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Cahiers du Médecin. 2002 Dec; 6(58):45-46.This article presents a report from the macroeconomic and health committee to determine the place of health in economic and social development created by the WHO in the year 2000. The main conclusions for all aspects were presented when the report was submitted to the WHO general assembly in 2002. The observations thus raised indicated that economic losses linked to poor health have been underestimated, especially in developing countries and that the role of health in economic growth has been strongly undervalued. Because of this several pathologies are still responsible for a high percentage of avoidable deaths, particularly maternal and perinatal pathologies and infectious diseases in children. It is also noted that the level of health expenses is insufficient and that the recommended financing strategy is based on growth in budgetary credits consecrated to health and to an increase in donor subsidies. The report emphasizes the different essential actions capable of reaching disadvantaged populations and on the correct steering by the public authorities of contributions from donors in the public and private sectors. Other remarks were collected about the various financing mechanisms on the global scale to combat certain endemic infections, specifically AIDS, tuberculosis, and malaria. Efforts to improve access by the populations to essential and indispensable drugs are also being made. The report underlines the need for the signing of a health pact between governments and development agencies in order to increase resources allocated to health. For the development of health in Morocco, the author emphasizes all aspects raised in this report and suggests the creation of a "Health and development" commission as advised by the WHO.
[Republic of Zaire: report of mission on needs assessment for population assistance] Republique du Zaire: rapport de mission sur l'evaluation des besoins d'aide en matiere de population.
New York, New York, Fonds des Nations Unies pour les activities en matiere de population, 1985. ix, 63,  p. (Rapport No. 72)The UN Fund for Population Activities sent a needs assessment mission to Zaire in 1983. The mission recommends that the 1st priority be given to analyzing and exploiting the results of the 1984 census, Zaire's 1st census. It is recommended that the Institut National de la Statistique participate in data collection and analysis for the census. The lack of trained demographers is noted, and teaching statistics and demography should be made a priority. 3 areas of research in population matters are priorities: 1) the detailed analysis of the results of the census, 2) modern contraceptive usage, and 3) malnutrition in mothers and children. The creation of a national commission on human resources and population is recommended. Zaire has a rather large medical-health infrastructure that is badly adapted to the actual needs of the population. The problem is not only the lack of resources but also the absence of clear health policies. Population education does not currently exist in Zaire, but formal population education could be placed at all levels of the educational system. As regards population information and communication, radio coverage is very important in a country that is largely rural. Women are still undervalued in Zaire society. They participate actively in the country's economy, but they remain on the margins of the modern sector. The new department on female conditions and social affairs has 2 priorities: 1) improving the quality of life of rural women with income-generating projects and 2) creating adult female education centers in urban areas.
[Mali: report of mission on needs assessment for population assistance] Mali: rapport de mission sur l'evaluation des besoins d'aide en matiere de population.
New York, New York, Fonds des Nations Unies pour la Population, 1988. x, 67 p. (Rapport No. 95)The UN Fund for Population Activities sent a 2nd needs assessment to Mali in September 1985. Mali is a vast Sahelian country, characterized by vast deserts. Only 16.8% of the population is urbanized. Mali is essentially agricultural. The 3rd 5-year development plan covered the years 1981-1985. Population factors do not occupy the place they deserve in development planning in Mali. Recommendations for population and development planning include forming an organization to promote population policy and territorial resource management. Recommendations on data collection include creating a national coordinating committee for demographic statistics, analyzing census data from 1976 and planning for the census of 1987, and reorganizing the vital statistics system. The mission recommends the creation of a national organization to coordinate research activities in the country. Recommendations on health and family planning services include examining bottlenecks in the national health system, redistributing health personnel, and improving planning and administration. The mission recommends extending the educational system in Mali. Materials on population must be included in educational materials. Facts on the condition of women and their participation in economic life are insufficient. The mission recommends the creation of a section for women in the Ministry of State to gather social, economic, and demographic information on women.
[Cape Verde: report of mission on needs assessment for population assistance] Cap-Vert: rapport de mission sur l'evaluation des besoins d'aide en matiere de population.
New York, New York, Fonds des Nations Unies pour la Population, 1988. ix, 66 p. (Rapport No. 93)The Un Fund for Population Activities sent a mission to Cape Verde in 1986 to evaluate their need for population assistance. Small and densely populated, Cape Verde is a poor country which counts on large amounts of international assistance for economic and social development. Demographic data has been collected in Cape Verde for a long time, but it is necessary to improve data collection so that the results can be better used by the government to plan demographic policy. The census of 1990 will be the 2nd one since independence. The big problems of Cape Verde constitute fertility and migration. Institutional support for the Direction Generale de la Statistique will help them take charge of a national system of data collection. In development planning, the mission recommended 2 projects; 1) the support of the organization Unity for analyzing existing data, and 2) a scheme of national territorial resource management. The mission recommends financing a research program to promote national development. The health situation in Cape Verde is better than that of many African countries. However, there are still many public health problems, such as infectious diseases, malnutrition, high fertility, a lack of health education programs, and insufficient health personnel and training for them. Therefore, the mission recommends decentralization of health services, health education, taking advantage of popular organizations, prenatal care, training for traditional midwives, preventive health measures for children, oral rehydration therapy for diarrhea, and family and sex education. Information, education, and communication activities are extremely limited. To extend the integration of women in the process of development, the mission recommends collecting statistics on women, especially in work and employment, and developing productive activities for women.
[Reproductive health: policies and practices. Case studies: Brazil, India, Morocco, and Uganda] Sante de la reproduction: politiques et pratiques. Etudes de cas: Bresil, Inde, Maroc et Ouganda.
Washington, D.C., Population Reference Bureau [PRB], 1999 Jan. 32 p.The Cairo Program of Action, developed during the UN International Conference on Population and Development (ICPD), encourages countries to act in a number of areas to promote the individual and social well-being of their populations. Moreover, the program asks that family planning services be made readily available as part of a comprehensive reproductive health care strategy. To evaluate how the Cairo program is applied in different settings, case studies were conducted in Brazil, India, Morocco, and Uganda. These studies documented changes made to reproductive health-related policies and services, as well as the political and social environment in which such programs and initiatives are implemented. In addition, the researchers examined how resources were collected and allocated in order to ensure the support of reproductive health programs. In the four countries studied, the ICPD reaffirmed efforts already taken to ensure the delivery of family planning services in the context of a more global health policy. The process of debate and cooperation which took place in Cairo sometimes served as a catalyst, as in the elimination in India of fixed targets for certain family planning methods, and in the abortion debate in Brazil. Greater political openness, growing nongovernmental organization activity, and an improved visibility and influence of the women s rights movement were observed in each of the four researched countries; all changes potentially linked to the implementation of the Cairo program.
[Social mobilization and information, education, communication (IEC) in the area of population] Mobilisation social et information--education--communication (I.E.C) en matire de population.
FAMILLE, SANTE, DEVELOPPEMENT / IMBONEZAMURYANGO. 1988 Apr; (11):23-8.Despite efforts by Rwanda's National Office of Population (ONAPO) to increase awareness of Rwanda's population problems, there has been little change in the reproductive behavior of the rural population. ONAPO plans to formulate an overall information, education, and communication (IEC) campaign in the area of maternal-child health and family planning to inform the population about Rwanda's sociodemographic problems and the solution offered by family planning. The campaign will have 3 main components: 1) provision of information to the general population through the informal educational system 2) training and school-based population information and 3) production of educational materials to support the training and communication programs. IEC programs for maternal-child health and family planning will be integrated into more widely accepted activities having some degree of permanence, such as the school system, health centers, and religious institutions. The communal centers for development and permanent training will play an especially strong role in the integrated IEC plans for rural areas. Center personnel will help the population understand the connection between family planning and the socioeconomic and health status of families and will motivate couples to use family planning. The overall IEC plan will receive support from the National Revolutionary Movement for Development, the Association of Rwandan Women for Development, the Ministry of the Interior and of Communal Development, and the Ministry of Public Health and Social Affairs. Various other ministries, religious organizations, international organizations, and nongovernmental organizations should also support the IEC effort.
[Acquired immunodeficiency syndrome (AIDS): WHO meeting and consultation on the safety of blood and blood products] Syndrome d'immunodeficit acquis (SIDA): reunion et consultation de l'OMS sur la securite du sang et des produits sanguins.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1986 May; 61(18):138-40.The World Health Organization (WHO) convened a meeting of experts on April 14-16, 1986, to review the available information on the safety of blood and blood products in relation to acquired immunodeficiency syndrome (AIDS). It was attended by over 100 participants from 34 countries and followed by a consultation which took into consideration previous recommendations, new information, and many different circumstances which exist regarding AIDS at the global level. This discussion reports the main conclusions and recommendations of the consultation. Tests to detect antibody to the AIDS virus now are available to assist in the elimination of potentially infectious units of blood and plasma, yet it is important to recognize that information and education remain crucial elements in any AIDS prevention program and that they continue to be relevant to the safety of blood and blood products. In that respect, measures to limit the transmission of LAV/HTLV-III by whatever means will be most effective in communities which are as well informed as possible about the disease, how it is transmitted, and how donors can assist in assuring a safe blood supply by being alert to donor suitability criteria. In some countries risk factors for AIDS have been identified in homosexual and bisexual men, intravenous drug abusers, and their sexual partners. Self-exclusion systems in which persons with risk factors refrain from giving blood, and blood screening programs for virus antibody have been effective in contributing to a safe blood supply. Experience also has shown that frequently when persons infected with the AIDS virus have donated blood, risk factors could later be identified, but many of those donors may not have recognized or acknowledged that they carried a risk. The value of specific screening and control measures which have been found useful in many developed countries should be assessed by other countries in the context of their overall health programs and the availability of human and material resources. Well-accepted general principles concerning the use of blood and blood products need to be emphasized since they can contribute to the control of AIDS. The most important principles are: strategies of health services such as improved antenatal care can reduce the demand for blood and should be encouraged; when appropriate and safer components and derivatives can be produced and are available, they are preferable to whole blood or plasma; and whole blood or plasma should be transfused only when medically justified. Decisions to institute laboratory screening of donors should be made with full awareness that there are several essential components of such a program. Information and education for donors about AIDS, its risk factors, and blood transmission is one of the basic considerations. Exclusion based on a current history of possible exposures to known risk factors as well as symptoms can help to reduce the number of infected donors.
[Indicators for health-for-all strategies: an overview] Indicateurs pour les strategies de la sante pour tous: apercu general.
WORLD HEALTH STATISTICS QUARTERLY/RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1986; 39(4):286-9.To facilitate attainment of the goal of health for all by the year 2000, the World Health Organization (WHO) has developed a set of global and regional indicators for monitoring progress. The main application of these indicators should be to monitor and evaluate the health situation and manage the health system at all levels. To be managerially and socially relevant, health indicators should be tailored to the main health problems in each country. Moreover, each country should decide which information is most essential, the most cost-effective means of acquiring it, and how to present it. The articles that follow this overview provide good examples of the variety of situations and needs encountered by individual health systems and by groups of countries at different stages of social and economic development. They further point to a need to develop additional indicators beyond the ones proposed by WHO.
[New cold chain monitor to be introduced on 1 January 1985] Introduction d'une nouvelle fiche de controle de la chaine du froid le 1er Janvier 1985.
[Unpublished] 1984.  p. (EPI/CCIS/84.6)As of January 1, 1985, a new and simpler vaccine cold chain monitor will be distributed with vaccines supplied by the UN International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO). This new monitor (available in Arabic, English, French, and Portuguese) has the same function as the previous monitor, but it has 3 new features. These are: temperatures above 10 degrees Centigrade are monitored by a strip indicator that has only 3 windows, marked A, B, and C, and temperatures above 34 degrees Centigrade are monitored by a disk indicator; a simplified interpretation guide has been added to the bottom of the card; and the back of the card has some instructions on the use of the indicator. As previously, the new cold chain monitor will be activated by the vaccine manufacturer and sent with the vaccine to the central store. The storekeeper should complete the top part of the card. The monitor then is sent with the vaccine down the cold chain. The top part of the card should be completed at each level of the cold chain -- when the vaccine arrives in the store and again when the vaccine is dispatched. In the cold chain, the vaccine cold chain monitor has 2 functions: to monitor any temperatures above 10 degrees Centigrade so that the cold chain can be improved; and to give the person responsible for caring for the vaccine some guidance on whether to use the vaccine or not.
[Expanded Programme on Immunization: Global Advisory Group] Programme Elargi de Vaccination: Groupe consultatif mondial.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1984 Mar 23; 59(12):85-9.In addition to the conclusions and recommendations reached at the 6th meeting of the Expanded Program on Immunization (EPI) Global Advisory Group and summarized in this report, the Group reviewed at length the status of the program in the Western Pacific Region and made a series of recommendations specifically directed to activities in the Region. Of particular significance for the operational progress of the global program are the recommendations concerning "Administration of EPI Vaccines," which were subsequently endorsed by the Precongress workshop on Immunization held before the XVIIth International Congress of Pediatrics in Manila in November 1983. These recommendations are not listed here. In his report to the World Health Assembly in 1982, the Director-General summarized the major problems which threaten the success of efforts to achieve the World Health Organization (WHO) goal of reducing morbidity and mortality by providing immunization for all children of the world by 1990. The 5-Point Action Program adopted at that time remains a relevant guide for countries and for WHO as they work to resolve those problems. The EPI is concerned about the prevention of the target diseases, not merely with the administration of vaccine. In addition to working toward increases in immunization coverage, the EPI must assure the strenghtening of surveillance systems so that the magnitude of the health problem represented by the target diseases is known at the community, district, regional, and national levels; immunization strategies are continuously adapted in order to reach groups at highest risk; and the target diseases are reduced to a minimum. The development of surveillance systems is one of the priorities in the development of effective primary health care services. Disease surveillance in its various forms should be used at all management levels for monitoring immunization programs performance and for measuring program impact. Specific recommendations regarding disease surveillance to be undertaken at global and regional levels and at the national level are listed. The results of more than 100 lameness surveys conducted in 25 developing countries confirm that paralytic poliomyelitis constitutes an important public health problem in any area in which the disease is endemic. In most programs, initial emphasis should be placed on the develpment of sentinel surveillance sites to monitor disease incidence trends. Some progress has been made in acting on the recommendations made at the meeting on the prevention of neonatal tetanus held in Lahore in 1982, but intensification of activities is required. In many developing countries, the surveillance and control of diphtheria must be improved. All aspects of progress and problems in the global program are reflected at least somewhere in the Western Pacific Region, and most of the findings and recommendations generally are valid beyond the regional boundaries.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1980 Feb 1; 55(5):33-4.At its final meeting in December 1979, the Global Commission for the Certification of Smallpox Eradication concluded that smallpox eradication has been achieved on a worldwide basis and there is no evidence that smallpox will return as an endemic disease. The 65th session of the WHO's Executive Board, held on January 25, 1980, endorsed these conclusions and made 19 recommendations covering the areas of vaccination policy, reserve stocks of vaccine, investigation of suspected smallpox cases, laboratories retaining variola virus stocks, human monkeypox, laboratory investigations, documentation of the smallpox eradication program, and WHO headquarters staff. Sufficient freeze-dried smallpox vaccine to vaccinate 200 million people will be maintained by WHO in refrigerated depots in 2 countries. WHO will ensure that appropriate publications are produced describing smallpox and its eradication, with special emphasis on the principles and methods that are applicable to other programs.
[Expanded Programme on Immunization: stability of freeze dried measles vaccine] Programme Elargi de Vaccination: stabilite du vaccin antirougeoleux lyophilise.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1981 Jun 12; 56(23):177-9.This report brings up to date those data summarized previously regarding the stability of freeze-dried measles vaccine and is based on information obtained from the London School of Hygiene and Tropical Medicine. The World Health Organization (WHO) intends to establish a requirement for the stability of freeze-dried measles vaccine, and a draft of such a requirement is represented along with an analysis of how such a requirement would influence WHO acceptance of the vaccine included in this report. A plaque assay method was used to determine the potency of measles vaccine which had been stored in a freeze-dried state at 37 degrees Centigrade for varying intervals. Vaccine containers were exposed at 37 degrees Centigrade in a water bath and duplicate samples transferred to -70 degrees Centigrade at intervals ranging from 1 to 28 days. The residual infectious virus was determined by the plaque assay method in parallel with vaccine that had not been incubated. The results from 16 patches produced by 9 manufacturers are summarized in a table, which includes recent data a well as the results from the previous report. 2 criteria of stability are included: the number of days required for the live virus titer to drop to an acceptable minimum level when stored at 37 degrees Centigrade (Criterion 1); and the loss of live virus titer when stored for 7 days at 37 degrees Centigrade (Criterion 2). Neither criterion is sufficient on its own. A quite unstable vaccine might still have the required potency after being stored for a week at 37 degrees Centigrade if the vaccine had a high virus titer initially. Yet, a product with satisfactory stability might still fail the potency requirement if its initial virus titer was borderline. A figure shows how the vaccines would be rated according to the proposed requirements. The proposed requirement for the stability of freeze-dried measles vaccine will be presented to the Expert Committee on Biological Standardization during its meeting in September 1981. If accepted, it would become effective by March 1982.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1981 Nov 13; 56(45):353-8.As a result of the May 1980 recommendation of the 33rd World Health Assembly that smallpox vaccination should be discontinued in every country, except for investigators at special risk, vaccination of the general public had been abandoned in 144 countries as of November 1981. Vaccination remains obligatory in 5 countries (Burma, Chad, Egypt, Kuwait, and Tunisia); present vaccination policy is unknown in an additional 7 countries. However, as recommended, WHO has continued surveillance of suspected cases and maintains an international smallpox rumor registry. Between January 1978-November 1981, 168 cases of suspected smallpox were reported to WHO from 59 countries, including 24 reported in 1981. All 167 cases investigated to date have not been smallpox; 60% have proved to be chicken pox, measles, or other skin diseases. WHO does not recommend initiation of preventive vaccination on the basis of a smallpox rumor until a presumptive diagnosis of smallpox has been established.
[Health costs and financing and the work of WHO] Cout et financement de la sante et activities de l'OMS.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(4):339-50.This discussion examines the international responses to issues and problems in the cost and financing of the health sector, focusing on the work of the World Health Organization (WHO). It describes the growth of attention to these concerns beginning in the 1970s, reviews methods and applications of financial analysis in greater detail, and summarizes progress to date and the agenda for work. Emphasis is on the developing countries, for they face the most urgent problems regarding costs and financing, and more attention is directed to their needs for support in this area. By the early 1970s it was clear that progress in health development particularly in the most underprivileged countries was unsatisfactory and that changes were needed if services were to have an appreciable impact on the health problems of developing populations. A major study conducted jointly by the UN Children's Fund (UNICEF) and WHO identified several of the critical problems associated with resources. The essential financial concerns requiring attention in connection with primary health service coverage, the need for more equitable distribution of existing resources for health and the priority of resources allocation to peripheral health services were examined in detail by a WHO Study Group on Financing Health Services which met in 1977. Among the problems of health finance, those of the overall lack of funds, the maldistribution of health resources, rising health care costs, and the lack of coordination were found to be particularly important. The Study Group concluded that, despite difficulties, it was possible to collect information of sufficient reliability for planners' needs and at a modest cost, even for the private sector. To help bring this about, it recommended that research centers and universities, in collaboration with national health authorities of their country, devote considerable attention to data collection methods. The reports, studies, and papers prepared at various meetings deal in general with specific aspects of health cost and financing. A major element, and evolving product, of the meetings and studies related to developing countries was a manual on financing health services, originally based on the recommendations of the 1st Study Group meeting. This draft document served as background material for a series of further meetings and was used to guide many of the country financing studies. A number of other health financing manuals were also developed between 1979-81. In its final published form the WHO manual attempts to be relevant to all developing countries. The manual describes health policies and their financial aspects and outlines techniques for data collection. If the recommendations of the 1st Study Group are compared with the achievements recorded thus far, the following facts come to light: many countries have undertaken surveys of health sector financing and resource allocation; increased interest in this subject has been shown by other international organizations; much progress has been made in the development and refinement of methodologies for collecting and using financial data; international activities and country studies have made it possible to provide reports for country leadership; and issues of financial planning and management often appear in medium and longterm plans.
The family planning movement within the African Region of the International Planned Parenthood Federation. Le mouvement pour la planification familiale dans la Region Afrique de la Federation Internationale pour la Planification Familiale.
Africa Link. 1984 Sep; 1, 3-11.The African Region of International Planned Parenthood Federation (IPPF) was established in 1971 to: encourage and sustain voluntary groups, provide information about family planning as a basic right, provide limited family planning services where acceptable and needed, and eventually influence change in public opinion so that governments could accept some responsibility for family planning programs. Today almost all of Anglophone Africa is covered by IPPF-funded activities, progress is being made in Francophone Africa, and Lusophone Africa is a target for the 1980s. National family planning associations and the IPPF have laid a firm foundation for family planning and raised its credibility to acceptable levels. However, both inadequate logistic infrastructures for the smooth flow of services and overcaution in adopting innovative methods such as community-based delivery systems to those not easily reached by coventional delivery systems have led service to lag behind demand. Leaders at all levels must join efforts to solve this dilemma. Family planning associations are the best suited channels for family planning work in the African Region, but they lack the capacity to cover all needs. As a result, these associations are shiftingg their efforts toward supplementing government work in this area. Although the government response has been far from uniform, governments have shown an ability to accommodate the operations of family planning organizations and have integrated family planning into national health services. Although 19 governments in the Region consider the fertility levels in their countries to be satisfactory and a few consider fertility too low, family planning is accepted as an instrument for the promotion of family welfare. The importance of national leadership in promoting and implementing family planning programs is increasingly recognized. Parliamentarians can formulate national policies favorable to family planning, promote awareness among their constituencies, and vote for more resources for the family planning effort.
[Benin: report of Mission on Needs Assessment for Population Assistance] Benin: rapport de Mission sur l'Evaluation des Besoins d'Aide en Matiere de Population.
New York, UNFPA, 1983 Apr. 42 p. (Report No. 58)This report of a needs assessment carried out by a UN Fund for Population Activities (UNFPA) Mission in Benin in November 1980 includes chapters on assistance needs and recommendations in the area of population; geographic, political, administrative, demographic, and socioeconomic characteristics of the country as well as socioeconomic and demographic planning and policy; demographic trends; formulation of population policy; collection and analysis of demographic data; demographic research, health; population information, education, and communication; women and development; and external assistance. Benin is characterized by low per capita income, high rates of infant, child, and maternal mortality, high fertility, and unequal population distribution combined with pressure on cultivated land. Rural exodus is fueling rapid urban growth. The population of 3.5 million in 1980 was growing at 2.97% annually. The economy is essentially agricultural. Because Benin is poor in minerals, development efforts are concentrated on agricultural and rural development, with efforts made to reduce unemployment and underemployment especially in urban areas. National objectives also are to improve the educational system and health infrastructure. The government is concerned about the high rate of mortality and morbidity and unequal spatial distribution. Although no overall population policy has been adopted, the government pursues some goals with demographic effects such as attempting to extend preventive medicine, maternal and child health services and birth spacing services to rural areas. The 1979 census is expected to furnish the government with the information necessary to formulate a population policy. The Mission recommended immediate assistance for analyzing and publishing census results, and also that a national demographic survey and migration study be undertaken. Reform of the civil registration system would enable better data to be collected. A demographic teaching and research center should be created at the University of Benin. An interministerial committee should be created to assist in formulation and implementation of a population policy. The extension of health services funded by the UNFPA should be implemented immediately and a communication component should be added.
[Togo: report of Mission on Needs Assessment for Population Assistance] Togo: rapport de Mission sur l'Evaluation des Besoins d'Aide en Matiere de Population.
New York, UNFPA, 1983 Feb. 66 p. (Report No. 57)This report of a needs assessment carried out by a UN Fund for Population Activities (UNFPA) Mission in Togo in late 1980 includes chapters on the country's geographic, administrative, and cultural background, socioeconomic and demographic characteristics, and national development policy and population goals; data collection; demographic research and population policy formulation; implementation of policy; external population assistance; and recommendations of the Mission. The population of Togo was estimated at 2.7 million in 1981 and is expected to nearly double by the year 2000. Infant, child, and maternal mortality rates are high, and population distribution is very uneven in different regions, with severe pressure on cultivable lands. The country has enjoyed considerable economic growth in the past 2 decades, with the gross national products (GNP) quadrupling in constant dollars from 1960-75. The rate of increase of the GNP was 7% from 1966-70, 5.6% from 1971-75, and about 3% from 1976-80. 3/4 of Togo's inhabitants derive their livelihood from agriculture, but in 1979 they produced only 28% of the GNP. Self-sufficiency in food is not total. Since 1966 Togo has elaborated 4 5-year plans whose orientations were to promote economic independence, the growth of production, reduction in regional disparities, and human development. The demographic variable has not been integrated into general economic and social development policy. The government has adopted a noninterventionist attitude toward population and considers the demographic situation to be fairly satisfactory. The only actions concern control of infant mortality. Some social and economic interventions, such as the priority given to provision of potable water, will inevitably have an impact on population. Togo has a solid infrastructure and qualified and experienced personnel for demographic data collection. The country is planning an ambitious program of demographic data collection and permanent surveillance. Maternal and child health care are provided in nearly 300 centers. About 1/2 of births occur under medical supervision. The national family welfare program provides family health services and information on birth spacing. A secondary school sex education program is under development. Population education is included in out-of-school educational programs. Population communication programs are not very advanced. Among the recommendations of the Mission were that financial aid be given to institutions responsible for demographic data collection and dissemination and to the demographic research unit of the University of Benin.