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Health and health services in Judaea, Samaria and Gaza 1983-1984: a report by the Ministry of Health of Israel to the Thirty-Seventh world Health Assembly, Geneva, May 1984.
Jerusalem, Israel, Ministry of Health, 1984 Mar. 195 p.Health conditions and health services in Judea, Samaria, and Gaza during the 1967-83 period are discussed. Health-related activities and changes in the social and economic environment are assessed and their impact on health is evaluated. Specific activities performed during the current year are outlined. The following are specific facets of the health care system that are the focus of many current projects in these districts; the development of a comprehensive network of primary care programs and centers for preventive and curative services has been given high priority and is continuing; renovation and expansion of hospital facilities, along with improved staffing, equipment, and supplies for basic and specialty health services increase local capabilities for increasingly sophisticated health care, and consequently there is a decreasing need to send patients requiring specialized care to supraregional referral hospitals, except for highly specialized services; inadequacies in the preexisting reporting system have necessitated a continuting process of development for the gathering and publication of general and specific statistical and demographic data; stress has been placed on provision of safe drinking water, development of sewage and solid waste collection and disposal systems, as well as food control and other environmental sanitation activities; major progress has been made in the establishment of a funding system that elicits the participation and financial support of the health care consumer through volunary health insurance, covering large proportions of the population in the few years since its inception; the continuing building room in residential housing along with the continuous development of essential community sanitation infrastructure services are important factors in improved living and health conditions for the people; and the health system's growth must continue to be accompanied by planning, evaluation, and research atall levels. Specific topics covered include: demography and vital statistics; socioeconomic conditions; morbidity and mortality; hospital services; maternal and child health; nutrition; health education; expanded program immunization; environmental health; mental health; problems of special groups; health insurance; community and voluntary agency participation; international agencies; manpower and training; and planning and evaluation. Over the past 17 years, Judea, Samaria, and Gaza have been areas of rapid population growth and atthe same time of rapid socioeconomic development. In addition there have been basic changes in the social and health environment. As measured by socioeconomic indicators, much progress has been achieved for and by the people. As measured by health status evaluation indicators, the people benefit from an incresing quantity and quality of primary care and specialty services. The expansion of the public health infrastructure, combined with growing access to and utilization of personal preventive services, has been a key contributor to this process.
[Unpublished] 1984 May 8. 31 p. (CE 92/12)This report shows how demographic information can be analyzed and used to identify and characterize the groups assigned priority in the Regional Plan of Action and that it is necessary for the improvement of the planning and allocation of health resources so that national health plans can be adapted to encompass the entire population. In discussing the connections between health and population characteristics in the countries of the region, the report covers mortality, fertility and health, and fertility and population increase; spatial distribution and migration; and the structure of the population. Focus then moves on to health, development, and population policies and family planning. The final section of the report considers the response of the health sector to population trends and characteristics and to development-related factors. The operations of the health sector must be revised in keeping with the observed demographic situation and the projections thereof so that the goal of health for all by the year 2000 may be realized. In several countries of the region mortality remains high. In 1/3 of them, infant mortality during the period 1980-85 exceeds 60/1000 live births. If measures are not taken to reduce mortality 55% of the population of Latin America in the year 2000 will still be living in countries with life expectancies at birth of under 70 years. According to the projections, in the year 2000 the birthrate will stand at around 29/1000, with wide differences between the countries of the region, within each of them, and between socioeconomic strata. High fertility will remain a factor hostile to the health of women and children and a determinant of rapid population growth. Some governments view the present or predicted growth rates as excessive; others want to increase them; and some take no explicit position on the matter. The countries would be well advised to assign values to their birthrate, natural increase, and periods for doubling their populations in relation to their development plans and to the prospects for improving the standard of living and health of their populations. An important factor in urban growth is internal migration. These migrants, like some of those who move to other countries, may have health problems requiring special care. Regardless of a country's demographic situation, the health sector has certain responsibilities, including: the need to promote the framing and adoption of population and development policies, in whose implementation the importance of health measures is not open to question; and the need to favor the intersector coordination and articulation required to ensure that population aspects are considered in national development planning.
[National Conference on Fertility and Family, Oaxaca de Juarez, Oaxaca, April 13, 1984] Reunion Nacional sobre Fecundidad y Familia, Oaxaca de Juarez, Oax., a 13 de abril de 1984.
Mexico City, Mexico, CONAPO, 1984. 228 p.Proceedings of a national conferences on the family and fertility held in April 1984 as part of Mexico's preparation for the August 1984 World Population Conference are presented. 2 opening addresses outline the background and objectives of the conference, while the 1st paper details recommendations of a 1983 meeting on fertility and the family held in New Delhi. The main body of the report presents 2 conference papers and commentary. The 1st paper, on fertility, contraception, and family planning, discusses fertility policies; levels and trends of fertility in Mexico from 1900 to 1970 and since 1970; socioeconomic and geographic fertility differentials; the relationship of mortality and fertility; contraception and the role of intermediate variables; the history and achievements of family planning activities of the private and public sectors in Mexico; and the relationship between contraception, fertility, and family planning. The 2nd paper, on the family as a sociodemographic unit and subject of population policies, discusses the World Population Plan of Action and current sociodemographic policies in Mexico; the family as a sociodemographic unit, including the implications of formal demography for the study of family phenomena, the dynamic sociodemographic composition of the family unit, and the family as a mediating unit for internal and external social actions; and steps in development of a possible population policy in which families would be considered an active part, including ideologic views of the family as a passive object of policy and possible mobilization strategies for families in population policies. The conference as a whole concluded by reaffirming the guiding principles of Mexico's population policy, including the right of couples to decide the number and spacing of their children, the fundamental objective of the population policy of elevating the socioeconomic and cultural level of the population, the view of population policy as an essential element of development policy, and the right of women to full participation. Greater efforts were believed to be necessary in such priority areas as integration of family planning programs with development planning and population policy, creation of methodologies for the analysis of families in their social contexts, development and application of contraceptive methodologies, promotion of male participation in family planning, coordination of federal and state family planning programs, and creation of sociodemographic information systems to ensure availability of more complete date on families in specific population sectors. The principles of the World Population Plan of Action were also reaffirmed.
In: Third Asian and Pacific Population Conference (Colombo, September 1982). Selected papers. Bangkok, Thailand, Economic and Social Commission for Asia and the Pacific, 1984. 9-40. (Asian Population Studies Series No. 58)This report summarizes the recent demographic situation and considers prospective trends and their development implications among the 39 members and associate members of the Economic and Social Commission for Asia and the Pacific (ESCAP). It presents data on the following: size, growth, and distribution of the population; age and sex structure; fertility and marriage; mortality; international migration; growth and poverty; food and nutrition; households and housing; primary health care; education; the working-age population; family planning; the elderly; and population distribution. Despite improvements in the frequency and quality of demographic data collected in recent years, big gaps continue to exist in knowledge of the demographic situation in the ESCAP region. Available evidence suggests that the population growth rate of the ESCAP region declined between 1970 and 1980, as compared with the preceding decade, but that its rate of decline was slow. Within this overall picture, there is wide variation, with the most developed countries having annual growth rates around 1% and some of the least developed countries having a figure near 3%. The main factors associated with the high growth rates are the past high levels of fertility resulting in young age structures and continuing high fertility in some countries, notably in middle south Asia. The population of countries in the ESCAP region is expected to grow from 2.5 billion in 1980, to 2.9 billion in 1990, and to 3.4 billion persons by the year 2000. This massive growth in numbers, which will be most pronounced in Middle South Asia, will occur despite projected continuing moderation in annual population growth rates. Fertility is expected to continue its downward trend, assuming a more widespread and equitable distribution of health, education, and family planning services. Mortality is expected to decline further from its current levels, where life expectancy is often at or around 50 years. In several countries, more than 10 in every 100 babies born die before their 1st birthday. The extension of primary health care services is seen as the key to reducing this figure. Rapid population growth and poverty tend to reinforce each other. Low income, lack of education, and high infant and child mortality contribute to high fertility, which in turn is associated with high rates of natural increase. High rates of natural increase feed back to depress socioeconomic development. High population growth rates and their correlates of young age structures and heavy concentrations of persons in the nonproductive ages tend to depress production and burden government expenditure with high costs for social overhead needs. Rapid population growth emerges as an important factor in the persistence of chronic undernutrition and malnutrition. It increases the magnitude of the task of improving the educational system and exacerbates the problem of substandard housing that is widely prevalent throughout Asia.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 289-303. (International Conference on Population, 1984; ST/ESA/SER.A/91)The United Nations Fund for Population Activities (UNFPA) assistance program encompasses basic data collection, population dynamics, formulation of population policies, implementation of general policies, family planning activities, communication and education programs, and special programs and multisector activities. This paper focuses on UNFPA assistance in the area of mortality. The Fund does not provide support for activities related to the reduction of mortality per se; rather, it contributes indirectly to the improvement of infant, child, and maternal health through assistance to family planning programs integrated with maternal-child health care. The types of activities UNFPA supports in this area include prenatal, delivery, and postnatal care of mothers and infants; infant and child care; health and nutrition education; promotion of breastfeeding; monitoring of infant malnutrition; and diagnostic studies and treatment of infertility and subfecundity. The Fund has cumulatively expended about US$87.3 million for activities in the area of mortality and health policy. The Fund is currently providing collaborative assistance to the World Health Organization and the UN for a comprehensive project aimed at measuring mortality trends and examining the roles of socioeconomic development and selected interventions in the mortality decline in certain developing countries. At present there is a need for research on the persistence of high mortality in the least developed countries, the early levelling off of life expectancies in many countries, and the determinants of socioeconomic differentials in mortality. Understanding of the mortality situation in many developing countries has been hindered by a lack of descriptive data on mortality by socioeconomic, regional, and occupational status. The real challenge lies in the implementation of policies designed to reduce mortality; political, managerial, and cultural factors unique to each country, as well as pervasive poverty, make this a difficult process.
Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 37-79. (International Conference on Population, 1984.; ST/ESA/SER.A/91)This paper reviews the major issues that have emerged in the analysis of mortality and health policy since the 1974 World Population Conference. The 1st part summarizes current mortality conditions in the major world regions and evaluates progress toward achieving the goals of the World Population Plan of Action. It is noted that the current mortality situation is characterized by continued wide disparities between the more developed and less developed regions, especially during the 1st year of life. The 2nd part focuses on the synergistic relationship between health and development, including social, economic, and health inequalities. It is asserted that mortality rates in developing countries are a function of the balance governments select between development strategies favoring capital accumulation and concentrated investments on the 1 hand and strategies oriented toward meeting basic needs and reducing inequalities in income and wealth. Data from developed countries suggest that economic development does not necessarily lead to steady gains in life expectancy. Some variations in mortality may reflect changes in family relationships, especially women's status, that are induced by social and economic development, however. The 3rd part of this paper analyzes the effect of health policies on mortality, including curative and preventive programs and primary health care. The lack of community participation is cited as a key factor in the weak performance of primary health care in many developing countries. In addition, there is strong evidence that the concepts and technologies of modern medicine must be adapted to existing systems of disease prevention and care to gain acceptability. The 4th section, on the implementation of health policies, discusses health care management, planning, and financing. It is noted that successful implementation of health policies is often hindered by scarcity, inadequate allocation, and inefficient utilization of health resources. Finally, more effective means to cope with rising costs of health care are needed.
Studies in Family Planning. 1984 Nov-Dec; 15(6/1):296-302.The international Conference on Population, held in Mexico City in August 1984, met to review past developments and to make recommendations for future implementation of the World Population Plan of Action. Despite the several ifferences of opinion, the degree of controversy was minor for an intergovernmental meeting of this size. The 147 government delegations at the Conference reached overall agreement on recommendations for future international commitment to expanding population efforts in the future. This review examines the recommendations of the Mexico Conference with regard to health, family planning, women in development, research, and realted issues. The total 88 recommendations wre intended to reaffirm and refine the World Population Plan of Action adopted in Bucharest in 1974, and to strengthen the Plan for the next decade. Substantial improvement in development was noted including fertility and mortality declines, improvements in school enrollement and literacy rates, as well as access to health services. Economic trends, however, were much less encouraging. While the global rate of population growth has declined slightly since 1974, world population has increased by 770 million during the decade, with 90% of that increase in the developing countries. Part of the controversy at the Conference focused on the remarkable change of position by the US delegation, which largely reversed the policies expressed at Bucharest. The US delegation stated that population was a neutral issue in development, that development is the primary requirement in achieving fertility decline. Several recommendations emphasized the need to integrate population and development planning, and called for increased national and international efforts toward the eradication of mass hunger, illiteracy, and unemployment; achievement of adaquate health and nutrition levels; and improvement in women's status. The need for futher development of management, training, information, education and communication was recognized. A clear call to strenghten global efforts in population policies and programs emerged.
[Unpublished] 1984. Presented at the Second African Population Conference, Arusha, Tanzania, January 9-13, 1984. 21 p.This discussion of Ethiopia focuses on: sources of demographic data; population size and age-sex distribution; urbanization; fertility; marital status of the population; mortality and health; rate of natural increase; economic activity and labor force activity rates; food production; education; population policies and programs; and population in development planning. As of 1983, Ethiopia's population was estimated at 33.7 million. Agriculture is the mainstay of the economy. Ethiopia has not yet conducted a population census, however, the 1st population and housing census is planned for 1984. The population is young with children under 15 years of age constituting 45.4% of the total population; 3.5% of the population are aged 65 years and older. The degree of urbanization is very low while the urban growth rate is very high. Most of the country is rural with only 15% of the population living in localities of 2000 or more inhabitants. In 1980-81 the crude birthrate was 46.9/1000. The total fertility rate was 6.9. Of those aged 15 years and older, 69.2% of males and 71.3% of females are married. According to the 1980-81 Demographic Survey the estimates of the levels of mortality were a crude death rate of 18.4/1000 and an infant mortality rate of 144/1000. At this time 45% of the population have access to health services. It is anticipated that 80% of the population will be covered by health care services in 10 years time. Ethiopia is increasing at a very rapid rate of natural increase; the 1980 estimation was 2.9% per annum. Despite the rich endowments in agricultural potential, Ethiopia is not self-sufficient in food production and reamins a net importer of grain. Enrollment at various levels of education is expanding rapidly. There is no official population policy. Financial assistance received from the UN Fund for Population Activities and the UN International Children's Emergency Fund for population programs is shown.
London, International Planned Parenthood Federation, Europe Region, 1984 Jun. 122 p.Reflections, speculations, and partial evaluations of work already undertaken in the International Planned Parenthood Federation (IPPF) Europe Region concerning migrants and planned parenthood are presented. This project, initiated by the Federal Republic of Germany Planned Parenthood Association (PPA), PRO FAMILIA, stemmed from the practical experiences and problems of 1 family planning association in the Europe region. The original substantive framework, consisting of data collection and correspondence, plenary meetings, and subworking group meetings on specific areas of interest, was not altered. Throughout the project, as the work was accomplished, the emphasis shifted to different aspects to migrant work. The 1st questionnaire was intended to provide a sociodemographic profile of the participating countries, a show European migratory movements, and ascertain the ethnicity of the target groups in the different countries. The 2nd questionnaire was related specifically to PPA and/or other family planning center's data and activities and attempted to explore PPA attitudes toward migrant clients, when special facilities for migrants were provided, and whether PPAs felt there was a particular need for such services. The report provides a sociodemographic background of migration in Europe. In addition it includes information from donor countries and recipient countries, examining family planning services in the Federal Republic of Germany and the UK. It also covers training; information, education, and communication; adolescence and 2nd generation migrants; and migrant work. It is necessary to be particularly aware of political sensitivities in treating immigrant fertility regulation. Ideally, the aim is to provide an integrated service for migrants and natives both, catering to individual needs. Until this is feasible, the goal must be to work toward an integrated service, recognizing the needs and providing special services where possible if this is judged tobe the best approach to catering to those needs. Migrant needs must be discovered rather than assumed. Better use should be made of the available printed material, which should be utilized to complement oral information where possible. Experience has shown that family planning personnel working with migrants need additional training. The main components of this training should include self-awareness, insight, and knowledge.
Draper Fund Report. 1984 Jun; (13):1-3.The UN International Conference on Population to be held in Mexico City in August 1984, responding to an unprecedented upsurge of interest in population over the last decade, offers developed and developing countries the opportunity to assess current and likely future population trends, to comment on programs and progress during the past 10 years, and to determine desirable future directions. More developing countries are reporting diminished declining fertility and family size in countries of widely varying ethnic, social, and economic makeup. Although it is likely that the future will bring a steadily declining rate of world population growth, culminating in stability, present trends indicate that it will take more than a century for world population to stabilize. Meanwhile growth continues. The developing world's annual average birthrate from1975-80 was twice as high as the developed world's. Also there are large areas, much of Latin America and most of Africa, where growth rates continue very high. Other areas, such as parts of Asia, do not follow the general declining trend despite trend despite, in some instances, a long history of population programs. Interest in population programs and demand for resources to support them are growing, but the population dimension is sometimes unrecognized in development planning. The experience of the last decade illustrates that population assistance can make a uniquely valuable contribution to national development when it is given in accord with national policies, is appropriate to local conditions and needs, and is delivered where it can make the most impact. Substantial evidence exists that women in the developing world undertand the risks of repeated pregrancy and would like to take steps to reduce them. It is evident that providers of family planning services are not yet sufficiently responsive to women's own perceptions of their needs and that the social and economic conditions which make family planning a reasonable option do not yet exist. Influxes of immigrants, short and long term, legal and illegal, create particular problems for receiving countries. It is important for sending countries to know what effect the absence of their nationals is having on the domestic economy and essential for receiving countries to consider the protection of the human rights of international migrants, including settlers, workers, undocumented migrants, and refugees. It is a particular responsibility of the industrialized nations to make careful use of limited resources and to ensure that their comsumption contributes to the overall balance of the environment. In most developing countries infectious and parasitic disease remains the primary cause of death, particularly among the young. Much of this toll is preventable. The International Conference on Population provides an opportunity to establish in broad terms the conditions and directions of future cooperation.