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Copenhagen, Denmark, World Health Organization, Regional Office for Europe, 1986 Apr. 19 p. (NURS/EURO 86.2; DOC.6367J)This is a simplified guide prepared for teachers, administrators, practitioners, and researchers in nursing midwifery, medico-social work services in the European region of WHO. It discusses recent international developments, mandates and resolutions concerning nursing, midwifery, and medico-social work passed at the global level. Some common problems facing nurses in all settings include: 1) constraints in the ability to define their own practices, 2) nursing midwifery personal placed in settings which do not use the expertise acquired in education, 3) too few institutions include mandatory continuing education for nursing and midwifery, and 4) resources available in medico-social work have not been acknowledged at an international level. However, the WHO constitution mandates the following, policy relative to nursing: 1) strengthening the health services, 2) improving teaching standards, and 3) conducting research in the health field. WHO assembly resolutions specific to nursing, midwifery, and medico-social work in the past have led to 1) education of nursing personnel, 2) resolutions on maternal and child health care services, 3) use of social workers, and 4) a stronger role for midwives/nurses in launching comprehensive primary health care (PHC). Executive board resolutions relate mostly to publication of expert committee reports emphasizing training in public health, health care for the elderly, and monitoring progress in implementing strategies. The European Regional Committee in 1974 made the role of the nurse in the health field in the 1980's the topic of its 26th technical discussions. In spite of the intercountry and country implementation of recommended by the member states, there is a need for dynamic progress in health-oriented training for nurses.
Report of the Interregional Seminar to Promote the Implementation of the International Plan of Action on Aging, Kiev, Ukrainian Soviet Socialist Republic, 9-20 September 1985.
New York, New York, United Nations, Department of International Economic and Social Affairs, 1986. 46 p. (ST/ESA/81.)The Interregional Seminar to Promote the Implementation of the International Plan of Action on Aging was held from 9-20 September, 1985, at the October Palace of Culture at Kiev, the Ukrainian Soviet Socialist Republic. The objective of the seminar was to promote the implementation of the International Plan of Action on Aging at the interregional, regional, and national levels with a view to formulating strategies for improving its implementation. The International Plan of Action on Aging focuses on both developmental and humanitarian aspects of the aging of populations. It contains recommendations covering health and nutrition, protection of elderly consumers, housing and the environment, family, social welfare, income security and employment, and education. The Plan of Action, however, can only provide broad guidelines and general principles as to the way in which the international community, governments, non-governmental organizations, and society at large can meet the challenge of the progressive aging of the world's population. More specific approaches and policies must be conceived of and formulated in terms of the traditions, cultural values, and socioeconomic conditions of individual countries. Representatives of 28 countries, UN organizations, and members of the UN International Network for Information exchange on aging took part in the seminar. Discussions focused on national experience in implementing the recommendations of the International Plan of Action on Aging.
[New York, United Nations, 1986.] 27 p.The ongoing crisis confronting women and children in the Third World--where disease and hunger are taking millions of lives of young children every year and where population growth still proceeds at an unacceptably high rate--is actually worsening in some areas. The European Parliamentarians' Forum on Child Survival, Women, and Population: Integrated Strategies was held under the auspices of The Netherlands government and organized in cooperation with 3 UN organizations: the World Health Organization, UNICEF, and the UN Fund for Population Activities. It is critical that the world regain the momentum of past decades in reducing appalling child mortality rates, improving the health and status of women, and slowing population growth. Development programs from health education to agriculture are hampered or crippled by the inability of development planners to recognize the centrality of the woman's role. Maternal and child health is the logical entry point for primary health care. Education is the springboard for rescuing women in the Third World from poverty, illness,endless childbearing, and lowly social status. One should educate women to save children. Women in the developing world must be given access to basic information to be able to take advantage of new, improved or rediscovered technologies such as 1) oral rehydration therapy, 2) vaccines, 3) growth monitoring through frequent charting to detect early signs of malnutrition, 4) breast feeding, and 5) birth spacing. Education is the single most documented factor affecting birth rate, status of women, and infant and child health. The presentations at The Hague threw into sharp relief the close links, the cause and effect chains, and the synergisms associated with all the factors connected, directly or indirectly, with child survival, women's status, and population--factors such as education, economic opportunities, and overall development questions. A 4-point agenda includes 1) encouraging UN agencies and organizations concerned with social development to work closely together and to enhance the effectiveness of their programs, 2) seeking greater support for the UN's social development programs, 3) focusing public attention on the interrelatedness of health, maternal and child survival and care, women's status, and freedom of choice in family matters, and 4) maintaining and strengthening commitment through the dialogue of parliamentarians.
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE. 1986 Jan; 35(1):1-2.A paper by Hazlett et al. is of particular importance because it addresses the question of the role of acute respiratory infections (ARI) as a cause of morbidity and especially mortality in 3rd world children. Diarrheal disease and malnutrition are generally thought to be the major killers of these children, and until recently little attention was paid to ARI. Recent data suggest that ARI are more important than realized previously and almost certainly are the leading cause of death in children in developing countries. It is estimated that each year more than 15 million children less than 5 years old die, obviously most in socially and economically deprived countries. Since death usually is due to a combination of social, economic, and medical factors, it is impossible to obtain precise data on the causes of death. It has been estimated that 5 million of the deaths are due to diarrhea, over 3 million due to pneumonia, 2 million to measles, 1.5 million to pertussis, 1 million to tetanus, and the other 2.5 million or less to other causes. Since pertussis is an acute respiratory infection and measles deaths frequently are due to infections of the respiratory tract, it is becoming clear that ARI are associated with more deaths than any other single cause. The significance of this is emphasized when the mortality rates from ARI in developed and underdeveloped nations are compared. Depending on the countries compared, age group, and other factors, increases of 5-10-fold have been reported. These factors raise the question of why respiratory infections are so lethal for 3rd world children. The severity of pneumonia, which is the cause of most ARI deaths, seems to be the big difference. Data are accumulating which show that bacterial infections are associated with the majority of severe infections and "Streptococcus pneumoniae" and "Haemophilus influenzae," infrequent causes of pneumonia in developed world children, are the microorganisms incriminated in a large proportion of cases. The increase in severity of ARI in 3rd world children has been associated, at least in port, with malnutrition, diarrheal diseases, an increased parasite load, and more recently with air pollution. Crowding and other factors associated with poverty doubtless also play a role. How these various factors contribute to increased severity and lethality is not well understood. The increasing recognition of the important role played by ARI as causes of mortality in 3rd world children is encouraging. The UN International Children's Emergency Fund (UNICEF) has joined the World Health Organization in the battle against ARI in developing countries, and the 2 organizations recently issued a joint statement on the subject in which they pledged to collaborate to integrate an ARI component into the primary health care program.
Sterilizations by sex and percentages of: male to female sterilizations and total number of sterilizations as percentage of total new acceptors. 1979-1984.
[Unpublished] . 3 p.This is an International Planned Parenthood Federation (IPPF) collection of data detailing numbers of sterilizations in each country of the western hemisphere from 1979 to 1985. The table presents sterilizations among males and females, total number of sterilizations, ratio of male to female expressed in percentages, and ratio of sterilizations to new acceptors also expressed as percentages. The countries with the numbers over 10,000 in 1986 were Columbia, Guatemala and the Dominican Republic. Countries with 1000 to 9999 were U.S., Honduras, Mexico, El Salvador, Ecuador and Brazil, in order. Most nations reported 5 to 10 times more female than male sterilizations. The exception was the U.S., with 10 times more vasectomies in the latter years. The total reported ranged from 63,400 in 1980 to 94,448 in 1985.
POSTGRADUATE MEDICAL JOURNAL. 1986; 62(724):93-6.Breastfeeding has been on the decline in the 3rd world for the past 20 years or so. Modernization has been blamed, yet in the industrialized nations of Sweden, Britain, and the US, women play significant roles in the labor force, are active in professional and public life, and in most Western nations the educated women and those from the professional and upper classes are most likely to breastfeed their babies. Regarding milk substitutes, many products unacceptable in the Western market are on sale in developing nations. In the absence of strong governmental controls, consumer pressure, and professional vigilance, bottle feeding is taken lightly with disasterous consequences. 3 main dangers have been identified: those arising from the nonavailability of protective substances of breast milk to the infant; those arising from the contamination of the feed in a highly polluted environment of poverty and ignorance of simple principles of hygiene; and those arising from overdilution of feeds on the account of the costs of the baby foods. Market forces and competition led the manufacturers of baby foods to stake their claims to the markets of the 3rd world, and almost all of them adopted undesirable promotional methods. The ensuing uproar led to an International Code of Ethics being adopted at the 33rd world Health Assembly under the auspices of the World Health Organization. Although the matter should have rested there, some manufacturers developed their own codes and have persuaded governments to adopt alternative codes. The present situation with regard to infant feeding in the 33rd world should be considered in the context of the international developments identified and also in light of several social and demographic processes. At the current rates of growth in population up to 80% of humanity will be living in the 3rd world by the end of the 20th century. The 2nd demographic phenomenon of social and political significance is the unprecedented increase in the growth of the urban population with national health and social services failing to respond adequately to the challenge of this growth. In many developing countries national planners and economists are beginning to look upon human milk as an important national resource, and the need for a network of services to ensure the nutrition and health of pregnant and lactating women is obvious and is recognized internationally. With regard to the question of adequacy of breast milk, there are many gaps in knowledge. Each community needs to be studied separately, and those involved in scientific research in 1 environment should resist the temptation of extrapolating the results to communities and societies with a different set of circumstances.
HEALTH POLICY AND PLANNING. 1986 Mar; 1(1):37-47.This economic analysis assesses the probable costs of implementing various activities of the World Health Organization's (WHO's) global strategy of "health for all by the year 2000" and the likelihood that developing countries will be able to afford these costs, either on their own or with the assistance of developed countries. If this policy is to be transformed into concrete results, there must be a plan complete with budgetary requirements, planned activities, and expected results specified in adequate detail. The overall costs of the activities proposed by the global strategy would amount to approximately 5% of the gross national product of most developing countries, with water supplies and primary health care comprising the most expensive activities. Although there is a good match between estimated resource requirements and planned activities, the desired outcomes are often unlikely to result from the activities proposed. At present, all 25 industrial market and nonmarket industrial developed countries have already achieved the outcome goals of the global strategy; however, these countries account for only 25% of the world's population. Of the 63 middle-income countries, 54 have already achieved a gross national product per capita of over US$500, but only 22 have an infant mortality rate better than 50/1000. Very few low-income countries are close to reaching their targets for income, infant mortality, life expectancy, or literacy. On the basis of current trends, 25-33% of countries are considered unlikely to achieve the outcome goals by the year 2000. In general, it appears that expenditure targets are too low to cover the needed health services activities. Further research on the costs of health promoting activities such as immunization and primary health care should be given high priority.
Development co-operation, 1986 review: efforts and policies of the members of the Development Assistance Committee.
Paris, France, Organisation for Economic Co-Operation and Development, 1986. 292 p.The 1986 annual report details the efforts and policies of the Development Assistance Committee members of the Organisation for Economic Co-operation and Development (DECD). Part 1 provides an overview of development assistance by region and ways it might be improved as well as a chapter on Africa's long-term prospects. Part 2 covers current trends and policy issues in official development assistance, including volume trends and prospects, basic priorities, shifts in geographic and functional aid distribution, financial terms of aid, environmental concerns, and the role of women in development. Individual countries' assistance is covered as well as multilateral agencies. Part 3 deals with improving aid effectiveness through strengthened aid co-ordination and better policies. Separate sections cover improved development policies and coordination, technical assistance in support of improved economic management capacity, cooperation in agricultural development, and cooperation for improved energy sector management. Part 4 reviews trends in external resource flows to Sub-Saharan Africa. Annexes detail good procurement practices for official development assistance and the recommendations of the Council of the DECD on the environment and development assistance.
World Health Organization, [WHO], Geneva, Switzerland, 1986. 89 p. (WHO/RPD/ACHR(HRS)/86)This report is the outcome of a study undertaken to outline for the WHO an approach to health research strategy, which sees health development in a historical and evolutionary perspective. There are 2 approaches to disease problems, 1 through control of disease origins, the other through intervention in disease mechanisms. The research strategy of the WHO should be devised primarily in the light of commitment to substantial progress in health by the year 2000, particularly in countries where the need is greatest. Steps that are likely to lead to rapid advance in health care include: control of diseases associated with poverty, control of communicable and noncommunicable diseases specific to the tropics, control of diseases associated with affluence, treatment and care of the sick, and delivery of health services. Goals must be determined in light of the circumstances and priorities of each country; each country should establish targets related to accomplishments in the following areas: national commitments to policies and programs supportive of health for all; improvements in mortality and morbidity rates; improvements in life-style and related health measures; improvements in coverage and various aspects of the quality of care; and improvements in health status and coverage of disadvantaged and marginal subgroups in the population.
[The Collaborating Centers of the World Health Organization and AIDS: report of a meeting of the World Health Organization] Les Centres Collaborateurs de l'OMS et le SIDA: memorandum d'une reunion de l'OMS.
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1986; 64(1):63-8.The World Health Organization (WHO) meeting on acquired immune deficiency syndrome (AIDS) held in Geneva in September 1985 stressed the importance of the WHO collaborating centers in the worldwide struggle against AIDS. The network of collaborating centers was established after and April 1985 WHO meeting to facilitate international cooperation in training of laboratory personnel, supplying reference reactives, evaluating diagnostic tests, and organizing activities to establish the natural history of the disease in different parts of the world. The AIDS virus is transmitted during sexual intercourse, by parenteral exposure to blood or contaminated blood products, or from the mother to the infant during the perinatal period. In the US and Western Europe, over 90% of victims are still homosexual and bisexual men, intravenous drug users, and their sexual partners, but in many developing countries heterosexuals with active sex lives are the main victims. There are no indications that the virus is spread by casual contact or by insect vectors. Health authorities of all countries should establish surveillance programs to measure the extent of AIDS infection. A precise case definition including only the most serious manifestations of the disease should be used. The US Centers for Disease Control definition has been approved for countries with appropriate diagnostic capabilities. Only immunological diagnostic methods are practical for large scale routine testing. Radioimmunological and immunoenzymatic titers are the most frequently used routine testing procedures. They are very sensitive, but because of the possibility of false positive results, confirmation using another test is needed for individuals belonging to low risk populations. The Western blot or other immunoblotting tests are most often used for confirmation. Progress in laboratory diagnosis would be furthered if international reference standards, simpler diagnostic tests, and other measures were made avaliable. Until drugs capable of preventing and treating AIDS become available, prevention will depend mainly on reduction of risks based on information and education. Cases of AIDS spread by blood transfusion can be eliminated by excluding donors belonging to high-risk groups and by testing the blood for antibodies before transfusion. Reuse of nonsterile needles and syringes should be absolutely avoided. Despite efforts to identify an effective agent for treatment of AIDS, no substance has been found as yet that supplies more than a transitory arrest of viral replication. Interferon has been shown to be effective against Kaposi's sarcoma. New antiviral agents should be careful studied in conformity with accepted protocols for drug evaluation. Numerous attempts to develop an anti-AIDS vaccine are underway. The heterogeneity of the virus poses a significant problem. Several specific recommendations for its 1986-87 program were made to further the role of the WHO as a centraL clearinghouse for AIDS information.
WORLD HEALTH FORUM. 1986; 7(2):131-4.Although WHOHs work is directed mostly to developing countries, the aim of WHO is to help bring about the highest possible level of health among all peoples. This article discusses ways in which developed countries also benefit from WHO's activities. In the area of international services, WHO provides worldwide epidemiological surveillance, the international drug monitoring system, the international program on chemical safety, the establishment of standards, biological and chemical standardization, statistics and the international classification of diseases, and publications. WHO also combats problems that are particularly serious in developed countries: cardiovascular disease, respiratory ailments, cancer, mental health and drug abuse. Other direct benefits include organization of public health systems, medical research and further training of health staff. WHO's activities also have indirect benefits. For instance, any improvement in health in developing countries is good for developed countries; this is particularly true in the area of communicable diseases. The reports of expert committees and of working groups, other publications including the WHO monographs and public health papers, and the input of collaborating centers add up to an incomparable guide to national health services. Finally, the application of the primary health care concept in developing countries has lead to reflection on adjustments that might be made in health care systems of developed countries.
[The Population Council in Latin America and the Caribbean 1985] The Population Council en Latinoamerica y en el Caribe 1985
Mexico D.F., Mexico, The Population Council, . 26 p.This pamphlet describes the work of the Population Council in the Latin America/Caribbean region in the year 1985. Activities are grouped under 5 headings. 1) Health and family planning (FP) activities: The Population Council has been involved with operational research for FP and maternal-child health (MCH) programs in several countries, and on projects as diverse as distribution of oral rehydration equipment (Ecuador) to testing of mass-media promotion of vasectomies (Brazil). A cost-benefit analysis was carried out for FP activities of the Mexican Social Security institution. Social marketing has been explored as an alternative and less costly distribution system for contraceptives in Colombia. Natural FP training as an alternative method was integrated into the array of FP services of the MCH program in Bogota, Colombia. A training viideotape has been used by community health programs in Boyaca, Colombia. 2) Health, Infant Mortality, and Adolescent Fertility: A workshop dealing with the problem of child survival, which is still quite serious in Latin America, was held in Mexico, with the participation of an international panel of experts. A pilot project on adolescent pregancy has been organized paralled with a project of female education and fertility in developing countries. 3) As part of an overall initiative for the introduction of new contraceptives, the NORPLANT implant, which releases levonorgestrel from silastic rubber implants under the skin, was introduced on an experimental basis in several countries. 4) Population and development projects have consisted of working papers, and program evaluations for programs in Mexico, Jamaica, and Peru. 5) Finally grants to students in population-related social and biomedical sciences have been administered by the council: a total of 236 in 18 countries between 1953 and 1985.
Washington, D.C., Worldwatch Institute, 1986. 66 p. (Worldwatch Paper 70)This monograph focuses on developing electric power, the efficient use of electricity, new approaches in rural electrification, and decentralizing generators and institutions. Electric power systems, for a long time considered showpieces of development, now are central to some of the most serious problems 3rd world countries face. Many 3rd world utilities are so deeply in debt that international bailouts may be required to stave off bankruptcy. Financial probles, together with various technical difficulties, have resulted in a serious decline in the reliability of many 3rd world power systems, which may impede industrial growth. At this time the common presumption that developing countries will soon attain the reliable, economical electricity service taken for granted in industrial nations is in doubt. World Bank support of electricity systems grew from $85 million annually in the mid-1950s to $271 million in the mid-1960s, $1400 million in the early 1970s, and $1800 million in the early 1980s. The Bank's support of electrtic power projects has leveled off in recent years and shrunk in proportional terms as lending expanded in other areas. The general trend is toward greater centralization and governmental control of electric power systems. Commercial banks and government supported lending institutions prefer to deal with a strong central authority that has government financial backing yet is outside the day-to-day political process. The World Bank files reveal a consistent push for greater centralization and consolidation of authority whenever questions of the structure of a power system arise. Over the years, the World Bank has gradually becomes stricter in the institutional preconditions it sets for power loans. By the early 1980s, 3rd world countries were using 6 times as much electric power as they had 20 years earlier but compared with industrial nations electricity plays a relatively small role in 3rd world economies. In most developing nations electricity consumption is so low and the potential future uses so great that electricity use continues to expand even when the economy does not. Meeting projected growth in the demand for electricity services will be virtually impossible without substantial efficiency improvements. The cornerstone of any new program is improve efficiency is a pricing system that reflects the true cost of providing power. Rather than a blanket cure for the problems of village life, rural electrification is simply a tool that is appropriate in some cases. Electric cooperatives offer an approach to rural electrification that has worked well in some countries.
Tokyo, Japan, Institute of Developing Economies, 1986. xxxviii, 513 p.This is the 11th edition of this catalog of the official and unofficial statistical materials published in developing countries. It contains information on 8,152 titles concerning 128 countries. The citations are listed by region, country, and up to nine subject headings, which include Population and labour, and Social statistics and others. For each citation, information is provided on country, publisher, title, volume or series number, and call number. An appendix listing publications from international organizations and statistical institutions in developed countries is included, as well as an appendix providing a directory of statistical organizations in developing countries. (SUMMARY IN JPN)
Population Today. 1986 Feb; 14(2):3, 8.The UN recently released its lastest population projection for 1985-2025. Although demographers remain uncertain about the future shape and rate of population growth, the UN figures are generally regarded as representing the state of the art in projection making. The UN makes medium, high, and low variant projections. According to the medium variant, the world population, in millions, will be 4,837 in 1985, 6,122 in 2000, 7,414 in 2015, and 8,206 in 2025. High and low variant projections, in millions, for 2025 are 9,088 and 7,358. The medium variant projection indicates that between 1985-2025 the population, in millions, will increase from 3,663-6,809 in the developing countries but only from 1,1754-1,396 in the developed countries. In other words, the proportion of the world's population residing in the developed countries will decrease from 24%-17% between 1985-2025. The world's growth rate will continue to decline as it has since it peaked at 2.1% in 1965-70. According to the medium variant, the projected growth rate for the world will be 1.63% between 1985-90, 1.58% between 1990-95, 1.38% between 2000-05, 1.18% between 2010-15, and 0.96 between 2020-25. The growth rate will decrease from 1.94%-1.10% for the developing countries and from 0.60%-0.29% for the developed countries between 1985-2025. The medium variant projections assume that the total fertility rate will decrease from 3.3 in 1985-90 to 2.8 in 2000-05 and to 2.4 in 2020-25. Respective figures are 3.7, 3.0, and 2.4 for the developing countries only and 2.0, 2.0, and 2.1 for the developed countries only. By 2025 the age structure of the developing countries is expected to be similar to the current age structure of the developed countries. In 2025, the 10 countries with the largest populations and their expected populations, in millions, will be China (1,475), India (1,229), USSR (368), Nigeria (338), US (312), Indonesia (273), Brazil (246), Bangladesh (219), Pakistan (210), and Mexico (154). The populations of some countries which are relatively small at the present time will be quite large in 2025. For example, the population, in millions, will be 111 for Ethiopia and 105 for Vietnam. The projections are summarized in 4 tables.