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[Unpublished] 1985 Nov 19. Presented to the Executive Board, Seventy-seventh Session, Provisional Agenda Item 18. 20 p. (EB77/27)The Expanded Program on Immunization (EPI) has made major public health gains in the past decade. The central EPI strategy has been to deliver immunization in consonance with other health services, particularly those directed toward mothers and children. However, in the least developed countries and many other developing countries, it does not appear likely that national budgets will be sufficient by 1990 to support full immunization coverage on a sustained basis or that an adequate number of national managers can be assembled to staff effective programs. At the November 1985 meeting of the EPI Global Advisory Group, recommendations were made to accelerate global progress. These recommendations reflect optimism that the 1990 goal of reducing morbidity and mortality by immunizing all children of the world can be achieved, but also acknowledge that many fundamental problems of national program management remain to be resolved. 3 general actions needed are: 1) promote the achievement of the 1990 immunization goal at national and international levels through collaboration among ministries, organizations, and individuals in both the public and private sectors; 2) adopt a mix of complementary strategies for program acceleration; and 3) ensure that rapid increases in coverage can be sustained through mechanisms which strengthen the delivery of other primary health care interventions. The 4 specific actions needed are: 1) provide immunization at every contact point, 2) reduce drop-out rates between first and last immunizations, 3) improve immunization services to the disadvantaged in urban areas, and 4) increase priority for the control of measles, poliomyelitis, and neonatal tetanus. Continued efforts are also required to strengthen disease surveillance and outbreak control, reinforce training and supervision, ensure quality of vaccine production and administration, and pursue research and development.
Accelerated immunization programmes and CSDR: their meaning and broader implications for development [editorial]
ASSIGNMENT CHILDREN. 1985; 69-72:vii-xxvi.This editorial introduces a special issue of "Assignment Children" devoted to the theme of universal child immunization by 1990. Not only will this campaign significantly reduce morbidity and mortality from 6 childhood diseases, but it will also, through the experience of massive public participation, create conditions favorable for achieving development goals in areas other than health care. Immunization is a means for enabling those who have grasped the concept of protection of one's children to carry this effort into other areas for other goals. If families are to be empowered in this way, the knowledge and know-how held by the experts at the top must be melded with traditional knowledge and the wish of parents to protect their children from disease and death. The usual concept of development conveys ethnocentric and central power biases as well as a fragemented and sectoral approach. In contrast, accelerated immunization programs represent an example of action within a new development paradigm. This approach addresses not just symptoms, but fundamental causes of underdevelopment in the areas of health and survival. Although the underlying causes of poverty are only marginally affected by such campaigns, the validation of important goals of the majority of the population can release social energy and increase individuals' control over other aspects of their life.
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.
Geneva, Switzerland, WHO, 1980. 412 p.This report on the world health situation comes in 2 volumes, and this, the 2nd volume, reviews the health situation by country and area, with the additions and amendments submitted by the governments, and an addendum for later submissions. Information is presented for countries in the African Region, the Region of the Americas; the Southeast Asia Region, the European Region, the Eastern Mediterranean Region, and the Western Pacific Region. The information provided includes the following areas: the primary health problems, health policy; health legislation; health planning and programming; the organization of health services; biomedical and health services research; education and training of health manpower; health establishments; estimates of the main categories of health manpower; the production and sale of pharmaceuticals; health expenditures; appraisal of health services; demographic and health data; major public health problems; training establishments; actions taken; preventive medicine; and public health.