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Vaccine. 2013 Apr 18; 31(Suppl 2):B81-B96.Middle-income countries (MICs) as a group are not only characterized by a wide range of gross national income (GNI) per capita (US $1026 to $12,475), but also by diversity in size, geography, governance, and infrastructure. They include the largest and smallest countries of the world-including 16 landlocked developing countries, 27 small island developing states, and 17 least developed countries-and have a significant diversity in burden of vaccine-preventable diseases. Given the growth in the number of MICs and their considerable domestic income disparities, they are now home to the greatest proportion of the world’s poor, having more inhabitants below the poverty line than low-income countries (LICs). However, they have little or no access to external funding for the implementation of new vaccines, nor are they benefiting from an enabling global environment. The MICs are thus not sustainably introducing new life-saving vaccines at the same rate as donor-funded LICs or wealthier countries. The global community, through World Health Assembly resolutions and the inclusion of MIC issues in several recent studies and important documents-including the Global Vaccine Action Plan (GVAP) for the Decade of Vaccines-has acknowledged the sub-optimal situations in some MICs and is actively seeking to enhance the situation by expanding support to these countries. This report documents some of the activities already going on in a subset of MICs, including strengthening of national regulatory authorities and national immunization technical advisory groups, and development of comprehensive multi-year plans. However, some additional tools developed for LICs could prove useful to MICs and thus should be adapted for use by them. In addition, new approaches need to be developed to support MIC-specific needs. It is clear that no one solution will address the needs of this diverse group. We suggest tailored interventions in the four categories of evidence and capacity-building, policy and advocacy, financing, and procurement and supply chain. For MICs to have comparable rates of introduction as other wealthier countries and to contribute to the global fight against vaccine-preventable diseases, global partners must implement a coordinated and pragmatic intervention strategy in accord with their competitive advantage. This will require political will, joint planning, and additional modest funding.
Bulletin of the World Health Organization. 2007 Mar; 85(3):192-199.International health policy-makers now have a variety of institutional instruments with which to pursue their global and national health goals. These instruments range from the established formal multilateral organizations of the United Nations to the newer restricted-membership institutions of the Group of Eight (G8). To decide where best to deploy scarce resources, we must systematically examine the G8's contributions to global health governance. This assessment explores the contributions made by multilateral institutions such as the World Health Organization, and whether Member States comply with their commitments. We assessed whether G8 health governance assists its member governments in managing domestic politics and policy, in defining dominant normative directions, in developing and complying with collective commitments and in developing new G8-centred institutions. We found that the G8's performance improved substantially during the past decade. The G8 Member States function equally well, and each is able to combat diseases. Compliance varied among G8 Member States with respect to their health commitments, and there is scope for improvement. G8 leaders should better define their health commitments and set a one-year deadline for their delivery. In addition, Member States must seek WHO's support and set up an institution for G8 health ministers. (author's)
The World Health Organization multinational study of breast-feeding and lactational amenorrhea. II. Factors associated with the length of amenorrhea.
Fertility and Sterility. 1998 Sep; 70(3):461-471.The objective was to determine the relation between infant feeding practices (and other factors) and the duration of postpartum amenorrhea, and to establish whether there are real differences in the duration of postpartum amenorrhea for similar breast-feeding practices in different populations. Design: Prospective, nonexperimental, longitudinal follow-up study. Setting: Five developing and two developed countries. Patient(s): Four thousand one hundred eighteen breast-feeding mothers and their infants. Breast-feeding women collected ongoing information about infant feeding and family planning practices, plus the return of menses. Fortnightly follow-up occurred in the women's homes. A multivariate analysis explored the association between the risk of menses return and 16 infant feeding variables and 11 other characteristics. Ten factors (in addition to center effects) were significantly related to the duration of amenorrhea. Seven of these were infant feeding characteristics and the remaining three were high parity, low body mass index, and a higher frequency of infant illness. The breast-feeding stimulus is strongly linked to the duration of postpartum amenorrhea. Cross-cultural effects also are extremely important and may have caused the variations in feeding, the variation in amenorrhea, or both. (author's)
Bulletin of the World Health Organization. 1956; 15:5-41.The author reviews that mortality statistics from cancer of the breast in females and from malignant neoplasms of the uterus and of the other female genital organs for nineteen countries over the years 1920-53, first considering the general trend of the mortality series for each group of diseases for all ages and then analysing for each sector of mortality the changes which have occurred in the age-specific death-rates in some pivotal years during the same period. Considerable differences in the levels of total mortality from each group of tumours for various countries are noted. The important variations among age-specific death-rates for cancer of the breast in females and for uterine neoplasms in various countries are examined and their significance is commented upon. (excerpt)
Bulletin of the World Health Organization. 1955; 22:63-83.This paper presents the results of the tuberculin-testing of over 3,600 patients in tuberculosis hospitals and of nearly 34,000 schoolchildren in widely separated areas where arrangements could be made for specially trained personnel to work uniform materials and techniques. Both patients and children were tested with an intradermal dose of 5 TU, and the children were retested with 100 TU if the reactions were less than 5 mm. The results confirm those of earlier papers, that at least two different kinds of naturally acquired tuberculin sensitivity are found in many human populations: a high-grade sensitivity, designated as specific for virulent tuberculous infection, and a low-grade kind designated as non-specific, or not specific for tuberculous infection. Specific sensitivity is the kind found in tuberculous patients and in some schoolchildren everywhere. It follows a remarkably uniform pattern wherever it is found, apparently varying only in prevalence, not in degree, from place to place. In contrast, non- specific sensitivity varies both in prevalence and in degree. It ranges from nearly universal prevalence in some localities to almost complete absence in others, from a low degree to a relatively high degree approaching that of specific sensitivity. Non-specific sensitivity is not correlated with specific sensitivity and may have different causes in different places. (excerpt)
World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women.
American Journal of Obstetrics and Gynecology. 2006 Mar; 194(3):639-649.The purpose of this trial was to determine whether calcium supplementation of pregnant women with low calcium intake reduces preeclampsia and preterm delivery. Randomized placebo-controlled, double-blinded trial in nulliparous normotensive women from populations with dietary calcium !600 mg/d. Women who were recruited before gestational week 20 received supplements (1.5 g calcium/d or placebo) throughout pregnancy. Primary outcomes were preeclampsia and preterm delivery; secondary outcomes focused on severe morbidity and maternal and neonatal mortality rates. The groups comprised 8325 women who were assigned randomly. Both groups had similar gestational ages, demographic characteristics, and blood pressure levels at entry. Compliance were both 85% and follow-up losses (calcium, 3.4%; placebo, 3.7%). Calcium supplementation was associated with a non-statistically significant small reduction in preeclampsia (4.1% vs 4.5%) that was evident by 35 weeks of gestation (1.2% vs 2.8%; P = .04). Eclampsia (risk ratio, 0.68: 95% CI, 0.48-0.97) and severe gestational hypertension (risk ratio, 0.71; 95% CI, 0.61-0.82) were significantly lower in the calcium group. Overall, there was a reduction in the severe preeclamptic complications index (risk ratio, 0.76; 95% CI, 0.66-0.89; life-table analysis, log rank test; P = .04). The severe maternal morbidity and mortality index was also reduced in the supplementation group (risk ratio, 0.80; 95% CI, 0.70-0.91). Preterm delivery (the neonatal primary outcome) and early preterm delivery tended to be reduced among women who were %20 years of age (risk ratio, 0.82; 95% CI, 0.67-1.01; risk ratio, 0.64; 95% CI, 0.42-0.98, respectively). The neonatal mortality rate was lower (risk ratio, 0.70; 95% CI, 0.56-0.88) in the calcium group. A 1.5-g calcium/day supplement did not prevent preeclampsia but did reduce its severity, maternal morbidity, and neonatal mortality, albeit these were secondary outcomes. (author's)
WHO / CONRAD Technical Consultation on Nonoxynol-9, World Health Organization, Geneva, 9–10 October 2001. Summary report.
Geneva, Switzerland, WHO, 2003.  p. (PN-ACQ-110)An effective, easy to use vaginal microbicide would provide women with a method under their own control with which to protect themselves against infection with the human immunodeficiency virus (HIV). While many novel compounds are currently being developed and tested, it will be many years before a new product can be fully evaluated and distributed to users. The spermicide Nonoxynol-9 (N-9) has been widely available as a contraceptive for many years and has been shown to be effective against HIV in laboratory studies. If it also provided effective protection against HIV in clinical studies, N-9 could be made rapidly available to women who require protection. The World Health Organization Global Programme on AIDS (GPA) and the Joint United Nations Program on HIV/AIDS (UNAIDS) sponsored a clinical trial of a gel containing N-9 to assess its effectiveness in protecting against HIV. Preliminary results from the study were presented in July 2000 at the 13th International AIDS Conference in Durban, South Africa, and showed, contrary to expectation, that the HIV incidence was higher in women using N-9 than in women using a comparison product. While a disappointment with regard to the rapid deployment of an effective microbicide, these results also raised questions about the safety of N-9 when used for its main indication, protection against unwanted pregnancy. After presentation of the preliminary results from the study in July 2000, the World Health Organization (WHO) was approached to provide an assessment of the scientific information regarding the safety and effectiveness of N-9 when used for family planning purposes. This summary should permit Member States to assess the risks and benefits of N-9 use among women in their country who may be at risk of HIV infection from inadequately protected sexual activity. Accordingly, the WHO Department of Reproductive Health and Research (RHR) convened a Technical Consultation in October 2001, in partnership with the CONRAD Program, Arlington, VA, USA, to review the available evidence and provide advice to member states on the use of N-9. The Consultation included experts from developed and developing countries with experience in product development, safety assessment, and public health and representatives from collaborating agencies (Annex). Reviews of key issues were commissioned prior to the meeting and are summarised in this report. The meeting also considered the submitted manuscripts from recently completed studies directly relevant to the safety and effectiveness of N-9. This report summarises the evidence presented to the meeting on the safety of N-9 and its effectiveness for protection against pregnancy, sexually transmitted infections (STIs) and HIV. The meeting concluded with recommendations on the use of N-9 and identified key areas of uncertainty where more research was urgently required. (excerpt)
Arlington, Virginia, Family Health International [FHI], HIV / AIDS Prevention and Care Department, 2001.  p. (UNAID Best Practice Key Materials; USAID Cooperative Agreement No. HRN-A-00-97-00017-00)Countries with low HIV prevalence share a set of concerns and challenges regarding their responses to a potential HIV epidemic. Many of these countries also present an opportunity to avert large numbers of future HIV infections if appropriate prevention strategies are chosen and implemented early, greatly reducing future HIV/AIDS-related costs to the country. The purpose of this publication is to identify those challenges and propose a prevention strategy that can maintain low HIV prevalence in the general population, while reducing existing or preventing potential HIV sub-epidemics in population subgroups with substantial levels of risk behavior. Decisions on the strategic placement and targeting of prevention interventions are important to both international agencies and countries planning their prevention response. Both need to make difficult choices regarding geographic and population subgroups to ensure that resources are allocated efficiently. (excerpt)
New reference values for thyroid volume by ultrasound in iodine-sufficient schoolchildren: a World Health Organization / Nutrition for Health and Development Iodine Deficiency Study Group Report.
American Journal of Clinical Nutrition. 2004 Feb; 79(2):231-237.Goiter prevalence in school-age children is an indicator of the severity of iodine deficiency disorders (IDDs) in a population. In areas of mild-to-moderate IDDs, measurement of thyroid volume (Tvol) by ultrasound is preferable to palpation for grading goiter, but interpretation requires reference criteria from iodine-sufficient children. The study aim was to establish international reference values for Tvol by ultrasound in 6–12-y-old children that could be used to define goiter in the context of IDD monitoring. Tvol was measured by ultrasound in 6–12-y-old children living in areas of long-term iodine sufficiency in North and South America, central Europe, the eastern Mediterranean, Africa, and the western Pacific. Measurements were made by 2 experienced examiners using validated techniques. Data were log transformed, used to calculate percentiles on the basis of the Gaussian distribution, and then transformed back to the linear scale. Age- and body surface area (BSA)–specific 97th percentiles for Tvol were calculated for boys and girls. The sample included 3529 children evenly divided between boys and girls at each year (x ± SD age: 9.3 ± 1.9 y). The range of median urinary iodine concentrations for the 6 study sites was 118-288 µg/L. There were significant differences in age- and BSA-adjusted mean Tvols between sites, which suggests that population-specific references in countries with long-standing iodine sufficiency may be more accurate than is a single international reference. However, overall differences in age- and BSA-adjusted Tvols between sites were modest relative to the population and measurement variability, which supports the use of a single, site-independent set of references. These new international reference values for Tvol by ultrasound can be used for goiter screening in the context of IDD monitoring. (author's)
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)
Journal of Adolescent Health. 2003 Oct; 33(4):240-251.The contemporary health problems of young people occur within the context of the physical, social, cultural, economic, and political realities within which they live. There are commonalities and differences in this context among developed and developing countries, thus differing effects on the individual’s personal as well as national development. Internationally, the origins and evolution of health care for adolescents can be viewed as an unfolding saga taking place particularly over the past 30 years. It is a story of advocacy and subsequent achievement in all corners of the world. This paper reviews the important developments in the international arena, recognizes major pioneers and milestones, and explores some of the current and future issues facing the field. The authors draw heavily on their experiences with the major nongovernmental adolescent health organizations. The special roles of the World Health Organization, Pan American Health Organization, and United Nations Children’s Fund (UNICEF) are highlighted, and special consideration is given to the challenge of inclusion through youth participation. (author's)
[Unpublished] 2003 Jul 9. 15 p.How can information and communication technologies (ICT) be used to promote gender equality in developing nations and to empower women? This essay seeks to deal with that issue, and with the gender effects of the “information revolution.” While obvious linkages will be mentioned, the essay seeks to go beyond the obvious to deal with some of the indirect causal paths of the information revolution on the power of women and equality between the sexes. This is the third1 in a series of essays dealing with the Millennium Development Goals (MDGs). As such, it deals specifically with Goal 3: to promote gender equality and to empower women. It is published to coincide with the International Conference on Gender and Science and Technology. The essay will also deal with the specific targets and indicators for Goal 3. (excerpt)
Medical Hypotheses. 2003 Jul; 61(1):21-22.According to the United Nations, global fertility has declined in the last century as reflected by a decline in birth rates. The earth’s surface air temperature has increased considerably and is referred to as global warming. Since changes in temperature are well known to influence fertility we sought to determine if a statistical relationship exists between long-term changes in global air temperatures and birth rates. The most complete and reliable birth rate data in the 20th century was available in 19 industrialized countries. Using bivariate and multiple regression analysis, we compared yearly birth rates from these countries to global air temperatures from 1900 to 1994. A common pattern of change in birth rates was noted for the 19 industrialized countries studied. In general, birth rates declined markedly throughout the century except during the baby boom period of approximately 1940 to 1964. An inverse relationship was found between changes in global temperatures and birth rates in all 19 countries. Controlling for the linear yearly decline in birth rates over time, this relationship remained statistically significant for all the 19 countries in aggregate and in seven countries individually (p <0:05). Conclusions. The results of our analyses are consistent with the underlying premise that temperature change affects fertility and suggests that human fertility may have been influenced by change in environmental temperatures. (author's)
The World Health Organization multinational study of breast-feeding and lactational amenorrhea. IV. Postpartum bleeding and lochia in breast-feeding women.
FERTILITY AND STERILITY.. 1999 Sep; 72(3):441-7.The main purpose of this study was to compare the duration of postpartum lochia among 7 groups of breast-feeding women, and in addition, to investigate whether age, parity, birth weight, or the amount of breast-feeding affects this duration. The participants included 4118 breast-feeding women aged 20-37 years living in China, Guatemala, Australia, India, Nigeria, Chile, or Sweden. The duration of lochia, frequency of an end-of-puerperium bleeding episode, and frequency of post-lochia bleeding episodes within 56 days of delivery were measured. This study revealed that the median duration of lochia was 27 days and varied significantly among the centers (range, 22-34 days). In about 11% of the women, lochia lasted >40 days. An end-of-puerperium bleeding episode around the 40th day postpartum was reported by 20.3% of the women. Bleeding within 56 days of delivery (separated from lochia by at least 14 days) occurred in 11.3% of the women and usually was followed by a confirmatory bleeding episode 21-70 days later. This study was able to quantify the average duration of postpartum lochia at 3-5 weeks, with significant variations by population. Lochia durations of >40 days were not unusual. A separate and distinct end-of-puerperium bleeding episode occurred in 1 out of every 4-5 women, although it is unclear how this phenomenon is clinically, socially, or culturally significant.
The World Health Organization multinational study of breast-feeding and lactational amenorrhea. III. Pregnancy during breast-feeding.
FERTILITY AND STERILITY.. 1999 Sep; 72(3):431-40.This prospective longitudinal study aimed to determine the risk of pregnancy during lactational amenorrhea relative to infant feeding status. The participants included 4118 breast-feeding mother-infant pairs, with maternal age of 20-37 years, recruited from 7 study centers located in China, Guatemala, Australia, India, Nigeria, Chile, and Sweden. Infant feeding practices, menstrual status, and the number of pregnancies were recorded. The results revealed that in the first 6 months after childbirth, cumulative pregnancy rate during amenorrhea, depending on how the end of amenorrhea was defined, ranged from 0.9% (95% confidential interval (CI) = 0-2%) to 1.2% (95% CI = 0-2.4%) during full breast-feeding, and from 0.7% (95% CI = 0.1-1.3%) to 0.8% (95% CI = 0.2-1.4%) up to the end of partial breast-feeding. At 12 months, the rates ranged from 6.6% (95% CI = 1.9-11.2%) to 7.4% (95% CI = 2.5-12.3%) during full breast-feeding, and from 3.7% (95% CI = 1.9-5.5%) to 5.2% (95% CI = 3.1-7.4%) up to the end of partial breast-feeding. Regardless of the degree of supplementation, the pregnancy rate increased with time from 6th to the 12th month postpartum. Overall, the rate of pregnancy during amenorrhea was unaffected by variations in the return of menses. This large, multicenter study found that the cumulative 6-month rate of pregnancy during lactational amenorrhea was between 0.8% (95% CI = 0-1.4%) and 1.2% (95% CI = 0-2.4%). This is equivalent to the protection provided by many nonpermanent contraceptive methods as they are actually used and upholds the 1988 Bellagio Consensus.
VOX SANGUINIS. 1994; 67(4):377-81.As part of an effort to monitor the safety of global blood transfusion services, the World Health Organization circulates a questionnaire for use in a database on blood safety. In 1992, 67% of countries responding to the survey (100% of developed, 66% of developing, and 46% of less developed countries) were screening all blood donations for HIV antibodies and 87% of these countries (100% of developed, 92% of developing, and 63% of less developed countries) carried out supplementary testing to confirm positive results. All developed countries, 72% of developing, and 35% of less developed countries screen blood for hepatitis B surface antigen and 94%, 71%, and 48%, respectively, screen for syphilis. The primary reasons for inadequate blood testing are the cost of test kits and reagents and the unreliability of supplies. The proportion of safe donors is highest in systems where all donors are voluntary and nonremunerated--conditions that exist in 85% of developed countries but only 15% of developing and 7% of less developed countries. Blood safety would also be improved by more appropriate use of transfusions and the provision of alternatives such as saline and colloids. Other problems include insufficient blood supply (e.g., none of the less developed and only 9% of developing countries collect 30 units or more per 1000 population per year) and inadequate quality assurance in all aspects of preparatory testing.
New York, New York, Population Council, Center for Poplicy Studies, 1985 Aug. 42 p. (Center for Policy Studies Working Papers No. 113)This analysis of family planning program funding suggests that current funding levels may be inadequate to meet projected contraceptive and demographic goals. Expenditures on organized family planning in less developed countries (excluding China) totaled about US$1 billion in 1982--about $2/year/married woman of reproductive age. Cross-sectional analysis indicates that foreign support as a proportion of total expenditures decreases with program duration. Donor support to family planning in less developed countries has generally declined from levels in the late 1970s. This is attributable both to positive factors such as program success and increased domestic government support as well as requirements for better management of funds and the worldwide economic recession. Foreign assistance seems to have a catalytic effect on contraceptive use only when the absorptive capacity of family planning programs--their ability to make productive use of resources--is favorable. The lower the stage of economic development, the less visible is the impact of contraceptive use or fertility per investment dollar. On the other hand, resources that do not immediately yield returns in contraceptive use may be laying the foundation for later gains, making increased funding of family planning programs an economically justifiable investment. The World Bank has estimated that an additional US$1 billion in public spending would be required to fulfill the unmet need for contraception. To increase the contraceptive prevalence rate in developing countries to 58% (to achieve a total fertility rate of 3.3 children) in the year 2000 would require a public expenditure on population programs of US$5.6 billion, or an increase in real terms of 5%/year. Improved donor-host relations and coordination are important requirements for enhancing absorptive capacity and program performance. A growing willingness on the part of donors to allow countries to specify and run population projects has been noted.
Washington, D.C., PAHO, Pan American Sanitary Bureau/Regional Office of the World Health Organization, 1985. xix, 265 p. (Official Document No. 201)Efforts to meet the goal of health for all by the year 2000 have been hampered by the internal and external problems faced by many countries of the Americas. The pressures of external debt have been accompanied by a reduction in the resources allocated to social sector programs, including health programs. In addition, the conflict in Central America has constrained solutions to subregional problems. The health sector suffers from uncoordinated services, lack of trained personnel, and waste. Thus 30-40% of the population do not have access to basic health services. In 1984, the governments in the region, together with the Pan American Health Organization (PAHO), undertook projects in 5 action areas: new approaches and technology, development, intra- and intersectoral linkages, joint activities by groups of countries, mobilization of national resources and external financing, and preparation of PAHO to meet the needs of these processes. New approaches include the expansion of epidemiological capabilities and practices, the use of low-cost infant survival strategies, the improvement of rural water supplies, and the development of domestic technology. Interorganizational linkages are aimed at eliminating duplication and filling in gaps. Ministers of health and directors of social security programs are working together to rationalize the health sector and extend coverage of services. Similarly, countries have grouped to deal with common problems and offer coordinated solutions. The mobilization of national resources involves shifting resources into the health field and increasing their efficiency and effectiveness by setting priorities. External resources are recommended if they supplement national efforts and are short-term in nature. In order to enhance these strategies, PAHO has increased the managerial and operating capacity of its central and field offices. This has required consolidating programs, retraining staff, and instituting information systems to monitor activities and budgets. The report summarizes health indicators and activities by country, for all nations under PAHO.
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)
Ann Arbor, Michigan, University Microfilms International, 1984.  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)
Report on developments and activities related to population information during the decade since the convening of the World Population Conference, Bucharest, 1974.
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.
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.
Role of the pharmaceutical industry of the developing countries in research on fertility regulation.
In: Diczfalusy E, Diczfalusy A, ed. Research on the regulation of human fertility: needs of developing countries and priorities for the future, Vol. 2. Background documents. Copenhagen, Denmark, Scriptor, 1983. 975-86.The pharmaceutical industry of the developing countries is at present not equipped for and unlikely to contribute much to the discovery and development of new fertility regulating agents, but could play an effective role in process development, and in the organization of clinical trials. In view of the crucial role of the pharmaceutical industry to bring the research effort on a new contraceptive to fruition, and because of the waning interest of the industries of the developed countries in this field, the pharmaceutical companies of the developing countries should be encouraged to get involved in research by special incentives from their national governments, such as tax exemption for investment made for inhouse research of for sponsored research. The subsidiaries of multinational corporations, which dominate the pharmaceutical industry in the developing world, must establish research centers in these countries with efforts focussed on local priority health problems, such as contraceptive development; such research conducted in some of the developing countries would be more cost effective. It would be necessary to establish government or public sector research institutes to supplement the research facilities of the private industries, particularly for animal toxicology studies; these institutions could even serve as regional centers, supported by international agencies, since some of the smaller countries may not be able to develop their own centers. The collaboration between industrial, academic and public secotr institutions should be encouraged and formalized to establish partnership in research on contraceptive development; the exact mode and form would depend upon the scientific and technical institutional structure and industrial development status of each country. (author's modified)
In: Current problems in obstetrics and gynecology, Vol. 5, No. 6, edited by John M. Leventhal. Chicago, Illinois, Year Book Medical Publishers, 1982. 4-41.This article addresses the medical aspects of population growth, with specific focus on a demographic overview, population policies, family planning programs, and population issues in the US. The dimensions of the population problem and their implications for social and economic development are reviewed. The world's response to these issues is discussed, followed by an assessment of what has been accomplished, particularly as it relates to the record of national family planning programs in developing countries. The impact of population growth on such issues as education, available farm land, deforestation, and urban growth are discussed. Urban populations are growing at an unprecedented rate, posing urgent problems for action. From a public health perspective, data are reviewed which demonstrate that having children at short intervals (2 years) or at unfavorable maternal ages (18 or 35) and/or parity (4) has a negative impact on maternal, infant and childhood morbidity and mortality, particularly in developing countries. Increasing the age of marriage, delaying the 1st birth, changing and improving the status of women, increasing educational levels and improving living conditions in general also are important in reducing population growth. Probably the most important, but most controversial intervention, has been the development of national family planning programs aimed at increasing the public's access to modern contraceptive and sterilization methods. India was the 1st country to declare a formal population policy (in the 1950s) with the goal of reducing population growth. Currently, close to 35 countries have formal policies. The planned parenthood movement, with central support from the London office of the International Planned Parenthood Federation (IPPF), has played a most important role in making family planning services available. 2 population issues in the US today are reviewed briefly in the final section: teenage pregnancy and the changing age structure.