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Effects of the World Bank's maternal and child health intervention on Indonesia's poor: evaluating the safe motherhood project.
Social Science and Medicine. 2011 Jun; 72(12):1948-55.This article examines the impact of the World Bank's Safe Motherhood Project (SMP) on health outcomes for Indonesia's poor. Provincial data from 1990 to 2005 was analyzed combining a difference-in-differences approach in multivariate regression analysis with matching of intervention (SMP) and control group provinces and adjusting for possible confounders. Our results indicated that, after taking into account the impact of two other concurrent development projects, SMP was statistically significantly associated with a net beneficial change in under-five mortality, but not with infant mortality, total fertility rate, teenage pregnancy, unmet contraceptive need or percentage of deliveries overseen by trained health personnel. Unemployment and the pupil-teacher ratio were statistically significantly associated with infant mortality and percentage deliveries overseen by trained personnel, while pupil-teacher ratio and female education level were statistically significantly associated with under-five mortality. Clinically relevant changes (52-68% increase in the percentage of deliveries overseen by trained personnel, 25-33% decrease in infant mortality rate, and 8-14% decrease in under-five mortality rate) were found in both the intervention (SMP) and control groups. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Public choices, private decisions: sexual and reproductive health and the Millennium Development Goals.
[New York, New York], United Nations Development Programme, UN Millennium Project, 2006.  p.Sexual and reproductive health (SRH) was given an international consensus definition at the International Conference on Population and Development (ICPD) in 1994. At its core is the promotion of healthy, voluntary and safe sexual and reproductive choices for individuals and couples, including decisions on family size and timing of marriage, that are fundamental to human well-being. Sexuality and reproduction are vital aspects of personal identity and key to creating fulfilling personal and social relationships within diverse cultural contexts. SRH does not only involve the reproductive years but emphasizes the need for a life-cycle approach to health. It touches on sensitive, yet important, issues for individuals, couples and communities, such as sexuality, gender discrimination and male/female power relations. Attainment of SRH depends vitally on the protection of reproductive rights, a set of long-standing accepted norms found in various internationally agreed human rights instruments. The ICPD adopted the goal of ensuring universal access to reproductive health by 2015 as part of its framework for a broad set of development objectives. The Millennium Declaration and the subsequent Millennium Development Goals (MDGs) set priorities closely related to these objectives. Progress towards the MDGs depends on attaining the ICPD reproductive health goals. The leaders of the world ratified that understanding in the 2005 World Summit Outcome Document. (excerpt)
[Sydney], Australia, Youth for a Sustainable Future Pacifika, 2006.  p.The Millennium Development Goals, better known as the MDGs, are a set of goals committed to reducing poverty, illiteracy, inequality and disease in developing countries. In September 2000, leaders from 189 nations including 14 Pacific Island nations, agreed to achieve the MDGs by endorsing the Millennium Declaration. The Declaration is a special documentation because it specifies responsibility for all countries to enhance the global agenda on human development. This means that even developed countries like the United States, Australia and New Zealand, are responsible for assisting developing countries in meeting the goals. (excerpt)
New York, New York, United Nations, 2005.  p.Global poverty rates are falling, led by Asia. But millions more people have sunk deep into poverty in sub-Saharan Africa, where the poor are getting poorer. Progress has been made against hunger, but slow growth of agricultural output and expanding populations have led to setbacks in some regions. Since 1990, millions more people are chronically hungry in sub-Saharan Africa and in Southern Asia, where half the children under age 5 are malnourished. Five developing regions are approaching universal enrolment. But in sub-Saharan Africa, fewer than two thirds of children are enrolled in primary school. Other regions, including Southern Asia and Oceania, also have a long way to go. In these regions and elsewhere, increased enrolment must be accompanied by efforts to ensure that all children remain in school and receive a high-quality education. The gender gap is closing — albeit slowly — in primary school enrolment in the developing world. This is a first step towards easing long-standing inequalities between women and men. In almost all developing regions, women represent a smaller share of wage earners than men and are often relegated to insecure and poorly paid jobs. Though progress is being made, women still lack equal representation at the highest levels of government, holding only 16 per cent of parliamentary seats worldwide. (excerpt)
Geneva, Switzerland, WHO, 2004 Apr 15. 15 p. (A57/13)By resolution WHA55.19, the Health Assembly requested the Director-General “to develop a strategy for accelerating progress towards attainment of international development goals and targets related to reproductive health … .” A progress report setting out the key elements of the strategy and summarizing the Executive Board’s comments thereon was reviewed and noted by the Fifty-sixth World Health Assembly. In order to ensure maximum involvement of Member States and other interested parties in the development of the strategy, four regional consultations were held: for the South-East Asia and Western Pacific Regions jointly (Colombo, 2-4 June 2003), for the European Region (Copenhagen, 5-7 June 2003), the Region of the Americas (Washington, DC, 11-13 June 2003), and jointly for the African and Eastern Mediterranean Regions (Harare, 7-9 July 2003). The aim of these meetings was two-fold: to review country-level experiences and lessons learnt in implementing reproductive health strategies, policies and programmes; and to review, and make recommendations on, the draft global reproductive health strategy. WHO subsequently convened a meeting of experts (Geneva, 18 and 19 September 2003) to provide final input into the draft strategy. The resulting text is annexed. The draft strategy was considered by the Board at its 113th session in January 2004. The Board adopted resolution EB113.R11, which contained a further resolution recommending the Fifty-seventh World Health Assembly, inter alia, to endorse the strategy. (excerpt)
New Delhi, India, World Health Organization, Regional Office for South-East Asia, 1985. vii, 126 p. (SEARO Regional Health Papers No. 8)The progress of activities to improve the health status of women in Southeast Asia, including WHO programs in family health, maternal and child health, and the training of women health workers, is examined in this paper. Data and information on the health and socioeconomic situation of women was drawn from Bangladesh, Bhutan, Burma, the Democratic People's Republic of Korea, India, Indonesia, Maldives, the Mongolian People's Republic, Nepal, Sri Lanka, and Thailand. Compared to 1975, there is now a definite focus on women's issues in national and international forums, deeper understanding of women's position and role in the development of nations, and more emphatic advocacy of women's rights. Several Southeast Asian nations have enacted legislation outlawing discrimination and protecting women from exploitation at work and at home, but the amount of resources devoted to implementing and enforcing change has been far less than needed. Each country in the region is profiled individually giving national policies on women, data on women's health status, the socioeconomic situation, status of women in the health professions, health legislation and social support to women, and women's non-governmental organizations.
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.
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.