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  1. 1
    031138

    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.

    World Health Organization [WHO]. Division of Family Health. Maternal and Child Health Unit

    [Unpublished] 1984. 95 p. (MCH/84.5)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.
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  2. 2
    027206

    International Workshop on Youth Participation in Population, Environment, Development at Colombo, 28th Nov. 83 to 2nd Dec. 83.

    World Assembly of Youth

    Maribo, Denmark, WAY, [1984]. 120 p.

    The objectives of the International Youth Workshop on Population and Development were to provide a forum to the leaders of national youth councils and socio-political youth organizations. These leaders were brought together to review national and local youth activities and their plans and action programs for the future. The outlook for these discussions was local, regional, and global. In addition the Workshop aimed at providing interaction among the youth organizations of the developing and the developed countries. These proceedings include an inaugural address by Gemini Atukorata, Minister of Youth Affairs, Government of Sri Lanka and presentations focusing on the following: youth and development; the key role of youth in production and reproduction -- important factors of development; 60% of the aid goes back to the giving country in several ways; adolescent fertility as a major concern; social development for the poor with particular reference to the well-being of children and women; commitment for the cause is the key to attract funds; and observance of the International Youth Year under the themes of participation, development, and peace. The 11th workshop session dealt with follow-up and the future direction of the World Assembly of Youth (WAY). The following points emerged in this most important session: WAY should emphasize "Youth Participation in Development" as the major program; WAY's population programs should not be limited to just information, education, and communication, and youth groups should be encouraged to become service delivery agents for contraceptives wherever possible; environment awareness should become an integral part of population and development programs; youth in the service of children, health for all, and drug abuse should be the new areas of operation for WAY; and programs of youth working in the service of disabled, especially disabled young people, and youth and crime prevention programs also found favor with the participants. Recommendations and action programs are outlined. Proceedings include a summary of WAY activities and resolutions.
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  3. 3
    034498

    FPA youth projects planned for 1985.

    International Planned Parenthood Federation [IPPF]

    [Unpublished] [1984]. [3] 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.
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  4. 4
    033836

    Report on the evaluation of various family life education projects with particular emphasis on youth in the English-speaking Caribbean: general conclusions and recommendations.

    Corona E; Epps RP; Kodagoda N; Simonen M

    New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Nov. xii, 39, [7] 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.
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  5. 5
    268448

    Report on the evaluation of various family life education projects with particular emphasis on youth in the English-speaking Caribbean: country reports.

    Corona E; Epps RP; Kodagoda N; Simonen M

    New York, New York, United Nations Fund for Population Activities [UNFPA], 1984 Nov. xiv, 89 p.

    UNFPA has provided funding for various family life education (FLE) projects with particular emphasis on youth in the English-speaking Caribbean since the mid-1970s; this report is an independent evaluation of the projects in Antigua, Barbados, Dominica, Jamaica, St. Lucia, and St. Christopher and Nevis. Although birth rates are relatively low in the English-speaking Caribbean, the incidence of adolescent pregnancy and the number of births to women under the age of 20 is an important problem in the region. The Mission concluded overall that the projects have contributed to pioneering and groundbreaking efforts demonstrating that it is possible to initiate and make considerable progress in the implementation of FLE/FP programs for adolescents even when adolescent pregnancy and births are still highly sensitive and controversial issues and when there are no official policies in favor of such programs. The Mission concluded also that project design had improved over the years and projects have moved from addressing a wide variety of broad issues to a more focused consideration of adolescent fertility. All the projects included in the evaluation have contributed to the training in FLE/FP of a large number of family life educators, teachers, and nurses and, as a result, have significantly strengthened professional national capability. The projects have shown that despite the lack of official policy approving FLE in schools and generally overcrowded curricula, FLE can be introduced into schools. In the area of FP service delivery, the projects included in the evaluation have contributed to making FP services generally available through integration with the government maternal and child health services. The main management issues across the projects were similar and included staffing, coordination, supervision, monitoring and evaluation. There is a need to adjust project design so that gender separation is minimized and that the FLE content deals better with issues such as self-awareness, sex roles, and self-esteem. The wider impact of the projects included in this evaluation, to be reflected, for example, in reduced incidence of teenage pregnancy, reduced maternal and infant/child morbidity and mortality, and more generally in the life patterns of women, cannot yet be measured.
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  6. 6
    268442

    A summary of the report on the evaluation of MEX/79/P04 "Integration of population policy with development plans and programmes".

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1984 Jul. 19, [9] p.

    The objective of this UNFPA project was to build the institutional and methodological base for integration of population policy into and its harmonization with national, sectoral and state policies or socioeconomic development in Mexico. More specifically, the project was to achieve integration of population policy with 6 sectoral plans, 24 state plans and the Master Development Plan within 3 years. Although the Mission considers it an achievement that the project signed agreements with all 31 states and the Federal District, no formal contacts had been made with the 6 sectors. Mexico's National Population Council (CONAPO) coordinated the project. The Mission recommended that support to integration activities be continued on the basis of the experience that has been acquired. Therefore it is necessary 1) to strengthen the activities at the state level; 2) to support the development of methodologies considering the impact of socioeconomic plans and programs on demographic variables and to provide a comprehensive program of international technical experience; 3) to recognize that responses to ad hoc support activities are an important integration instrument for both sectors and states; and 4) to exact greater clarity concerning the role of the project in the National Population Program. A lack of aedquately trained personnel proved to be a continual obstacle to implementation. The Mission recommends that at an early stage in the development of such projects a thorough assessment of the human resource requirements and existing capacity for integration of demographic and socioeconomic variables be made and that, based on this assessment, a specific training strategy be developed and incorporated in the project's design. In addition to training, the project also included research support activities; the outputs, however, were descriptive rather than analytical, which can be traced to both the design and execution of the work plan for research activities. The UNFPA's funding constraints and its management of reduced funds further complicated the project's execution, which suffered from high personnel turnover and lack of coordination of project activities.
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  7. 7
    268221

    POPIN Working Group on Dissemination of Population Information: Report on the meeting held from 2 to 4 April 1984.

    United Nations. Department of International Economic and Social Affairs. Population Division. International Population Information Network [POPIN]

    Popin Bulletin. 1984 Dec; (6-7):69-79.

    The objectives of this meeting were: to analyze the general dissemination strategy and functions of POPIN member organizations and assess the methods currently employed to identify users; to select publications or other information output and evaluate how they are being distributed and how procedures for the selective dissemination of information are developed; to develop guidelines for determining the potential audience and reader's interests; to discuss the methodology for maintaining a register of readers' interest; to develop guidelines for establishing linds with key press and broadcasting agencies to ensure rapid dissemination of information; to dientify media and organizations currently involved in the dissemination of population information; to document experience and provide recommendations for the utilization of innovative approaches to serve audiences; and to explore ways and means to meet the special needs of policy makers. Problem areas in population information dissemination were identified at the meeting as well as priority areas in meeting speical information needs of policy makers. Collection of information for dissemination is difficult, costly and time-consuming; there is a shortage of staff trained in the repackaging and dissemination of population information; the direct use of the mass media for information dissemination is still very limited; and financial resources are limited. Priority areas include: compilation of a calendar of events or meetings; conducting media surveys and inventories of population infromation centers and their services and compilation of results; resource development through product marketing and preparation of resource catalogues; and preparation of executive summaries highlighting policy implications to facilitate policy making. Recommendations include: promotion of training and technical assistance in population information activities by the POPIN Coordinating Unit; encouraging member organizations with relevant data bases to develop subsets for distribution to other institutions and, where feasible, to provide technical assistance and support for their wider use; the POPIN Coordinating Unit should alert its members regularly of new technological facilities and innovations in the field of information; organizations conducting population information activities at the national and/or regional levels should be encouraged to provide the POPIN Coordinating Unit with yearly calendars of meetings for publication in the POPIN Bulletin; and the members of POPIN are urged to emphasize the need to incorporate specific plans and budgets for population information activities.
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  8. 8
    030809

    FPIA: 1984-1986. A strategic plan.

    Planned Parenthood Federation of America [PPFA]. Family Planning International Assistance [FPIA]

    New York, New York, FPIA, 1984 Mar. [5], 113 p.

    Family Planning International Assistance (FPIA) initiated strategic planning in 1983, including mission statement, objectives, means, and tactics commonly used to reach the objectives and considerations for strategy development. This document contains background information, FPIA's rationale for developing a 3-year strategic plan, the plan's method, a strategic plan summary, and country plans for countries in the Caribbean, Central America, South America, Asia, and Africa. FPIA's rationale for developing a 3-year strategic plan is as follows: to address AID/W's ongoing need for a clear rationale for continued funding in a time of limited resources; to increase FPIA's capability to make decisions systematically; to organize efforts to carry out decisions and to measure decisions through systematic feedback; to increase FPIA's capability to monitor progress in reaching objectives; to increase FPIA's control over its environment; to continue to address 1981 evaluation findings; and to decrease time involved in plan preparation by planning over a longer time period. FPIA's tactic statements describe the basic approaches to be used in carrying out a predetermined strategy by: extending existing family planning services of government and nongovernment institutions to new geographic areas or to new populations; initiating family planning service in institutions not currently involved in service provision; providing parallel or complementary services; transferring management technology; training staff; working with resistant populations, adolescents, utilizing local resources; and supplying family planning commodities to projects and nonproject institutions. Once objectives were set, the regions were ready to write a strategy for each country. To facilitate writing the strategies, each region received the following series of strategic considerations: state of development of the family planning program in each country; government plans, AID, and USAID mission strategies; type of program FPIA, AID/W, and USAID currently is funding; and rationale for continued private voluntary organization/FPIA support to the country. The strategic plan summary (1984-86) includes FPIA's goals, policy, and philosophy and FPIA's mission, goals, and objectives.
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  9. 9
    029715

    Official development assistance for population activities: a review.

    Herz BK

    Washington, D.C., World Bank, 1984. 153 p. (World Bank Staff Working Papers No. 688; Population and Development Series No. 13)

    The 5 chapters of this document, which traces the sources of assiastance for family planning and other population programs from developed countries and the flow of assistance through principal channel organizations to developing countries, focus on the following: population assistance flows; rationales for population assistance; the shape of population programs; the major channels; and the future of population assistance. Official development assistance for population comes primarily from the US, the Nordic countries, and more recently from the Federal Republic of Germany and Japan. Population assistance is channeled primarily through the UN Fund for Population Assistance (UNFPA), nongovernmental organizations, bilateral programs, and the World Bank. In discussing why developing countries seek and why developed countries provide population assistance, this paper concentrates on official views of how population growth and high fertility affect economic development, environment, maternal and child health, and women's welfare. It explains why some countries are reluctant to seek or provide more population assistance. The paper also analyzes what population assistance does to extend reliable and affordable family planning services and information and to improve understanding of population growth, its causes, and consequences. It summarizes current population policies and family planning programs in major regions of the 3rd world and considers the role of assistance. This paper identifies the comparative advantages of principal organizations providing population assistance, focusing on UNFPA, the major nongovernment organizarions, and the major bilateral programs. Finally, it discusses the evolution of "policy issues" affecting population assistance, particularly donors' concern for "demand" for family planning, cost effectiveness of family planning services, safety, and voluntarism.
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  10. 10
    021441
    Peer Reviewed

    A perspective on long-term population growth.

    Demeny PG

    Population and Development Review. 1984 Mar; 10(1):103-26.

    This paper presents some of the results of projections prepared by the World Bank in 1983 for all the world's countries. The projections (presented against a background of recent demographic trends as estimated by the United Nations) trace the approach of each individual country to a stationary state. Implications of the underlying fertility and mortality assumptions are shown mainly in terms of time trends of total population to the year 2100, annual rates of growth, and absolute annual increments. These indices are shown for the largest individual countries, for world regions, and for country groupings according to economic criteria. The detailed predictive performance of such projections is likely to be poor but the projections indicate orders of magnitude characterizing certain aggregate demographic phenomena whose occurrence is highly probable and set clearly interpretable reference points useful in discussing contemporary issues of policy. (author's)
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  11. 11
    028398

    Voices in harmony for health for all.

    Mahler H

    Who Chronicle. 1984; 38(4):155-60.

    The voice of the World Health Organization's (WHO) internal world is reassuring and tells of widespread political will to attain the goal of health for all, yet another voice says that if the policies adopted in WHO are slowly trickling into national health systems, the process of infiltration is much too slow and may still be far from completion by 2000. A number of developed countries are taking the challenge of health for all very seriously both within their own boundaries and in their dealings with less developed countries, but too many of them did not even take the trouble to report on the results of their monitoring of the health for all strategy. Some claimed off the record that it would have been too complicated in view of the size and complexity of their health system; others that they were not really in need of a strategy since their health service was so comprehensive. If the developed countries shy away from the responsibilities they accepted, why should more be expected of the developing countries. At Alam Alta there was enthusiastic support for action from all countries, no matter what their level of development. Most difficult to assess is the extent to which people themselves are taking the goal of health for all seriously. If the social aspects of the strategy are difficult to monitor, one would expect that the financial aspects should be clearer. This is not the case. Few countries, including the most economically developed, were able to assess the amount and flow of resources for health for all. In particular, they were unable to distinguish between the allocation of funds for the continuation of old policies and for the promotion of new ones. WHO has embarked on a new General Program of Work -- the 7th in the history of the organization. The program aims at making member nations more self-reliant than ever in the fields of health. The major task is to build up solid health infrastructures that are capable of delivering the most needed programs to the most people on the basis of equality of access for all. Unfortunately, only the sounds of the 7th program have made themselves heard, not the substance. Among the organization's successes can be included many of WHO's publications, particularly the "Health for All" series, but these publications are being used much too sparingly. New managerial arrangements have been introduced to help countries make the best use of everything WHO has to offer, yet all moves too slowly.
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  12. 12
    028381

    A watershed of ideas.

    Rowley J

    People. 1984; 11(4):4-7.

    A significant happening at the International Conference on Population, which took place in Mexico City during August 1984, was the world consensus on the need to act more urgently to deal with the interrelated problems of population and development and to provide the conditions of life and means by which everyone can plan their family. The note of concern about the impact of population growth and about its distribution and structure was consistent. Support for expanded family planning services came from all sides, including Africia and Latin America. The UN agencies and the World Bank came nearest to injecting a visionary and emotional charge into the occasion. Their near universal message was the need to release and mobilize the energies of the people and slow excessive population growth by investing in their health, education, environment, employment opportunities and in family planning. Bradford Morse, Administrator of the UN Development Program, added a powerful plea, that the international factors of protectionism, debt, and high increase rates, arms spending, and ddeclining aid flows must be addressed if the goals of the original Plan of Action, i.e., to promote "economic development, wuality of life, human rights, and fundamental freedoms," were to be dealt with. James Grant, Executive Director of UNICEF, stated tha the experience of the past decade confirms "that development and population programs are interacting, mutually reinforcing efforts that work with the 'seamless' web of income, nutrition, health, education, and fertility." The final document put the same idea into various paragraphs. This consensus position was simple and consistent, but in its way, revoluntionary. The elements which brought about this agreement were made clear from the start. The 1st was the change in government attitudes towards population. In 4/5 of the world governments regard population as a key factor inn development strategy. A 2nd factor was that governments now feel more independent and less under external pressure. A 3rd element was that women in nearly all countries desire fewer children than they wanted previously and many are coming out openly and stating that they did not want their last child. A 4th factor was the awareness that population problems affect developed countries as well as developing countries. Along with these changes has come greater awareness of the health and social benefits of family planning. These ideas find expression the the 38 pages of recommendations which were eventually agreed on. The most significant of these was the added emphasis given to the role and status of women.
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  13. 13
    267328

    The United Nations and the politics of population, 1960-74.

    Patton CG

    Ann Arbor, Michigan, University Microfilms International, 1984. [505] p.

    One form of international authority proposed by David Mitrany was that of an advisory and coordinating one where both the performance of a task and the means for its accomplishment remain mainly under national control. Mitrany's theoretical framework and its organizational analogue within the UN and national political arenas account for the emergence of a new UN population policy to cope with the rapid global population growth between 1960 and 1974. The most prestigious outcome of this policy was the United Nations Fund for Population Activities (UNFPA), whose centralized contributions came primarily from the US, Japanese, Swedish, and some other west European governments. Its aim is to assist governments in the development of national family planning programs and in related demographic and family planning training and research programs. UNFPA grants went to UN-system agencies, governments, and private organizations. Recipients include India, Pakistan, Egypt, Malaysia, Kenya, Nigeria and Mexico. A mew ideology emerged to support the concept of an interventionist policy to lower the birth rate. That ideology include the responsibility of each government for its own population; an emphasis on social framework for parental choices about family size; and a legitimate role for international assistance. How the UNFPA came into existence is a political process involving government delegations and officials, UN Secretarist staff, and representatives of selected religious and population transnational organizations. It is also a Laswellian social process model of 7 decision-outcomes marking the significant population events and interactions underlying the creation of UNFPA. 6 UN resolutions and 2 decisions by the Secretary-General denominate these decision outcomes. 2 analytic approaches account for these decision outcomes--the Parsonian concept of organized levels (institutional, managerial, and technical) in conjunction with the Laswellian concepts of centralization/decentralization and concentration/decontration, and the concept of coalitions, (legislative and programming). This expanded UN population policy process reveals the interconnectedness of elites and groups in a global network centered at UFPA. (author's modified)
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  14. 14
    267312

    Report on developments and activities related to population information during the decade since the convening of the World Population Conference, Bucharest, 1974.

    Hankinson R

    New York, United Nations, 1984 Jun. vi, 52 p. (POPIN Bulletin No. 5 ISEA/POPIN/5)

    A summary of developments in the population information field during the decade 1974-84 is presented. Progress has been made in improving population services that are available to world users. "Population Index" and direct access to computerized on-line services and POPLINE printouts are available in the US and 13 other countries through a cooperating network of institutions. POPLINE services are also available free of charge to requestors from developing countries. Regional Bibliographic efforts are DOCPAL for Latin America. PIDSA for Africa, ADOPT and EBIS/PROFILE. Much of the funding and support for population information activities comes from 4 major sources: 1) UN Fund for Population Activities (UNFPA): 2) US Agency for International Development (USAID); 3) International Development Research Centre (IRDC): and 4) the Government of Australia. There are important philosophical distinctions in the support provided by these sources. Duplication of effort is to be avoided. Many agencies need to develop an institutional memory. They are creating computerized data bases on funded projects. The creation of these data bases is a major priority for regional population information services that serve developing countries. Costs of developing these information services are prohibitive; however, it is important to see them in their proper perspective. Many governments are reluctant to commit funds for these activites. Common standards should be adopted for population information. Knowledge and use of available services should be increased. The importance os back-up services is apparent. Hard-copy reproductions of items in data bases should be included. This report is primarily descriptive rather than evaluative. However, given the increase in population distribution and changes in government attitudes over the importance of population matters, the main tasks for the next decade should be to build on these foundations; to insure effective and efficient use of services; to share experience and knowledge through POPIN and other networks; and to demonstrate to governments the valuable role of information programs in developing national population programs.
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  15. 15
    028281

    Doctors--barefoot and otherwise. The World Health Organization, the United States, and global primary medical care.

    Mullan F; Bryant JH

    Jama. 1984 Dec 14; 252(22):3146-8.

    The international effort to provide primary health care (PHC) services for all by the year 2000 requires the development of appropriate manpower resources in the developing countries. Given the limited health budgets of developing countries, research on manpower development is necessary to ensure that funds for manpower development are used in the most efficient manner. In recognition of this need, the World Health Organization (WHO) and the International Organization for Medical Sciences convened a workshop, entitled "Health for All - A Challenge to Health Manpower Development Research" in Ibadan, Nigeria in 1982. The participants at the workshop agreed that manpower development strategies must be developed in the context of PHC, and that the current manpower development strategies in most developing countries do not provide the type of manpower required in PHC systems. Specifically, the workshop recommended that health manpower development strategies must 1) take into account the fact that health improvement is dependent not just on health services but on improvements in sanitation, water, housing, and nutrition; 2) recognize that PHC systems require an extensive cadre of health workers, paramedics, and auxiliary personnel, and that PHC systems are not highly physician dependent; and 3) recognize that medical schools must train physicians capable of serving the needs of the entire population rather than just the needs of the elite few. Participants also recognized that the development of effective strategies may be hindered by various professional, technical, financial, and bureaucratic factors. Given the pressing needs and scarce resources of developing countries, manpower development research must be highly policy oriented. The recommendations of the workshop were endorsed by WHO's Advisory Committee on Medical Research in 1983 and then distributed to WHO's 6 regional offices. The regional offices are currently discussing the recommendations with individual countries in an effort to determine how each country can implement the recommendations. The success of the effort to train appropriate manpower will require the assistance of developed countries and especially the US. The US can assist by providing training in US institutions for individuals from developing countries. Training programs, however, must be reoriented in such a way as to equip students to work in PHC settings. Medical personnel from the US can provide technical assistance in the developing countries, but efforts must made to ensure that this assistance is directed toward the development of PHC prsonnel and services.
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  16. 16
    027533

    No development without grass-roots action.

    Grant JP

    Development: Seeds of Change. 1984; 2:66-7.

    UN International Children's Emergency Fund (UNICEF) experience over the last 20 years suggests that successful development for poor people is not possible without substantial grassroots involvement. This is the experience both in the developing and in industrialized countries. In the 1960s it became increasingly clear to UNICEF that if programs were to succeed with the small and landless farmers and the urban slum dwellers, there was no possibility of finding enough money to meet needs of these people through governmental channels. It was equally clear that in most places the existing patterns of development andeconomic growth would not reach these people until the year 2000 or thereabots. It was this that led UNICEF to adopt its basic services approach in the late 1960s and early 1970s, which implied that the cost of the most needed basic health services, education, and water had to be reduced to manageable limits. At this stage UNICEF began to articulate the imperative of using paraprofessionals, the need for much greater use of technology that was appropriate to rural and slum areas, and the importance of involving the people in this effort. Looking at those low income countries which have managed to achieve longer life expectancy and higher literacy rates, they are all societies which have practiced much more people's participation in economic and social activities than most other countries. These 3 very different societies -- China, South Korea, and Sri Lanka -- all have had a rather unique degree of people's participation in the development process. Grassroots participation in development is a very important element in developing and in industrial countries. 1 example concerns the whole question of proper nutrition practices, the promotion of breastfeeding, and the problem of the infant formula code. It was the people's groups which picked up the research results in the 1960s, which showed that breastfeeding was a better and more nutritious way of feeding children. The 2nd example pertains to the US government recommendation of significant cuts in UNDP and UNICEF, and the refusal of Congress to give in to those cuts. In regard to the developing countries, over the last year it has increasingly become the consensus of international experts that a childrens' health revolutioon is possible. The conclusion was based upon the fact that there were 2 new sets of developments coming together that created this new opportunity: some new technological advances in the development of rural rehydration therapy; and the capacity to communicate with poor people. With the whole emphasis on the basic human needs of the last 10 years, and on primary health care in the last 5 years, literally millions of health auxiliaries and community workers have been trained, a group of people who, if a country can mobilize them, can provide a new form of access.
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  17. 17
    027467

    Adoption of the Report of the Conference: report of the Main Committee.

    Concepcion MB

    [Unpublished] 1984 Aug 13. 40 p. (E/CONF.76/L.3; M-84-718)

    This report of the International Conference on Population, held in Mexico City during August 1984, includes: recommendations for action (socioeconomic development and population, the role and status of women, development of population policies, population goals and policies, and promotion of knowledge and policy) and for implementation (role of national governments; role of international cooperation; and monitoring, review, and appraisal). While many of the recommendations are addressed to governments, other efforts or initiatives are encouraged, i.e., those of international organizations, nongovernmental organizations, private institutions or organizations, or families and individuals where their efforts can make an effective contribution to overall population or development goals on the basis of strict respect for sovereignty and national legislation in force. The recommendations reflect the importance attached to an integrated approach toward population and development, both in national policies and at the international level. In view of the slow progress made since 1974 in the achievement of equality for women, the broadening of the role and the improvement of the status of women remain important goals that should be pursued as ends in themselves. The ability of women to control their own fertility forms an important basis for the enjoyment of other rights; likewise, the assurance of socioeconomic opportunities on a equal basis with men and the provision of the necessary services and facilities enable women to take greater responsibility for their reproductive lives. Governments are urged to adopt population policies and social and economic development policies that are mutually reinforcing. Countries which consider that their population growth rates hinder the attainment of national goals are invited to consider pursuing relevant demographic policies, within the framework of socioeconomic development. In planning for economic and social development, governments should give appropriate consideration to shifts in family and household structures and their implications for requirements in different policy fields. The international community should play an important role in the further implementation of the World Population Plan of Action. Organs, organizations, and bodies of the UN system and donor countries which play an important role in supporting population programs, as well as other international, regional, and subregional organizations, are urged to assist governments at their request in implementing the reccomendations.
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  18. 18
    026268

    Concise report on the world population situation in 1983: conditions, trends, prospects, policies.

    United Nations. Department of International Economic and Social Affairs. Population Division

    New York, United Nations, 1984. 108 p. (Population Studies, No. 85; ST/ESA/SER.A/85)

    The 3 parts of this report on world, regional, and international developments in the field of population, present a summary of levels, trends, and prospects in mortality, fertility, nuptiality, international migration, population growth, age structure, and urbanization; consider some important issues in the interrelationships between economic, social, and demographic variables, with special emphasis on the problems of food supply and employment; and deal with the policies and perceptions of governments on population matters. The 1st part of the report is based primarily on data compiled by the UN Population Division. The 2nd part is based on information provided by the Food and Agriculture Organization of the UN (FAO) and the International Labor Organization (ILO), as well as that compiled by the Population Division. The final part is based on information in the policy data bank maintained by the Population Division, including responses to the UN Fourth Population Inquiry among Governments. In 1975-80 the expectation of life at birth for the world was estimated at 57.2 years for both sexes combined. The corresponding figure for the developed and developing regions was 71.9 and 54.7 years, respectively. In 1975-80 the birthrate of the world was estimated at 28.9/1000 population and the gross reproduction rate was 1.91. These figures reflect considerable decline from the levels attained 25 years earlier: a crude birthrate of 38/1000 population and a gross reproduction rate of 2.44. World population grew from 2504 million in 1950 to 4453 million in 1983. Of the additional 1949 million people, 1645 million, or 84%, accrued to the less developed countries. The impact of population growth on economic development and social progress is not well understood. The governments of some developing countries still officially welcome a rapid rate of population growth. Many other governments see cause for concern in the need for the large increases in social expenditure, particularly for health and education, that accompany a young and growing population. Planners are concerned that the rapidly growing supply of labor, compounded by a trend toward rapid urbanization, may exceed that which the job market is likely to absorb. In the developed regions the prospect of a declining, or an aging, population is also cause for apprehension. There is a dearth of knowledge as to the impact of policies for altering the consequences of these trends. Many policies have been tried, in both developed and developing countries, to influence population growth and distribution, but the consequences of such policies have been difficult to assess. Frequently this problem arises because their primary objectives are not demographic in character.
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  19. 19
    024929

    Mortality trends and prospects in developing countries: some "best-data" indications.

    Stolnitz GJ

    In: United Nations. Department of International Economic and Social Affairs. Population projections: methodology of the United Nations. New York, N.Y., United Nations, 1984. 60-6. (Population Studies, No. 83; ST/ESA/SER.A/83)

    This paper offers suggestions for guiding the next projection's exercise at the United Nations in light of third world life tables which, although severely limited, are believed to be relatively reliable. Of prime importance is the suggestion that expectation of life at birth in a number of less developed areas has begun to overtake and surpass the lower levels of such measures among the populations of developed countries. Although this is the 1st such occurrence on record, it is not likely to be reversed. A major implication of these patterns is that the causal linkages which have historically connected levels and patterns of socioeconomic development with those of mortality have become greatly attenuated. It is safe to say that major new causal mechanisms for reducing mortality have come into play which demographers have yet to comprehend adequately for purposes of projection. Another suggestion is to increase attention to the specific status and performance of national public-sector health programs (including water supply and sanitation) key factors affecting the onset and scale of mortality downtrends during the postwar decades. In addition, increasingly close attention needs to be paid to political disturbances, affecting health-care programs financing and associated delivery systems. With few exceptions, differences between female and male life expectancies at birth have been rising in the sample areas under review, implying that the gains over time for females have been higher than those for males. This directional pattern at both ages is remarkably similar to what has been found to hold with notable consistency among developed countries since 1920. Its prevalence suggests a bench-mark for checing the projected longevity differentials between males and females in the next UN exercise; at a minimum, these should be compared with past directions and magnitudes of change. Added or new attention should be given to comparisons between developed country and less developed country mortality measures; to how such measures vary by age at given points of time and shift by age over time; to sex differentials of both mortality levels and changes; and to the rapidly growing stocks of information becoming available on leading correlates of deaths, survival and morbidity rates. Such attention will enhance the quality, relevance and reliability of the future work of the UN on population projections.
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  20. 20
    025567

    The United Nations Conference on Population.

    Salas RM

    Draper Fund Report. 1984 Jun; (13):1-3.

    The UN International Conference on Population to be held in Mexico City in August 1984, responding to an unprecedented upsurge of interest in population over the last decade, offers developed and developing countries the opportunity to assess current and likely future population trends, to comment on programs and progress during the past 10 years, and to determine desirable future directions. More developing countries are reporting diminished declining fertility and family size in countries of widely varying ethnic, social, and economic makeup. Although it is likely that the future will bring a steadily declining rate of world population growth, culminating in stability, present trends indicate that it will take more than a century for world population to stabilize. Meanwhile growth continues. The developing world's annual average birthrate from1975-80 was twice as high as the developed world's. Also there are large areas, much of Latin America and most of Africa, where growth rates continue very high. Other areas, such as parts of Asia, do not follow the general declining trend despite trend despite, in some instances, a long history of population programs. Interest in population programs and demand for resources to support them are growing, but the population dimension is sometimes unrecognized in development planning. The experience of the last decade illustrates that population assistance can make a uniquely valuable contribution to national development when it is given in accord with national policies, is appropriate to local conditions and needs, and is delivered where it can make the most impact. Substantial evidence exists that women in the developing world undertand the risks of repeated pregrancy and would like to take steps to reduce them. It is evident that providers of family planning services are not yet sufficiently responsive to women's own perceptions of their needs and that the social and economic conditions which make family planning a reasonable option do not yet exist. Influxes of immigrants, short and long term, legal and illegal, create particular problems for receiving countries. It is important for sending countries to know what effect the absence of their nationals is having on the domestic economy and essential for receiving countries to consider the protection of the human rights of international migrants, including settlers, workers, undocumented migrants, and refugees. It is a particular responsibility of the industrialized nations to make careful use of limited resources and to ensure that their comsumption contributes to the overall balance of the environment. In most developing countries infectious and parasitic disease remains the primary cause of death, particularly among the young. Much of this toll is preventable. The International Conference on Population provides an opportunity to establish in broad terms the conditions and directions of future cooperation.
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  21. 21
    025380

    Statistics on children in UNICEF countries.

    UNICEF

    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.
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  22. 22
    024921

    Some problems in the making of population projections.

    Tabah L

    In: United Nations. Department of International Economic and Social Affairs. Population projections: methodology of the United Nations. Papers of the United Nations Ad Hoc Expert Group on Demographic Projections, United Nations Headquarters, 16-19 November 1981. New York, United Nations, 1984. 15-6. (Population Studies No. 83; ST/ESA/SER.A/83)

    As the UN demographic estimates and projections cover all the developed and developing countries, special problems are encountered in data collection and evaluations. The responsibility for the UN projections rests primarily with the Population Division, but the results are the product of collaboration by all responsible offices within the UN system. This is 1 of the strengths of the UN population projections, yet there are numerous problems concerning those projections. Aside from the perpetual difficulties with collection and estimation of basic demographic indicators from incomplete data, all of which must be continuously undertaken, there are 8 major problems which have become more important in recent years and concern the current UN demographic projections. The 1st problem is the question of meeting the needs of the users who are the researchers, the planners, and the policymakers. The 2nd problem is that significant improvement can be made in the methodologies with, on the 1 hand, the prodigious advances in calculation devices and research techniques and on the other, a better knowledge of the economic and social context of demographic variables. The 3rd major problem in the component method of projections of fertility, which continues to be the most influential component to the future population of most nations. Another component of projection, mortality, has become a pressing issue in the field of projection as well. Knowledge of mortality in the third world is highly fragmentary. The 5th problematic issue is urbanization and city growth. There are severe problems with data comparability and projection methods. Sixth, for several developing and developed countries international migration plays a significant role in their population growth. More problematic than estimating the current net numbers of migrants is formulating assumptions about future patterns of international migration. Seventh, thus far demographic projections have largely been based on the demographic theory of transition, which appears to continue to be useful for developing countries. Yet, the demographic transition models are affected by a wider variety of trajectories than anticipated. Finally, no one has been able to explain clearly the major simultaneous movements of fertility of the developed countries. The question of obvious policy significance is what will happen in the future.
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  23. 23
    023691

    Smoking control strategies in developing countries: report of a WHO Expert Committee.

    Masironi R

    World Smoking and Health. 1984 Spring; 9(1):4-6.

    An Expert Committee met in World Health Organization Headquarters in Geneva in November 1982 to discuss Smoking Control Strategies in Developing Countries. They reviewed the harmful health effects of different types of tobacco which characterized developing countries and the adverse effects of tobacco use on their economics due to smoking related diseases and higher smokers' work absenteeism. It advised on the objectives of smoking control programs, including data collection; education and information; legislation; smoking cessation; the role of medical, political, social, and religious leaders; the role of WHO, UN agencies, and nongovernmental organizations; research on smoking behavior; and evaluation of program efficacy. In addition, the Committee provided guidance on how to counteract tobacco industry arguments. More than a million people worldwide die prematurely each year because of cigarette smoking. In developed countries smoking is generally understood to cause lung cancer, coronary heart disease, chronic bronchitis, and other respiratory disorders. Major campaigns have been launched to reduce the rate of smoking. The public in most developing countries are unaware of the dangers, and no educational, legislative, or other measures are being taken to combat the smoking epidemic. The Committee called for firm steps to be taken to prevent this unnecessary modern epidemic. The incidence of tobacco related diseases is increasing in developing countries. Many of the developing countries have cigarettes on sale with high yields of tar and nicotine. Tobacco cultivation has spread to about 120 countries, becoming a substantial source of employment and creating new vested interests. Overall, the costs outweigh the "benefits." Tobacco taxes may be Politically comfortable," that is, easy to administer and generally acceptable to smokers, but these taxes do not contribute to national wealth but merely redistribute wealth. They cannot offset the economic losses caused by tobacco production and use: health service expenditures on smoking related diseases, disablement and work absenteeism, domestic and forest fires, use of scarce fule to cure tobacco, and reduced food production. Action against smoking can be inexpensive yet effective. Health warnings can be placed on cigarette packets, and legislation can be enacted to put an end to the double standards in marketing practices, whereby cigarettes of the same brand carrying health warnings in developed countries are marketed without these warnings in developing countries. Recommendations issued to governments and public health authorities in developing countries are listed.
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  24. 24
    024924

    Current projection assumptions for the United Nations demographic projections.

    United Nations. Secretariat

    In: United Nations. Department of International Economic and Social Affairs. Population projections: methodology of the United Nations. New York, N.Y., United Nations, 1984. 25-32. (Population Studies, No. 83; ST/ESA/SER.A/83)

    The United Nations population projection assumptions are statements of expected trends in fertility, mortality and migration in the world. In every assessment, each of the 3 demographic components is unambiguously specified at the national level for each of the 5-year periods during the population interval (1950-2025). The approach used by the UN in preparing its projections is briefly summarized. At the general level, the analyst relies on available information of past events and current demographic levels and differentials, the demographic trends and experiences of similar countries in the region and his or her informed interpretations of what is likely to occur in the future. One common feature of the UN population projections that guides the analyst in preparing the assumptions is the general conceptual scheme of the demographic transition, or the socio-economic threshold hypothesis of fertility decline. As can be observed from the projected demographic trends reported in this paper, population stabilization at low levels of fertility, mortality and migration is the expected future for each country, with the only important differences being the timing of the stabilization. Irrespective of whether the country is developed, with very low fertility (for example, the Federal Republic of Germany or Japan), or developing with high fertility (such as, Bangladesh or the Syrian Arab Republic), it is assumed that fertility will arrive at replacement levels in the not too distant future. Serious alternative theories or hypotheses of population change, such as declining population size, are not only very few in number, but they tend to be somewhat more unacceptable and inconvenient to the demographic analyst as well as being considerably less palatable to goverments.
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  25. 25
    021845

    US is key player in Salvador's controversial birth control plan.

    Hedges C

    CHRISTIAN SCIENCE MONITOR. 1984 Jan 13; 78(34):8, 23.

    The US Agency for International Development (USAID) has played a key role in El Salvador's family planning program and has identified population control as among its main objectives in the country. In addition to helping to start the Salvadorean Health Ministry's Family Planning Coordination Office, USAID has provided over $4 million to the Salvadorean Demographic Association (ADS). These organizations distribute contraceptives nationwide and perform surgical sterilizations on women. USAID estimates that 25% of women of childbearing age in El Salvador are now using some form of contraception. However, the program has been criticized by many local physicians and health workers. It is argued that the US has ignored the really pressing health needs of the Salvadorean people and is attempting to limit the number of poor people. The most controversial aspect of the population program concerns the surgical sterilizations performed on 21,000 women each year. Relief workers have charged that food has been offered to women in displaced persons camps if they agree to be sterilized, and that some procedures are performed against the will of patients. ADS teams make home visits to explain the advantages of sterilization, and each field nurse is expected to sign up an average of 1 woman/day for the procedure. USAID officials have indicated they will conduct an investigation into the alleged abuses of sterilization. The agency has also initiated a US$25 million program in El Salvador intended to reduce shortages of pharmaceutical supplies and replace some medical equipment.
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