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BMJ. British Medical Journal. 2003 Jul 5; 327:3-4.One promising strategy is to market sanitation and handwashing as if they were consumer products like cars or shampoo. Consumers see the building of a toilet as a home improvement not as a health intervention. Equally they use soap to make hands look, feel, and smell good, not to prevent sickness. Public money could be spent on marketing hygiene and toilets, thus generating demand that can then be met by the private sector. The private sector also knows how to generate behaviour change through marketing. If consumer demand for hygiene and toilets can be stimulated with the help of the private sector, public funds can be liberated to support public infrastructure and to help the very poorest who cannot afford to adopt new technologies. This approach is being tested in six countries, where public-private partnerships between soap companies, governments, and agencies such as theWorld Bank aim to increase rates of handwashing with soap massively (www.globalhandwashing.org). (excerpt)
The role of the health sector in the development of national and international food and nutrition policies and plans, with special reference to combating malnutrition, 13th Plenary Meeting, 24 May 1978.
Geneva, WHA, 1978 May 24. 10 p. (WHA31.47/WHA34.22)The 31st World Health Assembly (WHA) has considered the Director General's report on the role of the health sector in the development of national and international food and nutrition policies and plans and endorses the functions of the health sector in this field. The WHA is convinced that malnutrition is 1 of the major impediments to realizing the goal of health for all by the year 2000, and that new approaches based on clearly defined priorities and maximum utilization of local resources are needed for a more effective action to combat malnutrition. The WHA recommends that Member States give the highest priority to stimulating permanent multisector coordination of nutrition policies and programs and to preventing malnutrition in pregnant women, lactating women, infants, and children by doing the following: 1) supporting and promoting breast feeding with educational activities to the general public, 2) legislative and social actions to facilitate breastfeeding by working mothers, 3) implementing the necessary promotional and facilitating measures in the health services and regulating inappropriate sales promotion of infant foods that can be used to replace breast milk, 5) ensuring timely supplementation and appropriate weaning practices and the feeding of young children with the maximum utilization of locally available and acceptable foods, and 6) conducting, if necessary, action oriented research to support this approach and the training of personnel for its promotion. Governments and multilateral and bilateral organizations and agencies are urged to support the proposed programs of research and development in nutrition through their technical and scientific institutions and workers and by financial contributions. A copy of the international code of marketing of breastmilk substitutes is included. The 11 articles of the code cover the following: aim and scope of the code, definitions, information and education, the general public and mothers, health care systems, health workers, persons employed by manufacturers and distributors, labelling, quality, and implementation and monitoring.
FRONT LINES. 1987 Sep; 27(8):8-9, 11.The USAID's mission in Nepal is to assist development until the people can sustain their own needs: although the US contributes only 5% of donor aid, USAID coordinates donor efforts. The mission's theme is to emphasize agricultural productivity, conserve natural resources, promote the private sector and expand access to health, education and family planning. Nepal, a mountainous country between India and Tibet, has 16 million people growing at 2.5% annually, and a life expectancy of only 51 years. Only 20% of the land is arable, the Kathmandu valley and the Terai strip bordering India. Some of the objectives include getting new seed varieties into cultivation, using manure and compost, and building access roads into the rural areas. Rice and wheat yields have tripled in the '80s relative to the yields achieved in 1970. Other ongoing projects include reforestation, irrigation and watershed management. Integrated health and family planning clinics have been established so that more than 50% of the population is no more than a half day's walk from a health post. The Nepal Fertility Study of 1976 found that only 2.3% of married women were using modern contraceptives. Now the Contraceptive Retail Sales Private Company Ltd., a social marketing company started with USAID help, reports that the contraceptive use rate is now 15%. Some of the other health targets are control of malaria, smallpox, tuberculosis, leprosy, acute respiratory infections, and malnutrition. A related goal is raising the literacy rate for women from the current 12% level. General education goals are primary education teacher training and adult literacy. A few descriptive details about living on the Nepal mission are appended.
WHO Chronicle 33(7-8):267-274. July-August 1979.The 350 participants at the 32nd World Health Assembly, held in Geneva from May 11-17, 1979, discussed ways to promote technical cooperation among developing countries (TCDC) and factors which act as constraints to TCDC. The participants agreed that strategies must be developed at the national, regional, and global level and recommended that 1) each country adopt a national health policy and establish an information system with exchange facilities; 2) areas in which regional cooperation is to be vigorously sought are in the manufacture and quality control of drugs, information exchange, and the development of research facilities and training of health personnel; and 3) WHO is to act as a promotor and coodinator for TCDC activities, help develop and facilitate information exchange, and encourage the drug industry to supply drugs on a nonprofit basis to TCDC programs. Constraints on TCDC included 1) the unfounded fear that the TCDC approach will delay the development of self-reliance for 3rd world countries; 2) the lack of administration facilities and structures needed for regional and national coordination; 3) various legal, financial, and political factors which inhibit cooperation; 4) language barriers; and 5) a lack of knowledge about the resources and capabilities available in each country which could be shared by others. Financing of TCDC projects will be done primarily through allocations in the national budgets in each of the developing countries and multinational financing. Funds from UN programs and from other organizations interested in promoting TCDC principles must be sought.
Washington, D.C., Agency for International Development, 1982 May. 8 p. (A.I.D. Policy Paper)The Task Force of the US Agency for International Development (US AID) sets forth the overall objectives, policy decisions, and programming implications for food and agricultural assistance funded from Development Assistance, Economic Support Fund, and PL 480 budgets. The objective of US food and agricultural assistance is to enable developing countries to become self-reliant in food through increased agricultural production and greater economic efficiency in marketing and distribution of food products. Improved food consumption is gained through expanded employment to increase purchasing power, increased awareness of sound nutritional principles, and direct distribution of food from domestic or external sources to those facing severe malnutrition and food shortages. Policy elements to accomplish these objectives include 1) improving country policies to remove constraints on food production; 2) developing human resources and institutional capabilities, including research on food and agriculture problems; 3) expanding the role of private sectors in developing countries and private sector in agricultural development; and 4) employing available assistance instruments and technologies in an integrated and efficient manner. A sound country policy framework is fundamental for agricultural growth and should 1) rely on free markets, product incentives, and equitable access to resources; 2) give priority to complementary public sector investments that complement and encourage rather than compete with private sector growth. Private and voluntary organizations (PVOs) can also offer low-cost approaches to agricultural development that take local attitudes and conditions into account. Under appropriate conditions, US AID will finance a share of recurrent costs of food and agricultural research, education, extension or related institutions, provided that policy and institution frameworks assure effective utilization and the country is making maximum and/or increasing domestic resource mobilization efforts.