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  1. 1

    Research on the menopause.

    World Health Organization. Scientific Group

    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.
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  2. 2

    Field studies in human reproduction.

    Kessler A

    [Unpublished] 1968 Dec. 5 p. (HR/FS/68.5)

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  3. 3

    [Recommendations of the Population World Plan of Action and of the United Nations Expert Group on Population Distribution, Migration and Development] Recomendaciones del Plan de Accion Mundial sobre Poblacion y del Grupo de Expertos de la Organizacion de las Naciones Unidas sobre Distribucion de la Poblacion, Migracion y Desarrollo.

    De Oliveira O

    In: Reunion Nacional sobre Distribucion de la Poblacion, Migracion y Desarrollo, Guadalajara, Jalisco, 11 de mayo de 1984, [compiled by] Mexico. Consejo Nacional de Poblacion [CONAPO]. Mexico City, Mexico, CONAPO, 1984. 21-31.

    Highlights are presented of the expert meeting on population distribution, migration, and development held in Hammamet, Tunisia, in March 1983 to prepare for the 1984 World Population Conference. Rafael Salas, Secretary General of the World Population Conference, indicated in the inaugural address of the meeting that changes in the past 10 years including the increasing importance of short-term movements, illegal migrations, and refugees would require international agreements for their resolution. In the area of internal migrations, Salas suggested that in addition to migration to metropolitan areas which continues to predominate, short-term movements of various kinds need to be considered in policy. Improvement in the quality of life of the urban poor is an urgent need. Leon Tabah, Adjunct Secretary General of the World Population Conference, pointed out that population distribution and migration had received insufficient attention in the 1975 World Population Conference, and that the World Population Plan of Action should be modified accordingly. Among the most important findings of the meeting were: 1) The Plan of Action overstressed the negative effects of urbanization and rural migration. Available evidence suggests that migration and urbanization are effects rather than causes of a larger process of unequal regional and sectorial development 2) The historical context of each country should be considered in research and planning regarding population movements. 3) Analyses of the determinants and consequences of migration were reexamined in light of their relationship to the processes of employment, capital accumulation, land tenure, technological change, ethnic and educational aspects, and family dynamics. 4) The need to consider interrelationships between urban rural areas in formulation of policy affecting population distribution was emphasized. 5) National development strategies and macroeconomic and sectoral policies usually have stronger spatial effects than measures specifically designed to influence population distribution, and should be examined to ensure compatability of goals. 6) Population distribution policies should not be viewed as ends in themselves but as measures to achieve larger goals such as reducing socioeconomic inequalities. 7) Multiple levels of analysis should be utilized for understanding the causes and consequences of population movements. 8) Programs of assistance should be organized for migrants and their families. 9) The human and labor rights of migrants and nonmigrants should be considered in policy formulation. 10) Policies designed to improve living and working conditions of women are urgently needed.
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  4. 4

    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

    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

    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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  7. 7

    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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