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Application opportunities of geographic information systems analysis to support achievement of the UNAIDS 90-90-90 targets in South Africa.
South African Medical Journal. 2017 Nov 27; 107(12):1065-1071.In an effort to achieve control of the HIV epidemic, 90-90-90 targets have been proposed whereby 90% of the HIV-infected population should know their status, 90% of those diagnosed should be receiving antiretroviral therapy, and 90% of those on treatment should be virologically suppressed. In this article we present approaches for using relatively simple geographic information systems (GIS) analyses of routinely available data to support HIV programme management towards achieving the 90-90-90 targets, with a focus on South Africa (SA) and other high-prevalence settings in low- and middle-income countries. We present programme-level GIS applications to map aggregated health data and individual-level applications to track distinct patients. We illustrate these applications using data from City of Johannesburg Region D, demonstrating that GIS has great potential to guide HIV programme operations and assist in achieving the 90-90-90 targets in SA.
Geneva, Switzerland, WHO, 2017. 184 p. (Interactive Visualization of Health Data)In order to reduce health inequalities and identify priority areas for action to move towards universal health coverage, governments first need to understand the magnitude and scope of inequality in their countries. From April 2016 to October 2017, the Indonesian Ministry of Health, WHO, and a network of stakeholders assessed country-wide health inequalities in 11 areas, such as maternal and child health, immunization coverage and availability of health facilities. A key output of the monitoring work is a new report called State of health inequality: Indonesia, the first WHO report to provide a comprehensive assessment of health inequalities in a Member State. The report summarizes data from more than 50 health indicators and disaggregates it by dimensions of inequality, such as household economic status, education level, place of residence, age or sex. This report showcases the state of inequality in Indonesia, drawing from the latest available data across 11 health topics (53 health indicators), and eight dimensions of inequality. In addition to quantifying the magnitude of health inequality, the report provides background information for each health topic, and discusses priority areas for action and policy implications of the findings. Indicator profiles illustrate disaggregated data by all applicable dimensions of inequality, and electronic data visuals facilitate interactive exploration of the data. This report was prepared as part of a capacity-building process, which brought together a diverse network of stakeholders committed to strengthening health inequality monitoring in Indonesia. The report aims to raise awareness about health inequalities in Indonesia, and encourage action across sectors. The report finds that the state of health and access to health services varies throughout Indonesia and identifies a number of areas where action needs to be taken. These include, amongst others: improving exclusive breastfeeding and childhood nutrition; increasing equity in antenatal care coverage and births attended by skilled health personnel; reducing high rates of smoking among males; providing mental health treatment and services across income levels; and reducing inequalities in access to improved water and sanitation. In addition, the availability of health personnel, especially dentists and midwives, is insufficient in many of the country’s health centres. Now the country is using these findings to work across sectors to develop specific policy recommendations and programmes, such as the mobile health initiative in Senen, to tackle the inequalities that have been identified.
Geneva, Switzerland, WHO, 2016. 96 p.The report addresses two overarching questions: What inequalities in childhood immunization coverage exist in low- and middle-income countries? And how have childhood immunization inequalities changed over the last 10 years? In answering these questions, this report draws on data about five childhood immunization indicators, disaggregated by four dimensions of inequality, and covering 69 countries. The findings of this report indicate that there is less inequality now than 10 years ago. Global improvements have been realized with variable patterns of change across countries and by indicator and dimension of inequality. The current situation in many countries shows that further improvement is needed to lessen inequalities; in particular, inequalities related to household economic status and mother’s education were the most prominent. (Excerpt)
New York, New York, UNICEF, Data and Analytics Section, 2015. 8 p.This report provides an overview of key facts about child marriage in Africa. While rates of child marriage are slowly decreasing across the continent, the rate of progress combined with population growth means there will not be a substantial reduction in the number of child brides. If current trends continue, almost half of the world’s child brides in 2050 will be African.
Monitoring health inequality: an essential step for achieving health equity. Illustrations of fundamental concepts.
Geneva, Switzerland, WHO, 2014.  p. (WHO/FWC/GER/2014.1)This booklet communicates fundamental concepts about the importance of health inequality monitoring, using text, figures, maps and videos. Following a brief summary of main messages, four general principles pertaining to health inequalities are highlighted: 1. Health inequalities are widespread; 2. Health inequality is multidimensional; 3. Benchmarking puts changes in inequality in context; and 4.Health inequalities inform policy. Each of the four principles is accompanied by figures or maps that illustrate the concept, a question that is posed as an extension and application of the material, and a link to a video, demonstrating the use of interactive visuals to answer the question. The videos are accessible online by scanning a QR code (a URL is also provided). The next section of the booklet outlines essential steps forward for achieving health equity, including the strengthening and equity orientation of health information systems through data collection, data analysis and reporting practices. The use of visualization technologies as a tool to present data about health inequality is promoted, accompanied by a link to a video demonstrating how health inequality data can be presented interactively. Finally, the booklet announces the upcoming State of inequality report, and refers readers to the Health Equity Monitor homepage on the WHO Global Health Observatory.
American Journal of Tropical Medicine and Hygiene. 2007; 77 Suppl 6:133-137.National disease burdens are often not estimated at all or are estimated using inaccurate methods, partly because the data sources for assessing disease burden-nationally representative household surveys, demographic surveillance sites, and routine health information systems-each have their limitations. An important step forward would be a more consistent quantification of the population at risk of malaria. This is most likely to be achieved by delimiting the geographical distribution of malaria transmission using routinely collected data on confirmed cases of disease. However, before routinely collected data can be used to assess trends in the incidence of clinical cases and deaths, the incompleteness of reporting and variation in the utilization of the health system must be taken into account. In the future, sentinel surveillance from public and private health facilities, selected according to risk stratification, combined with occasional household surveys and other population-based methods of surveillance, may provide better assessments of malaria trends. (author's)
Deaths and disease burden by cause: global burden of disease estimates for 2001 by World Bank country groups. Revised.
[Washington, D.C.], World Bank, Disease Control Priorities Project, 2005 Jan.  p. (Disease Control Priorities Project Working Paper No. 18)The World Health Organization has undertaken a new assessment of the GBD for the year 2000 and subsequent years. The three goals articulated for the GBD 1990 (8) remain central: to decouple epidemiological assessment of the magnitude of health problems from advocacy by interest groups of particular health policies or interventions; to include in international health policy debates information on non-fatal health outcomes along with information on mortality; and to undertake the quantification of health problems in time-based units that can also be used in economic appraisal. The specific objectives for GBD 2000 are similar to the original objectives: to quantify the burden of premature mortality and disability by age, sex, and region for 135 major causes or groups of causes; to develop internally consistent estimates of the incidence, prevalence, duration, and case-fatality for over 500 sequelae resulting from the above causes; to describe and value the health states associated with these sequelaeof diseases and injuries; to analyze the contribution to this burden of major physiological, behavioral, and social risk factors by age, sex and region; to develop alternative projection scenarios of mortality and non-fatal health outcomes over the next 30 years, disaggregated by cause, age, sex and region. (excerpt)
Asia-Pacific Population Journal. 2007 Apr; 22(1):3-7.While the science of demography addresses the whole of the human population, substantive demographic research is most often focused on populations with common characteristics. For the last six decades the nation state has been the social unit that has dominated demographic research. The reasons for this focus make perfect sense. Nations define their populations in terms of citizenship and define the ways in which people will be identified in any effort to count the numbers. They have the authority, the interest and the resources to carry out collections of information about members of these defined populations. As members of the United Nations they collaborate with other nations to develop the methodological and technical tools used to analyse national population numbers in ways that are relevant to state policies and actions. In short, the nation is the foundation unit for understanding human population composition and growth. Global population numbers are estimated by compiling the information collected by nations. Interest in populations of units smaller than the nation also relies on national statistical collections and national definitions of component populations, but for most users of data the focus is on the nation, and not the units beyond or below that political entity. (excerpt)
Lancet. 2006 Aug 19; 368(9536):629-630.The International Agency for Research on Cancer (IARC) was founded by a Resolution of the World Health Assembly in September, 1965. At that time, although data were sparse, cancer was widely considered to be a disease of developed high-resource countries. Now, the situation has changed dramatically with the majority of the global cancer burden found in low-resource and medium-resource countries. It is estimated that in 2000 almost 11 million new cases of cancer were diagnosed worldwide, 7 million people died from cancer, and 25 million persons were alive with cancer. The continued growth and ageing of the world's population will greatly affect the future cancer burden. By 2030, it could be expected that there will be 27 million incident cases of cancer, 17 million cancer deaths annually, and 75 million persons alive with cancer. The greatest effect of this increase will fall on low-resource and mediumresource countries where, in 2001, almost half of the disease burden was from non-communicable disease. (excerpt)
National estimates for maternal mortality: an analysis based on the WHO systematic review of maternal mortality and morbidity.
BMC Public Health. 2005 Dec 12; 5:131.Despite the worldwide commitment to improving maternal health, measuring, monitoring and comparing maternal mortality estimates remain a challenge. Due to lack of data, international agencies have to rely on mathematical models to assess its global burden. In order to assist in mapping the burden of reproductive ill-health, we conducted a systematic review of incidence/prevalence of maternal mortality and morbidity. We followed the standard methodology for systematic reviews. This manuscript presents nationally representative estimates of maternal mortality derived from the systematic review. Using regression models, relationships between study-specific and country-specific variables with the maternal mortality estimates are explored in order to assist further modelling to predict maternal mortality. Maternal mortality estimates included 141 countries and represent 78.1% of the live births worldwide. As expected, large variability between countries, and within regions and subregions, is identified. Analysis of variability according to study characteristics did not yield useful results given the high correlation with each other, with development status and region. A regression model including selected country-specific variables was able to explain 90% of the variability of the maternal mortality estimates. Among all country-specific variables selected for the analysis, three had the strongest relationships with maternal mortality: proportion of deliveries assisted by a skilled birth attendant, infant mortality rate and health expenditure per capita. With the exception of developed countries, variability of national maternal mortality estimates is large even within subregions. It seems more appropriate to study such variation through differentials in other national and subnational characteristics. Other than region, study of country-specific variables suggests infant mortality rate, skilled birth attendant at delivery and health expenditure per capita are key variables to predict maternal mortality at national level. (author's)
Manila, Philippines, World Health Organization [WHO], Regional Office for the Western Pacific, 2003.  p.The objective of this paper is to review documented evidence and examine the relationships between the food supply, dietary patterns and obesity in Pacific countries. Obesity and consumption of imported foods seems to be an urban phenomenon in the Pacific. A suitable definition for a recommended proportion of fat in a national diet has been established. Before European contact, the food behaviour of the people of the Pacific region may have remained the same for millennia. The main staples were root crops. Upon European contact, Pacific people were described as strong, muscular and mostly in good health. The leaders and ruling classes appeared to be obese and high value was placed on fatty foods. Daily food intake consisted of large quantities of starchy roots supplemented with leaves, fish, coconuts and fruits. (excerpt)
The challenge of Trypanosoma brucei gambiense sleeping sickness diagnosis outside Africa. [Le défi que pose le diagnostic de la maladie du sommeil à Trypanosoma brucei gambiense en dehors de l'Afrique]
Lancet Infectious Diseases. 2003 Dec 1; 3(12):804-808.Sleeping sickness is a lethal African disease caused by parasites of the Trypanosoma brucei subspecies, which is transmitted by tsetse flies. Occasionally, patients are reported outside Africa. Diagnosis of such imported cases can be problematic when the infection is due to Trypanosoma brucei gambiense, the chronic form of sleeping sickness found in west and central Africa. The low number of trypanosomes in the blood and the non-specific, variable symptoms make the diagnosis difficult, particularly when the index of suspicion is low. When the trypanosomes have penetrated into the central nervous system, neuropathological signs become apparent but even at this stage, misdiagnosis is frequent. Rapid and correct diagnosis of sleeping sickness can avoid inappropriate or delayed treatment and even death of the patient. In this article, an overview on diagnosis of imported cases of T b gambiense sleeping sickness is given, and possible pitfalls in the diagnostic process are highlighted. Bioclinical parameters that should raise the suspicion of sleeping sickness in a patient who has been in west or central Africa are discussed. Techniques for diagnosis are reviewed. A clinician suspecting sleeping sickness should contact a national reference centre for tropical medicine in his or her country, or the WHO, Geneva, Switzerland, or the Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA, for clinical consultation and provision of specific diagnostic tests. Appropriate drugs for sleeping sickness treatment are also provided by WHO and the CDC. (excerpt)
Bulletin Économique et Social du Maroc. 2000; (159):21-24.According to the 1998 World Human Development Report (HDR), Morocco ranks 125th with a human development indicator (HDI) of 0.557 points. The indicator elements pertaining to life expectancy, adult literacy and schooling levels remain unchanged in the HDI, but the revenue indicator has improved. These important changes have armed this HDI with a more solid methodological base. With an average per capita revenue of 3,310 dollars (PPP), Morocco finds itself in the revenue segment that has undergone the most significant revision of the standardized value. In effect, although it is not found among the principal Arab countries which have successfully reduced deficits in terms of human development during the last two decades, Morocco has, however, successfully reduced them by 27%. The progress made by this country in terms of human development in the last decade can be seen in the struggle against poverty and is reinforced and consolidated by the commitment of the Head of State for the purpose of improving the living conditions of the poor. The struggle against poverty constitutes the fundamental goal of the UNDP, around which are centered most of the programs and projects whose implementation should contribute to promoting the necessary environment for poverty reduction and consequently, to improved human development. The strategy chosen for the UNDP's intervention is broken into two parts: one is to support strategies and policies in the struggle against poverty, and the other lies in local initiatives for validating these same policies. It targets the socio-geographic aspect of action, on the one hand, benefiting the most vulnerable social groups such as women, children, and girls in the poorest areas, and on the other hand, is directed at those geographic areas that are the most ill-favored in the rural world as well as urban outskirts. The process of integrating Morocco into a free trade zone with the European Union has required the implementation of reforms at the legal and institutional level to manage ever stiffer competition in the world market.
Human development report 2003. Millennium Development Goals: a compact among nations to end human poverty.
New York, New York, Oxford University Press, 2003. xv, 367 p.The central part of this Report is devoted to assessing where the greatest problems are, analysing what needs to be done to reverse these setbacks and offering concrete proposals on how to accelerate progress everywhere towards achieving all the Goals. In doing so, it provides a persuasive argument for why, even in the poorest countries, there is still hope that the Goals can be met. But though the Goals provide a new framework for development that demands results and increases accountability, they are not a programmatic instrument. The political will and good policy ideas underpinning any attempt to meet the Goals can work only if they are translated into nationally owned, nationally driven development strategies guided by sound science, good economics and transparent, accountable governance. That is why this Report also sets out a Millennium Development Compact. Building on the commitment that world leaders made at the 2002 Monterrey Conference on Financing for Development to forge a “new partnership between developed and developing countries”—a partnership aimed squarely at implementing the Millennium Declaration—the Compact provides a broad framework for how national development strategies and international support from donors, international agencies and others can be both better aligned and commensurate with the scale of the challenge of the Goals. And the Compact puts responsibilities squarely on both sides: requiring bold reforms from poor countries and obliging donor countries to step forward and support those efforts. (excerpt)
Journal of the American Water Resources Association. 2000 Aug; 36(4):799-809.Drinking of arsenic-contaminated tubewell water has become a serious health threat in Bangladesh. Arsenic contaminated tubewells are believed to be responsible for poisoning nearly two-thirds of this country's population. If proper actions are not taken immediately, many people in Bangladesh will die from arsenic poisoning in just a few years. Causes and consequences of arsenic poisoning, the extent of area affected by it, and local knowledge and beliefs about the arsenic problem - including solutions and international responses to the problem - are analyzed. Although no one knows precisely how the arsenic is released into the ground water, several contradictory theories exist to account for its release. Initial symptoms of the poisoning consist of a dryness and throat constriction, difficulty in swallowing, and acute epigastric pain. Long-term exposure leads to skin, lung, or bladder cancer. Both government and nongovernmental organizations (NGOs) in Bangladesh, foreign governments, and international agencies are now involved in mitigating the effects of the arsenic poisoning, as well as developing cost-effective remedial measures that are affordable by the rural people. (author's)
Media Development. 2002; 49(4):27.There is growing recognition that those who most need the boost that information communication technologies (ICTs) can provide are least able to take advantage of it. The bridging of this 'digital divide', is, therefore, now high on the global development agenda with multi-lateral and bi-lateral agencies channelling millions of dollars into projects which aim to support the ability of the marginalised to harness the power of ICTs. (excerpt)
World Health Organization Technical Report Series. 1981; (670):1-120.This report includes the collective views of a World Health Organization (WHO) Scientific Group on Research on the Menopause that met in Geneva during December 1980. It includes information on the following: 1) the endocrinology of the menopause and the postmenopausal period (changes in gonadotropins and estrogens immediately prior to the menopause and changes in gonadotropin and steroid hormone levels after the menopause); 2) the age distribution of the menopause (determining the age at menopause, factors influencing the age at menopause, and the range of ages at menopause and the definition of premature and delayed menopause); 3) sociocultural significance of the menopause in different settings; 4) symptoms associated with the menopause (vasomotor symptoms, psychological symptoms, disturbances of sexuality, and insomnia); 5) disorders resulting from, or possibly accelerated by, the menopause (osteoporosis, atherosclerotic cardiovascular disease, and arthritic disorders); 6) risks, with particular reference to neoplasia, of therapeutic estrogens and progestins given to peri- and postmenopausal women (endometrial cancer, breast cancer, and gallbladder disease); 7) fertility regulating methods for women approaching the menopause (fertility and the need for family planning in women approaching the menopause, problems of family planning in perimenopausal women, and considerations with regard to individual methods of family planning in women approaching the menopause); and 8) estrogen and the health care management of perimenopausal and postmenopausal women. At this time some controversy exists as to whether there is a menopausal syndrome of somatic and psychological symptoms and illness. There are virtually no data on the age distribution of the menopause and no information on its sociocultural significance in the developing countries. The subject of risks and benefits of estrogen therapy in peri- and postmenopausal women is of much importance in view of the large number of prescriptions issued for this medication in developed countries, which indicates their frequrnt use, and the different interpretations and opinions among epidemiologists and clinicians on both past and current studies on this subject. Specific recommendations made by the Scientific Group appear at the end of each section of the report. The following were among the general recommendations made: WHO sponsored research should be undertaken to determine the impact on health service needs of the rapidly increasing numbers of postmenopausal women in developing countries; uniform terminology should be adopted by health care workers with regard to the menopause; uniform endocrine standards should be developed which can be applied to the description of peri- and postmenopausal conditions and diseases; and descriptive epidemiological studies of the age at menopause should be performed in a variety of settings.
[Geneva, Switzerland], UNAIDS, 1998 Jun. 75 p.Estimates by the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization indicate that, by the beginning of 1998, 30.6 million people were infected with HIV and 11.7 million HIV-related deaths had occurred. During 1997, 5.8 million new HIV infections were reported and 2.3 million people died of AIDS. Also in 1997, almost 600,000 children were infected with HIV, primarily through their mothers before or during birth or through breast feeding. At present, there are 8.2 million AIDS orphans. 89% of people with HIV live in sub-Saharan Africa and the developing countries of Asia, which together account for less than 10% of the global gross national product. It will be a long time before the benefits conferred by combination antiretroviral therapy will be experienced in developing countries. Well-designed, carefully targeted prevention campaigns have been able to arrest or reverse HIV trends, however. The most effective campaigns work simultaneously on many levels, each initiative reinforcing the others. This UNAIDS report presents global estimates of the HIV/AIDS epidemic by the end of 1997 and summarizes current knowledge on AIDS orphans, the evolution of the AIDS epidemic in each world region, prevention efforts, injecting drug use and HIV, preventing sexual transmission of HIV among youth, HIV testing, HIV and mortality, treatment regimens, vertical transmission, and HIV/AIDS estimation techniques and indicators.
In: Methodology for population studies and development, edited by Kuttan Mahadevan, Parameswara Krishnan. New Delhi, India, Sage, 1993. 82-121.Migration can be obligatory (transfers in job, joining husbands place) or sequential (the movement of dependents), besides being voluntary. The major data sources for the study of migration are population censuses, sample surveys, and population registers. A continuous population registration system has been in existence in the Scandinavian countries, a few West European countries, Taiwan, Israel, Japan, and some East European countries. Developed countries have developed techniques of estimating migration without sample surveys by using other sources built in within their social system. The censuses are the most widely used data sources for migration research where direct questions on migration (place of birth, place of last residence, place of residence at a specific prior date, and duration of residents) set the focus on the volume, level and pattern, differential selectivity, origin, and destination. Migration can be measured by the direct (census or sample survey) and indirect (residual methods from vital statistics and survival ratios based on census and/or life table) approaches. Selectivity in migration deals with differences in migration related to age, sex, marital status, education, occupation, ethnic origin, and language. Other topics addressed include determinants of migration; statistical generalizations and laws (Ravenstein's laws, push-pull theory); typologies; economic, spatial, behavioral, and mathematical approaches in migration theory; Zelinsky's hypothesis of migration/mobility transition; and the demographic, economic, and social consequences of migration. The migration process in multidimensional, time and space specific, thus a single theory is not comprehensive enough to explain its dynamics. Instead, a series of theories can be formulated: theory of migration for peasants, theory of migration for intellectuals, and theory of migration for cultural groups. This necessitates the development of comprehensive typologies of migration.
In: International Population Conference / Congres International de la Population, Montreal 1993, 24 August - 1st September. Volume 2, [compiled by] International Union for the Scientific Study of Population [IUSSP]. Liege, Belgium, IUSSP, 1993. 249-58.Information is provided on the population of the world to the year 2150 based on UN long-range projections. 9 major areas were consolidated into Group 1 (Northern America, Europe, Oceania, and USSR) and Group II (China, India, Other Asia, Latin America, and Africa). The long-range projections use as a base the population size for 2025 from 1 of the 4 variants of the 1990 Revision. Extensions were prepared to the 1990 Revision: the medium, medium/low, low, medium/high, high, and constant fertility extensions. According to the medium fertility extension, the population of the world but be multiplied by 4.6 between the years 1950 and 2150, growing from 2.5 billion to 11.5 billion, and eventually stabilize at 11.6 billion a half century later. By the year 2150 there will be 33% more old people, aged 65 and over, than children under age 15, and 50% as many very old people, aged 80 and over, as children. In 2150 the proportion of the population under age 15 will be 18%, having declined from 32% in 1990 and 21% in 2050. In 2150, the proportion of the population aged 65 and over will be 24%; up from 6% in 1990 and 14% in 2050. The proportion of aged 80 and over will increase from 1% in 1990 to 3% in 2050 and 0% in 2150. The range in projected population size, for the year 2150, between the low and high fertility extensions is 4.3 billion persons to 28.0 billion persons assuming future fertility stabilized at 1.7 r 2.5 children/woman. Although the areas in Group 1 include about 20% of the population of the world in 1990, they will contribute less than 2% of the increase in the world population between 1990 and 2150, with more than 98% taking place in the areas of Group II (medium extension). The growth of the world population will take place essentially in the Group II. Africa will continue to be the fastest growing area. Its population is projected to be multi lied by 14 between 1950 and 2150. Its share of the world population will reach 27% in 2150 with a total of 3 billion and 90 million inhabitants.
Ann Arbor, Michigan, University Microfilms International, 1992. viii, 138 p. (Order No. 1350571)AIDS/HIV infection is pandemic. In Singapore and Thailand, however, the incidence of HIV infection has grown at an especially alarming rate due to the countries' status of being internationally recognized tourist destinations and the high prevalence of prostitution. The demographics, socioeconomics, health care systems, and geographical location also influence the course of the disease in the countries. This paper reviews the policies, management, current determinants, and distribution of HIV infection and AIDS in Singapore and Thailand. Projections for the future and prospects for prevention and control are offered. Different sections define AIDS; give the historical background of AIDS and origin of the virus; describe modes of transmission of HIV/AIDS and geographic patterns of AIDS; discuss the epidemiology of HIV/AIDS in Asia, the management of HIV/AIDS, the social impact of HIV/AIDS, future trends and projections of the HIV/AIDS epidemic, and effective policies and strategies in the prevention and control of the HIV/AIDS epidemic. Mortality and morbidity projections and the potential to manage the epidemic seem particularly grim for Thailand, although Singapore's regimental and authoritarian approach may prove more promising. Policy makers in these countries must get moving to prevent and control HIV/AIDS. The possibility of involving the World Health organization for technical assistance should be considered.
New York, New York, UNFPA, . v, 36 p. (Report)The former government of Romania sought to maintain existing population and accelerate population growth by restricting migration, increasing fertility, and reducing mortality. The provision and use of family planning (FP) were subject to restrictions and penalties beginning in 1986, the legal marriage age for females was lowered to 15 years, and incentives were provided to bolster fertility. These and other government policies have contributed to existing environmental pollution, poor housing, insufficient food, and major health problems in the country. To progress against population-related problems, Romania most urgently needs to gather reliable population and socioeconomic data for planning purposes, establish the ability to formulate population policy and undertake related activities, rehabilitate the health system and introduce modern FP methods, education health personnel and the public about FP methods, promote awareness of the need for population education, and establish that women's interests are served in government policy and action. These topics, recommendations, and the role of foreign assistance are discussed in turn.
[Unpublished] . 27 p. (USAID Contract No. DPE-5927-C-00-5068-00)Health personnel in Niger report that malaria is the leading diagnosis in health facilities (1980-1984), about 380,000 cases/year), but just 19% of the population live within a 5 km radius of a health facility. A 1985 household survey reveals that 31.4% of children had a febrile illness (presumptive malaria) within the last 2 weeks and 22.1% of all child deaths were presumptive malaria related. The Government of Niger began developing a national malaria program in 1985 to reduce malaria-related deaths rather than morbidity reduction, because available data indicated that morbidity reduction was not feasible. There is no standard treatment regimen for presumptive malaria, however. Some studies indicate that an effective dose regimen is 10 mg chloroquine/kg body weight in a single dose. Some health workers use other antimalarial arbitrarily. Lack of uniformity can increase the risk of chloroquine and Fansidar resistant falciparum. Government officials are thinking about having only chloroquine available at first level facilities. It plans to set up national surveillance for chloroquine resistance. Niger has just 1 trained malariologist, indicating a need for training of more staff. To keep government costs to a minimum, it wants to set chloroquine at all points in the distribution network. The program's plan of action also includes chemoprophylaxis for pregnant women, limited vector control in Niamey, and health education stressing reducing breeding sites. A REACH consultant believes that it is possible for the program to reach its coverage targets within 5 years. Obstacles include limited access to health care, unavailable chloroquine in warehouses, and lack of untrained personnel (the main obstacle). The consultant suggests various interventions to help Niger meet its targets, e.g., periodic coverage surveys. The World Bank, WHO, the Belgian Cooperation, and USAID are either providing or planning to provide support to the malaria control programs.
[Nairobi, Kenya], United Nations Environment Programme [UNEP], 1990. , 42 p. (UNEP Regional Seas Reports and Studies No. 123)The UN Environment Programme (UNEP) ocean program is studying global marine environments to form a policy to protect the oceans. This report examines the marine environment of the Indian Ocean, Bay of Bengal, the Arabian Sea, and the Andaman Sea. Bacteria and viruses comprise the most important contaminants in the South Asia seas. They enter marine life which humans eat and then develop diarrhea. Pathogens enter the seas through untreated sewage which causes much eutrophication. Zooplankton contain considerable concentrations of heavy metals and pesticides. None of the zooplankton samples drawn from seas around India in 1978, 1981, 1983, and 1985 contained mercury, however. Yet mercury and other heavy metals are present in fish species in at least the Ganges River estuary, Andaman Sea, the Karachi harbor in Pakistan, and seas around Bangladesh. Common chlorinated pesticides found off the coast of India include DDT, aldrin, dieldrin, and BHC. Industrial development is increasing the levels of other contaminants such as solid waste and synthetic detergents. Coastal erosion is common in South Asia. Considerable siltation occurs at the head of the Bay of Bengal. Several urban areas are reclaiming the sea using materials from solid wastes and garbage, but these materials leach which causes public health problems. In India, nuclear power plants operate near the coast where they release 50% of the generated heat to the coastal environment. Dredge materials from harbors in India are dumped offshore which resulted in almost complete depletion of fisheries near these harbors. Tourism poses a threat to coastal environments due to the increase in nonbiodegradable solid waste such as cans, plastics, and empty bottles. Oil tanker disasters, bilge washings, and discharge of ballast water contribute to the sizable amount of oil pollution in the Indian ocean. Exploitation damages coral reefs, mineral deposits, mangroves, and marine life.
POPULATION GEOGRAPHY. 1989 Jun-Dec; 11(1-2):86-96.This paper surveys the contributions of the International Geographic Union (IGU) and the International Cartographic Association (ICA) to the field of population studies over the past 3 decades. Reviewing the various focal themes of conferences sponsored by the organizations since the 1960s, the author examines the evolution of population studies in IGU and ICA. During the 1960s, IGU began holding symposia addressing the issue of population pressure on the physical and social resource in developing countries. However, it wasn't until 1972, at a meeting in Edmonton, Canada, when IGU first addressed the issue of migration. But since then, migration has remained on the the key concerns of IGU. In 1978, the union hosted a symposium on Population Redistribution in Africa -- the first in a series of conferences focusing on the issue of migration. As an outgrowth of migration, the IGU also began addressing the related issue of population education. The interest in migration has continued through the 1980s. In addition to studies of regional migration, the IGU has also focused on conceptual issues such as migrant labor, environmental concerns, women and migration, and urbanization. In 1984, IGU began cooperating with ICA in the areas of census cartography and population cartography. The author concludes his review of IGU and ICA activities by discussing the emerging trends in population studies. The author foresees a more refined study of migration and more sophisticated population mapping, the result of better study techniques and the use of computer technology.