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  1. 1
    375813

    State of health inequality, Indonesia.

    World Health Organization [WHO]; Indonesia. Ministry of Health

    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.
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  2. 2
    182047

    Human development report 2003. Millennium Development Goals: a compact among nations to end human poverty.

    United Nations Development Programme [UNDP]

    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)
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  3. 3
    033687

    Demographic trends and their development implications.

    United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]

    In: Third Asian and Pacific Population Conference (Colombo, September 1982). Selected papers. Bangkok, Thailand, Economic and Social Commission for Asia and the Pacific, 1984. 9-40. (Asian Population Studies Series No. 58)

    This report summarizes the recent demographic situation and considers prospective trends and their development implications among the 39 members and associate members of the Economic and Social Commission for Asia and the Pacific (ESCAP). It presents data on the following: size, growth, and distribution of the population; age and sex structure; fertility and marriage; mortality; international migration; growth and poverty; food and nutrition; households and housing; primary health care; education; the working-age population; family planning; the elderly; and population distribution. Despite improvements in the frequency and quality of demographic data collected in recent years, big gaps continue to exist in knowledge of the demographic situation in the ESCAP region. Available evidence suggests that the population growth rate of the ESCAP region declined between 1970 and 1980, as compared with the preceding decade, but that its rate of decline was slow. Within this overall picture, there is wide variation, with the most developed countries having annual growth rates around 1% and some of the least developed countries having a figure near 3%. The main factors associated with the high growth rates are the past high levels of fertility resulting in young age structures and continuing high fertility in some countries, notably in middle south Asia. The population of countries in the ESCAP region is expected to grow from 2.5 billion in 1980, to 2.9 billion in 1990, and to 3.4 billion persons by the year 2000. This massive growth in numbers, which will be most pronounced in Middle South Asia, will occur despite projected continuing moderation in annual population growth rates. Fertility is expected to continue its downward trend, assuming a more widespread and equitable distribution of health, education, and family planning services. Mortality is expected to decline further from its current levels, where life expectancy is often at or around 50 years. In several countries, more than 10 in every 100 babies born die before their 1st birthday. The extension of primary health care services is seen as the key to reducing this figure. Rapid population growth and poverty tend to reinforce each other. Low income, lack of education, and high infant and child mortality contribute to high fertility, which in turn is associated with high rates of natural increase. High rates of natural increase feed back to depress socioeconomic development. High population growth rates and their correlates of young age structures and heavy concentrations of persons in the nonproductive ages tend to depress production and burden government expenditure with high costs for social overhead needs. Rapid population growth emerges as an important factor in the persistence of chronic undernutrition and malnutrition. It increases the magnitude of the task of improving the educational system and exacerbates the problem of substandard housing that is widely prevalent throughout Asia.
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  4. 4
    031969

    China: report of Mission on Needs Assessment for Population Assistance.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1984 May. xii, 156 p. (Report No. 67)

    A Needs Assessment and Program Development Mission visited the People's Republic of China from March 7 to April 16, 1983 to: review and analyze the country's population situation within the context of national population goals as well as population related development objectives, strategies, and programs; make recommendations on the future orientation and scope of national objectives and programs for strengthening or establishing new objectives, strategies, and programs; and make recommendations on program areas in need of external assistance within the framework of the recommended national population program and for geographical areas. This report summarizes the needs and recommendations in regard to: population policies and policy-related research; demographic research and training; basic population data collection and analysis; maternal and child health and family planning services; management training support for family planning services; logistics of contraceptive supply; management information system; family planning communication and education; family planning program research and evaluation; contraceptive production; research in human reproduction and contraceptives; population education and dissemination of population information; and special groups and multisectoral activities. The report also presents information on the national setting (geographical and cultural features, government and administration, the economy, and the evolution of socioeconomic development planning) and demographic features (population size, characteristics, and distribution, nationwide and demographic characteristics in geographical core areas). Based on its assessment of needs, the Mission identified mjaor priorities for assistance in the population field. Because of China's size and vast needs, external assistance for population programs would be diluted if provided to all provincial and lower administrative levels. Thus, the Mission suggests that a substantial portion of available resources be concentrated in 3 provinces as core areas: Sichuan, the most populous province (100,220,000 people by the end of 1982); Guandong, the province with the highest birthrate (25/1000); and Jiangsu, the most densely populated province (608 persons/square kilometer. In all the government has identified 11 provinces needing special attention in the next few years: Anhui, Hebei, Henan, Hubei, Hunan, Jilin, Shaanxi and Shandong, in addition to Guangdong, Jiangsu, and Sichuan.
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  5. 5
    031976

    Ghana: report of Mission on Needs Assessment for Population Assistance.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1984 Jul. vii, 59 p. (Report No. 68)

    This report of a Mission visit to Ghana from May 4-25, 1981 contains data highlights; a summary of findings; Mission recommendations regarding population and development policies, population data collection and analysis, maternal and child health and family planning, population education and communication programs, and women and development; and information on the following: the national setting; population features and trends (population size, growth rate, and distribution and population dynamics); population policy, planning, and policy-related research; basic data collection and anaylsis; maternal and child health and family planning (general health status, structure and organization of health services, maternal and child health and family planning activities, and family planning services in the private sector); population education and communication programs; women, youth, and development; and external assistance in population. Ghana gained independence in 1957. The country showed early promise of rapid development. Although well-endowed with natural and human resources, Ghana now suffers from food scarcity, inadequate infrastructure and services, inflation, inequities in income distribution, unemployment, and underemployment. Per capita gross national product (GNP) was $400 in 1981; between 1960-81 the average annual growth of GNP was -1.1%. A high rate of natural increase of the population has compounded development problems by intensifying demands for food, consumer goods, and social services while simultaneously increasing the constraints on productivity. The population, estimated at 13 million in mid-1984, is growing at a rate of 3.25% per annum. Immigration and emigration have contributed to changes in the size and composition of the population. Post-independence development policies favored the urban areas, encouraging a steady rural-to-urban shift in the population. At the same time, worsening socioeconomic conditions spurred the emigration of professional, managerial, and technical personnel and skilled workers. Ghana was the 1st sub-Saharan African nation to establish an official population policy. Since the formulation of the policy in 1969, successive governments have remained committed to its emphasis on fertility reduction while increasing attention to the problems of mortality and morbidity and rural/urban migration. Recognizing the need to intensify the commitment to population policies, the Mission recommends support for a program to further the awareness of policy makers of the relationship between population trends and their areas of responsibility. The Mission recommends the creation of a special permanent population committee and the strengthening of the Ministry of Finance and Economic Planning's Manpower division. The Mission also makes the following recommendations: the provision of training, technical assistance, and data processing facilities to ensure the timely provision of demographic data for socioeconomic planning; data collected in the pilot program of vital registration be evaluated before the system is expanded; the complete integration of maternal and child health and family planning and general health services within the primary health care system; and improvement in women's access to resources such as education, training, and agricultural inputs.
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  6. 6
    050982

    Report on international financial resources for maternal/child health and family planning.

    Maine D; Wray JD; Wallace M; Belsey MA; Foo-Gregory CL

    [Unpublished] 1985. 47 p. (MCH/85.4)

    Despite improvements during the last decade in the health of women and children in developing countries, a great deal remains to be done. Barriers to continued progress take a number of forms, including financial and institutional. A study of existing data on international funding for maternal/child health and family planning (MCH/FP) shows the following: in 1983 the total official development assistance funding from developed countries totalled US$39.6 billion; 72% of these funds were dispersed through bilateral agencies, the rest through multilateral agencies (in 1983); nearly 6% of bilateral funds were allocated to the health sector (which includes population); analysis of 77 UNDP country reports indicates that about 1/10th of development funding is devoted to health and population; this proportion varies considerably by geographical region, being highest in Latin America and lowest in Africa; funding for MCH/FP programs constitutes about 1/15th of health and population funds reported by the UNDP; again, this proportion is lower in Africa than in Asia or Latin America, although this may be changing; in terms of women and children to be served, it appears that, on average, international funding for MCH/FP programs provides less than US$1 each; a survey of donor agencies indicates that most donors are willing to increase their funding of MCH/FP programs; when the donors were asked to name factors that would induce them to increase MCH/FP funds, the 2 most common answers were: more requests for funding, and , better evidence of unmet needs. Institutional barriers to optimal utilization of MCH/FP resources are discussed, including those often encountered in nongovernmental, bilateral and multilateral agencies, as well as in host countries and industry. Finally, a number of models for effective utilization of development funds are drawn from experience and developed. They include models of global, national, institutional and health services efforts. (author's)
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  7. 7
    030796

    Burma: report of Mission on Needs Assessment for Population Assistance.

    United Nations Fund for Population Activities [UNFPA]

    New York, UNFPA, 1985 Mar. viii, 68 p. (Report No. 70)

    The UN Fund for Population Activities (UNFPA) is in the process of an extensive programming exercise intended to respond to the needs for population assistance in a priority group of developing countries. This report presents the findings of the Mission that visited Burma from May 9-25, 1984. The report includes dat a highlights; a summary and recommendations for population assistance; the national setting; population policies and population and development planning; data collection, analysis, and demographic training and research;maternal and child health, including child spacing; population education in the in-school and out-of school sectors; women, population, and development; and external assistance -- multilateral assistance, bilateral assistance, and assistance from nongovernmental organizations. In Burma overpopulation is not a concern. Population activities are directed, rather, toward the improvement of health standards. The main thrust of government efforts is to reduce infant mortality and morbidity, promote child spacing, improve medical services in rural areas, and generally raise standards of public health. In drafting its recommendations, whether referring to current programs and activities or to new areas of concern, the Mission was guided by the government's policies and objectives in the field of population. Recommendations include: senior planning officials should visit population and development planning offices in other countries to observe program organization and implementation; continued support should be given to ensure the successful completion of the tabulation and analysis of the 1983 Population Census; the People's Health Plan II (1982-86) should be strengthened through the training of health personnel at all levels, in in-school, in-service, and out-of-country programs; and the need exists to establish a program of orientation to train administrators, trainers/educators, and key field staff of the Department of Health and the Department of Cooperatives in various aspects of population communication work.
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  8. 8
    010484

    Laos: progress will be slow.

    Ramdoyal R

    World Health. 1982 Jun; 28-9.

    The Lao People's Democratic Republic, a country faced with the problem of ensuring an outlet to the sea, suffers from all the undesirable economic and social consequences which being a landlocked country entails. Foreign products which Laos needs will be bought at a high cost in time and in scarce foreign exchange, but without foreign exchange the country is unable to obtain what it needs for economic and social development. The local manufacture of many items that are important for the country's growth remains limited because its dependence on supplies from abroad has always retarded technical development. At this time the national economy is advancing too slowly in relation to its capacity and to domestic demand. A factor seriously affecting the capacity for development has been the protracted war in which Laos has been embroiled by its geographical position. Health services, particularly in rural areas, reflect this situation as do all the other essential services. Defective communication networks have contributed to the weakness of the health sector. For many years the country has been receiving assistance from the World Health Organization (WHO) tailored to its needs, but the insecurity created by the war has precluded penetration into the most remote and poorest areas. Currently, the low rate of graduation from secondary schools limits the recruitment of people to be trained for the many vacant posts in the health services. WHO has the technical capacity for helping Laos to speed up its health development process, but it must first overcome the most important hurdle by introducing a more efficient system of management and creating among the staff the necessary confidence and decision making ability that are required. WHO is now helping Laos to deal with the priority problems that have been identified, i.e., the most common and most serious diseases. Malaria has been brought under control in 2 of 13 provinces. A drinking water supply project is being financed, and an immunization campaign against the common diseases of childhood has been initiated. Health education is another problem area. In rural areas WHO is primarily concerned with a project for developing primary health care so that improved health services can be made available in the most remote regions.
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  9. 9
    039113

    Measles: summary of worldwide impact.

    Assaad F

    REVIEWS OF INFECTIOUS DISEASES. 1983 May-Jun; 5(3):452-9.

    This summary of the worldwide impact of measles discusses epidemiology, reported incidence, clinical severity, community attitudes toward measles, and the impact of immunization programs on measles. Measles, 1 of the most ubiquitous and persistent of human viruses, occurs regularly everywhere in the world except in very remote and isolated areas. Strains of measles virus from different counties are indistinguishable, and serum antibodies from diverse population have identical specificity. Yet, the epidemic pattern, average age at infection, and mortality vary considerably from 1 area to another and provide a contrasting picture between the developing and the developed countries. In the populous areas of the world, measles causes epidemics every 2-5 years, but in the rapidly expanding urban conglomerations in the developing world, the continuous immigration from the rural population provides a constant influx of susceptible individuals and, in turn, a sustained occurrence of measles and unclear epidemic curves. In the economically advanced nations, measles epidemics are closely tied to the school year, building up to a peak in the late spring and ceasing abruptly after the summer recess begins. Maternal antibody usually confers protection against measles to infants during the 1st few months of life. The total number of cases of measles reported to WHO for 1980 is 2.9 million. Considering that in the developing world alone almost 100 million infants are born yearly, that less than 20% of them are immunized against measles, and that various studies indicate that almost all nonimmunized children get measles, less than 3 million cases of measles in 1980 is a gross underestimate. There was adecrease in the global number of reported cases of measles during the 1979-80 period due primarily to the reduction in the number of cases in the African continent and, to a lesser extent, in Europe. It is premature to conclude that such a reported decline is real and that it reflects the beginning of a longterm trend. The contrast between the developed and the developing worlds is most marked in relation to the severity and outcome of measles. Case fatality rates of more than 20% have been reported from West Africa. It has been estimated that 900,000 deaths occur yearly in the developing world because of measles, but data available to WHO indicate that the global case fatality rate in the developing world approaches 2% (in contrast to 2/10,000 cases in the US), and the actal mortality may be greater than 1.5 million deaths per year. The advent of WHO's Expanded Program on Immunization has brought about an awareness of the measles problem. Whenever and wherever measles vaccine has been used effectively on a large scale, a marked reduction in the number of cases has been recorded.
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  10. 10
    024950

    Country profile: Sierra Leone.

    International Planned Parenthood Federation. Africa Region; Planned Parenthood Federation of Sierra Leone

    [Nairobi, Kenya], International Planned Parenthood Federation, Africa Region, [1983]. 28 p.

    This profile of Sierra Leone discusses the following: geographical features; neighboring countries; ethnic and racial groups and religion; systems of government; population, namely, size, distribution, age/sex distribution, and women of reproductive age; socioeconomic conditions -- agriculture, industry, exports, imports, employment, education, health, and social welfare; family planning/population -- government policies, programs, Planned Parenthood Association of Sierra Leone (PPASL), nongovernment organizations and voluntary agencies, private organizations, sources of funding, and future trends of policies and programs; and the history, constitution, and structure and administration of the PPASL. According to the 1974 census, the population of Sierra Leone totaled 2,735,159. In 1980 it was estimated to have grown to 3,474,000. With an average annual growth rate of about 2.7%, it is expected to reach 6 million in 2000 and to have doubled in 27 years. Sierra Leone has a population density of 48 people/sq km. In 1974, 27.5% of the population lived in urban centers with 47% living in Freetown alone. The indigenous population includes 18 major ethnic groups; the Temne and Mende are the largest of these. The percentage of nonnationals increased from 2.7% in 1963 to 2.9% in 1974 and includes nationals mainly from the West African subregion with a sprinkling of British, Lebanese, Americans, Indians, and others. In 1974 the sex ratio was 98.8 males/100 females. In 1981 it was estimated that 41% of the total population was under age 15 and 5% over age 65, making the dependency burden very high. Agriculture is now the main focus of the government's development policy. Minerals are an important source of foreign exchange. It was estimated in 1980 that the total economically active population would reach 1.2 million, of whom the majority would be employed in agriculture. Women made up approximately 1/3 of the economically active population in 1970. The adult literacy rate recently has been estimated at 12% of the population. The government allows the PPASL to freely operate in the country, but it has not as yet declared a population policy. In 1973 the government did recognize the effects of rapid population growth on the nation's socioeconomic development. As a pioneering organization in family planning, the PPASL has made considerable effort in promoting the concept of responsible parenthood. Its motivational programs are geared towards informing and educating the public on the need for having only those children whom individuals and couples can adequately provide for in terms of health, nutrition, education, clothing, and all other basic necessities. Family planning services are provided to meet the demand thus created to enable families and individuals to exercise free and informed choice for spacing or limiting of children. Between 1971 and 1983 the UN Fund for Population Activities (UNFPA) provided financial assistance to Sierra Leone for population activities in the amount of US$2,659,382.
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