), and emphasis on actions at the
    local and primary care level.

    For approximately the last three years the Organization has been working
toward the development of a proposed Plan of Action for the quadrennium
1992-1995, which is based in part on a strategic project supported by the W.K.
Kellogg Foundation and will generally follow the Conceptual Framework
presented in Annex I.  Below is a summary of this Plan of Action.


III PLAN OF ACTION FOR THE COMPREHENSIVE HEALTH OF
    ADOLESCENTS

General Purpose:

To contribute to the development of national and Regional initiatives aimed at
ensuring comprehensive health care for adolescents in the countries of the
Region.
A.  OBJECTIVES

    The project described below constitutes an important axis of the
international cooperation with the countries in the comprehensive health area
of comprehensive health of the adolescent.


    General Objectives:

    1)To develop support mechanisms with a view to optimizing the
      participation and performance of the national, subregional, and
      Regional networks of comprehensive health care programs for
      adolescents and to implementing alternative methodologies of
      participation, especially by adolescents, in order to promote and
      strengthen comprehensive health care at the local level.

    2)To develop ways of adapting the health services to provide
      comprehensive health care for adolescents.

    3)To design and implement a plan for human resource development in
      order to facilitate the teaching and delivery of comprehensive health
      care for adolescents.

B.  STRATEGIES

    The proposed project itself is a strategic mechanism for strengthening,
accelerating, and ordering the gradual process of adolescent health development
in the Region.  It, in turn, will be carried out within the following strategic
framework:

1.  From a process standpoint, the project will adhere to the basic principles
of Primary Health Care (PHC) and will seek to:

    a)Give emphasis to basic and primary prevention through the promotion
      of protective measures, the control of risk factors, and the reduction of
      morbidity and mortality.

    b)Apply the following comprehensive approaches:

      - Risk approach

      - Community-based planning and promotion of community and
        intersectoral participation

      - Family approach for prevention and restorative intervention

      - Interdisciplinary and intersectoral teamwork

    c)Encourage the involvement of youth organizations and adolescents and
      young people in the various stages of programming.

    d)Apply a contextual approach to the interpretation of the origin and
      relative importance of determining factors, lifestyles and health-
      related behaviors, and levels of health and development in adolescents,
      taking into account the:

      - Political and economic context (macro)

      - Cultural context and changes therein (intermediate)

      - Local context (micro)
        .Family
        .Schools
        .Workplace
        .Recreation areas
        .Place of residence
        .Other

2.  From the operational standpoint, there will be five main strategies:

    (a) Utilization of local, regional, and national resources through
        scientific societies; technical-scientific institutions; subregional
        agreements; leaders in maternal, child, and adolescent health; local
        programs and projects such as the Kellogg and UNFPA projects for
        the development of activities in the areas of scientific dissemination,
        training, and methodological evaluation and demonstration.  The
        technical, technological, and logistical resources available at the
        Regional (PAHO) and global (WHO) levels will be utilized.

    (b) Activation and strengthening of networks of leaders of community-
        based projects, programs, and institutions within and between
        selected countries.

    (c) Utilization of a subregional focus for the selection of countries and
        for certain activities, taking advantage of the geographical proximity
        of countries and their relative similarity in terms of needs, resources,
        culture, etc.  The objective is to optimize resources and promote a
        possible exchange of cooperation and experiences.  From the
        subregional level activities may be extended to the national and local
        levels through the formation of multipliers (cascade effect).

    (d) Selection of six (6) countries for the formation of a network to
        coordinate the development actions, supported by centers located in
        another network comprising another five (5) countries of the Region. 
        The first network of focal countries will include Argentina, Bolivia,
        Guatemala, Paraguay, the Dominican Republic, and an English-
        speaking Caribbean country to be selected.
      
    The second network will incorporate centers in Brazi