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The Millennium Development Goals and the road to 2015: Building on progress and responding to crisis.
Washington, D.C., World Bank, 2010.  p.The Millennium Development Goals provide a multidimensional framework for attacking poverty in a world of multipolar growth. By focusing on measurable results, they provide a scorecard for assessing progress toward mutually agreed targets. And by enlisting the support of national governments, international agencies, and civil society in a development partnership, they have brought greater coherence to the global development effort. In this way they take us beyond the old, sterile opposition of “developed” and “developing” or “north” and “south.” The evidence from the last 20 years, documented in the statistical record of the MDGs, is that where conditions and policies are right for growth with equity, rapid and sustainable progress toward improving the lives of the poorest people can take place. Not every country will achieve the global MDG targets in the time allowed. Success has not been distributed evenly and there have been serious setbacks. Some countries are still burdened by legacies of bad policies, institutional failures, and civil and international conflict. For them, progress toward the MDGs has been delayed, but the examples of good progress by others point the way for their eventual success.
[Crisis in human resources for health: millennium development goals for maternal and child health threatened] Tekort aan gezondheidswerkers in Afrika: millenniumdoelstellingen voor moeder- en kindzorg in gevaar.
Nederlands Tijdschrift Voor Geneeskunde. 2010; 154(5):A1159.International migration of health care workers from low-income countries to the West has increased considerably in recent years, thereby jeopardizing the achievements of The Millennium Development Goals, especially number 4 (reduction of child mortality) and 5 (improvement of maternal health).This migration, as well as the HIV/AIDS epidemic, lack of training of health care personnel and poverty, are mainly responsible for this health care personnel deficit. It is essential that awareness be raised amongst donors and local governments so that staffing increases, and that infection prevention measures be in place for their health care personnel. Western countries should conduct a more ethical recruitment of health care workers, otherwise a new millennium development goal will have to be created: to reduce the human resources for health crisis.
Last chance for the world to live up to its promises? Why decisive action is needed now on child health and the MDGs. A World Vision policy briefing.
Milton Keynes, United Kingdom, World Vision International Policy and Advocacy, 2008 Sep. 15 p. (World Vision Policy Briefing)Now is the window of opportunity to ensure that 2015 will be remembered as the year the world lived up to its promise to the world's poorest and most vulnerable people. This short briefing paper considers child health in the context of the three health-focused MDGs, identifies concrete steps needed in the coming months to put the MDGs back on track, and summarises World Vision's own efforts to contribute to their achievement. (Excerpt)
New York, New York, United Nations, Department of Economic and Social Affairs, 2007 Jun. 36 p.Since their adoption by all United Nations Member States in 2000, the Millennium Declaration and the Millennium Development Goals have become a universal framework for development and a means for developing countries and their development partners to work together in pursuit of a shared future for all. The Millennium Declaration set 2015 as the target date for achieving most of the Goals. As we approach the midway point of this 15-year period, data are now becoming available that provide an indication of progress during the first third of this 15-year period. This report presents the most comprehensive global assessment of progress to date, based on a set of data prepared by a large number of international organizations within and outside the United Nations system. The results are, predictably, uneven. The years since 2000, when world leaders endorsed the Millennium Declaration, have seen some visible and widespread gains. Encouragingly, the report suggests that some progress is being made even inthose regions where the challenges are greatest. These accomplishments testify to the unprecedented degree of commitment by developing countries and their development partners to the Millennium Declaration and to some success in building the global partnership embodied in the Declaration. The results achieved in the more successful cases demonstrate that success is possible in most countries, but that the MDGs will be attained only if concerted additional action is taken immediately and sustained until 2015. All stakeholders need to fulfil, in their entirety, the commitments they made in the Millennium Declaration and subsequent pronouncements. (excerpt)
Lancet. 2007 Apr 14; 369(9569):1238-1239.More than 10 million children are dying every year, mainly in developing countries, from causes that could be mostly prevented by available cost-effective interventions. Governments worldwide have committed themselves to improve this reality by adopting the Millennium Declaration, in which one of the ten Millennium Development Goals (MDGs) calls for a two-thirds reduction in the number of deaths for children younger than 5 years from the 1990 baseline. From a group of 20 proven interventions that could reduce child mortality by more than 60% (if their coverage could be improved from estimates made in 2000 to 99% of those who need them), three include vaccines: Haemophilus influenzae type B vaccine, measles vaccine, and tetanus toxoid. However, these effective interventions, including vaccines, were not delivered in a way that could reach children who need them most,4 and when delivered, they usually tend to serve the rich and privileged first, leaving the poor to the end. (excerpt)
Lancet. 2006 Apr 8; 367(9517):1137.Francisco Songane, a former Mozambican health minister who took over as Director of the new Partnership for Maternal, Newborn and Child Health on Feb 1, 2006, is a man with a mission. His goal is to capitalise on emerging political will--after years of neglect by the international community-- to reduce the unacceptably high toll of 11 million women, infants, and children under the age of 5 years who die every year from largely preventable diseases. "Children are dying and mothers are dying", he told The Lancet. "It is not normal to die in childbirth. It is not normal to die as a newborn", he says, commenting that in some countries, such as Mozambique, many women do not name their children for the first month because so many babies die. "We have to change that kind of fatalism. We cannot accept that people who make up two thirds of the world's population are dying silently without anyone helping", Songane asserts. (excerpt)
Tracking progress towards the Millennium Development Goals: reaching consensus on child mortality levels and trends.
Bulletin of the World Health Organization. 2006 Mar; 84(3):225-232.The increased attention to tracking progress towards the Millennium Development Goals (MDG), including Goal 4 of reducing child mortality, has drawn attention to a number of interrelated technical, operational and political challenges and to the underlying weaknesses of country health information systems upon which reliable monitoring depends. Assessments of child mortality published in 2005, for almost all low-income countries, are based on an extrapolation of the trends observed during the 1990s, rather than on the empirical data for more recent years. The validity of the extrapolation depends on the quality and quantity of the data used, and many countries lack suitable data. In the long run, it is hoped that vital registration or sample registration systems will be established to monitor vital events in a sustainable way. However, in the short run, tracking child mortality in high-mortality countries will continue to rely on household surveys and extrapolations of historical trends. This will require more collaborative efforts both to collect data through initiatives to strengthen health information systems at the country level, and to harmonize the estimation process. The latter objective requires the continued activity of a coordinating group of international agencies and academics that aims to produce transparent estimates -- through the consistent application of an agreed-upon methodology -- for monitoring at the international level. (author's)
Bulletin of the World Health Organization. 2004 Feb; 82(2):156-157.Many developing countries will not be able to reach the health-related Millennium Development Goals (MDGs) unless clear and immediate action is taken combined with a concerted effort over the next 12 years, warned the World Bank and WHO in Geneva at a meeting on 8 and 9 January. The meeting brought together representatives from concerned countries, development agencies and UN organizations to assess progress towards the healthrelated goals and to map out a future strategy for their achievement. The World Bank and WHO noted that the health goals are particularly difficult to meet and that progress towards them is slower than towards some of the other goals. Four of the eight MDGs, set at the United Nations Millennium Summit in September 2000, relate to health: to reduce maternal mortality by threequarters and child mortality by twothirds, halve the proportion of people who suffer from hunger, combat HIV/ AIDS, malaria and other diseases, and improve access to safe drinking-water and essential drugs. (excerpt)
Finance and Development. 2003 Dec; 40(4):14-19.With just 12 years left to achieve the W Millennium Development Goals, a greater sense of urgency is needed by all sides if the targets are to be met. Many developing countries are making substantial progress toward the MDGs as a result of improved policies, better governance, and the productive use of development assistance. But they could do more with the right mix of policy reforms and additional help. Scaling up efforts to meet the MDGs by 2015 presents both opportunities and challenges. By acting now, developed countries can hasten progress by providing more and better aid and by allowing greater access to their markets. Developing countries, for their part, will need to continue to improve their policies and the way they are implemented. Without greater impetus, there is a serious risk that many countries will fall far short on many of the goals. (excerpt)
POPULATION AND DEVELOPMENT REVIEW. 1994 Mar; 20(1):239-45.In January 1994, a meeting convened in Tokyo by the government of Japan of 15 experts in the field of population, development, and international cooperation resulted in adoption of a document entitled "Towards a Global Partnership in Population and Development: The Tokyo Declaration." This declaration prefigured the key issues and action recommendations of the September 1994 International Conference on Population and Development (ICPD). The Declaration (presented in this document in its entirety) opens with an introduction which describes the current (and changing) political climate in regard to population issues in which the ICPD will take place. Part 1 of the declaration includes a consideration of the relationship between population and sustainable development, women's role in decision-making and the status of females, reproductive health and family planning (FP), population distribution and migration, and south-south cooperation. The declaration contains specific recommendations for action in each area, with the recommendations addressed to governments, the UN, nongovernmental organizations (NGOs), donors, and the international community. Part 2 stresses a move from commitment to action and strongly recommends that by the year 2015 all governments 1) ensure the completion of the equivalent of primary school by all girls and boys and, as soon as that goal is met, facilitate completion of secondary educational levels; 2) in cases where mortality rates are highest, achieve an infant mortality rate below 50/1000 live births with a corresponding maternal mortality rate of 75/100,000 births; 3) in cases with intermediate levels of mortality, achieve an infant mortality rate below 35/1000, an under age 5 years mortality rate below 45/1000, and a maternal mortality rate below 60/100,000; and 4) provide universal access to a variety of safe and reliable FP methods and appropriate reproductive health services (with safe and effective FP methods available in all country's national FP programs by the year 2000). The international community is further urged to support the goals of the ICPD, and the international donor community is asked to support the participation of NGOs in the ICPD. Part 2 ends with an appeal to the international community to mobilize resources to meet these goals. Finally, the declaration calls upon the international community to stabilize world population and address the interrelated issues, and the participants of the Tokyo meeting pledged their individual support to this effort.
In: Population policies and programmes. Proceedings of the United Nations Expert Group Meeting on Population Policies and Programmes, Cairo, Egypt, 12-16 April 1992. New York, New York, United Nations, 1993. 27-41. (ST/ESA/SER.R/128)The world population reached 5.4 billion in mid-1991, and it is growing by 1.7% per annum. The medium-variant United Nations population projection for the year 2025 is now 8.5 billion, 260 million more than the United Nations projection in 1982. This implies reducing the total fertility rate in the developing countries from 3.8 to 3.3 by the year 2000 and increasing contraceptive prevalence from 51 to 59%. This will involve extending family planning services to 2 billion people. For the first time, fertility is declining worldwide, as governments have adopted fertility reduction measures through primary health care education, employment, housing, and the enhanced status of women. Since the 1960s, contraceptive prevalence in developing countries has grown from less than 10% to slightly over 50%. However, 300 million men and women worldwide who desire to plan their families lack contraceptives. Life expectancy has been increasing: for the world, it is 65.5 years for 1990-1995. Infant mortality rates have been halved. Child mortality has plummeted, but in more than one-third of the developing countries it still exceeds 100 deaths/1000 live births. Globally, child immunization coverage increased from only 5% in 1974 to 80% in 1990. At the beginning of the 1980s, only about 100,000 persons worldwide were infected with HIV. During the 1980s, 5-10 million people became infected. WHO projects that the cumulative global total of HIV infections will be between 30 and 40 million by 2000. The European governments are concerned with growing international migration. Currently, 34.5% of governments have adopted policies to lower immigration. In the early 1970s, the number of refugees worldwide was about 3.5 million; by the late 1980s, they had increased to nearly 17 million. A Program of Action for the Least Developed Countries for the 1990s was adopted in September 1990 to strengthen the partnership with the international donor community.
Strengthening maternal and child health programmes through primary health care. Guidelines for countries of the Eastern Mediterranean Region. Based on the deliberations of the Intercountry Meeting on the Integration of MCH into Primary Health Care, Amman, Jordan, 11-15 December 1988.
Alexandria, Egypt, WHO, EMRO, 1991. 75 p. (WHO EMRO Technical Publication No. 18)All countries in the WHO Eastern Mediterranean Region (EMRO) have had maternal and child health (MCH) programs for many years, yet maternal mortality and morbidity and infant mortality remain high. The EMRO office in Jordan, recognizing this dilemma, convened a meeting of national managers from the 22 EMRO member states to discuss how to integrate MCH programs with primary health care (PHC). The meeting resulted in the publication of guidelines and goals to help each country integrate MCH into PHC which would strengthen MCH services and improve MCH status. The managers noted the need to switch from a pregnancy-oriented approach to a holistic approach in which MCH/PHC programs and society consider women as more than childbearers. MCH/PHC programs and society need to be concerned about the well-being of females beginning with infancy and should place considerable health promotion for girls during the pubertal spurt and adolescence. They should also promote prevention of iron deficiency anemia in women. Since maternal mortality is especially high is EMRO, the national managers clearly laid out approaches for health services to reduce maternal mortality caused by obstetrical complications. They also recognized the need for a practical alternative to obstetric care provided by health workers--training traditional birth attendants in each village. They also provided guidance on improving prenatal care to reduce perinatal and neonatal mortality such as vaccination of every pregnant woman with the tetanus toxoid. Since the causes of death in the postneonatal period, MCH/PHC programs need to take action to reduce malnutrition and infection. For example, they must promote breast feeding for at least the first 6 months of life. The managers suggested the implementation of the Child Survival and Development Strategy which includes growth monitoring.
IN POINT OF FACT 1991 Jun; (76):1-3.This paper describes the serious effect of diarrheal and acute respiratory (ARI) disease upon children under 5 years old, and international efforts undertaken by the World Health Organization (WHO) to reduce such mortality. Combined, these diseases account for more then 1/2 of all deaths in this age group, and constitute the most serious threat to their health. WHO estimates for 1990 that diarrheal illnesses caused 3.2 million childhood deaths and that ARI caused 4.3 million. While some child deaths are due to measles and pertussis, the majority is caused by pneumonia and the consequences of diarrheal illnesses. These deaths could be readily averted through the timely, effective treatment of trained health workers with essential drugs. Immunization as well as improved nutrition, particularly through the practice of exclusive breast feeding of the child's 1st 4-6 months of life, are addition weapons potentially employed against child mortality. WHO programs for diarrhea and ARI control focus upon simplified treatment guidelines, training, communication messages, drug supplies, and evaluation methodology. Despite obstacles such as the marketing of useless and/or potentially dangerous anti-diarrheal drugs and cough and cold remedies, and inappropriate breastmilk substitutes and unnecessary foods, widespread progress in program development and implementation has been made over the past decade. Increased amounts of oral rehydration therapy and solutions are available and used, while many health workers have benefited from training programs.
WORLD HEALTH. 1992 Sep-Oct; 28-9.Adding a tiny bit of iodine to salt is the standard and proven long-term strategy for controlling iodine-deficiency disorders such as endemic goiter and cretinism, physical and mental retardation, impaired school performance and work capacity, and increased rates of abortion, stillbirth, congenital anomalies, and perinatal, infant, and child mortality. The 1990 World Summit for Children acknowledged the magnitude and seriousness of this problem and called for efforts to eliminate the root cause of these conditions by the year 2000. Salt industry representatives and government officials from Botswana, Lesotho, Malawi, Mozambique, Namibia, Zaire, Zambia, and Zimbabwe subsequently met in April 1992 to decide how to ensure that all salt consumed in the region is iodinated at the production source. Workshop participants agreed on appropriate levels of iodine and suitable packaging to ensure the retention of iodine even after salt has been transported over great distances or stored for long periods. Moreover, the Botswana Company agreed to assume the cost of iodinating all salt for human and animal consumption which it will supply to 10 countries in southern and central Africa.
In: Issues in contemporary international health, edited by Thomas A. Lambo and Stacey B. Day. New York, New York, Plenum Medical Book Company, 1990. 113-33.The causes of mortality and disability in the world are reviewed, and the 4 most important mechanisms for promoting maternal and child health are proposed: female literacy, family planning, community-based efforts and global strategies for international cooperation. The health needs of women, children and adolescents, who make up the majority and the most vulnerable segment of the population, must be met. Malnutrition is the single most important cause of health problems through adult life, and affects 20 million children in Africa alone. Statistics are cited for infant mortality, vaccine-preventable diseases, diarrheal diseases and respiratory infections, infant mortality and maternal mortality. The key determinant of infant survival is female literacy. Existing scientific cooperation is the closet thing we have to a global international community. An example of applied scientific solutions to health care is the risk approach in maternal health care. 2 strategies of scientific cooperation have emerged: the international center model in a country or region to address a specific problem, and the task force model, as used effectively by WHO, UNICEF, and the Task Force for Child Survival. Research topics on health in developing countries are listed that could be tackled by universities and scientific networks, e.g. scientific research is lacking on how to make household hygiene effective in poor countries. A concerted global research effort and surveillance effort is needed for AIDS.
Meeting of principal investigators of risk approach study in MCH care, report of an intercountry meeting, Rangoon, Burma, 30 December 1985-3 January 1986.
[Unpublished] 1986 Sep 5. ii, 42 p. (SEA/MCH/183; RAS/85/P23)Objectives of the intercountry meeting of principal investigators of risk approach study in maternal-child health (MCH) care were: 1) to review the results of the risk approach studies in Burma, India, and Thailand that have been done to identify research design and method problems, and to propose solutions for improved study; 2) to identify research issues relevant to study, and applying the risk strategy; 3) to explore the devices for application of the risk approach results in delivery of MCH/family planning (FP); and 4) to find further areas for research. In Burma, some problems were: there were no proper patient records; and staff was not being scheduled properly. There was a drop in the overall incidence of low birth weight deliveries from 21% in 1977-78 to 10-16% in 1983-83. The Indian project was started in January 1981, and lasted until the end of December, 1984. Study design was a "before and after" model. The overall risk detection rate was 80%. In Thailand a "before and after" model was used in 136 villages of 18 subdistricts in the Bang Pa In district of Ayuthaya Province. The before intervention situation took place in 1977-78; the after period runs from May, 1980 to April, 1983. Overall results show better coverage of prenatal, natal, and child care; and improvement in diarrhea and tetanus morbidity in newborns. The Amphur Nong Rua area of Khon Kaen was chosen as the 2nd Thailand project area. Its population is 77,209 (1983) living in 116 villages. A stratified random sampling technique was used. All women who miscarried or delivered from January 1, 9182 to December 31, 1983 and all infants born to these mothers were included. The health system of Bhutan is discussed, as well as health organization in Burma, India, Indonesia, Nepal, Sri Lanka, and Thailand. Researchable issues include low birth weight, social-behavioral, nutritional deficiency, and mental health studies. An action program is described.
In the child's best interest. A primer on the U.N. Convention on the Rights of the Child. New edition. Revised text.
East Greenwich, Rhode Island, Foster Parents Plan International, 1989. , 46 p.In March 1989, the United Nation's (UN) Commission on Human Rights adopted a draft Convention on the Rights of the Child. Poland submitted the original proposal to the UN in 1978. A final convention was scheduled to be set before the UN General Assembly for adoption in late 1989. To become international law, at least 20 UN member countries must ratify it. It is crucial that this convention becomes law to guarantee children around the world basic human rights that all too often are denied them. Presently no nation protects the rights of all its children or affords them adequate health care, housing, day care, and nutrition. For example, > 38,000 children die/day because they do not have access to food, shelter, or primary health care. In the United States, > 11 million children do not have health insurance and do not receive basic health care. In addition, these nations fail to protect children from abuse, neglect, and exploitation. For example, poverty forces many children into prostitution in both the developed and developing countries. Further, > 100 million children worldwide work under hazardous conditions and sometimes receive no pay. Unstable political conditions, such as war, have resulted in > 10 million child refugees worldwide who often live in temporary shelters and receive insufficient food and health care. Since children are particularly vulnerable, it is the responsibility of adults to defend children's rights. The Convention defines these rights as the right to survival, the right to protection, and the right to develop in a safe environment free from discrimination.
In: AIDS and associated cancers in Africa, edited by G. Giraldo, E. Beth-Giraldo, N. Clumeck, Md-R. Gharbi, S.K. Kyalwazi, G. de The. Basel, Switzerland, Karger, 1988. 6-10.The global acquired immunodeficiency syndrome (AIDS) epidemic has, in fact, been comprised of 3 successive epidemics. The 1st of these epidemics is infection with human immunodeficiency virus (HIV), which has already affected 5-10 million people worldwide. The 2nd epidemic, following the 1st but with a delay of several years, is the epidemic of AIDS and other related conditions. By September 1987, a total of 59,563 cases of AIDS had been reported to the World Health Organization (WHO) from 123 countries. However, given the reluctance of some countries to report AIDS and underrecognition of the syndrome, WHO believes the actual number of global AIDS cases is closer to 100,000. 10-30% of HIV-infected persons appear to develop AIDS within a 5-year period, suggesting that 500,000-3 million new cases of AIDS will emerge during the next 5 years. The 3rd epidemic is the wave of economic, social, and political reaction to the 1st 2 epidemics. Since AIDS most often affects individuals in the most economically and socially productive age groups, it can be expected to have a devastating effect on social and economic development in Third World countries. In areas where 10% or more of pregnant women are infected with HIV, projected gains in infant and child health anticipated through child survival initiatives will be cancelled out. AIDS is also having a devastating effect on the health care system in Third World countries as AIDS patients consume limited supplies of drugs, require costly diagnostic tests, and occupy limited numbers of hospital beds. Fear and ignorance about AIDS has threatened free travel between countries and open international exchange and communication. WHO believes the spread of AIDS can be stopped, but only through a sustained, longterm commitment that extends beyond the boundaries of individual countries. AIDS control will require both committed national AIDS programs and strong international leadership, coordination, and cooperation.
The potential of national household survey programmes for monitoring and evaluating primary health care in developing countries. L'apport potentiel des enquetes nationales sur les menages a la surveillance et a l'evaluation des soins de sante primaires dans les pays en developpement.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1985; 38(1):38-64.National programs of household sample surveys, such as those being encouraged through the National Household Survey Capability Program (NHSCP), are a principal source of information on primary health care in developing countries. Being representative of the total population, the major population subgroups and geographic subdivisions, they permit calculation of health status and utilization of health services. Household surveys have an important role to play in monitoring and evaluating primary health care since they sample directly the intended beneficiaries, and so can be used to judge the extent to which programs are meeting expected goals. Caution is necessary, however, since methodological problems have been experienced for many evaluation surveys. National surveys are especially appropriate for measuring many indicators of progress towards national goals within a broad socioeconomic perspective. Future directions in making the optimum use of household surveys for health program purposes are indicated. The NHSCP is a major undertaking of the UN system including WHO to collaborate with developing countries to establish a continuing flow of integrated statistics on a recurrent basis to support the national development process and information priorities. It brings together the principal users and producers of data to plan and conduct surveys which respond to national needs and priorities. The NHSCP encourages countries to employ a permanent national field organization for data collection. Areas of discussion are: the potential for monitoring and evaluation, the household survey as a source of health indicators, the demand for household surveys of health, followed by a summary of the health and health-related topics covered by 6 national health and nutrition surveys conducted in several developing countries. The special themes of infant and child mortality, morbidity and nutritional surveillance are also considered. The experience of many developed countries has been very positive with the use of nonmedically organized health surveys. Although the sample survey can be used in many settings to obtain population-based data, it must be carefully designed and implemented according to scientific procedures in order for the results to be validly extrapolated to the population or subgroups of primary concern.
Operational responses to the World Population Plan of Action in programmes of the UNFPA in the areas of fertility, family and family planning.
In: United Nations. Department of International Economic and Social Affairs. Population Division. Fertility and family. New York, New York, United Nations, 1984. 439-66. (International Conference on Population, 1984; Statements)This paper reviews briefly the experience of UNFPA supported programs related to family, fertility and family planning in developing countries, through the analysis of recommendations of the 1974 World Population Plan of Action and corresponding UNFPA programs. The paper also identifies some programmatic areas that need emphasis in the further implementation of the recommendations of the Plan. Among the Plan's many recommendations, those dealing with the protection of the family, with the improvement of the status of women, with modernization and fertility and with the right of individuals and couples to plan their families, are of special importance to family and fertility. With the accumulation of experience throughout the last decade, the Fund has moved from its original projects approach to a program approach comprising a set of complementary population activities. More recently a needs assessment approach has been adopted. Many UNFPA activities touch upon the reduction of infant, child and maternal mortality, and the improvement of the role and status of women. The Fund takes family planning to include those practices that help individuals or couples to avoid unwanted births, to bring about wanted births, to control the timing of births and to determine the number of children in a family. The Fund supports a broad spectrum of activities in family planning. Among the most important are education and communication programs, activities to strengthen service delivery and to expand population coverage; program management and evaluation, operational, behavioral, and clinical research. Collaboration between UNFPA and individual countries has led to changes in ways of thinking about population. The most important finding, perhaps, relates to the perception of the many dimensions of the population problem. Issues which need further action in the implementation of the Plan include the urgent need to formalize national commitment to fertility, family and related population activities. To improve the link between population and development activities, greater efforts should be made to involve women in the design, implementation and management of population and family planning projects. In general, there is an urgent need to improve family planning services. In spite of an impressive number of research studies on fertility behavior, there is a need for a policy-oriented analysis of fertility decline. Finally, in view of the increased interest in natural family planning as a method of fertility regulation, there is an important need to collect data on the subject, to train natural family planning teachers and to develop teaching materials. Appendices list UNFPA assisted projects in fertility, family and family planning.
[Unpublished] 1984 Aug 13. 40 p. (E/CONF.76/L.3; M-84-718)This report of the International Conference on Population, held in Mexico City during August 1984, includes: recommendations for action (socioeconomic development and population, the role and status of women, development of population policies, population goals and policies, and promotion of knowledge and policy) and for implementation (role of national governments; role of international cooperation; and monitoring, review, and appraisal). While many of the recommendations are addressed to governments, other efforts or initiatives are encouraged, i.e., those of international organizations, nongovernmental organizations, private institutions or organizations, or families and individuals where their efforts can make an effective contribution to overall population or development goals on the basis of strict respect for sovereignty and national legislation in force. The recommendations reflect the importance attached to an integrated approach toward population and development, both in national policies and at the international level. In view of the slow progress made since 1974 in the achievement of equality for women, the broadening of the role and the improvement of the status of women remain important goals that should be pursued as ends in themselves. The ability of women to control their own fertility forms an important basis for the enjoyment of other rights; likewise, the assurance of socioeconomic opportunities on a equal basis with men and the provision of the necessary services and facilities enable women to take greater responsibility for their reproductive lives. Governments are urged to adopt population policies and social and economic development policies that are mutually reinforcing. Countries which consider that their population growth rates hinder the attainment of national goals are invited to consider pursuing relevant demographic policies, within the framework of socioeconomic development. In planning for economic and social development, governments should give appropriate consideration to shifts in family and household structures and their implications for requirements in different policy fields. The international community should play an important role in the further implementation of the World Population Plan of Action. Organs, organizations, and bodies of the UN system and donor countries which play an important role in supporting population programs, as well as other international, regional, and subregional organizations, are urged to assist governments at their request in implementing the reccomendations.
New York, New York, United Nations, 1984. ix, 476 p. (International Conference on Population, 1984; Statements)The Expert Group on Fertility and Family was one of 4 expert groups assigned the task of examining critical, high priority population issues and, on that basis, making recommendations for action that would enhance the effectiveness of and compliance with the World Population Plan of Action. The report of the Expert Group consisted of 6 topics: 1) fertility response to modernization; 2) family structure and fertility; 3) choice with respect to childbearing, 4) reproductive and economic activity of women, 5) goals, policies and technical cooperation, and 6) recommendations. Contained in this report are also selected background papers with discuss in detail fertility determinants such as modernization, fertility decision processes, socioeconomic determinants, infant and child mortality as a ddeterminant of achieved fertility in some developed countries, the World Fertility Survey's contribution to understanding of fertility levels and trends, fertility in relation to family structure, measurement of the impact of population policies and programs on fertility, and techinical cooperation in the field of fertility and the family.
International Conference on Population, 1984. Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983
New York, N.Y, United Nations. Department of International Economic and Social Affairs, 1984. vi, 320 p. (no. ST/ESA/SER.A/91)These are the proceedings of the Expert Group on Mortality and Health Policy convened in preparation for the International Conference on Population, held in Mexico City in August 1984. The aim of the expert group was to examine critical, high-priority population issues and to make recommendations for revisions to the World Population Plan of Action. The present publication contains a report of the discussions and a list of recommendations concerning mortality and health goals, health and development, social policies and programs, mortality and reproductive behavior, data collection and research, and technical cooperation. The report also includes a selection of background papers. These papers deal with mortality and health policy in the context of the World Population Plan of Action and of policies and programs affecting mortality and health, the costs of developing a child survival package in developing countries, financial analysis to assess the viability of health programs, technical cooperation in mortality and health policy, and United Nations Fund for Population Activities (UNFPA) assistance in this area.
In: UNICEF Bangladesh. Situation analysis report, prepared for UNICEF Bangladesh country programming. [DACCA] Bangladesh, UNICEF, 1977 Apr. 25-34.The lack of a vital registration system in Bangladesh and the absence of any nationwide health statistics make it impossible to form an accurate impression of the situation of maternal and child health in the country. However, the few statistics gathered from small scale research projects show that infant and child mortality rates in Bangladesh are unacceptably high. The most important children's health problems in the rural areas appear to be diarrheal diseases, dysentery and malnutrition. A number of factors contribute to this low level of health status including poverty, lack of health and nutrition education, lack of health services and poor sanitation. Children's health care needs are usually served by the same facilities as the general public; the existing health services do not address the major health problems of children which could be cured and prevented with rather unsophisticated interventions. Data on maternal health is also insufficient. Crude indicators reveal that women marry young, the mean age at 1st delivery is 18.5 and the average number of pregnancies in a woman's reproductive life is 8. Maternal mortality is high and the largest proportion of these deaths are directly related to obstetrical factors, with eclampsia being the commonest single cause of death. Family planning programs, antenatal and postpartum services could reduce a large proportion of these maternal deaths. Health services for mothers are of poor quality. No information is available on % of deliveries attended by the various providers (physicians, nurses, TBAs, relatives) and about the quality of such deliveries. Recent government health policy focuses on establishing a health infrastructure in the rural areas, which is prevention-oriented. Examination of the government's health budget, however, does not reveal that health is a high priority. An important recent addition to the government's health delivery system specifically for children is the initiation of Under-5 Clinics, held once a month and offering comprehensive services, e.g., immunization, physical exams, stool and blood exams, nutrition and hygiene training and milk supplement provision. In terms of policy, this is the 1st massive effort specially concerned with children; the initial response indicates an important commitment to children by the government. UNICEF's assistance in the past 5 years has consisted primarily of supplies of drugs, medical equipment and vehicles. Future UNICEF aid will be planned with a more Basic Services/Primary Health Care approach which is domiciliary and rural-based. Attached are tables illustrating trends in infant and child mortality and their causes.
New York, New York, UNICEF, . 42 p.In the last 12 months, world-wide support has been gathering behind the idea of a revolution which could save the lives of up to 7 million children each year, protect the health and growth of many millions more, and help to slow down world population growth. This document summarizes case studies which illustrate the techniques which make this revolution possible. These techniques are: oral rehydration therapy (ORT); growth monitoring; expanded immunization using newly improved vaccines to prevent the 6 main immunizable diseases which kill an esitmated 5 million children a year and disable 5 million more (measles, whooping cough, neonatal tetanus, polio, diphtheria and tuberculosis); and the promotion of scientific knowledge about the advantages of breastfeeding and about how and when an infant should be given supplementary foods. Results are summarized from Guatemala, Papua New Guinea, Brazil, Egypt, Indonesia, Barbados, the Philippines, Nicaragua and Honduras, Malawi, China, Nepal, Bangladesh, Colombia, and Ethiopia. The impact of economic recession and female education on childrens' health is discussed, and basic statistics for developed and underdeveloped countries are given.