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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.
[Ivory Coast: report of the Mission on Needs Assessment for Population Assistance] Cote d'Ivoire: rapport de Mission sur l'Evaluation des Besoins d'Aide en Matiere de Population.
New York, New York, UNFPA, 1984 Sep. viii, 57 p. (Report No. 69)Conclusions and recommendations are presented of the UN Fund for Population Activities (UNFPA) Mission which visited the Ivory Coast from February 20-March 15, 1983 to assess population assistance needs. Ivory Coast officials believe that the population, estimated at 8,034,000 in 1980, is insufficient given the country's economic needs. Its very rapid rate of growth is estimated at over 4.5%/year, of which 1.5% is due to foreign immigration. 42% of the population is urban. The country has undergone exceptional economic growth in the past 2 decades, and the per capita income is now estimated at over $US1000 annually. Social development does not seem to have kept pace, however, and the mortality rate of 15.4/1000 is that of a country with only 1/2 the per capital income. The 1981-85 Ivory Coast Plan proposes a change from a growth economy to a society in which individual and collective welfare is the supreme goal. Up to date data on the size, structure, and dynamics of the population will be needed to aid in preparation of the 1986-90 and 1991-95 plans. A 2nd national population census is planned for 1985. Until the present, rapid population growth had been considered a boon, but problems are arising of massive rural exodus, high rates of urban unemployment coupled with manpower shortages in agriculture, and growing demographic pressure on health, educational, and social infrastructures, especially in the cities. The government has maintained its pronatalist stance, and government health programs have been directed only to mortality and maternal and child health. The need to control fertility and to use birth spacing as a tool to combat maternal and infant mortality is being increasingly felt, and a private family welfare association was able to form in 1979. A policy of maternal and child health encouraging spacing to improve family welfare would probably be welcomed in the Ivory Coast. The Mission recommended that a population policy be formulated which would correspond to the national demographic reality and development objectives. Basic demographic data collection should focus on the 1985 general census, which should have high priority. The civil registration system should be reorganized. A planned migration survey should cover the whole year to take into acconnt seasonal variations, but preparations should not begin until the census is completed. A multiple objective survey could be undertaken in 1988 to determine the nature and scope of interrelationships between demographic variables and economic and sociocultural variables, and a survey of infant mortality on a small sample could be done in 1989. The planned manpower and employment survey should be completed. Population research should receive high government priority. In regard to maternal and child health, the government should take an official position on the problem of birth spacing as a means of combatting maternal and infant deaths. IEC activities should be expanded, and efforts should be made to encourage the participation of women in development.
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.