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New York, New York, UNICEF, 2008 May. 54 p.Every year, the United Nations Children's Fund (UNICEF) publishes The State of the World's Children, the most comprehensive and authoritative report on the world's youngest citizens. The State of the World's Children 2008, published in January 2008, examines the global realities of maternal and child survival and the prospects for meeting the health-related Millennium Development Goals (MDGs) - the targets set by the world community in 2000 for eradicating poverty, reducing child and maternal mortality, combating disease, ensuring environmental sustainability and providing access to affordable medicines in developing countries. This year, UNICEF is also publishing the inaugural edition of The State of Africa's Children. This volume and other forthcoming regional editions complement The State of the World's Children 2008, sharpening from a worldwide to a regional perspective the global report's focus on trends in child survival and health, and outlining possible solutions - by means of programmes, policies and partnerships - to accelerate progress in meeting the Millennium Development Goals. (excerpt)
Geneva, Switzerland, WHO, Department of Child and Adolescent Health and Development, 2002. 28 p. (WHO/FCH/CAH/02.23)Although the past 15 years have seen a decline in child mortality due to pneumonia, it remains a very important cause of death in developing countries. In Africa in particular, pneumonia and malaria are by far the most important causes of death for children under 5. The overall aim of this meeting was to help to define practical community approaches which could deliver a rapid reduction in this preventable mortality. WHO has developed and supported the use of case management of pneumonia through the ARI Programme and later as a part of IMCI. The main focus for these initiatives has been the health facility, although much of the demonstration of the efficacy of the clinical interventions was carried out at community level, using community health workers. IMCI uses the same clinical methodology. Although IMCI stresses the promotion of care-seeking by families with sick children, in general, the clinical management of such children is offered at the first level health facility. The importance of providing care without delay for children with malaria has led to the development and introduction, so far on a small scale, of interventions based in the community, either through a community health worker or directly by families, who are provided with packs of antimalarials. These two diseases in childhood, pneumonia and malaria, have major overlaps in terms of clinical presentation, the requirements for their effective management and the feasibility of providing standardised care in the community. Technically sound and operationally manageable community interventions that tackled both conditions would offer a most valuable tool for use in the reduction in child mortality in developing countries. (excerpt)
Geneva, Switzerland, WHO, Department of Child and Adolescent Health and Development, 2004.  p. (WHO/FCH/CAH/04.06; UNICEF/PD/Pneumonia/01)Pneumonia remains a major killer of children under five years of age. The best way to reduce pneumonia-related mortality is to provide effective treatment promptly. A meeting of experts, national and international agencies, a meta-analysis of trials, and a comprehensive review of community treatment programmes all came to the same conclusion: Pneumonia can be effectively treated in the community. UNICEF and WHO therefore recommend that community-level treatment be carried out by well-trained and supervised community health workers. (excerpt)
PAHO TODAY. 2001 Jan; 1.In January 2001, the Pan American Health Organization (PAHO) and the American Red Cross (ARC) began working in partnership to reduce deaths in children under 5 years old. Under the US $6 million agreement, both organizations are providing financial and technical assistance to design and carry out community-based projects in each of the 10 countries. These include Bolivia, Colombia, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Nicaragua, Peru and Venezuela. The joint effort reinforces and sustains family and community practices that are important for child health at the district level through the Integrated Management of Childhood Illness (IMCI). In the IMCI approach, primary health care workers are taught a complete process to evaluate the health status of children brought to a health post or clinic. The project is expected to last 5 years and will serve as a model to test conceptual approaches and implementation methods that can help other regions develop community and household components.
[Vaccination, the right of each child, World Day of Health 1987] Vacunacion: derecho de cada nino, Dia Mundial de la Salud 1987.
BOLETIN DE LA OFICINA SANITARIA PANAMERICANA. 1987 Mar; 102(3):263-80.In the 10 years since the Panamerican Health Organization (PAHO) and the World Health Organization initiated the Extended Immunization Program in the Americas (PAI), coverage has increased from less than 1/3 to over 1/2 of children immunized in their first year against 6 major childhood diseases. Due mainly to the PAI, the incidence of measles, tetanus, and diptheria has been reduced by 1/2, that of whooping cough by 75%, and that of tuberculosis by about 5% annually. About 75% of children are immunized against polio, which has 1/10 as many victims today as 10 years ago. PAHO and several other organizations have targeted 1990 for eradication of polio from the South American continent. Since the PAI was established in 1977, more than 15,000 health workers have been trained, cold chains have been established to preserve vaccines, and more than 250 technicians have been trained to maintain and repair the needed equipment. The cost of the campaign to eradicate polio is estimated at US $ 24 million per year for the entire region--a low total compared to the costs of hospitalization and rehabilitation of the victims in the absence of such a program. The goal of immunizing all the world's children by 1990 proposed by the World Health Assembly in 1977 is achievable, but much remains to be done. The number of children immunized in the largest Third World countries ranges from 20-90% owing in part to national immunization days but also to assumption by local communities of the goal of universal immunization by 1990. All deaths produced by these 6 killer diseases are not registered, but the World Health Organization estimates that measles takes 2.1 million lives annually, neonatal tetanus 800,000, and whooping cough 600,000. Governmental and nongovernmental international organizations have made financial help available to countries needing it for their immunization programs. Most developing countries are expected to achieve the goal of universal immunization by 1990, but the 10 poorst countries of Africa and the Eastern Mediterranean may not be able to do so. At the worldwide level, 41% of the 118 million children who survive their first year have been vaccinated against measles and 46% against tuberculosis. 47% have received the full course of vaccine against diptheria, whooping cough, tetanus, and polio. The cost of these immunization is $5-15 per child and 80% is assumed by local countries. The World Health Organization recommends that all children, even the undernourished or slightly ill, be vaccinated, and that all health services vaccinate. Parents should be urged to return for the 2nd and 3rd doses of polio and DPT vaccines. Vaccination programs should pay more attention to impoverished urban populations. Several countries of the region have added innovations such as vaccination against other illnesses, house to house searches for unvaccinated children, or use of mass media to publicize national vaccination programs.
In: Proceedings of the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C., edited by Richard Cash. Washington, D.C., Agency for International Development [AID], Bureau for Science and Technology, 1983. 8-13. (International Conference on Oral Rehydration Therapy, 1983, proceedings)The worst economic setbacks since the 1930s do not augur well for the 100s and millions of children already trapped in the day-to-day silent emergency resulting from the conjunction of extreme poverty and underdevelopment which contributes so greatly to the death and disability toll which afflict over 40,000 small children per day. In the absence of special measures to accelerate health progress significantly, millions more children and mothers in low income areas are likely to die in the decade ahead. This meeting on promoting oral rehydration therapy is a concrete reminder that the key to the effectiveness in improving children's conditions is a refusal to accept a limitation upon what can be done with the available resources. In September, 1982, UNICEF invited a group of experts drawn from international agencies and nongovernmental groups involved in improving the lives of children to meet and discuss the problem. They recognized that certain elements of the primary health care strategy, including oral rehydration therapy, could greatly contribute to the realization of the health for all goal. They focused on community-based services and primary health care and how to improve health services. The improved techniques and technologies, the increased acceptance of the primary health care approach, and a new capacity of social organization for reaching low-income families could save a high proportion of children's lives. Nutritional surveillance, oral rehydration, breastfeeding and better weaning practices, immunization, family spacing, food supplements, and health education will contribute to the health of millions of mothers and families. Everyone is urged to make a commitment to strive for the health for all goal. The media, private organizations and ministeries of health must all join in the effort.
[A possible objective from now to the year 2000: reduce infant mortality in the third world by half] Un objectif possible d'ici 1' an 2000: reduire de moitie la mortalite infantile dans les pays du tiers-monde
Hygiene Mentale. 1984 Jun; 3(2):41-9.Every day 40,000 children die throughout the world, most of them in developing countries. There is a close relationship between infant mortality, life expectancy at birth, the adult literacy rate and national income per capita. Why such huge differences between the infant mortality rate of 7/1000 (live births) in Sweden and 208 in Upper Volta? The 4 scourges which afflict developing countries: hunger (malnutrition), disease, ignorance and poverty are responsible for this state of affairs. The author suggests that coordinated action by governments and International Agencies should be taken to halve the infant mortality rate by the year 2000. He notes that in the past 3 mistakes were made which should not be repeated. The 1st was to improve the living conditions of the population. The green revolution in India provides a striking example of an important progress which benefited only the wealthier farmers. A 2nd mistake was to believe that only a medical approach reduces the infant mortality rate. A 3rd error was to overlook the importance of health education and not to seek the active participation of the people concerned. The author recalls that the International Union for Health Education carried out a sanitary and social program from 1975 to 1978 in Africa, south of the Sahara. To this effect, the IUHE had to find out what the people really wanted, whether they could be motivated to increase the welfare of the villagers by measures adapted to existing possibilities, and to study how the people could recruit health workers among the villagers and train them to create village health committees. 4 weapons used together should reduce the infant mortality rate by 1/2 in the developing world before the end of the century. They are: the promotion of breast feeding, the extended coverage of vaccinations, the early detection of malnutrition and the treatment at hoem of diarrheic diseases thanks to oral rehydration. (author's modified) (summaries in ENG, SPA)
In: American University of Beirut. Faculty of Health Sciences. Human resources for primary health care in the Middle East. Beirut, Lebanon, American Univeristy of Beirut, 1980. 13-21.During 1979, the International Year of the Child, the World Health Organization (WHO) encouraged efforts to improve the collection of information on health and health related problems faced by underprivileged populations. To focus attention on health care for children, the theme of this year's World Health Day on April 7 was the well being of the child. The slogan, "a healthy child, a sure future," was chosen to promote breastfeeding, oral rehydration, nutrition, education, and immunization against the 6 major childhood diseases included in WHO's expanded immunization program. Currently, less than 10% of children in developing countries receive immunization. WHO and its member countries have committed themselves to providing immunization services for every child in the world by 1990, as part of the goal of "health for all by 2000." WHO recommends that each country appoint a program manager and supporting staff to provide detailed plans of operation for immunization. Emphasis in the planning stage should be on the integration of immunization services within the primary health care network for each country. Diarrheal diseases rank among the 1st 3 leading causes of death in children, taking an estimated 5-18 million lives a year, particularly among children under age 5. Dr. Halfdan Mahler, Director General of WHO, has said that the task of safeguarding the health of children cannot be realized through conventional means. What is required is a "radical new approach" which emphasizes the mobilization of national and international resources, the imaginative use of traditional medicine, and the development of health technologies relevant to local needs. A WHO study in 8 developing countries found that 90% of all child deaths could be avoided by safe water and sanitation. This can be regarded as the core of the problem, which indirectly relates to population dynamics and community attitudes. There also appears to be a link between child deaths and births. Maternal and child health care services are not well established in developing nations. Guidelines, quoted from David Werner's book "The Village Health Worker" are quoted to help bridge the gap in reaching the masses. Community health programs will have to be organized on the basis of local needs and priorities. Local health workers from within the community will have to be selected and trained in the delivery of simple basic health care and be responsible to the community.