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Support to mainstreaming AIDS in development. UNAIDS Secretariat strategy note and action framework, 2004-2005.
Geneva, Switzerland, UNAIDS, . 10 p.Twenty years into the pandemic, there is now ample evidence for the complex linkages between AIDS and development: development gaps increase people's susceptibility to HIV transmission and their vulnerability to the impact of AIDS; inversely, the epidemic itself hampers or even reverses development progress so as to pose a major obstacle to the achievement of the Millennium Development Goals. The growing understanding of this two-way relationship between AIDS and development has led to the insight that, in addition to developing programmes that specifically address AIDS, there is a need to strengthen the way in which existing development programmes address both the causes and effects of the epidemic in each country-specific setting. The process through which to achieve this is called 'Mainstreaming AIDS'. In recognition of this, the 2001 United Nations General Assembly Special Session Declaration of Commitment on HIV/AIDS requires countries to integrate their AIDS response into the national development process, including poverty reduction strategies, budgeting instruments and sectoral programmes. (excerpt)
Oxford, England, Oxford University Press, 1990. xix, 136 p.The Commission on Health Research for Development is an independent international consortium formed in 1987 to improve the health of people in developing countries by the power of research. This book is the result of 2 years of effort: 19 commissioned papers, 8 expert meetings, 8 regional workshops, case studies of health research activities in 10 developing countries and hundreds of individual discussions. A unique global survey examined financing, locations and promotion of health research. The focus of all this work was the influence of health on development. This book has 3 sections: a review of global health inequities and why health research is needed; findings of country surveys, health research financing, selection of topics and promotion; conclusions and recommendations. Some research priorities are contraception and reproductive health, behavioral health in developing countries, applied research on essential drugs, vitamin A deficiency, substance abuse, tuberculosis. The main recommendations are: that all countries begin essential national health research (ENHR), with international partnership; that larger and sustained international funding for research be mobilized; and that larger and sustained international funding for research be mobilized; and that international mechanisms for monitoring progress be established. The book is full of graphs and contains footnotes, a complete bibliography and an index.
Intermediating development assistance in health: prospects for organizing a public/private investment portfolio.
Washington, D.C., Family Health, 1980 July 23. 162 p.The objective of this study is to identify and assess the potential role of intermediary organizations in furthering AID health assistance objectives. The 1st section of this report is an introduction to the potential roles of intermediaries through health assistance via the private voluntary community. A background of the private voluntary organizations is discussed along with some of the constraints that may impede their activity, such as competing interests, values and priorities. The following section defines what is and should be an intermediary organization along with examples of certain functions involved; a discussion of the experience of AID in the utilization of intermediaries follows. 3 models of utilization of intermediaries are analyzed according to the rationale involved, strategy, advantages and constraints. The 3rd section attempts to define and identify AID's needs for programming its health assistance in regard to primary health care, water and sanitation, disease control and health planning. A detailed analysis of the potential roles of intermediary organizations is discussed in reference to policy development, project development and design, project implementation, research, training and evaluation. The 4th section identifies the programming strengths and interests among listed private voluntary organizations in the US. The 5th section discusses the potential of intermediaries in health assistance in reference to the options for funding them in health and the constraints to direct AID funding of intermediary organizations. The last section discusses a series of recommendations made in regard to the development and funding of an international effort to marshall private resources in support of health assistance. Problems and constraints, as well as resources and opportunities, for the development of this international effort are further discussed.
[Unpublished] 1994.  p.In its preamble, this document provides an assessment of population issues in 1994 as compared to 1974 when the United Nations World Population Plan of Action was approved at the World Conference in Bucharest. It then delineates the following major challenges of primary concern to the international community: 1) reducing poverty, 2) improving the status of women; 3) dealing with the increasing annual increments in population; 4) the continued high rate of population growth; 5) changes in population structure; 6) high levels of infant and maternal mortality; 7) the inability of some governments to influence fertility rates; 8) the unmet needs for family planning; 9) the disequilibrium between rates of change in population and changes in resources, the environment, and development; 10) internal migration and urbanization; 11) international migration; 12) refugees; 13) the increasing number of people who lack the basic tools of survival; 14) the consequences of advances in agricultural technology and in genetic engineering; 15) the relatively high proportion of young people in some countries; 16) the data collection, analysis, and utilization needs of developing countries; and 17) the need for increased support to implement the Plan. After placing the Plan firmly within the framework of other intergovernmental strategies and plans, the document makes a special statement of the importance of the world community working for peace. 88 specific recommendations are then addressed to governments but are also applicable to international organizations, nongovernmental organizations, private institutions or organizations, or families and individuals. The recommendations for action encompass the following issues: socioeconomic development, the environment, and population; the role and status of women; development of population policies; population goals and policies; and promotion of knowledge and policy. Recommendations for implementing these actions consider the role of national governments, that of international cooperation, and the monitoring, review, and appraisal process.
[Unpublished] 1992. Presented at the 120th Annual Meeting of the American Public Health Association [APHA], Washington, D.C., November 8-12, 1992. 27,  p.In the mid 1980s, USAID started nonproject assistance, mainly in the economic sectors, to African countries. The countries received nonproject assistance after they fulfilled conditions which influence institutional and/or policy reforms. The longest running health sector reform program in Africa was in Niger and was slated to receive portions of the funds after fulfilling 6 specific predetermined reform activities. Yet, between 1986 and 1991, Niger had implemented only 2 of them. It did accomplish the population/family planning reforms: expansion of family planning services, a national population policy, analyses and implementation of improvements in the pricing and distribution of contraceptives, and legalization of use and distribution of contraceptives. Continuing economic deterioration during the 1980s and political upheavals after 1989 somewhat explained why the other reform activities were not implemented. Other equally important factors were a very complex sector grant design (more than 20 reforms in 6 policy/institutional areas) with little incentive to realize the reforms, insufficient number of staff (limited to senior personnel) to implement the reforms, and just 1 USAID staff to monitor and facilitate activities. The nonproject assistance for the primary health care (PHC) system in Nigeria had a simpler design than that in Niger. The reform goals were shifting responsibility for PHC from curative care to preventive health services. After USAID and the Nigerian government signed an agreement, they included policy reforms promoting privatization of health services. Only 1 reform was implemented. Factors which could lead to success of nonproject assistance include host government needs to perceive it owns the objectives and building financial and institutional sustainability. In conclusion, nonproject assistance can be effective when implementing policy reforms that the host government has already adopted.
AMERICAN JOURNAL OF PUBLIC HEALTH. 1990 Oct; 80(10):1188-92.Health trends since 1950 in both developed and developing countries are classified and discussed in terms of causative factors: socioeconomic development, cross-national influences and growth of national health systems. Despite the vast differences in scale of health statistics between developed and developing countries, economic hardships and high military expenditures, all nations have demonstrated significant declines in life expectancy and infant mortality rates. Social and economic factors that influenced changes included independence from colonial rule in Africa and Asia and emergence from feudalism in China, industrialization, rising gross domestic product per capita and urbanization. An example of economic development is doubling to tripling of commercial energy consumption per capita. Social advancement is evidenced by higher literacy rates, school enrollments and education of women. Cross-national influences that improved overall health include international trade, spread of technology, and the universal acceptance of the idea that health is a human right. National health systems in developing countries are receiving increasing shares of the GNP. Total health expenditure by government is highly correlated with life expectancy. The view of the World Bank and the International Monetary Fund that health care should be privatized is a step backward with anti-egalitarian consequences. The UN Economic Commission for Africa attacked the IMF and the World Bank for promoting private sector funding of health care stating that this leads to lower standards of living and poorer health among the disadvantaged. Suggested health strategies for the future should involve effective action in the public sector: adequate financial support of national health systems; political commitment to health as the basis of national security; citizen involvement in policy and planning; curtailing of smoking, alcohol, drugs and violence; elimination of environmental and toxic hazards; and maximum international collaboration.
New York, New York, Oxford University Press, 1990. xvii, 423 p.This text on international health covers historical and contemporary health issues ranging from water distribution systems of the ancient Aztecs to the worldwide endemic of AIDS. The author has also included areas not in the 1979 version: the 1978 Alma Ata conference on primary health care, infant and maternal mortality, health planning, and the role of science and technology. The 1st chapter discusses how each population movement, political change, war, and technological development has changed the world's or a region's state of health. Next the book highlights health statistics and how they can be applied to determine the health status of a population. A text on international health would be incomplete without a chapter on understanding sickness within each culture, including a society's attitude towards the sick and individual behavior which causes disease, e.g. smoking and lung cancer. 1 chapter features risk factors of a disease that are found in the environment in which individuals live. For example, in areas where iodine is not present in the soil, such as the Himalayas, the population exhibits a high degree of goiter and cretinism. Others present the relationship between socioeconomic development and health, e.g., countries at the low socioeconomic development spectrum have low life expectancies compared to those at the high socioeconomic end. An important chapter compares national health care systems and identifies common factors among them. An entire chapter is dedicated to organizations that provide health services internationally, e.g., private voluntary organizations. 1 chapter covers 3 diseases exclusively which are smallpox, malaria, and AIDS. The appendix presents various ethical codes.
New York, New York, United Nations Children's Fund, 1989 May. 48 p.This policy review of United Nations Childrens Fund's (UNICEF) developmental strategies on the well being of children is subdivided into 5 sections. Section 1 discusses issues of social development in developing countries and highlights progress made in infant mortality rates, life expectancy rate, literacy rate, and school enrollment. However, economic growth remained below the target level, and this indirectly offset the gains in social development. Section 2 gives an overview of the health situation of children in the 1980's. During this decade 3 basic strategies (Basic services, Child Survival and Development Program, and Primary Health Care) were endorsed primarily by UNICEF provide health related services to children at low cost. Although slight progress was made with regards to immunization, ORT, breastfeeding, emphasis on food supplements, female literacy, and child spacing, these efforts were hampered by the global economic recession in the early 1980's. Section 3 addresses the unmet needs of children, focusing on the approximately 155 million children who are living in absolute poverty. Of interest was the high childhood mortality rate attributed to preventable diseases, high maternal mortality rates causing a large % of motherless children, nutritionally-related complications having it's gravest tolls in children, a large % of children being victims of armed conflicts, natural disasters, and the breakdown of the traditional family. Section 4 addresses the goals for the year 2000, and sets specific targets for maternal health, child health, nutrition, water supply, and basic education. Section 5 focuses on possible strategies needed, emphasizing specific targets for country and region, reaching the unreached the need for socialization and mobilization, empowerment of women, and an economic foundation to meet basic human requirements.
Population and development in Africa, statement made at the Parliamentary Conference on Population and Development in Africa, Nairobi, Kenya, 6 July 1981.
New York, N.Y., UNFPA, . 5 p.The United Nations estimated the population of Africa at 470 million in 1980, representing an addition of 250 million persons between 1950 and 1980. The average annual population growth rate has been continuously rising from about 2.1% during 1950-1955 to 3.0% now and is expected to decline only in the last decade of this century. As a result of this high growth rate, the population of this continent will have exceeded 850 million by the year 2000. The United Nations recently undertook an exercise to determine when and at what level the world population would stabilize; the population of Africa is likely to stabilize in the year 2110 at 2.2 billion. It is important to keep this long-term perspective in mind while discussing the issues of population and development. An improvement in the quality of life is considered crucial in bringing about a decline in fertility and mortality rates. It appears that the most important policy measures which can improve the quality of life are education, especially education of women, provision of health care resulting in reduced infant and child mortality rates and the elimination of malnutrition.
Geneva, Switzerland, WHO, . 16 p.This report discusses the important place of women in health and development as perceived by WHO and as formulated in various World Health Assembly resolutions, particularly those concerned with the UN Decade for Women. Underlying all objectives is that of increasing knowledge and understanding about how the various socioeconomic factors that make up women's status affect and are affected by their health. The aim of WHO's Women, Health and Development (WHD) activities, is the integration or incorporation of a women's dimension within on-oing programs, specifically as part of "Health for All" strategies. Chief among WHD objectives and groups of activities are the improvement of women's health status, increasing resources for women's health, facilitating their health care roles and promoting equality in health development. Overall WHD activities stress the importance of data on women's health status, the dissemination of this and related information, and the promotion of social support for women. The WHD component of ongoing WHO programs focuses mainly on managerial and technical support to national programs of maternal-child health/family planning care. The present report also includes an update on the incorporation of women's issues within WHO's on-going programs in human reproductive research, nutrition, community water supply and sanitation, workers' health, mental health, immunization, diarrheal diseases, research and training in tropical diseases and cancer. Women's participation in health services is discussed mainly within the context of primary health care and is based on their role as health care providers. The results of a multi-national study initiated in 1980 on the topic of women as health care providers should be ready in early 1984 and are expected to contribute a basis for further action.
New England Journal of Medicine. 1983 Fall; 61(4):659-86.In this examination of Saudi Arabia's health care accomplishments, it is argued that the World Health Organization's primary health care model is not the most appropriate for Saudi Arabia and countries like it. Saudi Arabia's health care policy is closely linked to its very rapid emergence as a new and distinctive society. Whereas most developing countries export physicians, Saudi Arabia imports them because the demand for physicians services cannot be met by the supply of indigenous physicians. Saudi health care development is very different from that of most of the third world. Although the country does have a great deal of western technology, Saudi Arabia seems to be following a different course of development from both the third world and the West. Unlike the West, the cost of medial technolgoy is not a problem for Saudi Arabia. Rather, it solves the problem of how to allocate its oil wealth to maintain political stability. The Saudis intend to make the best health care available to all its citizens; they are very concerned about the effect of modern technology on tradition. Therefore, the selection of technology is based on its cultural compatability, rather than on its costs. Primary care may be more technological and specialized than in the West. In Saudi Arabia primary health care may eventually be delivered entirely by specialists, rather than by general or family practitioners. The Saudis are expected to develop a health care system that will meet their particular needs. As with Saudi Arabia itself, health care is experiencing unprecedented change. Thus, the emerging Saudi system will be unique and innovative. Some of its accomplishments will be adopted by other developing countries; Western countries may look to Saudi Arabia as a natural laboratory of health care experimentation.
Brazzaville, Congo, World Health Organization, Regional Office for Africa, 1980. 86 p. (Health Development in Africa 1)Primary health care has been accepted by the 44 Member States and Territories of the African Region of the World Health Organization (WHO); the Health Charter for 1975-2000 was adopted in 1974 with its humanistic approach oriented to satisfying basic needs. Genuine technical cooperation between Member States is essential for health development and can be achieved on the regional level. By 1990 the following steps should be taken: 1) vaccination of all infants under 1 year against measles, pertussis, tetanus, poliomyelitis, diphtheria and tuberculosis, 2) supply of drinking water to all communities and 3) waging a war on hunger. Health development is seen as a social development policy requiring combined efforts in the fields of education, agriculture, transport, planning, economics, and finance as well as a national strategy which WHO can help to define. A new international economic order must aim at meeting basic needs of the poorest in the population and includes health needs. Basic health services must provide primary health care which includes preventive and curative care, promotional and rehabilitative care, maternal and child health, sanitation, health education, and systematic immunization. Secondary care includes outpatient services with specialized teams; tertiary care provides highly specialized services. These services must be geographically, financially, and culturally accessible to the community. Communication between health workers and community leaders is fundamental in setting up those services and group dynamics can be utilized in promoting change. WHO's 4 health priorities in Africa are: 1) epidemiological surveillance, 2) promotion of environmental health, 3) integrated development of health manpower and services, and 4) health development research promotion. The components of Africa's health care program are: 1) community education, 2) promotion of food supply and nutrition, 3) safe water and sanitation, 4) maternal and child health, 5) immunization, 6) disease prevention, 7) treatment of injuries and diseases and 8) provision of essential drugs. Proper training of personnel is crucial for the success of these steps, along with effective personnel management.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1982; 35(1):2-10.The goal of health for all by the year 2000 was first stated at the 1977 World Health Assembly and global strategy was launched at the 32nd World Health Assembly in 1979. This article focuses on life expectancy at birth as the most widely used indicator of the health status of populations and also the health status indicators most closely correlated with socioeconomic development. Developing countries have set a target of life expectancy of 60 years; at present 86% of these countries are exposed to mortality conditions which leave life expectancy at age 50. Among 80 countries with GNP per capita of more than $500 61 have life expectancy over 60 years and of the 35 with a life expectancy of 70 or more 28 have GNP over $2500. The largest concentration of countries below the target level is in Asia. Discovering the leading causes of death is crucial in raising life expectancy; in developed countries they are cardiovascular disease, malignant neoplasms, and accidents, accounting for 70% of all deaths. In developing countries there is variation with regard to level of modernization of the cause of death structure but in at least 1/2 the 3 latter causes are also predominant with diarrheal disease and infectious and parasitic conditions related to malnutrition the main causes in the other 1/2. When assessing the health care needs of developing countries the difference between countries regarding their ability to reduce mortality from the traditional diseases must be considered before deciding on use of resources.
New York, New York, UNFPA, 1983. 39 p. (Report No. 52)Samoa's major population problem is a high rate of natural population increase. The crude birth rate from 1971-1976 is estimated at 37.4/1000. The total fertility rate was estimated at 6.7 for the same period. Emigration has compensated for much of the natural population increase. The infant mortality rate is low; life expectancy is 64.3 years for females and 61 for males. A maternal and child health program with integrated child-spacing services is government supported. In 1979, 13% of all women of reproductive age used contraception. Samoa's 4th Five-Year National Devlopment Plan (1980-1984) includes a review of population trends. There is a need to develop a broad-based population policy. The Mission recommends that, to assist in the formulation and implementation of this policy, a high-level government office be appointed to coordinate population efforts, and a post of Population Coordinator created. Considerable data exist, although more information on specific development-related topics would be helpful. The Mission recommends that a survey unit should be set up. Service delivery of the maternal and child health and family planning activities should be improved. Traditional village social institutions should be included. The government plans to integrate population and family life education into the educational system through teacher training and curriculum development. Assistance in the produciton of materials would be helpful. The Mission recommends that women's activities be better coordinated.
New York, New York, UNFPA, May 1983. 74 p. (Report No. 55)Reports on the need for population assistance in Thailand. Areas are identified which require assistance to achieve self-reliance in formulating and implementing population programs. Thailand has had a family planning program since 1970 and UNFPA has been assisting population projects and programs in Thailand since 1971. A Basic Needs Assessment Mission visited the country in April 1981. Thailand is experiencing a rapid decline in the population growth rate and mortality rates have been declining for several decades. The Mission makes recommendations for population assistance and identifies priority areas for assistance, such as population policy formation; data collection; demographic research; health and family planning; population information, education, and communication; and women and development. The Mission recommends that all population efforts be centralized in a single agency with no other function. Thailand is also in need of more personnel in key agencies dealing with population matters. The Mission also recommends that external aid be sought for technical assistance and that population projections be revised based on the 1980 census. Thailand has made a great deal of progress in developing its health infrastructure and services, but some problems still remain, especially in areas of staff recruitment and deployment and in providing rural services. The Mission also recommends that external assistance be continued for short term training seminars and workshops abroad for professionals. Seminars should be organized to assist officials in understanding the importance of population factors in their areas.
New York, New York, UNFPA, 1982. 50 p. (Report No. 49)The rate of population increase in the Republic of Maldives was very low until the 1950s, but rose to more than 3% in the 1960s and early 1970s. An annual increase of 3.2% is estimated in the 1980s. The crude birth rate is high. Population increases like this will put enormous strains on most social activities. 4 clear population policies are emerging; 1) improvement in the health of mothers and children; 2) the need to control population growth, including improving acceptable family planning methods; 3) relief from overcrowding; and 4) development of the atolls to attract voluntary migration. The government has 3 additional aims: 1) increasing the quality and quantity of population statistics and its ability to analyze such data; 2) integrate women into development plans; and 3) improve education of children on environmental subjects, such as the interrelationship of the environment and population. The 1977 census was conducted with United Nations Fund for Population Activities (UNFPA) assistance. It is hoped that at least 1 Family Health Worker plus at least one Fooluma (traditional birth attendant) will work on each inhabited island; and 2 Community Health Workers and a health center will exist on each atoll. The Maternal and Child Health Program, including child spacing, is incorporated in their job descriptions. There is 1 hospital in Male'; 4 regional hospitals are planned. Male' hospital provides family planning service. A very active National Women's Committee exists. The government is encouraging the establishment of Women's Committees for Island Progress. The average woman has had 5.73 children, of whom 3.99 are alive. The number of children preferred is 3.38. International migration to Male' is a problem. Literacy is high, but there is a shortage of trained personnel. The country needs external assistance.
Chichester, England, John Wiley, 1982. 317 p.This textbook provides basic information on social policies aimes at improving the welfare of the populations in developing countried and assessing the effectiveness of the major social policies which have been applied to the problems of poverty in these countried. The book is an outgrowth of experience gained in teaching a course in social policy and planning at London School of Economics. The focus is on social policied rather than on social planning techniques, and the central theme is that state intervention and the implementation of social policies are a necessary prerequisite for improving the welfare of the inhabitants of 3rd World countried. The chapter defines underdevelopment. It stresses the need for governments to develop social policies in accordance with their needs and resources and to develop policies which will redistribute resources to the most seriously disadvantaged segments of their population. The 2nd chapter defines poverty, describes the basic inequalities in living standards and income which exist in 3rd World countries, and discuss the major theories which have been put forward to explain poverty. The next 5 chapters discuss the problems of population growth, rural and urban development, health, and housing. The various policied which have been formulated to deal with each of these problems are described and compared in regard to their effectiveness. The next chapter discusses social work and the problems associated with the development of social welfare services in developing countries. The final chapter deals with international issues and assesses. The value of bilateral and multilateral aid. Major assumptions underlying the presentation of the material are 1)poverty impedes development, 2)poverty will not disappear without government intervention, 3)economic development by itself cannot reduce poverty, 4)poverty is the result of social factors rather than the result of inadequacies on the part of poor indiciduals, 5)socialpolicies and programs formulated to deal with problems in the developed countries are inappropriate for application in developing countries; 6)social policies must reflect the needs of each country; and 7)social planning should be an interdisciplinary endeavor and should utilize knowledge derived from all the social sciences.
Tarawa, Kiribati, Ministry of Home Affairs. 130 p.This document is a report on a seminar held at the University of the South Pacific Center, Tarawa, from August 23-26, 1983, sponsored by the International Labour Organization (ILO) and the United Nations Fund for Population activities (UNFPA). The report begins with an overview of the geography of the islands, and 11 consolidates seminar recommendations concerning population planning to address the 2.24% population growth rate, improvement of family life, program level, decentralization of population and services, economic activities, local level groups, training programs, and local community centers. Individual group reports follow: community development/national development, and youth and family welfare. A Ministry of Finance report gives population statistics by island. Other reports are given by the Ministries of Health, Trade Industry and Labor, Education, Natural Resources, and Home Affairs and Decentralization. The ILO delegate papers cover the labor and population program of the ILO, family welfare as an important segment of working women's activity, objectives of family life education, and contract labor equity and migration in Kiribati. There is a brief survey of UNFPA programs in the area. Non-governmental organization delegates presenting included National Women's Federation of Kiribati, the Kiribati Trades Union Congress, the Save the Children Foundation, the Roman Catholic Mission, the Kiribati Protestant Church, and the Seventh Day Adventist Church. Concluding the report are seminar notes on questions and answers to the questions that did not otherwise appear in the report, and a list of speeches, seminar programs, and seminar participants.
Washington, D.C., U.S. Agency for International Development, May 1982. 12 p. (A.I.D. Policy Paper)Estimates indicate that 600 million people in less developed countries (LDCs) are in danger of not getting enough to eat. This policy paper reviews the justifications for US investment in improving nutrition in LDCs and sets out some policy guidelines for USAID programs. The objective of the nutrition policy is to maximize the nutritional impact of USAID's economic assistance. The policy recommendations are to place the highest priority on alleviating undernutrition through sectoral programs which incorporate nutrition as a factor in decision making. This can be effected through identifying projects based upon analysis of food consumption problems; this is especially appropriate in formulating country development strategies, especially in the areas of agriculture, rural development, education and health. USAID will give increasing attention, through research, analysis, experimental projects, and programs, to improve the ability to utilize the private sector whenever feasible to implement the policy, and to target projects to at-risk groups with the design of overcoming or minimizing constraints to meeting their nutritional needs. It will also monitor the impacts of development projects and strengthen the capacity of indigenous organizations to analyze and overcome nutrition problems.