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[Unpublished] .  p.The South-East Asia region is one of the most diverse and populous in the world. At midyear 1990, the total population of the world was estimated to be 5.3 billion people, of which 1.3 billion (24.6%) lived in the eleven countries of the South- East Asia region. During the next ten years it is expected to grow by 256.6 million, thus making up 25.3% of the world total (Health situation in south-east Asia 1991). The World Health Organization, WHO which is a pioneer organization working in the field of health. In May 1997 in the Thirtieth World Health Assembly adopted resolution WHA 30.43 in which it decided that the main social target of government and of WHO in the coming decades should be the attainment by all the people of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. This is popularly known as ‘health for all by the year 2000 ‘. What does ‘health for all’ mean? It means simply the realization of WHO’s objective of the ‘the attainment by all peoples of the highest possible level of health” and that as a minimum all people in all countries should have at least such a level of health that they are capable of working productively and of participating actively in the social life of the community in which they live. To attain such a level of health every individual should have access to primary health care and through it to all levels of a comprehensive health system. While the communities might be expected to have a similar general understanding of the meaning of health for all as outlined above, each country will interpret this meaning in the light of its social and economic characteristics, health status and morbidity patterns of its population, and state of development of its health system. In 1978 an International conference on Primary Health Care was held in Alma-Ata, USSR. This conference, which declared that primary health care is the key to attaining health for all, it emphasized that health development is essential for social and economic development, that the means for attaining them are intimately linked, and the action to improve the health and socioeconomic situation should be regarded as mutually supportive rather than competitive. The Declaration of Alma-Ata urged all government to formulate national policies, stategies and plans of action to launch and sustain primary health care as part of a comprehensive national health system and in coordination with other sectors. In the 1979, the Thirty-second World Health Assembly launched the Global Strategy for health for all when it adopted resolution WHA32.30.The Global Strategy indicates the broad lines of action to be taken I the health sector and in related social and economic sectors. It provided global targets to be considered by member states, taking into account their own socioeconomic and health situation and bearing in mind that all countries are aiming at the same targets for the year 2000. (excerpt)
Ann Arbor, Michigan, University Microfilms International, 1991. vii, 266 p. (Order No. 9116069)The effectiveness of official development assistance in responding to health problems in recipient countries may be examined in terms of 1) the results of specific aid-supported projects, 2) the degree to which the activities have contributed to recipients' institutional capacity, and 3) the impact of aid on national policy and the broader development process. A review of the literature indicates a number of conceptual and practical constraints to assessing health aid effectiveness. Numerous health projects have been evaluated and issues of sustainability have been studied, but relatively little is known about the systemic effects of health aid. The experience of Nigeria is analyzed between the mid-1970s and the late 1980s. In the 1970s, Nigeria's income rose substantially from oil revenues, and a national program was undertaken to increase the provision of basic health services. The program did not achieve its immediate objectives, and health sector problems were exacerbated by the decline of national income during the 1980s. Since 1987, a progressive national primary healthcare policy has been in place. Aid has been given to Nigeria in comparatively small amounts per capita. Among the major donors, WHO, UNICEF, and, most recently, the World Bank, have assisted the development of general health services, while USAID, UNFPA, and the Ford Foundation have aided the health sector with the principal objective of promoting family planning. 3 projects are examined as case studies. They are: a model of family health clinics for maternal and child care; a largescale research project for health and family planning services; and a national immunization program. The effectiveness of each was constrained initially by limited coordination among donors and by the lack of a supportive policy framework. The 1st 2 of these projects developed service delivery models that have been reflected in the national health strategy. The immunization program has reached nationwide coverage, although with uncertain systemic impact. Overall, aid is seen as having made a marginal but significant contribution to health development in Nigeria,a primarily through the demonstration of new service delivery approaches and the improvement of management capacity. (author's)
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.
Report of the evaluation of UNFPA assistance to Colombia's Maternal, Child Health and Population Dynamic's Programme, 1974-1978.
New York, United Nations Fund for Population Activities, July 1981. 181 p.This report for UNFPA (United Nations Fund for Population Activities) on Colombia's Maternal and Child Health and Population Dynamics (MCH/PD) program was prepared by an independent team of consultants which spent 3 weeks in Colombia in February 1980 reviewing documents, interviewing key personnel and observing program services. The report consists of 8 chapters. The 1st describes the terms of references of the evaluation mission. The 2nd chapter provides background information on Colombia and identifies some of the principal environmental factors that affect the program. Chapter 3 describes the organizational context within which the program operates. The chapter also includes a discussion of the UNFPA funding and monitoring mechanism and how that affects program planning and operations. Chapter 4 is a description of the program planning process; goals, strategies and objectives, and of the UNFPA and government inputs to the program between 1974-1978, the period under review. A large part of the report is devoted to describing and assessing each program activity. Chapter 5 consists of descriptions of management information; maternal care; infant, child and adolescent care; family planning; supervision; training; community education; and research and evalutation studies. Chapter 6 is an analysis of the program's impact on: maternal morbidity and mortality; infant morbidity and mortality; and fertility. Chapter 7 summarizes the Mission's conclusions and lists its recommendations. The final chapter deals with the Mission's position in relation to the 1980-1983 proposal. Appendices provide statistical data on medical activities, contraceptive distribution and use, content of training courses, target population, total expenditures, and norms for care, as well as organizational charts, individuals interviewed, and UNFPA assistance to other agencies in Colombia. (author's modified)