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Geneva, Switzerland, WHO, 2006. 15 p. (WHO/HIV/2006.05)In August 2006, the World Health Organization (WHO) launched a coordinated global effort to address a major and often overlooked barrier to preventing and treating HIV: the severe shortage of health workers, particularly in low- and middle-income countries. Called 'Treat, Train, Retain' (TTR), the plan is an important component of WHO's overall efforts to strengthen human resources for health and to promote comprehensive national strategies for human resource development across different disease programmes. It is also part of WHO's effort to promote universal access to HIV/AIDS services. TTR will strengthen and expand the health workforce by addressing both the causes and the effects of HIV and AIDS for health workers (Box). Meeting this global commitment will depend on strong and effective health-care systems that are capable of delivering services on a scale much larger than today's. (excerpt)
New York, New York, UNFPA, 2002. x, 103 p.Financial Resource Flows for Population Activities in 2000 is the fourteenth edition of a report previously published by UNFPA under the title of Global Population Assistance Report. The United Nations Population Fund has regularly collected data and reported on flows of international financial assistance to population activities. The Fund’s annual Reports focused on the flow of funds from donors through bilateral, multilateral and non-governmental channels for population assistance to developing countries1 and countries with economies in transition. Also included were grants and loans from development banks for population activities in developing countries. (excerpt)
Human development report 2003. Millennium Development Goals: a compact among nations to end human poverty.
New York, New York, Oxford University Press, 2003. xv, 367 p.The central part of this Report is devoted to assessing where the greatest problems are, analysing what needs to be done to reverse these setbacks and offering concrete proposals on how to accelerate progress everywhere towards achieving all the Goals. In doing so, it provides a persuasive argument for why, even in the poorest countries, there is still hope that the Goals can be met. But though the Goals provide a new framework for development that demands results and increases accountability, they are not a programmatic instrument. The political will and good policy ideas underpinning any attempt to meet the Goals can work only if they are translated into nationally owned, nationally driven development strategies guided by sound science, good economics and transparent, accountable governance. That is why this Report also sets out a Millennium Development Compact. Building on the commitment that world leaders made at the 2002 Monterrey Conference on Financing for Development to forge a “new partnership between developed and developing countries”—a partnership aimed squarely at implementing the Millennium Declaration—the Compact provides a broad framework for how national development strategies and international support from donors, international agencies and others can be both better aligned and commensurate with the scale of the challenge of the Goals. And the Compact puts responsibilities squarely on both sides: requiring bold reforms from poor countries and obliging donor countries to step forward and support those efforts. (excerpt)
The role of health centres in the development of urban health systems: report of a WHO Study Group on Primary Health Care in Urban Areas.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1992; (827):i-iv, 1-38.The WHO Study Group on Primary Health Care (PHC) in Urban Areas has written a report after examining the development of reference health centers in urban areas in various parts of the world. It considers such centers to be a potentially important way to improve urban health services. Reference health centers, with real roots in the community and good links to first level and referral level care, can address the problems of access to health care and intersectoral collaboration. Each center should be based on a general model, but its exact operation depends on local conditions and on a comprehensive situation analysis that considers social and financial factors and the level of organizational development. Each reference center should determine what needs to be done locally with local and national resources. Outside donors should only provide assistance for operational costs and a last resort. To plan services adequately, decision makers must define geographical catchment areas and travel times. These definitions must see to it that services integrate with each other vertically (with services at health post and hospital levels), and horizontally (with government, and nongovernmental, and community projects). A solid epidemiological understanding of major local health problems is essential for expanding PHC through reference health centers. This knowledge comes from an assessment of demographic, morbidity, mortality, and social data an evaluation of coverage of underserved and marginal groups. Reference health centers would be in an ideal position to gather and analyze these data. Innovative ways to obtain the resources for urban PHC are collection of user fees and close supportive links with universities and nongovernmental organizations. The Study Group looks at how reference health centers in Cali, Colombia; Manila, the Philippines; and Newark, New Jersey in the US, developed.
Washington, D.C., Pan American Health Organization, 1985. 172 p. (PAHO Scientific Publication 492.)At present, aging is the most salient change affecting global population structure, mainly due to a marked decline in fertility rates. The Pan American Health Organization Secretariat organized a Briefing on Health Care for the Elderly in October 1984. Its purpose was to enable planners and decision-makers from health and planning ministries to exchange information on their health care programs for the elderly. This volume publishes some of the most relevant papers delivered at that meeting. The papers are organized into the following sections: 1) the present situation, 2) services for the elderly, 3) psychosocial and economic implications of aging, 4) training issues, 5) research and planning issues, and 6) governmental and nongovernmental policies and programs.
Geneva, Switzerland, WHO, 1985. 101 p. (WHO/CDD/85.13)The Diarrheal Diseases Control (CDD) Program, initiated in 1978, is a priority program of WHO for attainment of the goal of Health for All by the Year 2000. Its primary objectives are to reduce diarrheal disease mortality and morbidity, particularly in infants and young children. This report describes the activities undertaken by the Program in the 1983-1984 biennium. During this period, the Program collaborated with more than 100 countries in the implementation of national diarrheal disease control and research activities. The biennium has witnessed a growing interest of other international, bilateral, and nongovernmental agencies in diarrheal disease control; their financial support and commitment have contributed in a large measure to furthering the development of CDD programs and related research in many countries. During the biennium, the services component continued to expand both the quantity and scope of its activities at global, regional, and national levels. This is readily seen from the increase in global acess to Oral Rehydration Salts (ORS) packets from less than 5% in 1981 to 21% in 1983. Other significant developments were a substantial increase in the number of countries planning and implementing programs and the initiation of a new management course in supervisory skills. Successful implementation of national primary health care systems was recognized as necessary for the achievement of the Program's objectives. Efforts of both developing and industrialized countries must continue in a joint endeavor to reduce the problem of diarrheal diseases, especially cholera, the most severe diarrheal disease. The following areas are discussed: the health services component; the research component; information services; program review bodies; program resources and obligations; and program publications and documents for 1983-1984.
WHO Programme in Maternal and Child Health and Family Planning. Report of the second meeting of the WHO Programme Advisory Committee in Maternal and Child Health, Geneva, 21-25 November 1983.
[Unpublished] 1984. 95 p. (MCH/84.5)The objectives of the 2nd meeting of the Program Advisory Committee (PAC) for the World Health Organization's (WHO's) Program in Maternal and Child Health, including Family Planning (MCH/FP) were to 1) assess the MCH/FP program's achievements since the 1st PAC meeting in June, 1982, 2) determine the level of scientific and financial resources available for the program, and 3) to examine the role of traditional birth attendants (TBAs) in the delivery of MCH/FP services. The committee reviewed the activities and targets of the program's 4 major areas (pregnancy and perinatal care, child health, growth, and development, adolescent health, and family planning and infertility), and developed a series of recommendations for each of these areas. Specific recommendations were also made for each of the major program areas in reference to the analysis and dessimination of information and to the development and use of appropriate health technologies. Upon reviewing the role of TBAs in the delivery of MCH/FP services, PAC recommended that all barriers to TBA utilization be removed and that training for TBAs should be improved and expanded. PAC's examination of financial support for MCH/FP activities revealed that for a sample of 26 countries, the average annual amount allocated to MCH activities was less than US$3/child or woman. This low level of funding must be taken into account when setting program targets. International funding agencies did indicate their willingness to increase funding levels for MCH programs. The appendices included 1) a list of participants, 2) an annotated agenda, 3) detailed information on the proposed activities of the program's headquarters for 1986-87, and 4) a description of the the function, organizational structure, and technical management of the MCH/FP program. Also included in the appendices was an overview of the current status of MCH and a series of tables providing information on infant, child, and maternal health indicators. Specifically, the tables provided information by region and by country on maternal, child, and infant mortality; causes of child deaths; maternal health care coverage; contraceptive prevalence; infant and child malnutrition; the number of low weight births; adolescent health; teenage births; breast feeding prevalence and duration; and the proportion of women and children in the population.
WORLD HEALTH FORUM. 1993; 14(4):333-44.WHO evaluated the implementation of the health-for-all strategy using data from 151 countries. 110 countries still endorsed the strategy. 95 have either completely implemented or further developed community involvement. Just 33 countries had more equitable distribution of resources. The percentage of gross national product (GNP) that the government dedicated to health rose in the least developed countries. Developed countries spent a higher proportion of their GNP on health than did developing countries (3.3% vs. 0.9%, 1991). Maldistribution of health personnel continued to be a major problem. Between 1985 and 1990, the proportion of people in developing countries with access to safe water rose from 68 to 75%. Adequate sewage disposal coverage rose from 46 to 71% (1985-1991). Prenatal care coverage by trained personnel increased from 58 to 67%. Tetanus toxoid coverage of pregnant women only increased from 24 to 34%. Most maternal deaths were a result of inadequate prenatal care, inadequate care during childbirth, pregnancies spaced too closely, multiparity, and poor health and nutritional status before the first pregnancy. Immunization coverage rose considerably in every region (e.g., 47-83% for diphtheria). Nevertheless, substantial differences in coverage existed between countries. A substantial trend towards more integrated primary health care occurred. Child survival rates improved, but the gap in infant mortality rates between developed countries and the least developed countries widened. The gap in health status between the poor and the wealthy had become larger. Developing countries in the process of the epidemiological transition continued to be burdened with both infectious and degenerative diseases. GNP and adult literacy rose, but less so in the least developed countries. These findings suggested that governments must sustain the commitment to reduce inequities, realign health systems, improve health financing systems, improve coordination between health sectors, and improve linkage between health and development.
New York, New York, Oxford University Press, 1993. xii, 329 p.The World Bank's 16th annual World Development Report focuses on the interrelationship between human health, health policy, and economic development. WHO provided much of the data on health and helped the World Bank on the assessment of the global burden of disease found in appendix B. Following an overview, the report has 7 chapters covering health in developing countries: successes and challenges; households and health; the roles of the government and the market in health; public health; clinical services; health inputs; and an agenda for action. Appendix a lists and discusses population and health data. The report concludes with the World Development Indicators for 127 low, lower middle, upper middle, and high income countries in tabular form. All developed and developing countries have experienced considerable improvements in health. But developing countries, particularly their poor, still experience many diseases, many of which can be prevented or cured. They are starting to encounter the problems of increasing health system costs already experienced by developed countries. The World Bank proposes a 3-part approach to government policies for improving health in developing countries. Governments must promote an economic growth that empowers households to improve their own health. Growth policies must secure increased income for the poor and expand investment in education, particularly for girls. Government spending on health must address cost effective programs that help the poor, such as control and treatment of infectious diseases and of malnutrition. Governments must encourage greater diversity and competition in the financing and delivery of health services. Donors can finance transitional costs of change in low income countries.
Mexico City, Mexico, MEXFAM, 1988 Feb. , 10 p.During 1987 the Mexican Federation for Family Planning (MEXFAM) continued developing its programs following the same orientation as in the previous year, but at a slower pace intended to achieve a greater degree of consolidation. A permanent mechanism for qualitative evaluation was arranged with the Mexican Institute for Social Studies, an external organization. Work was initiated in 4 new states, bringing the total to 26 of Mexico's 32 states. Activities were suspended in Yucatan because new information revealed that fertility rates were relatively low. MEXFAM does not seek to provide massive family planning coverage but rather to act as a catalyst for family planning activities. MEXFAM is expanding its program of "community doctors", in which it assists young medical school graduates to establish practices in underserved urban areas. In a similar program, "affiliate doctors", physicians already established in their communities, receive technical assistance and materials to begin offering family planning services. During 1987, MEXFAM initiated the "Young People" program to provide sex and family planning education to young people under 20 in schools, clubs, and recreation centers. Various films were made to provide sex education to the Young People program. They were well received in Mexico and some were broadcast in other countries. In 1987, 382,328 new users were served, compared to 174,634 in 1986. 73% of the new users were in MEXFAM programs and the rest were in collaborative programs. Mexico's deteriorating economic situation in 1987 was reflected in increasing resource scarcities for public health organizations. The broad geographic distribution and remoteness of some MEXFAM programs pose a serious challenge for control and supervision. Programs have been grouped into logistic centers with responsibility for supervision assigned on a regional basis. MEXFAM is making great efforts to improve its record system, adapt it to International Planned Parenthood Federation requirements, and make it compatible with the Ministry of Health record system. A certain amount of confusion is anticipated in 1988 as workers become accustomed to new record formats. User payments are the main source of local revenues for MEXFAM. Given Mexico's poor economic situation, the prospects for an increase in local donations are poor, but efforts to raise funds locally are continuous. 4 new external donors were added in 1987. The International Planned Parenthood Federation continues to be the main source of funds. 87% of MEXFAM funds were directly spent on projects and 13% on administration and general services in 1987.
Washington, D.C., PAHO, 1988 Jul. v, 117 p. (Official Document No. 221)The global economy continued to adversely affect member countries' health programs and activities in 1987. For example, Latin American and Caribbean countries lost >$US28 billion in 1987 and from 1982-1987 they lost $US130 billion. At the same time, the percentage of adolescents and elderly in the total population increased tremendously, the numbers of people experiencing chronic and disabling diseases also increased while infectious and parasitic diseases still posed challenges for the health community, and the number of urban poor continued to grow. In 1987, to help member countries deal with the everchanging health needs of their populations, PAHO focused on population groups and geographic regions and within these defined areas concentrated on specific diseases. For example, PAHO worked with member governments to formulate, implement, and evaluate policies and programs on the health of adults. Specifically, diseases and conditions emphasized in adult health included cardiovascular diseases, cancer, diabetes mellitus, accident prevention, and the prevention, treatment, and rehabilitation of alcoholism and drug abuse. Other emphases were maternal and child health and family planning and those diseases and conditions associated with the population. Additionally, PAHO continued with special programs and initiatives to maximize its role as a catalyst and to mobilize national and international resources in support of activities aimed at selected health priorities. Some of these initiatives included the Expanded Program on Immunization, the Emergency Preparedness and Disaster Relief Coordination, and the Caribbean Cooperation in Health. In addition, each country's PAHO activities have been summarized.
The role of the International Planned Parenthood Federation in setting international medical standards.
In: Recent advances in fertility control: proceedings of the 1st International Symposium on Recent Advances in Fertility Control, Tokyo, November 8, 1986. Edited by Seiichi Matsumoto. Amsterdam, the Netherlands, Excerpta Medica, 1987. 83-91. (Current Clinical Practice Series No. 45.)This chapter discusses 6 key areas that illustrate how the International Planned Parenthood Federation (IPPF) addresses its role and responsibilities. These areas include: 1) IPPF's size and scope of activities, 2) the Federation's role in setting and maintaining medical standards, 3) the work of the IPPF International Medical Advisory Panel, 4) IPPF's work with international organizations, 5) how the Federation tackles double standards in the quality of medical care around the world, and 6) sharing experience in family planning expertise worldwide. Brief summaries of information presented in these areas follow. 1) The IPPF is the world's leading voluntary family planning organization. It was founded in 1952 and has member associations in 123 countries; in the 1985, the IPPF reached approximately 5 million contraceptive acceptors around the world. 2) IPPF recognizes the critical importance of establishing and implementing internationally acceptable medical standards for family planning programs around the world. In places where there is opposition to family planning, critics can often be effectively silenced when programs can be seen to adhere to acceptable standards of practice. 3) The International Medical Advisory Panel is a small group of internationally renowned experts in family planning and contraceptive technology. The panel meets regularly, reviews the latest medical literature, and advises the Federation on the safety, effectiveness, and acceptability of contraceptive methods. 4) IPPF collaborates with a number of international organizations and sets standards for program activity in the areas of adolescent reproductive health and maternal and child health care. Another key area of collaboration is in seeking to ensure that family planning is incorporated into primary health care programs throughout the world. 5) IPPF is working to eradicate double standards in medical issues worldwide. Critics alleging the existence of double standards sometimes pass judgment on health standards in developing countries without realizing the impossibility of replicating the health care practices of countries with pharmacies and medical personnel available to all member of the population, at prices they can afford. 6) IPPF's history of successfully delivering family planning services has encouraged and increased the need to find ways of replicating them. An important part of IPPF's mechanism for sharing experiences and family planning expertise is through its active publications program. IPPF also has innovative projects working with young people, in encouraging male involvement in family planning, and in extending planned parenthood and women's development projects. (author's)
EPI NEWSLETTER. 1987 Oct; 9(5):3-5.This article sets forth data on vaccination coverage rates in children under 1 year of age in the individual countries of Latin America and the Caribbean in 1986. In the Region of the Americas as a whole, the 1986 coverage rate was 80% for oral poliovaccine, 54% for DPT, 55% for measles, and 63% for BCG. Vaccination coverage rates increased over 1985 levels for all but measles, which showed a 5% decline due to decreases in Brazil and Mexico. In the Caribbean subregion, the majority of country coverage rates for DPT and oral poliovirus vaccine are equal to or above 80%, while measles coverage rates are generally below 50%. In Central America, vaccine coverage rates with all antigens except BCG showed significant increases between 1985 and 1986. In Central America, coverage ranged from above 80% for oral poliovirus vaccine and DPT in Belize, Costa Rica, and Nicaragua, to below 40% in Guatemala. In general, countries in the region are improving vaccination performance as a result of establishment of vaccination days or campaigns and acceleration of the Expanded Program on Immunization. However, much work remains to be done if the goal of 100% immunization of children and women of childbearing age by 1990 is to be met.
New York, New York, FPIA, 1985. 206 p.Summarizing the work of the Family Planning International Assistance (FPIA) for the past 14 months, with emphasis on 1985, this document contains both regional and country reports for Africa, Asia and the Pacific, and Latin America. FPIA's strategy in Africa during 1985 was to focus on small, high-risk projects which call for extensive technical assistance. Project Assistance accounted for 48.8% of the total value of FPIA assistance to the region; Commodity Assistance accounted for 47.5% of the total value of FPIA assistance to the region. Special Grants accounted for slightly over 2.1% of the total assistance to Africa. In the Asia and Pacific Region, components of the FPIA strategy include: consolidate support and provide technical assistance to those agencies whose family planning services can be institutionalized and serve to complement and influence the goals, objectives, and program procedures of their governments' national family planning programs; problem solve with grantee agencies approaches to innovative delivery of temporary method services; provide training opportunities and technical assistance to project management and staff as well as to influential nonproject persons; and establish how FPIA commodities can complement supplies available to nongovernmental organizations through their government warehouses and bilateral supported community retail sales program. Project Assistance accounted for 47.1% of the total value of FPIA assistance in the region; Commodity Assistance accounted for 50.8% and Special Grants slightly over 1% of total assistance to the region. In Latin America, FPIA's program goals respond to agency goals of promoting family planning services in areas of unmet need, upgrading existing family planning service models, and encouraging service continuation following the phase-out of FPIA support. Project Assistance accounted for 46.8%, Commodity Assistance 52.2%, and Special Grants less than 1% of total FPIA assistance to the region. The combined value of all types of assistance provided worldwide during 1985 totaled over $18 million: $7.2 million in direct support to 128 funded projects in 39 countries; and $10.1 million in commodities shipped to 218 institutions in 66 countries. Oral contraceptive and condom shipments alone were sufficient to supply 2.4 million contraceptors for 1 year.
WORLD HEALTH FORUM. 1988; 9(2):185-99.This article explains how the concept of health for all developed within the context of the history of the World Health Organization (WHO). By the early 1970s a new idea was taking shape in WHO. Medical services were failing to reach vast numbers. Health would have to emerge from the people themselves. In the heat of discussion the new strategy was clarified and given a name--primary health care (PHC). An ambitious target was set for it--no less than health for all by the year 2000. It was decided that the community itself had to be involved in planning and implementing its own health care. A new type of health worker was called for, chosen by the people from among themselves and responsible to the community but supported by the entire health system. In virtually all countries, the emphasis on curative care would have to be balanced by an equal emphasis on prevention. Almost 90% of WHO's Member States were prepared to share with one another detailed information about the problems facing their health systems. Industrial countries were beginning to realize that sophisticated medical technology was no guarantee of good health and that health for all through PHC offered an alternative. Millions of health workers have been trained, extending services to low-income groups that had no access to modern health care. Among health professionals, lack of understanding of the PHC concept and insufficient concern for social equity remain the principal constraints. Another problem is that expenditure on health care tends to be viewed as a drain on scarce resources rather than as an investment in the nation's future. The mommentum of health for all can be sustained only by governments implementing at home the policies they have collectively agreed on at The World Health Assembly in Geneva.
WORLD HEALTH FORUM. 1988; 9(2):143-6.This article summarizes the activities and the philosophy of WHO in its effort to improve worldwide health care since its inception some 40 years ago. At the 1st World Health Assembly in 1948 it was pointed out that little could be achieved by medical services unless the existing economic, social and other relations among peoples have been improved. The immediate priorities of the new Organization were more limited: to build up health services in the areas destroyed by the war, and to fignt the spread of the big infectious killer diseases. It took almost 30 years before the WHO really got down to trying to do something about the economic, social and other conditions which lie at the heart of most health problems. The Alma-Ata Declaration in 1978 heralded a new era in health. The concept of primary health care and the global health-for-all strategy to implement it are now rapidly gaining ground. In villages, towns and districts, people are waking up to the fact that they can contribute to their own health destiny. As WHO embarks on its 5th decade, there are grounds for optimism: health is moving in the right direction in spite of major obstacles.
[Vaccination, the right of each child, World Day of Health 1987] Vacunacion: derecho de cada nino, Dia Mundial de la Salud 1987.
BOLETIN DE LA OFICINA SANITARIA PANAMERICANA. 1987 Mar; 102(3):263-80.In the 10 years since the Panamerican Health Organization (PAHO) and the World Health Organization initiated the Extended Immunization Program in the Americas (PAI), coverage has increased from less than 1/3 to over 1/2 of children immunized in their first year against 6 major childhood diseases. Due mainly to the PAI, the incidence of measles, tetanus, and diptheria has been reduced by 1/2, that of whooping cough by 75%, and that of tuberculosis by about 5% annually. About 75% of children are immunized against polio, which has 1/10 as many victims today as 10 years ago. PAHO and several other organizations have targeted 1990 for eradication of polio from the South American continent. Since the PAI was established in 1977, more than 15,000 health workers have been trained, cold chains have been established to preserve vaccines, and more than 250 technicians have been trained to maintain and repair the needed equipment. The cost of the campaign to eradicate polio is estimated at US $ 24 million per year for the entire region--a low total compared to the costs of hospitalization and rehabilitation of the victims in the absence of such a program. The goal of immunizing all the world's children by 1990 proposed by the World Health Assembly in 1977 is achievable, but much remains to be done. The number of children immunized in the largest Third World countries ranges from 20-90% owing in part to national immunization days but also to assumption by local communities of the goal of universal immunization by 1990. All deaths produced by these 6 killer diseases are not registered, but the World Health Organization estimates that measles takes 2.1 million lives annually, neonatal tetanus 800,000, and whooping cough 600,000. Governmental and nongovernmental international organizations have made financial help available to countries needing it for their immunization programs. Most developing countries are expected to achieve the goal of universal immunization by 1990, but the 10 poorst countries of Africa and the Eastern Mediterranean may not be able to do so. At the worldwide level, 41% of the 118 million children who survive their first year have been vaccinated against measles and 46% against tuberculosis. 47% have received the full course of vaccine against diptheria, whooping cough, tetanus, and polio. The cost of these immunization is $5-15 per child and 80% is assumed by local countries. The World Health Organization recommends that all children, even the undernourished or slightly ill, be vaccinated, and that all health services vaccinate. Parents should be urged to return for the 2nd and 3rd doses of polio and DPT vaccines. Vaccination programs should pay more attention to impoverished urban populations. Several countries of the region have added innovations such as vaccination against other illnesses, house to house searches for unvaccinated children, or use of mass media to publicize national vaccination programs.
[The Expanded Programme on Immunization: the results of its realization, problems and prospects] Rashirennaia Programma Immunizatsii: resultaty osushchestvleniia, problemy i perspektivy.
ZHURNAL MIKROBIOLOGII, EPIDEMIOLOGII I IMMUNOBIOLOGII. 1985 Feb; (2):114-20.A report to interested physicians in the USSR explained the progress of and problems associated with the World Health Organization (WHO) expanded immunization program, set up by resolution in 1974, to inoculate every child in the world up to age 1 against measles, pertussis, tetanus, polio, diphtheria, and tuberculosis by 1990. The program called for distribution of DTP anatoxin, live polio and measles virus, and Calmette-Guerin bacillus. By 1983, 50% of children in Europe, America, the Peoples Republic of China, and the immediately contiguous areas had been vaccinated against polio and DTP, but in developing countries the figures were only 24% and 31% respectively, and only 26% and 14% for measles and tuberculosis respectively. The decision was made in 1983 to concentrate more effort and resources on establishing national health programs by training higher level administrative workers and technicians to work at the local level in storing and delivering vaccines, and operation and maintenance of the refrigeration equipment, which is of vital importance in tropical regions. Refrigeration equipment has been developed recently to meet the unique conditions of the developing nations, periodic comprehensive evaluation of program implementation is conducted, and a series of laboratory and field studies are now underway to improve efficiency of implementation by improving the thermal stability of vaccines and the refrigeration chain, increasing availability of vaccines to the population, and improving the economy of operations. Audits show that vaccine losses now account for only 14% of expenditures, with 45% going for labor. Almost 80% of all costs are now being met by the countries involved. Thus, international cooperation has been instrumental in the results of the expanded immunization program.
Health aspects of population dynamics: report by the Director-General to the 21st World Health Assembly.
[Unpublished] 1968 Apr 24. 8 p. (A21/P and B/9)Add to my documents.
HEALTH POLICY AND PLANNING. 1986 Mar; 1(1):37-47.This economic analysis assesses the probable costs of implementing various activities of the World Health Organization's (WHO's) global strategy of "health for all by the year 2000" and the likelihood that developing countries will be able to afford these costs, either on their own or with the assistance of developed countries. If this policy is to be transformed into concrete results, there must be a plan complete with budgetary requirements, planned activities, and expected results specified in adequate detail. The overall costs of the activities proposed by the global strategy would amount to approximately 5% of the gross national product of most developing countries, with water supplies and primary health care comprising the most expensive activities. Although there is a good match between estimated resource requirements and planned activities, the desired outcomes are often unlikely to result from the activities proposed. At present, all 25 industrial market and nonmarket industrial developed countries have already achieved the outcome goals of the global strategy; however, these countries account for only 25% of the world's population. Of the 63 middle-income countries, 54 have already achieved a gross national product per capita of over US$500, but only 22 have an infant mortality rate better than 50/1000. Very few low-income countries are close to reaching their targets for income, infant mortality, life expectancy, or literacy. On the basis of current trends, 25-33% of countries are considered unlikely to achieve the outcome goals by the year 2000. In general, it appears that expenditure targets are too low to cover the needed health services activities. Further research on the costs of health promoting activities such as immunization and primary health care should be given high priority.
World Health Organization, [WHO], Geneva, Switzerland, 1986. 89 p. (WHO/RPD/ACHR(HRS)/86)This report is the outcome of a study undertaken to outline for the WHO an approach to health research strategy, which sees health development in a historical and evolutionary perspective. There are 2 approaches to disease problems, 1 through control of disease origins, the other through intervention in disease mechanisms. The research strategy of the WHO should be devised primarily in the light of commitment to substantial progress in health by the year 2000, particularly in countries where the need is greatest. Steps that are likely to lead to rapid advance in health care include: control of diseases associated with poverty, control of communicable and noncommunicable diseases specific to the tropics, control of diseases associated with affluence, treatment and care of the sick, and delivery of health services. Goals must be determined in light of the circumstances and priorities of each country; each country should establish targets related to accomplishments in the following areas: national commitments to policies and programs supportive of health for all; improvements in mortality and morbidity rates; improvements in life-style and related health measures; improvements in coverage and various aspects of the quality of care; and improvements in health status and coverage of disadvantaged and marginal subgroups in the population.
[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.
[Unpublished] .  p.Tables are presented that show the number of youth projects that Family Planning Associations (FPAs) intend to implement during 1985. The information was derived from the 63 Three Year Plans for 1985-87 received at the International Office by September 1984. This number covers most of the FPAs in each region. The exception is the Western Hemisphere where several of their plans arrived in London too late to be included in the analysis. 4 main types of youth work were identified, and this is shown for each country in the tables: to provide family life and population education for young people; to train teachers/youth leaders in the promotion of youth work; to provide family planning/counseling services for young people; and to promote increased awareness of issues affecting young people. The total number of youth projects planned for 1985 is 30 for the 15 countries of Africa. 24 projects are planned for the 13 countries of the Caribbean, Central, and South America. 59 projects are planned for 12 Asian countries.
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.
Report on the evaluation of various family life education projects with particular emphasis on youth in the English-speaking Caribbean: general conclusions and recommendations.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Nov. xii, 39,  p.Most family life education (FLE) projects included in this evaluation have the longterm objectives of reducing the incidence of teenage prognancy, and promotion of self-reliance and positive, responsible behavior among youth. The immediate objectives and project strategies are also very similar across projects, e.g., in-school and out-of-school FLE, comprehensive youth services, including family planning (FP) and training. The evaluation shows that project design has improved over the years (clearer and measurable formulation of objectives, more comprehensive workplans and better explanation of budgetary items) and projects have moved from addressing a wide variety of broad issues to a more focused consideration of adolescent fertility. However, the Evaluation Mission in concerned that due to the similarities in project design, country-and-time-specific factors have not always been adequately taken into consideration. Other concerns include the lack of systematic needs assessment and use of baseline data to guide implementation. All the projects evaluated have contributed to the training in FLE/FP of a large number of family life educators, teachers and nurses and have thus significantly strengthened professional national capability. Nevertheless, training needs still exist in motivational/attitudinal variables, sex roles, teaching/learning technics. The projects have made a significant contribution to the introduction of FLE into schools and teacher training institutions. The focus at present should be the institutionalization of FLE within the in-school sector, including the development of a policy approving FLE in schools. The development of community-based health centers was often the central activity of the out-of-school FLE component of the projects. These centers have contributed to shaping the countries' attitudes by creating an awareness of teenage pregnancy, by developing an acceptable strategy, by providing a focal point for discussing sensitive issues, and by becoming a mechanism for community mobilization. The projects have also contributed to making FP services available and specialized services for adolescents are being established. The emphasis has been more on education and awareness creation than on contraceptive distribution to adolescents. At present the need is to strengthen the service delivery components. The limited availability of data suggests that adolescent pregnancy remains an urgent problem in the region. Sustained and more focused FLE/FP program efforts directed to adolescents continue to be needed in the region. The most important general lesson learnt from the programs is that programs in adolescent fertility can be started and implemented in countries even prior to declaration of policy by governments. However, at a certain stage of implementation the programs cannot be carried further without explicit government policies and control.