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Health Policy and Development. 2004 Aug; 2(2):96-99.The World Food Programme (WFP) is the United Nations (UN) agency responding to humanitarian emergencies by delivering food aid to vulnerable populations worldwide. The protracted insurgency in northern Uganda resulted in the displacement of up to 1,619,807 people, largely women and children. The humanitarian situation among displaced persons in northern and eastern Uganda led to diminished coping abilities and increased food aid needs. Access to food through productive means varies but, on average, households can only access about 0.5 - 0.75 acres of land. Recent nutrition and health assessments conducted in Pader District, in Feb 2004 and in Gulu District, in June 2004, highlight high mortality rates of more than 1 death/10,000 people/day. While Global Acute Malnutrition (GAM) rates appear to fall within the normal range expected within African populations (<5% GAM), high mortality rates consistently highlight the severity of the health situation in the camps. The WFP Uganda Country Office currently implements a Protracted Relief and Recovery Operation (PRRO) and a Country Programme (CP). The PRRO targets Internally Displaced Persons in Northern Uganda through General Food Distribution (GFD) activities, school children, HIV/AIDS infected and affected households and other vulnerable groups. In partnership with the Government of Uganda (GOU), sister UN agencies, international and national NGOs and Community Based Organisations, WFP currently assists the 1,619,807 Internally Displaced Persons, (IDPs), including 178,741 school children in the Gulu and Kitgum, 19,900 people infected with or affected by HIV/AIDS in Gulu and Kitgum and more than 750 food insecure persons involved in asset creation. Whilst WFP and other humanitarian actors continue to provide relief support to the displaced communities of northern Uganda, it is clear that without increased security the crisis will continue. (author's)
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)
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):43-48.The nutrition situation seemed mixed. Whilst the situation is under-control in some regions where nutrition surveys have been done (category III), the nutrition situation was not satisfactory in Shamali plain and in some of the IDP/refugee settlements (category II). Winter is challenging, especially for the returnees. (excerpt)
Liberia. Report on the nutrition situation of refugees and displaced populations. [Libéria : Rapport sur l'état de nutrition des réfugiés et des populations déplacées]
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):27-28.The situation of IDPs, returnees and newly-created refugees in Liberia is of concern (category II). The large new influx of vulnerable people, adding further to the already high number of IDPs and refugees, will be a difficult challenge for humanitarian agencies to respond to. (excerpt)
Report: Second Conference of Asian Forum of Parliamentarians on Population and Development, 23-25 September 1987, Beijing, China.
New York, New York, United Nations Population Fund [UNFPA], 1987. , 72 p.The formal proceedings of the 1987 Asian (AFPPD) Conference of Parliamentarians on Population and Development (FPPD) are provided in some detail. 23 countries participated. The Asian Forum Beijing Declaration preamble, program of action, call to action, and rededication are presented. Background information indicates that these conferences have been ongoing since 1984 to exchange information and experience, to promote cooperation, and to sustain involvement of Parliamentarians in population and development issues. Official delegations represented Australia, Bangladesh, China, Korea, India, Iraq, Japan, Malaysia, Maldives, Mongolia, Nepal, Pakistan, Philippines, north and south Korea, Sri Lanka, Syria, Thailand, and Vietnam. Observers were from Bhutan, Cyprus, Indonesia, Kiribati, and Tonga. The UN Fund for Population Activities (UNFPA) was involved as Conference Secretariat as well as the Preparatory Committee of China. Other UN and nongovernmental organizations and Parliamentary Councils of the World, Africa, and Europe were involved. Summaries were made of opening conference addresses of Mr. Takashi Sato, Mr. Zhou Gucheng, Chinese Premier Zhao Zivang, Japanese Prime Minister Takeo Fukuda, Dr. Nafis Sadik from the UNFPA, Mrs. Rahman Othman for Mr. Sat Paul Mittal of AFPPD, Australian Prime Minister R.J.L. Hawke, India Prime Minister Rajiv Ghandi, Sri Lankan Prime Minister R. Premedasa, Philippine President Corazon Aquino, Pakistan President Mohammad Zia-ul-Hag, and Bangladesh President Hussain Muhammad Ershad. Election of officers was discussed. The plenary sessions reported on the present situation and prospects for Asian population and development, basic health services and family planning (FP), urbanization, population and food, and aging. Reports were also provided of an exchange among Parliamentarians, the adoption of conference documents and the AFPPD constitution, election of officers, and the closing speakers. Appendices provide a complete list of participants, the constitution which was adopted, and the addresses of Mr. Zhou Gucheng from China's National People's Congress; Mr. Zhao Ziyang, Premier of the State Council of the People's Republic of China; Mr. Takeo Fukuda of the Global Committee of FPPD, Dr. Nafis Sadik, Executive Director, UNFPA; and Mr. Sat Paul Mittal, Secretary General, AFPPD.
Lancet. 2000 Sep 23; 356(9235):1092.Despite "some" progress made during the UN oil-for-food program for Iraq, nutritional problems remain "serious and widespread" in central and southern Iraq, according to a report released by the UN Food and Agriculture Organization and World Food Programme last week. The report calls Iraq's malnutrition levels "unacceptably high", saying: "micronutrient deficiencies are common and iron deficiency anemia is high". And the nutritional status of school children especially of those from rural areas and poor households is a cause for concern, the UN warns. But in the North, where the UN distributes food and medicine directly, the levels have been substantially reduced. Food rations provided under the UN oil-for-food program throughout Iraq, the report warns, "do not provide a nutritionally adequate and varied diet". Although they provide reasonably adequate amount of energy and total protein, the rations have an insufficient amount of vegetables, fruit, and animal products; many households cannot afford to supplement their diet with micronutrient-rich foods. The report points out that 2 consecutive years of drought and lack of investment have resulted to substantial deterioration in agriculture in southern and central Iraq. In addition, health services remain far from adequate and the supply of medicines is not sufficient to meet local needs. The disrupted water supply has resulted in increases in diarrhea-related infant and child mortality rates. The report adds: "The indication of high levels of malnutrition supports UN findings that infant and child mortality have more than doubled since the end of the 1980s". The report recommends timely delivery of humanitarian imports including medicines, rehabilitation of the country's agriculture and health sectors, restoration of safe drinking water, and support for nutritional services. (full text)
Lancet. 1992 Sep 12; 340(8820):676.The health system in Somalia has all but disintegrated. The burden of civil war kills thousands every month, and famine is affecting millions. The conflict is characterized by total breakdown of law and order, disregard for the neutrality of the humanitarian relief effort, and fighting, which paralyzes agricultural and economic activity. The International Committee of the Red Cross (ICRC), Medicines San Frontiers (MSF), and the International Medical Corps (IMC) have committed not only funds but also expatriates to assist with the health problems. The ICRC devotes 25% of its global budget to the Somalia program. The 20,000 tons of food this organization brings in monthly barely cover 1/3 of the needs, which are estimated at about 60,000 tons/month for the 4.5 million Somalians thought still to be living in south and southwest Somalia. In the camps for displaced people, surveys using the Quack stick method frequently show that 90-95% of the under-5 population is malnourished. We have not seen such widespread malnutrition since the Biafra famine. The provision of food remains the 1st priority and efforts are being made to simultaneously provide health care. The hospitals in Mogadishu admit daily tens of people with gunshot wounds, and the few functioning hospitals devote most of their time and manpower to treating these wounded. Thanks to the commitment of the Somali health staff still remaining in the country and the courageous effort of the few expatriates of MSF, IMC, ICRC, and other agencies, many of these victims can now be helped in the 4 functioning hospitals. The ICRC also maintains a medical presence in 8 locations in Somalia: Merca, Kisimayo, Baidoba, Belet Huen, Belet Hawo, Garoe, and Berbera, as well as in 3 places in Kenya (Liboi, El Wak, and Mandera) for cross-border assistance. Because the conflict is highly volatile, a mobile ICRC surgical team is available to assist Somali doctors when a flareup of hostilities brings in substantial numbers of war wounded. The team has been able to assist the wounded in Doble, Garoe, Bossasso, and Biadoba. The team works side-by-side with Somali doctors, and up to a 100 operations in a week have been done. As well as provision of technical and material assistance, the psychological impact has been important: the local health care staff feel forgotten by the outside world. The presence of an expatriate team when they need help most is a powerful morale booster. 40 health care centers are maintained at these different locations, often the only curative care centers available. Public health programs include the provision of safe drinking water, vitamin A supplementation, and deworming, and UNICEF and Save the Children Fund provide vaccination for the displaced people. These efforts, often at high risk to the relief workers, show that international humanitarian relief can be active, even in a precarious security situation such as exists in Somalia. All these efforts will be in vain if there is no massive food aid soon. The UN need to rise to the challenge, not only in words, but also in deeds. The ICRC and other nongovernmental organizations have shown that aid is possible, provided there is tenacity and imagination. Failure to act now will result in a horror worse than the Ethiopian famine and more devastating than the tragedy of Biafra, and there will be more images to haunt the conscience of the international community. (full text)
NATURE. 1992 Jan 23; 355(6358):291.Fernando Orrega (Nature 353, 596; 1991) has been carried away by his lack of enthusiasm for the UN Population Fund. We certainly make mistakes--including using wrong per-capita food production figures in our 1991 State of World Population report. But he assumes that our mistake indicates cynicism or criminal carelessness--and that we do not accept. We (and the Food and Agriculture Organization, from which the data came) got the figures right in the 1990 State of World Population. They are not comforting. They support the idea that there is an impending food crisis in developing countries, and that rapid population growth has a lot to do with it. The World Bank--which Orrega quotes--also takes this view. There is a similar crisis in education. Mixing up enrollment figures with children at school does not help. There are 105 million children not at school and this figure will double by the end of the century, according to UNESCO. They may or may not have been enrolled in school at 1 time, as Orrega claims, but they are not at school now. The cost of providing education and health care for children is significant, even in developing countries. That is 1 reason why people in developing countries are having fewer children. India claims to have averted 108 million births. Does anyone--even Orrega--seriously contend that India would be better off if they had been born? That is, if India's population was now 1000 million instead of nearly 900 million? (full text)
Mortality and health issues in Asia and the Pacific: report of a seminar held at Beijing in collaboration with the Institute of Population Research, People's University of China from 22 to 27 October 1986.
New York, New York, United Nations, 1987. vi, 169 p. (Asian Population Studies Series No. 78.; ST/ESCAP/485.)The Seminar on Mortality and Health Issues was held at Beijing from 22 to 27 October 1986 as a cooperative venture between the UN Economic and Social Commission for Asia and the Pacific (ESCAP) and the Institute of Population Research, People's University of China, as part of the project, "Analysis of Trends and Patterns of Mortality in the ESCAP Region." Part 1 of the report includes a summary of the Beijing recommendations on health and mortality and the report of the seminar. Part 2 contains papers on a comparative analysis on trends and patterns of mortality in the ESCAP region, an overview of the epidemiological situation in the region, health for all by the year 2000, and inequalities in health.
Journal of the National Medical Association. 1985 Dec; 77(12):963-5.The goal of "Health for All by the Year 2000," adopted by the World Health Organization, will be pure rhetoric if all sectors involved are not sensitized to the problem of famine in many countries in Africa and other 3rd world nations. The medical profession should be made aware of this goal, both on national and international fronts. The case of Ethiopia is discussed as a valid example of a "diseased third world," focusing on the famine, other medical problems, and the health system. The last emperor of Ethiopia, Haile Selassie, was swept away by the 1974 revolution. The major cause of his downfall was the 1973 famine, which the emperor wanted to conceal from the outside world. A military government took over, espousing Marxist ideology and aligning itself with the Soviet Union. Famine has been endemic for decades; the last famine in 1973 claimed over 300,000 lives. The country never totally recovered from the effects of that drought, and as early as 1981-82, major relife organizations were warned of another looming crisis. Some of the causes of the current crisis include the absence of rain for 3 consecutive years that paralyzed agriculture, poor and primitive farming practices, and deforestation. It is estimated that the land area covered by forest has dropped from 16 to 3.1% over the last 20 years. This has adversely affected the moisture-retentive capacity of the soil. Other man-made contributory factors are the civil war, the resulting dislocation of the population, and administrative mismanagement. 10 million people now face starvation; 300,000 have already died, and 1000 per day continue to die. The attention of the international community is justifiably focused on the immediate task of providing food. Yet, the full medical aspect of the famine and its consequences have not been adequately handled. Assuming that international aid will effectively prevent further loss of life, the survivors will face a host of health problems, epidemics in particular. Most of the feeding camps and various refugee centers are overcrowded; elementary sanitary facilities are lacking. There is a critical shortage of vaccines and other medical supplies. The vast majority of the Ethiopian population suffers from various preventable communicable diseases. The leading 10 causes of morbidity diagnosed in 1976 were venereal diseases, helminthiasis, bacillary and amebic dysentery, gastroenteritis, leprosy, malaria, tuberculosis, schistosomiasis, trachoma, and influenza. WHO reports that health expenditures represent only 5.7% of the total budget and that only 20% of the population are vaccinated against smallpox, yellow fever, DPT (diptheria, pertussis, tetanus), measles, tuberculosis, and polio.
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.
General overview. A. Population, resources, environment and development: highlights of the issues in the context of the World Population Plan of Action.
In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 63-95. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)The acceptance by the international community of the importance of the interrelations between population, resources, environment, and development has been in large measure an outgrowth of the search for development alternatives that would reduce the disparities between developed and developing countries and ameliorate poverty within countries. Possibly the most important task of the Expert Group on Population, Resources, Environment, and Development is to identify more clearly the role of population within these interrelationships, i.e., to identify through which mechanisms population characteristics condition and are conditioned by resource use, environmental effects, and the developmental structure. To a considerable extent the incidence of poverty forms the root cause of many of the problems derived from the interrelationships between population, resources, environment, and development in developing countries. Affluence appears to be the major cause of many of the environmental and resource problems in the developed countries. The first 2 sections are devoted to issues considered crucial in the alleviation of poverty. Lack of food, adequate nutrition, health care, education, gainful employment, old age security, and adequate per capita incomes perpetuate poverty of large numbers of people in developing countries and therefore also their production and consumption patterns, which undermine, through environmental and resource degradation, the very resources on which they depend for their livelihood. The discussion of environment as a provider of resources first considers supplies of minerals, energy, and water. Attention is then directed to the stock of agricultural land that can be expanded through fertilization and irrigation and which may be reduced as a result of desertification, deforestation, urbanization, salinization, and waterlogging. Another section focuses on the need for integrating population variables into development planning. In the formulation of longterm development objectives, population can no longer be regarded as an exogenous force, but rather becomes an endogenous variable which affects and is affected by development policies, programs, and plans.
[Unpublished] 1984. Presented at the Second African Population Conference, Arusha, Tanzania, January 9-13, 1984. 21 p.This discussion of Ethiopia focuses on: sources of demographic data; population size and age-sex distribution; urbanization; fertility; marital status of the population; mortality and health; rate of natural increase; economic activity and labor force activity rates; food production; education; population policies and programs; and population in development planning. As of 1983, Ethiopia's population was estimated at 33.7 million. Agriculture is the mainstay of the economy. Ethiopia has not yet conducted a population census, however, the 1st population and housing census is planned for 1984. The population is young with children under 15 years of age constituting 45.4% of the total population; 3.5% of the population are aged 65 years and older. The degree of urbanization is very low while the urban growth rate is very high. Most of the country is rural with only 15% of the population living in localities of 2000 or more inhabitants. In 1980-81 the crude birthrate was 46.9/1000. The total fertility rate was 6.9. Of those aged 15 years and older, 69.2% of males and 71.3% of females are married. According to the 1980-81 Demographic Survey the estimates of the levels of mortality were a crude death rate of 18.4/1000 and an infant mortality rate of 144/1000. At this time 45% of the population have access to health services. It is anticipated that 80% of the population will be covered by health care services in 10 years time. Ethiopia is increasing at a very rapid rate of natural increase; the 1980 estimation was 2.9% per annum. Despite the rich endowments in agricultural potential, Ethiopia is not self-sufficient in food production and reamins a net importer of grain. Enrollment at various levels of education is expanding rapidly. There is no official population policy. Financial assistance received from the UN Fund for Population Activities and the UN International Children's Emergency Fund for population programs is shown.
Atlas World Press Review. 1978 Dec; 25(12):15-8.This article is excerpted from the UNFPA's Annual Report. It discusses the history of population control, fertility transitions occuring all over the world, the effectiveness of family planning programs, increased literacy programs, improvement of the status of women, international migration, food supply and the Green Revolution, and health services delivery promoting lower infant mortality rates. Also stressed is the urgent need for the recognition of national programs to control the population growth that is expected for the next 2 decades. Several concerns, such as the aging of children and adults in both developed and developing countries, will require special social needs such as education and employment. The changing family structure needs further investigation and will affect the formulation of future policies. It is emphasized that it is more useful to assist governments in realizing their aspirations than to try to change them.
Washington, D.C., U.S. Office of International Health, Division of Planning and Evaluation, 1976. 144 p. (Syncrisis: the dynamics of health, XIX)This report uses available statistics to examine health conditions in Senegal and their interaction with socioeconomic development. Background data are presented, after which population, health status, nutrition, environmental health, health infrastructure, facilities, services and manpower, national health policy and planning, international organizations, and the Sahel are discussed. Diseases such as malaria, measles, tuberculosis, trachoma and venereal diseases are endemic in Senegal, and high levels of infant and childhood mortality exist throughout the country but especially in rural areas. Diarrhea, respiratory infections, and neonatal tetanus contribute to this mortality and are evidence of the poor health environment, and lack of basic services including nutrition assistance, health education, and potable water. Nutrition in Senegal appears to be good in general, but seasonal and local variations sometimes produce malnutrition. Lowered fertility rates would reduce infant and maternal mortality and morbidity and might slow the present decline in per capita food intake. At present the government of Senegal has no population policy and almost no provisions for family planning services. Health services are inadequate and inefficient, with shortages of all levels of health manpower, poor planning, and overemphasis on curative services.