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Washington, D.C., World Bank, 1989. 55 p. (World Bank Technical Paper No. 102)After a brief explanation of the impact of breastfeeding on fertility worldwide, inaccurate assumptions about the decline of breastfeeding are explored to point out the need for renewed promotion of breastfeeding by World Bank projects. Breastfeeding, by inhibiting fertility through lactational anovulation, is one of the most important determinants of fertility, especially for 83% of couples in developing countries who do not use modern contraception. Many believe that breastfeeding does not need promoting in areas where it is the norm, yet this belief does not take into account the need for supporting breastfeeding women, teaching them to breastfeed exclusively and frequently for the 1st 4 months. The belief that declines in breastfeeding are inevitable is belied by recent evidence in developed countries. The reliability of breastfeeding as a contraceptive for individual women varies: poor, undernourished women who breastfeed extensively may be protected up to 21.7 months (Bangladesh). Advantages of breastfeeding include significant savings of money, foreign exchange, scarce contraceptive supplies, medical treatment of diarrhea and malnutrition in infants, and possibly mothers' time. In contrast, other caregivers can prepare milk substitutes, but breastfeeding can be encouraged in the work setting, or milk expressed for later use. A review of 68 World Bank Projects revealed that 37% of all Population, Health and Nutrition projects, enumerated in an appendix, contained explicit actions to promote breastfeeding. 10 recommendations for promoting breastfeeding end the report.
In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988]. 7 p.. (USAID Contract No. DPE-3040-A-00-5064-00)The US Agency for International Development (USAID) and the Institute for International Studies in Natural Family Planning are at work to find ways to remove barriers to family planning breastfeeding promotion efforts. Barriers include lack of or conflicting measures of program success along with lack of information on the breastfeeding/fertility relationship. The 2 organizations have taken the following steps to assist family planning organizations to increase their promotion and support of breastfeeding: identify current activities and potential barriers to breastfeeding promotion; develop guidelines for breastfeeding support and promotion; assess feasibility and impact of the guidelines; and disseminate the guidelines. Much remains to be done to integrate family planning and breastfeeding. The keys to success are: generating and communicating information which can be used readily by both the population and health policymakers in family planning programs; developing and disseminating guidelines and prototype materials which can be adapted to program needs; identifying, implementing, and evaluating programmatic ways to promote breastfeeding in community and clinical settings; and involving the population community -- at the local, national, and international levels, and in research, service delivery, policy, and training -- in an ongoing dialogue about the relationship of family planning and breastfeeding.
[Child health in Chile and the role of the international collaboration (author's transl)] Salud infantil en Chile y el rol de la colaboracion internacional.
Revista Chilena de Pediatria. 1982 Sep-Oct; 53(5):481-90.Assuring the rights sanctioned by the UN Declaration on the Rights of Children requires the participation of the family, community, and state as well as international collaboration. Health conditions in Chile have improved significantly and continuously over the past few decades, as indicated by life expectancy at birth of 65.7 years, general mortality of 9.2/1000 in 1972 and 6.2/1000 in 1981, infant mortality of 27.2/1000 in 1981. Although the country has experienced broad socioeconomic development, due to inequities of distribution 6% of households are indigent and 17% are in critical poverty. The literacy rate in 1980 was 94%, but further progress is needed in environmental sanitation, waste disposal, and related areas. Enteritis, diarrhea, respiratory ailments, and infections caused 60.4% of deaths in children under 1 in 1970 but only 37.8% in the same group by 1979. Measures to guarantee the social and biological protection of children in Chile, especially among the poor, date back to the turn of the century. Recent programs which have affected child health include the National Health Service, created in 1952, which eventually provided a wide array of health and hygiene services for 2/3 of the population, including family planning services starting in 1965; the National Complementary Feeding Program, which supervised the distribution in 1980 of 25,195 tons of milk and protein foods to pregnant women and small children; the National Board of School Assistance and Scholarships, which provides 300,000 lunches and 750,000 school breakfasts; and programs to promote breastfeeding and rehabilitate the undernourished. Health services are now extended to all children under 8 years in indigent families. Bilateral or multilateral aid to health services in Chile, particularly that offered by the UN specialized agencies and especially the World Health Organization, Pan American Health Organization, and UNICEF, have contributed greatly to the improvement of health care. The Rockefeller, Ford, and Kellogg Foundations have contributed primarily in the areas of teaching and basic and operational research. Aid from the US government assisted in the development of health units and in nutritional and family health programs. The International Childhood Center in Paris rendered educational aid in social pediatrics. (summary in ENG)