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WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1985; (724):1-206.In 1981, participants in the Joint FAO/WHO/UNU Expert Consultation on Energy and Protein Requirements met in Italy to reexamine the interrelationships between energy and protein requirements and to recommend methods to integrate requirement scales for energy and proteins. They stated that the use of a reference man or woman to determine energy requirements should no longer be used since it is unduly restrictive and there is a wide range of body size and patterns of physical activity. The tables exhibit this wide range so users can use those values that best apply to his or her conditions. Overall the participants agreed that estimates of energy requirements should be based on actual or desirable energy requirement estimates. In terms of children, however, this principle cannot be applied since there is not enough information available about their energy expenditure. Further no one could agree on how to determine what actual intakes are needed to maintain health in its broadest sense in either developing or developed countries since observed actual intakes are not necessarily those that maintain a desirable body weight or optimal levels of physical activity. Divers patterns of physical activity in different age and sex groups are presented nonetheless to guide users in applying requirement estimates. The maintenance protein requirements identified by the 1971 consultation for the young child < 6 years old, e.g. 1 g/kg.day for 5-6 year old, and the young male adult (.54-.99 g.kg/day) remained the same. The participants made indirect estimates of protein needs for the remaining age and sex groups. They acknowledged that digestibility can affect the availability of protein and protein requirements need to be adjusted for fecal losses of nitrogen. They concluded that the natural diets for infants and preschool children contain sufficient amount of essential amino acids, but not those of the remaining groups.
WORLD HEALTH. 1988 Jan-Feb; 10-11.In 1979 WHO invited its member states to participate in a global strategy for health and to monitor and evaluate its effectiveness using a minimum of 12 indicators. Members' 1982 implementation reports and 1985 evaluation reports form the basis for evaluating each measure. Indicators 1-6 have strong political and economic components in both developed and developing countries and are not complete. Indicator 7, for which rates of reply are satisfactory, asks whether at least 5 elements of primary health care are available to the whole population. The 8th gauge seeks information on the nutritional status of children, considering birth weight (a possible indicator of risk) and weight for age (a monitor of growth). Infant mortality rate and life expectancy at birth, indicators 9 and 10, are difficult to estimate in developing countries, and health services are not always kept informed of current estimates. Indicator 11 asks whether the literacy rate exceeds 70%; it can provide information on level of development and should emphasize literacy for women, for whom health information is critical. The last global measure yields information about the gross national product, which is not always the most recent, despite the trend of countries to publish their gross domestic product. Failure to make use of the best national sources, such as this, is one of several problems encountered by WHO's member states in collecting accurate data. Other problems include lack of universally acceptable definitions, different national accounting systems, disinterest of health authorities in economic matters, lack of staff, lack of financial resources in developing countries, and inadequately structured health system management. Each country must choose the most appropriate methods for collection of data. If an indicator cannot be calculated, the country is encouraged to seek and devise a substitute. WHO must produce more precise and reliable indicators. It must respond to requests for ways of improving or strengthening national systems.
ASSIGNMENT CHILDREN. 1987; (3):3-84.Recent findings from xerophthalmia studies in Indonesia have served as a catalytic force within the international health and nutrition community. These analyses conclude that, in Indonesia, there is a direct and significant relationship between vitamin A deficiency and child mortality. Further research is under way to determine the degree to which these findings are replicable in other countries and contexts. At the same time, representatives from international, bilateral, national and private organizations are critically examining their programs in vitamin A deficiency and xerophthalmia control for future planning. At UNICEF, there has been a special concern for vitamin A issues because of the possible implications in child survival. This is noted in the 1986 State of the World's Children Report. UNICEF recruited a consultant in January 1986 to examine its existing vitamin A programs, review scientific findings and meet with specialists to prepare policy options for consideration in future UNICEF involvement in the area of vitamin A. A brief background is given on the absorption, utilization, and metabolism of vitamin A, and its role in vision, growth, reproduction, maintenance of epithelial cells, immune properties, and daily recommended allowances. Topics cover xerophthalmia studies, treatment and prevention, prevalence, morbidity and mortality, program implications and directions, and procurement of vitamin A. Target regions include Asia, the Americas and the Carribean.
Socio-economic planning: legislative measures for improvement of the nutritional status of the mother/child dyad.
In: Hambraeus L, Sjolin S, eds. The mother/child dyad: nutritional aspects. Stockholm, Almqvist and Wiksell, 1979. 143-9. (Symposia of the Swedish Nutrition Foundation 15)Many legislative measures aimed at improving maternal and child nutrition were adopted by developed countries during the 20th century and some of these measures were also adopted by developing countries. These measures were reviewed and recent efforts by international, national, and institutional bodies to formulate policies to deal with nutritional problems were discussed. Measures adopted during the: 1900s with varying degrees of success included: 1) the introduction of nutritional programs into the school curriculum; 2) programs to reduce maternal nutritional deficiencies during the pregnancy; 3) measures to delay the age at marriage; 4) improvements in prenatal care; 5) hospital based programs to educate postpartum women in child nutrition; 6) programs aimed at promoting breastfeeding; 4) programs to provide low cost supplementary weaning foods; and 8) efforts to regulate the manufacture and sale of baby food products. At the international level various bodies have recommended the adoption of measures to improve working conditions for lactating and pregnant women and to reduce abusive marketing practices. At the national level, Algeria adopted policies aimed at promoting breastfeeding and improving nutritional standards through a variety of programs. China successfully promoted breastfeeding by adopting measures which make it easier for working women to breastfeed. France recently adopted policies aimed at regulating the sale of infant food products. In the future more efforts should be directed toward designing nutritional programs which take into account the needs of the local community and which provide nutritional services as an integral part of maternal and child health and community health services. Attention should also be directed toward improving the nutritional knowledge of the public and of the health professional.
Infant and young child nutrition, including the nutritional value and safety of products specifically intended for infant and young child feeding and the status of compliance with and implementation of the International Code of Marketing of Breast-milk Substitutes: report by the Director-General.
Geneva, Switzerland, WHO, March 1983. 39 p.This report to the Health Assembly is presented in 3 parts: Part I--a summary of the present global nutritional situation with particular reference to infants and young children--is based on an initial reading of the results of national surveillance and monitoring activities in over 50 countries. Part II has been prepared in accordance with resolution WHA34.23 which requested the Director-General to report to the Assembly on steps taken to assess the changes that occur with time and under various climatic conditions in the quality, nutritional value and safety of products specifically intended for infant and young child feeding. Part III, in accordance with resolution WHA34.22, summarizes information provided by Member States on action being taken to give effect to the International Code of Marketing of Breast-milk Substitutes. It should be read in conjunction with section VI of the Director-General's progress report which informed the 35th World Health Assembly of action taken by WHO and its Member States in the field of infant and young child feeding. In light of the information on the implementation of the Code contained in these 2 reports, and in the absence of any suggestions from Member States for change, the Director-General considers that it would be premature, at this time, to propose any revision of the text of the Code, either its form or content. The Health Assembly's attention will be drawn, in future biennial progress reports on infant and young child feeding, to any development which may have a bearing on the International Code, in accordance with its Article 11.7 and resolution WHA33.32.