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Development and testing of the South African National Nutrition Guidelines for People Living with HIV / AIDS.
SAJCN. South African Journal of Clinical Nutrition. 2003 Feb; 16(1):12-16.Malnutrition is a common consequence of HIV infection, and weight loss is used as a diagnostic criterion for HIV/AIDS. The relationship between HIV/AIDS and malnutrition and wasting is well described, with nutritional status compromised by reduced food intake, malabsorption caused by gastrointestinal involvement, increased nutritional needs as a result of fever and infection, and increased nutrient losses. Malnutrition contributes to the frequency and severity of opportunistic infections seen in HIV/AIDS and nutritional status is a major factor in survival. Failure to maintain body cell mass leads to death at 54% of ideal body weight. The effectiveness of nutrition intervention has been documented and dietary nutrition counselling is considered critical in the treatment of HIV/AIDS, especially in view of the fact that drug treatment is inaccessible to many people living with the virus in Africa. (excerpt)
New York, New York, UNICEF, 2005 Nov.  p.FGM/C is a fundamental violation of human rights. In the absence of any perceived medical necessity, it subjects girls and women to health risks and has life-threatening consequences. Among those rights violated are the right to the highest attainable standard of health and to bodily integrity. Furthermore, it could be argued that girls (under 18) cannot be said to give informed consent to such a potentially damaging practice as FGM/C. FGM/C is, further, an extreme example of discrimination based on sex. The Convention on the Elimination of All Forms of Discrimination against Women defines discrimination as "any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field." Used as a way to control women's sexuality, FGM/C is a main manifestation of gender inequality and discrimination "related to the historical suppression and subjugation of women," denying girls and women the full enjoyment of their rights and liberties. (excerpt)
New York, New York, UNICEF, 2005 Feb. 32 p.The objective of this study is to present available empirical evidence obtained through household surveys in order to estimate levels of registration and to understand which factors are associated with children who obtain a birth certificate, and thus realize their right to a name and legal identity. The paper presents a global assessment of birth registration levels, differentials in birth registration rates according to socio-economic and demographic variables, proximate variables and caretaker knowledge, as well as a multivariate analysis. Statistical associations between indicators regarding health, education and poverty can reveal potential linkages in programming to promote the registration of children. By analysing levels of birth registration in the context of other health, education and poverty indicators, the study points to opportunities to integrate advocacy and behaviour change campaigns for birth registration with early childhood care and immunization. By linking birth registration to early childhood programmes, a legal hurdle can become a helpful referral to promote improved health, education and protection for disadvantaged children and their caretakers. (excerpt)
Oxford, England, Oxford University Press, 1988. , 86 p.The 1988 UNICEF report on the world's children contains chapters describing the multi-sectorial alliance to support child health, the current emphasis on ORT and immunization, the effect of recession on vulnerable children, family rights to knowledge of basic health facts, and support for women in the developing world. Each chapter is illustrated by graphs. There are side panels on programs in specific countries, including Senegal, Syria, Colombia, Bangladesh, Turkey, India, Honduras, Japan and Southern Africa, and highlighted programs including immunization, AIDS, ORT, breast-feeding and tobacco as a test of health. The SAARC is a new regional organization of southern Asian countries committed to immunization and other health goals. Tables of health statistics of the world's nations, divided into 4 groups by "Under 5 Mortality Rate" present basic indicators, nutrition/malnutrition data, health information, education, literacy and media data, demographic indicators, economic indicators and data pertaining to women. The absolute numbers of child deaths had fallen to 16 million in 1980, from 25 million in 1950. Saving children's lives will not exacerbate the population problem because, realizing that their children will survive, families will have fewer children. Furthermore, the methods used to reduce mortality, such as breast feeding and empowerment of families to control their lives, are known to reduce fertility.
[Unpublished] 1985. 78 p.A Population/Family Health Assessment was conducted in the Democratic Republic of Madagascar (GDRN) to review population and family planning activities and to make general recommendations for improvement, including the type of US Agency for International Development (USAID) population assistance that should be provided. Despite the fact that Madagascar's population of approximately 9 million is growing at a rate of 2.8% annually, meaning the population will double in less than 25 years, there is no official population policy. Yet, it is significant that the reduction of maternal and infant mortality and morbidity has been identified as an explicit goal in the health sector, and the country's actions long have reflected an attitude of acceptance and support of family planning. The private family planning association is recognized as a nongovernmental organization, which provides clinical and contraceptive services throughout Madagascar. The public health system offers no family planning services. Although the French law of 1920 forbidding the sale and use of contraceptives has not been rescinded, it is not enforced. The private family planning association now provides contraceptive services in 40 Ministry of Health facilities at the request of public health physicians, and the government has approved the participation of 35 medical and paramedical personnel in training courses as well as the installation of laparoscopic equipment in 8 medical facilities. Several other organizations provide child spacing services. Despite the efforts being made, the availability of contraceptive services remains limited, and contraceptive prevalence was estimated at 1% of women aged 15-49 in 1982. Several obstacles impede accessibility to contraceptive services and expansion of family planning programs, including a culture which favors large families, the strong influence of the Catholic Church, and a limited number of medical centers providing family planning services. Further, communication between the Office of Population and the Ministry of Health has not been the most favorable for the development of effective programs either area, but the recent naming of a physician to the position of Director of Population may facilitate closer collaboration. The recommendations made outline a general strategy for the initiation of population activities in the shortterm.
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE. 1986 Jan; 35(1):1-2.A paper by Hazlett et al. is of particular importance because it addresses the question of the role of acute respiratory infections (ARI) as a cause of morbidity and especially mortality in 3rd world children. Diarrheal disease and malnutrition are generally thought to be the major killers of these children, and until recently little attention was paid to ARI. Recent data suggest that ARI are more important than realized previously and almost certainly are the leading cause of death in children in developing countries. It is estimated that each year more than 15 million children less than 5 years old die, obviously most in socially and economically deprived countries. Since death usually is due to a combination of social, economic, and medical factors, it is impossible to obtain precise data on the causes of death. It has been estimated that 5 million of the deaths are due to diarrhea, over 3 million due to pneumonia, 2 million to measles, 1.5 million to pertussis, 1 million to tetanus, and the other 2.5 million or less to other causes. Since pertussis is an acute respiratory infection and measles deaths frequently are due to infections of the respiratory tract, it is becoming clear that ARI are associated with more deaths than any other single cause. The significance of this is emphasized when the mortality rates from ARI in developed and underdeveloped nations are compared. Depending on the countries compared, age group, and other factors, increases of 5-10-fold have been reported. These factors raise the question of why respiratory infections are so lethal for 3rd world children. The severity of pneumonia, which is the cause of most ARI deaths, seems to be the big difference. Data are accumulating which show that bacterial infections are associated with the majority of severe infections and "Streptococcus pneumoniae" and "Haemophilus influenzae," infrequent causes of pneumonia in developed world children, are the microorganisms incriminated in a large proportion of cases. The increase in severity of ARI in 3rd world children has been associated, at least in port, with malnutrition, diarrheal diseases, an increased parasite load, and more recently with air pollution. Crowding and other factors associated with poverty doubtless also play a role. How these various factors contribute to increased severity and lethality is not well understood. The increasing recognition of the important role played by ARI as causes of mortality in 3rd world children is encouraging. The UN International Children's Emergency Fund (UNICEF) has joined the World Health Organization in the battle against ARI in developing countries, and the 2 organizations recently issued a joint statement on the subject in which they pledged to collaborate to integrate an ARI component into the primary health care program.
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.
Australian Society. 1984 Jun 1; 3(6):27-8.An estimated 15 million infants, largely from Africa, Asia, and Latin America, died in 1983. Many countries in the Third World have infant mortality rates of 150-200/1000 live births. UNICEF has outlines 7 steps that could significantly reduce the infant mortality rate: 1) use of growth monitoring charts, 2) oral rehydration therapy, 3) breastfeeding for at least 1 year, 4) a massive immunization campaign, 5) food supplementation for pregnant women and children at risk, 6) a family spacing education campaign, and 7) extension of female education. 2 other measures not emphasized by UNICEF but important for the health and survival of children are a government system of welfare for the care of the aged to partially solve the need for children and the equal valuation of male and female children. Concerned Australians are urged to spread the word about the UNICEF report, provide funds, and influence the Australian government to offer help through UNICEF to developing countries. Technically qualified people can go to Third World countries and work for better conditions. It should be noted, however, that Australia has its own Third World sector. The Aboriginal population is severely disadvantaged in terms of all the major indicators of quality of life. The infant mortality rate among Aboriginals is 25/1000 live births, which is 2.5 times the Australian national average. Life expectancy at birth is 53 years, or 20 years less than the national average. 80% of Aboriginals have no educational qualifications, and 80% are unemployed. Aboriginal households have less than 60% the average income available to non-Aboriginal households and the housing of the majority of the Aboriginal population is substandard.
New York, UNICEF, 1984 May. 280 p.The data in this set of 135 country profiles for 1981 are made up from 9 major sources and cover the countries and territories with which the UN International Children's Emergency Fund (UNICEF) cooperates. In terms of infant morttality, countries are divided into 5 infant mortality groups: a very high infant mortality (a) group of countries, with a 1981 infant mortality rate (IMR) estimate of 150 (rounded) or more deaths per 1000 live births; a very high infant mortality (b) group of countries with a 1981 IMR estimate between 110 (rounded) and 140 (rounded); a high infant mortality group of a middle infant mortality group of countries, with a 1981 IMR estimate of between 26 and 50 (rounded); and a low infnat mortality group of countries, with a 1981 IMR estimate of 25 or less. For each country data are also presented on nutrition, demographic, education, and economic indicators.
In: UNICEF Bangladesh. Situation analysis report, prepared for UNICEF Bangladesh country programming. [Dacca] Bangladesh, UNICEF, 1977 Apr. 20-4.The level and growth rate of population in Bangladesh is seen as 1 of the nation's most critical problems, affecting nearly all sectors of development. Demographic data in Bangladesh is poor due to a lack of a functioning vital registration system or other reliable data collection systems. The most recent estimate of total population as of January 1, 1977, is 82 million. The average density is estimated at 531 persons/km (1974), with 90% of the population concentrated in the rural areas. The crude death rate remains high at 19/1000 population, with an infant mortality rate estimated at 150/1000 live births. The total fertility and annual growth rates are judged extremely high and are related to several factors of underdevelopment particular to Bangladesh. These include mothers' reluctance to postpone or space births because of a high incidence of infant deaths; a low level of literacy and employment of women; inadequate community health care facilities; and a lack of acceptable family planning services in rural areas. The effects and consequences of this demographic situation on all age groups in Bangladesh is apparent in all areas of development: economic growth, food production, and the delivery of health, education and social services. Although the level of contraceptive awareness is high, the extent of acceptance of contraceptive practice in the country is estimated at only 5% of eligible couples. Despite a heavy concentration of government efforts in its Population Control/Family Planning Division (PC/FP), success has been limited due to struggles between the government's Health and Population Division; frequent administrative reorganization; personnel problems; difficulties in transferring local funds; innovative program development rather than concentration on regular program activities; and the resistance of the population to family planning and limitation. A family planning component has been included in most foreign assistance schemes (IDA;USAID;UNFPA). Of concern to UNICEF is the slow implementation of the family planning side and the generally poor level of maternal and child health care which falls under the PC/FP Division, rather than the Health Division.