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Maintaining momentum to 2015? an impact evaluation of interventions to improve maternal and child health and nutrition in Bangladesh.
Washington, D.C., World Bank, 2005 Aug.  p. (World Bank Report No. 34462)Improving maternal and child health and nutrition is central to development goals. The importance of these objectives is reflected by their inclusion in poverty-reduction targets such as the Millennium Development Goals (MDGs) and Bangladesh’s Interim Poverty Reduction Strategy Paper, supported by major development partners, including the World Bank and the U.K. Department for International Development (DFID). This report addresses the issue of what publicly supported programs and external assistance from the Bank and other agencies can do to accelerate attainment of such targets as reducing infant mortality by two-thirds. The evidence presented here relates to Bangladesh, a country that has made spectacular progress, but needs to maintain momentum in order to achieve its own poverty-reduction goals. The report addresses the following issues: (1) What has happened to child health and nutrition outcomes and fertility in Bangladesh since 1990? Are the poor sharing in the progress being made? (2) What have been the main determinants of maternal and child health (MCH) outcomes in Bangladesh over this period? (3) Given these determinants, what can be said about the impact of publicly and externally supported programs—notably those of the World Bank and DFID—to improve health and nutrition? (4) To the extent that interventions have brought about positive impacts, have they done so in a cost-effective manner? (excerpt)
Human development report 2003. Millennium Development Goals: a compact among nations to end human poverty.
New York, New York, Oxford University Press, 2003. xv, 367 p.The central part of this Report is devoted to assessing where the greatest problems are, analysing what needs to be done to reverse these setbacks and offering concrete proposals on how to accelerate progress everywhere towards achieving all the Goals. In doing so, it provides a persuasive argument for why, even in the poorest countries, there is still hope that the Goals can be met. But though the Goals provide a new framework for development that demands results and increases accountability, they are not a programmatic instrument. The political will and good policy ideas underpinning any attempt to meet the Goals can work only if they are translated into nationally owned, nationally driven development strategies guided by sound science, good economics and transparent, accountable governance. That is why this Report also sets out a Millennium Development Compact. Building on the commitment that world leaders made at the 2002 Monterrey Conference on Financing for Development to forge a “new partnership between developed and developing countries”—a partnership aimed squarely at implementing the Millennium Declaration—the Compact provides a broad framework for how national development strategies and international support from donors, international agencies and others can be both better aligned and commensurate with the scale of the challenge of the Goals. And the Compact puts responsibilities squarely on both sides: requiring bold reforms from poor countries and obliging donor countries to step forward and support those efforts. (excerpt)
Improving child survival and nutrition. The Joint WHO/UNICEF Nutrition Support Programme in Iringa, Tanzania.
Dar es Salaam, Tanzania, UNICEF, 1989. , 20 p.The June-October 1988 evaluation of the Joint WHO/UNICEF Nutrition Support Programme (JNSP) in the Iringa Region of Tanzania demonstrated substantial improvement in the nutritional status of infants and children and a decrease in child deaths since 1984. Prevalence rates of underweight children were 38% in the 2nd quarter of 1988 as compared with 56% in 1984. In addition, prevalence rates of severely underweight children in the 2nd quarters of 1988 and 1984 were 1.8% and 6.3% respectively. This was accomplished because of an enhanced awareness of nutrition among all the people in the region and decision makers consciously considered the growth and development of children as an objective in their daily work. Specifically, the JNSP targeted activities that increase and sustain people's ability to address nutrition problems. These activities included increasing accessibility to nutrition information, establishment of the village based nutritional status and death monitoring system done by existing village health committees and village health workers, and integrated training. These activities concentrated on maternal and child health, water and environmental sanitation, household food security, child care and development, income generating actions, research, and management and staff. This approach in Iringa can be adapted and transferred to other areas of Tanzania.
[Children's health. 40. Unacceptable that 14 million children die every year] Borns sundhed. 40. Uacceptabelt at 14 millioner born dor hvert ar.
SYGEPLEJERSKEN. 1987 Oct 7; 87(41):30-1.The 40th annual report of the UN Children's Emergency Fund (UNICEF) states that about 7 million of the 14 million children who die throughout the world each year could be saved by modern methods of health care and food supply. UNICEF's executive director James Grant points out that 40 years ago little international attention was given to mass death from starvation, but today any such crisis attracts the mass media, and people and governments act to avoid mass death. Undernourishment and epidemics continue to threaten the world's children and more than 280,000 children die from these causes each week. Even with the crises of the past two years in Africa there have been more deaths among children in India and Pakistan than in all of Africa's 46 countries together. Existing knowledge on cheap methods of improving the health of children in underdeveloped countries is sufficient to save at least 7 million children's lives each year. Many millions more could have a normal growth with better information on replacements on mother's milk, vaccinations and access to supplies of water, sugar, and salt for oral rehydration therapy. Just as important are the new technologies of the communications revolution which is taking place in underdeveloped countries. Most homes have a radio, and televisions are available in most villages and in many small communities there are schools and health workers.
World Health. 1985 Nov; 13-15.In November 1980, Dr. Halfdan Mahler, Director-General of the World Health Organization (WHO), and James Grant, head of the UN Children's Fund (UNICEF), drafted a joint program to improve the nutritional status of children and women through developmental measures based on primary health care. The government of Italy agreed to fund in full the estimated cost of US$85.3 million. When a tripartite agreement was signed in Rome in April 1982, the WHO/UNICEF Joint Nutrition Support Program (JNSP) came into being. It was agreed that resources would be concentrated in a number of countries to develop both demonstrable and replicable ways to improve nutrition. Thus far, projects are underway or are just starting in 17 countries in Africa, Asia, Latin America, and the Caribbean. In most of these countries, infant and toddler mortality rates are considerably higher than the 3rd world averages. Program objectives include reducing infant and young child diseases and deaths and at the same time improving child health, growth, and development as well as maternal nutrition. These objectives require attention to be directed to the other causes of malnutrition as well as diet and food. JNSP includes nutrition and many other activities, such as control of diarrhea. The aim of all activities is better nutritional status leading to better health and growth and lower mortality. Feeding habits and family patterns differ from 1 country to another as do the JNSP country projects. Most JNSP projects adopt a multisectoral approach, incorporating varied activities that directly improve nutritional status. Activities involve agriculture and education as well as health but are only included if they can be expected to lead directly to improved nutrition. A multisectoral program calls for multisectoral management and involves coordination at all levels -- district, provincial, and national. This has been one of the most difficult things to get moving in many JNSP projects, yet it is one of the most important. Community participation is vital to all projects. Its success can only be judged as the projects unfold, but early experiences from several countries are encouraging.
[Unpublished] 1984 May 3. Presented at the 1984 Annual Meeting of the Population Association of America, Minneapolis, Minnesota, May 3-5, 1984. 26 p.The paper summarizes the health strategy of the US Agency for International Development (AID). The goal of the strategy is to assist developing countries to 1) reduce mortality among infants and young children, and 2) to reduce disease and disability among selected population groups. The main strategy elements include: 1) improved and expanded use of available technologies; 2) development of new and improved technologies; and 3) strengthening human resource and institutional capability. A more in-depth look is taken at how AID implements its strategy in Asia emphasizing the primary goal of infant mortality reduction. The paper provides a demographic overview of the 9 AID-assisted Asian countries. A summary of AID's program support in Asia showing levels and trends by subcategory is provided. Particular attention is paid to projects supporting selective primary care. Finally, the paper discusses the difficulties of implementing the strategy in Asia and speculates on the chances for success. (author's)
[Child health in Chile and the role of the international collaboration (author's transl)] Salud infantil en Chile y el rol de la colaboracion internacional.
Revista Chilena de Pediatria. 1982 Sep-Oct; 53(5):481-90.Assuring the rights sanctioned by the UN Declaration on the Rights of Children requires the participation of the family, community, and state as well as international collaboration. Health conditions in Chile have improved significantly and continuously over the past few decades, as indicated by life expectancy at birth of 65.7 years, general mortality of 9.2/1000 in 1972 and 6.2/1000 in 1981, infant mortality of 27.2/1000 in 1981. Although the country has experienced broad socioeconomic development, due to inequities of distribution 6% of households are indigent and 17% are in critical poverty. The literacy rate in 1980 was 94%, but further progress is needed in environmental sanitation, waste disposal, and related areas. Enteritis, diarrhea, respiratory ailments, and infections caused 60.4% of deaths in children under 1 in 1970 but only 37.8% in the same group by 1979. Measures to guarantee the social and biological protection of children in Chile, especially among the poor, date back to the turn of the century. Recent programs which have affected child health include the National Health Service, created in 1952, which eventually provided a wide array of health and hygiene services for 2/3 of the population, including family planning services starting in 1965; the National Complementary Feeding Program, which supervised the distribution in 1980 of 25,195 tons of milk and protein foods to pregnant women and small children; the National Board of School Assistance and Scholarships, which provides 300,000 lunches and 750,000 school breakfasts; and programs to promote breastfeeding and rehabilitate the undernourished. Health services are now extended to all children under 8 years in indigent families. Bilateral or multilateral aid to health services in Chile, particularly that offered by the UN specialized agencies and especially the World Health Organization, Pan American Health Organization, and UNICEF, have contributed greatly to the improvement of health care. The Rockefeller, Ford, and Kellogg Foundations have contributed primarily in the areas of teaching and basic and operational research. Aid from the US government assisted in the development of health units and in nutritional and family health programs. The International Childhood Center in Paris rendered educational aid in social pediatrics. (summary in ENG)