another point worth noting is that the theory does improve or provide room for the additional skills like competency to the employee. Proficiency is very pivotal for quality production to the organization. In this dictum, if the theory cannot provide that to the workers, then the goal setting theory can easily fail hence undermining the progress of the organization as far as performance is concerned. From the analysis made, it is eminent does not suit an organization that aims at attaining high performance work system. The theory records a lot of limitations than advantages, hence making it unsuitable for such a setup. In case the leader is one who is focused and goal oriented or he is one who aims at providing greater leeway for the organization and is after mobilizing what is to be done, then the theory is not appropriate. Goal setting is one of the most cognitive needs of any organization. A leader may or may not seek to have organizational goals, but provide for his self satisfaction, such a leader can best apply goals setting theory. When setting up the theories to use within an organization, one should be very speculative to use the theories that makes the organization prosper. Goals setting as an example of motivation to the employees, only appeals to someone who is irrefutable oriented. Because of this, one may be evoked to compare personality when choosing the theories to use. A non-interventionist may be more obsessed with this type of theory and may not lay out the goals that transform the organization. All in all, such details might involve professional and administrative aspects like recordkeeping, job hierarchies, evaluation of reports which a leader who uses goal setting theory might not be ready for. 3.2 Process of Management In this case, a case study is done to evaluate the management of performance system in Malaysian government linked company. The purpose of the study was to examine the industrialization of the performance management system. It looked at some of the changes brought about by the government linked company program. The findings state that the activities of the company brought some changes in the way the business was operating. The finding states that the active became a routine appraising to the performance of the employees. In this case the employees became decoupled from all the activities taking place within the organization. In this precept, it did not change the ways in which members were carrying out their duties since no new ideas were brought in. this process is realized to be time consuming and costly in away and it is subject to confrontation. For any change to be effected in any government linked organization, a strong set up of management must be stipulated lest most of the things go a mess.3.3 Employees Skills and Training NeedsThe case study is carried out in from the Oil and Gas Industry in the UK. Fromm the study, workers need a lot for their satisfaction. Their skills need to be improved so that they give quality output. They also needs incentives whenever they do good, motivation makes them work aiming at achieving the set objectives. The company needs to organize for workshops and seminars to help improve in the skills of the employees since for them to produce quality products to merge the completive market. From the study, in as much as everyone in the industry may require training, it is realized that those having less experiences need to train more than any other worker. Training makes them work as opposed to before because there is acquisition of new skills. Also the management gets more clients since the level of production is increased and the quality of products also goes high. The specialists are involved in the training and by the end of the session; there is a lot of benefit inquired. An organization which aims at producing high performance work system must train her workers to and meet their needs. When the needs of the employees are met within appropriate time, they feel that they are catered for and respected. This makes them to work extra hard to achieve the set objectives. Training also increases the salary scale of the employees since additional experience is added to them.3.4 Crucial role of line Managers and HR in enabling and managing High Performance and ProductivityLine managers and Human Resource are very instrumental in ensuring that there is high performance in productivity. Partnership of lime managers and human resource is increasingly becoming common in most of the organization. HR department is entirely responsible for all human resource management activities, and a line manager shares the same responsibilities. Line manager have the power to influence the behavior of the employee to improve on the productivity. They play crucial role in coordinating the resources allocated in the organization for it to achieve the set goals and objective.A case study carried out in UK to show the relationship between the role of line managers and human resource point out that the line managers and human resource are interdependent. They both assist in sharing knowledge that improves the output of the organization. In this plinth, the lone manager is very premeditated in all the aspects of Human Resource manager. The ultimate goal of their interaction is towards bringing raising the performance of the company. The research shows that for an organization to be fit in the current future challenges that face them, the two has to partner. They ensure that poor and low performing employees are taken through training so that they merge the standards of the organization. They two in artnership, help in developing and reviewing policies that contribute to the positive growth of the organization. They foresee any problem that might affect the organization and prevent it in time without necessarily affecting the workers. They also plan for both long and short term goals and state how they should be achieved. In case a plan fails, they come together and find alternative means that can be substituted immediately so that the organization does not get into problems. They solve the problems that may arise among workers and ensures there is peaceful co existence among them. By doing so, they act as role models to the employees hence enabling them work in peace, love and unity. Therefore, the line managers and the human resource are very pivotal in ensuring that the organization achieves high performance work system.4.0 ConclusionsFrom the discussion, series of conclusions can be arrived at. First, in order to improve the performance of an organization, a lot should be put into considerations. There should be high performance from the employees. The human resource should ensure that appropriate approaches are put to meet the standards of the organization. Putting keen consideration on the welfare of the employees is very instrumental since it makes them work with motivation. From the discussion, the manager should apply appropriate theories that can bring good results to the development of the organization. Also, in order to attain good results, the employees who are undertrained should be taken through workshops and seminars to help in improving their experience. In so doing, the organization invests in them and quality of produce is realized. Lastly, line mangers and human resources managers are vey essential in the well being of an organization. Their presence makes the association firm because they help in laying out structures that improve the performance of the organization.

Family Planning Essay

In the past 50 years, family-planning programs have been heavily promoted across the developing world. A vast academic literature now tests both the intellectual rationale for these programs, as well as their impact on a wide range of demographic and economic outcomes. In recent years, the availability of new methods and new datasets from the developing world has intensified the academic research on these issues even though the support for family-programs themselves has diminished. This paper examines the economic and demographic literature on family planning programs and summarizes evidence of their impact on fertility as well as additional outcomes such as child mortality, investments in children’s human capital, the economic status of households and the macro-impacts on communities. The goal is to provide policy-makers with an understanding of the strengths, limitations and points of agreement that emerge from this vast literature. PRELIMINARY AND INCOMPLETE DRAFT 1. Introduction In the past 50 years, family planning (FP) programs have been heavily promoted across the developing world as a means to reduce fertility rates and promote economic development. The central assumption behind such programs is that the decline in birth rates during the early stages of demographic transition can promote economic growth, reduce environmental pressures, reduce dependency ratios and strengthen a societies’ ability to invest in health and education (Coale, Hoover, and Press 1958). At the micro-level, it has been assumed that a decline in fertility would relieve women of the burden of repeated child-bearing and free up opportunities for them to increase schooling and participate in the labor-force. A significant literature – shaped by economists and demographers – now tests these assumptions (Kelley and McGreevey 1994; Kelley 1995). Much of the literature however, remains either theoretical or focused on macro-correlations between variables such as fertility or population growth and indicators of development such as GDP growth or female education. The causal impact of declining fertility and/or the impacts of FP programs on fertility have proved to be difficult to find. One of the main challenges faced by researchers is that fertility decline is affected by a wide range of variables, including socioeconomic variables such as income, education (particularly female education) and female employment. Changes in these variables can affect the demand for FP, the structure of the programs, and their ultimate impact. There is also the issue of policy itself. FP programs are rarely rolled out randomly. Placement of programs in areas with distinct characteristics made it di fficult to identify the precise policy driver of any observed change in behavior. In recent years, the research has been enriched by the availability of new methods and new datasets from the developing world. This includes cross-sectional surveys such as the Demographic and Health Surveys (DHS), panel datasets such as the Family Life Surveys, and the use of random assignment evaluation methods that study causal relationships under careful scientific experimental structures. This paper examines this literature and summarizes evidence of the impact of FP programs on fertility as well as additional outcomes such as child mortality, investments in children’s human capital, the economic status of households and the macro-impacts on communities. We define an FP program as any organized effort to encourage couples to limit their family size, and space their births by using contraceptive information and services. This includes legislative, regulatory, and programmatic efforts to supply contraceptives to a population as well as efforts to reduce the demand for children and/or increase the demand for contraception through information and/or social marketing campaigns. The paper is organized as follows: Section 2 provides a brief history of FP programs in the post WWII era and argues that FP programs have declined in priority after the ICPD conference in Cairo in  1994. Sections 3 and 4 provide an overview of two strands of the literature on FP programs: non-experimental studies that use cross-sectional or panel data to evaluate large-scale FP programs in states, countries or regions; and experimental studies that analyze random or pseudo-random pilot projects. Section 5 examines the literature on the cost-effectiveness of FP programs. Section 6 provides some perspectives that are likely to interest policy-makers. PRELIMINARY AND INCOMPLETE DRAFT 2. Family planning programs: A short history Family planning (FP) programs emerged after World War II. The world’s first major program was established in India in 1951 and was soon after followed by Pakistan, the Republic of Korea, and China. By 1975, about 74 developing countries had established them (Seltzer 2002; Cleland et al. 2006). Most programs fall into three general groups: (a) those that specifically aimed to curtail population growth through explicit policies such as promoting contraception and/or establishing incentives to have fewer children; (b) those that did not aim to curtail population growth, but promoted FP for other purposes; and (c) those with no explicit population policies but allowed outside donors to run programs that were mostly small in scale (Nortman and Hofstatter 1980; Nortman 1985). The first group was dominated by Asian countries, mainly East Asia and some South Asian countries (Mauldin, Berelson, and Sykes 1978; Lapham and Mauldin 1985; Mauldin and Ross 1991)1. In China and Vietnam for e xample, the governments formally announced in the early 1960s that couples should have no more than two or three children and began a wide-range of interventions that either directly or indirectly contributed towards this goal. Many governments provided citizens with incentives to meet these targets. In China, couples with more than two children (or one child in some parts of China) were subjected to fines and penalties, though the enforcement of this program varies significantly (Short and Fengying 1998; Attane 2002). Permanent methods of contraception (mainly sterilization) were often provided for free.2 In Korea, Indonesia and Thailand, FP programs focused heavily on the expansion of usage of IUDs and other temporary methods in addition to permanent  methods. In South Asia, the programs were less strong than in East Asia but large in scope. India for example, established a vast network of clinics that were to provide contraceptive services. In the 1960s, this was followed by a public health–based outreach program which emphasized education and awareness particularly in rural areas (Harkavy and Roy 1997). A common feature of almost all programs in this group was that they were generally led, funded and managed by domestic governments, and involved a broad range of mini stries and mass organizations that focus on educating, promoting, and encouraging couples to use FP methods. Another common feature of programs in this group is that they were typically one component of broader development policies that aimed to increase access to health-care, education and industrialization. These authors have developed quantitative measures of family planning program strength, or â€Å"effort† that are based on the number and quality of institutions that are involved with family planning programs. The measures of effort came from the belief that strong family planning programs must possess some essential features: (a) It should offer a full range of contraceptive methods and deliver them through several delivery systems, particularly in rural areas; (b) It should have a corps of full-time fieldworkers and educated the public about contraception; (c) Prominent leaders should issue frequent statements favoring the use of contraceptives; (d) The program should have a full-time director, placed well up in the government structure, and various ministries and private agencies should provide technical, logistical and financial assistance. More will be said about these criteria, and the studies that support them later in this paper. In Vietnam, Bryant (1998: 246) writes that right before fertility declined, thousands of health workers were given basic training and sent to villages to promote use of mosquito nets, distribute locally made drugs, deliver babies, administer vaccinations, and carry out other standard primary health care functions. PRELIMINARY AND INCOMPLETE DRAFT The second group of countries was dominated by Latin America.3 Until about 1960, governments in this region remained strongly pro-natalist in their ideals (Mundigo 1996). This changed due to a concern about the high incidence of unsafe abortions in the mid-1960s. Abortions performed in unsanitary conditions by unqualified personnel were believed to contribute to maternal mortality and also resulted in large public expenditures as women with abortion-related complications sought care en masse from public hospitals (Mundigo 1996). To minimize disagreement with the Catholic Church however, FP programs in Latin America began as small private initiatives that were largely funded by international donors and NGOs. In most countries, particularly Brazil and Peru, these programs were ultimately incorporated into national public health programs. By the 1980s, countries in this group generally had broader goals than simply reducing fertility and/or the practice of unsafe abortion. They generall y aimed at improving maternal and child health through greater birth spacing, access to pre- and post-natal care. Some Asian programs also fall into this category. Bangladesh is particularly noteworthy. Its national program, launched in 1976, aimed to provide women with a wide a range of contraceptive methods through home-visits by a network of locally recruited female-health care workers. Sterilization was included in the package of options and in the first few years of the program, compensation was offered to those who chose the procedure (Cleland and Mauldin 1991). Yet the program remained largely voluntary and focused on maternal and child-health more broadly. A similar effort is seen in Iran, which launched its program in 1989. Free contraceptives were distributed through a network of village health workers, who also advised women on a broad range of maternal and child health issues. The third group of countries was almost entirely dominated by Sub-Saharan Africa. Some countries did establish programs early on. Kenya and Ghana for example, established FP programs in the late 1960s. Tanzania established a FP program in 1970. Senegal established an urban FP program in 1976 and a rural program in 1979. Much of Francophone Africa however, remained largely untouched by the wave of interest in FP programs throughout this period. A 1920 French law that banned advertising and distribution of contraceptives  continued to prevail. Across most of Africa, issues of population growth remained sensitive and highly politicized throughout the post-war period. Nigeria for example, adopted a national population council to study the issue of population growth but did not adopt any national policies to lower fertility (Caldwell and Caldwell, 1983). This was at least in part because census data that formed the basis of such decisions was regarded as too controversial. The results of the 1962 and 1973 census were actually nullified due to dispute and controversy over accuracy of the size of minority groups. Even when they were adopted, African FP programs differed significantly from their counterparts in other countries in several key ways. First, the focus was almost entirely on temporary methods, since permanent methods were regarded as culturally unacceptable (J. C Caldwell and P. Caldwell 1987; J. C Caldwell and P. Caldwell 1988). The establishment of robust supply chains for temporary contraceptives Only five Latin American countries fell in the first group – Mexico, Colombia, the Dominican Republic, El Salvador and Guatemala. Mexico is the largest among these. In 1974, access to family planning was declared as a constitutional right for all couples. In 1977, a national coordinating body was establish to expand the supply of contraception and a demographic target of population growth of no more than 2.5 percent per year by 1982 was declared. A wide variety of methods, including oral contraceptives as well as permanent sterilizations, were offered and the contraceptive prevalence rate doubled within a span of less than five years (Rodriguez-Barocio et al., 1980). PRELIMINARY AND INCOMPLETE DRAFT however, proved to be very challenging in the African context. The health-care infrastructure in this region was weak and burdened with a high demand for curative services. Moreover, most rural women resided far away from clinics or health centers (Caldwell and Caldwell 1992). Stringent eligibility criteria also made it difficult to reach women. In many cases, a woman’s access to contraception required the written consent of husband,  proof of marital status or age, blood tests (for oral contraceptives), frequent follow-up visits, and non-evidence based requirements that she be menstruating at the time that she starts using certain methods such as IUDs or hormone-based systems (Campbell et al., 1996). Cultural preferences for high fertility often made women unwilling to be seen attending these clinics. Moreover, since consumers did not receive adequate information about contraceptives, side-effects were often misinterpreted and rumors were propagated. These factors combined to cause discouragement and discontinuation in the long-run (Campbell et al., 1996). Across Asia and Latin America, the spread of primary healthcare services, rapid increases in female schooling, the processes of socio-economic development and the use of marketing campaigns to promote awareness of FP programs may have alleviated some of these problems. A second distinctive feature of African programs is that they were supported by a large number of international donors who rarely coordinated their actions with national governments or even between themselves. Since the weakness of domestic health infrastructure ruled out the establishment of â€Å"vertical† programs that packaged FP with primary health services, donors preferred to fund standalone programs that they could establish, manage and monitor themselves (Seltzer, 2002; Robinson and Ross, 2007; Mayhew, Walt, Lush and Cleland, 2005). The programs thus often remained small-scale. The goals used to evaluate the programs were often short-term in keeping with the demands of short budgetcycles. This approach stands in stark contrast to Asian and Latin American programs that were typically run by Ministries of Health and were backed by long-term budget commitments. Donor retreat International interest in FP programs lost momentum in the early 1980s. The intellectual shift behind this is often referred to as â€Å"revisionist thinking† and refers to a retreat from Malthusian fears about the crippling effect of population growth on economic growth as well as the concern with the adequacy of supplies of food and natural resources (Kelley 1995; Kelley 2001). A wide range of factors fueled revisionist thought: the rapid pace of fertility decline in Asia, the success of the green revolution, the lack of convincing academic evidence for a negative relationship between population growth and economic growth, etc. Economists emphasized that the long-run impact of population growth in economic development may not necessarily be negative. On the contrary, investments in human capital and innovation in growing populations can even have positive effects on growth and development outcomes (Simon and Lincoln 1977; Boserup 1981). Critics of FP programs used this literature to make the case that many FP programs in the developing world had been conceptualized and implemented with a false sense of urgency after World War II, without sufficient internal debate, deliberation and consensus (Kelley 1995; Kelley 2001). Revisionist intellectual thought was also reinforced by the voices of NGOs in international policy. These groups highlighted examples of FP programs that had not gone well in parts of China, India, Indonesia, Mexico, Peru, etc (for a summary, see Seltzer, 2002: 62—70). In India for example, the controversial PRELIMINARY AND INCOMPLETE DRAFT HITTS model (Health Department operated, incentive-based, target-oriented, time-bound, and sterilization-focused) was so unpopular that it contributed to the collapse of the Indian government in 1977 and prompted India to launch a significant critique of FP programs in international policy circles (Harkavay and Roy, 2007).4 Feminists argued that women in particular, paid a high price for population policies, for they had often been viewed as passive â€Å"targets† who needed to become â€Å"acceptors† of contraception (Dixon-Mueller, 1993). They demanded that policies recognize women as key agents in the process of reproduction and must empower them – through education, information and access to health services (that include but are not limited to FP) – to have establish control over their bodies. The impact of the rights-based approach was visible at the Vienna Conference on Human Rights in 1993 where there was an explicit recognition of the importance of reproductive rights and the need for national and international development policies to be built around these rights. The biggest shift however, occurred in Cairo at the International Conference on Population and Development in 1994. The definition of reproductive rights was took center-stage and included not only issues of reproductive decision-making,  but sexual health and female empowerment more generally.6 Delegates explicitly called for dropping demographic and FP program targets in favor of a broader policy agenda that included a range of reproductive and sexual health measures. FP thus became embedded into a broader set of policy-goals. In the words of the UNFPA, â€Å"[The ICPD Programme of Action] places human rights and well-being explicitly at the centre of all population and sustainable development activities. The Programme of Action moves discussion beyond population numbers and demographic targets: its premise is that development objectives — including early stabilization of population growth — can be achieved only by basing policies and programmes on the human rights, the needs and aspirations of individual women and men. Human-centred development -in the sense of investing in people generally, and particularly in health, education and building equity and equality between the sexes — is seen as a firm basis for sustained economic growth and sustainable development (UNFPA, 1995:9).† The representatives of 179 governments agreed on the need to ensure universal access to reproductive health services by the year 2015. These governments also agreed to increase spending on population According to Harkavy and Roy (2007), the government’s Department of Family Planning estimated that more than 20 million births were averted between 1956 and 1975. Calculations based on the number of births averted concluded that the annual birthrate fell from about 42 live births per 1,000 population in 1960–61 to about 38 in 1970–71 and about 35 in 1974–75. The critique of FP programs also came from health advocates who argued that despite the strides made in the safety of technologies such as oral pills and injectibles, safety issues remain. They did not agree that the benefits of choice outweighed the risks and argued that contraceptive safety needed greater attention (Seltzer, 2002). Other health advocates argued that FP had absorbed far too much policy attention and development assistance, neglecting other critically important issues. This includes the right not to be alienated from their sexual or reproductive capacity and bodily integrity through coerced sex or marriage, denial of access to birth control, sterilization without informed consent, freedom from unsafe contraceptive methods, from unwanted pregnancies or coerced child bearing, from unwanted medical attention. PRELIMINARY AND INCOMPLETE DRAFT  and related programs. The needed resources were estimated at $17 billion a year by 2000, climbing to nearly $22 billion by 2015.7 This agenda was however met with resistance by several groups. First, there were those who challenged the coupling of a gender ideology with issues of reproductive health. In Jordan for examples, elites felt that the proposals regarding reproductive health were acceptable, but proposals that aimed to reduce gender-based violence, deliver sex-education to adolescents, spread information about STIs and the promote gender equality conflicted with existing cultural norms and could not be implemented quickly (Luke and Watkins, 2002; Seltzer, 2002). A second challenge to the Cairo agenda came from religious groups felt that the expanded definitions of reproductive health and reproductive choice tacitly included abortion and more controversial methods of fertility reduction. Even though the Cairo agenda was carefully worded to not support abortion in any circumstances, many people believed that the two issues were too deeply related to be separated in practice (Seltzer, 2002).8 In 2001, with support from the Vatican, the United States publicly opposed abortion, once again implemented the â€Å"gag rule† and thereby withdrew association with all organizations that offer women abortion services as a part of their general effort to expand reproductive choices for women.9,10 A final challenge came from the sheer breadth and language of the agenda itself. Some have argued that the focus on sexual health and reproductive rights was so broad that it simply failed to gain traction in parliaments  and chambers of government across the developed world (Glasier et al. 2006; Fathalla et al. 2006). While Cairo advocates emphasized the importance of rights, donors were most interested in arguments that demonstrate a clear economic return on investment (Fathalla et al. 2006). The loss of focus also led to a fragmentation of academic and policy research. Many turned their attention to new competing priorities, such as HIV (Glasier et al. 2006; Fathalla et al. 2006, Blanc and Tsui, 2005). A visible sign of just how divisive the Cairo agenda was comes from the UN’s Millennium Development Goals, agreed to by nearly all nations in 2000. The only goals that were related to reproductive health were the reductions in maternal and child mortality. Reproductive choices and reproductive rights were completely sidelined. In fact, the Cairo goal of universal access to reproductive health services was possibly the only goal that had been agreed to through a series of global conferences that did not make the final list of eight Millennium Development Goals (United Nations, 2000). In 2007, these goals were modified to include â€Å"universal access to reproductive health† by 2015. Progress was to be measured by  www.unfpa.org The Program of Action stated that â€Å"in no case should abortion be promoted as a method of family planning,† and elsewhere that â€Å"in [such] circumstances in which abortion is not against the law, such abortion should be [made] safe.† This was intended to be a compromise between those who opposed abortion on all grounds and those governments and NGOs who permitted abortion in varying degrees. 9 This was one of President George W. Bush’s first acts in office in January, 2001. 10 A cap of $15 million was placed for foreign NGOs and multilateral organizations who could not certify that they will not support any abortion-related activities, even if they use their own funds for these activities four indicators: the contraceptive prevalence rate, the adolescent birth rate, antenatal care coverage, and the unmet need for FP (United Nations 2007; UNFPA 2011)  Another sign of the damage from Cairo is seen in the international HIV policies. In the late 1990s, policymakers in the United States and indeed much of the world, were compelled to focus on the challenge of HIV. Rather than building services into FP programs however, donors chose to establish entirely new programs. One of the biggest examples is the establishment of President’s Emergency Plan for AIDS Relief (PEPFAR) under US President George W. Bush in 2003. This was one of the largest efforts in history to address the challenge of one disease. The only relationship between this program and FP was i ts attempt to encourage abstinence as a form of prevention of HIV.11 Some have argued that the focus on HIV and AIDS simply replaced the Cairo agenda, when they should have in fact simply reinforced and complemented it (Blanc and A. O Tsui 2005). In summary, the global interest in FP programs has swung from extreme interest after World War II to disinterest at the turn of the century. The weakness of such programs is most pronounced in SubSaharan Africa. The rate of contraceptive prevalence remains only 26%, less than half of the world average, despite significant investments in treating sexually transmitted diseases such as HIV (WDI 2010). At the current time however, there appears to be a renewed interest in the role of FP, particularly in approaches that are broad-based, female-focused, voluntary and respectful of basic human rights. In the section ahead, we review the literature on the effectiveness and impact of FP programs with the goal of demonstrating that such programs can have impact on not just fertility but a variety of other aspects of women’s well-being. 3. What do we know about the impact of FP programs? Perspectives from the non-experimental approach FP programs in the 1960s, 1970s and 1980s were mostly established in the  absence of scientific evidence or agreement about program â€Å"best-practices†. This is mainly because detailed time-series data on economic as well as demographic variables was scarce at both the micro- and macro-level. Over time however, data was gathered and researchers began to test some of the fundamental assumptions underlying FP programs. The first wave of studies used a non-experimental approach, i.e. they evaluated the impact of FP programs involving using cross-sectional or panel data from a country, region, or set of regions to test the hypothesis that FP programs impacted contraceptive use or fertility. As more data became available, and FP programs were rolled out, these studies were updated and expanded. The research continues to evolve today, even though the interest in FP programs has declined among policy-makers. Most of the research in this area faces two key challenges. The first is the challenge of measurement. Given that FP programs are heterogeneous in goals, quality of services, delivery systems and implementation strategies, researchers must construct a measure of program strength and not rely 11 The following conditions were imposed in the United States Leadership against HIV/AIDS, Tuberculosis, and Malaria Act of 2003: 20% of funds were to be spent on prevention, 15% to be spent on palliative care, and starting in 2006, at least 55% were to be spent on treatment, at least 10% be spent on orphans and vulnerable children, and at least 33% of appropriated prevention funds be spent on abstinence-until-marriage programs. REFERENCES Amin, S. 1995. Socioeconomic change and the demand for children in rural Bangladesh. Population Council, Research Division. Angeles, G., Jason Dietrich, David Guilkey, Dominic Mancini, Thomas Mroz, Amy Tsui, and Feng Yu Zhang. 2001. A Meta-analysis of the Impact of Family Planning Programs on Fertility Preferences, Contraceptive Method Choice and Fertility. 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Caldwell. 1987. The cultural context of high fertility in sub-Saharan Africa. Population and development review 13, no. 3: 409–437. ———. 1988. Is the Asian family planning program model suited to Africa? Studies in Family Planning 19, no. 1: 19–28. Caldwell, J. C, Barkat-e Khuda, Bruce Caldwell, Indrani Pieris, and Pat Caldwell. 1999. The Bangladesh fertility decline: an interpretation. Population and Development Review 25, no. 1: 67–84. Chowdhury, M. E, R. Botlero, M. Koblinsky, S. K Saha, G. Dieltiens, and C. Ronsmans. 2007. Determinants of reduction in maternal