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  1. 1
    357666
    Peer Reviewed

    The Baby-Friendly Hospital Initiative 20 years on: facts, progress, and the way forward.

    Saadeh RJ

    Journal of Human Lactation. 2012 Aug; 28(3):272-5.

    The BFHI provides a framework for addressing the major factors that have contributed to the erosion of breastfeeding, that is, maternity care practices that interfere with breastfeeding. Until practices improve, attempts to promote breastfeeding outside the health service will be impeded. Although inappropriate maternity care cannot be held solely responsible for low exclusive breastfeeding rates and short breastfeeding duration, appropriate care may be a prerequisite for raising them. In many industrialized countries, BFHI activities were slow to start. Over the past 10 years and as the evidence was becoming increasingly solid and the commitment of health workers and decision makers has become stronger, considerable efforts are being made in most industrialized countries to implement the BFHI. However, coordinators of the BFHI in industrialized countries face obstacles to successful implementation that appear unique to these countries. Problems reported include opposition from the health care establishment, lack of support from national authorities, and lack of awareness or acceptance of the need for the initiative among government departments, the health care system, and parents. It is worth highlighting these facts to enable the BFHI coordinators in these countries to make well-designed and targeted plans with achievable objectives. Strengthening and scaling up the BFHI is an undisputed way to reduce infant mortality and improve quality of care for mothers and children. The BFHI has had great impact on breastfeeding practices. Reflecting new infant feeding research findings and recommendations, the tools and courses used to change hospital practices in line with Baby-Friendly criteria are available and ready to be used and implemented. Governments should ensure that all personnel who are involved in health, nutrition, child survival, or maternal health are fully informed and energized to take advantage of an environment that is conducive to revitalizing the BFHI; incorporate the basic competencies for protection, promotion, and support of optimal infant and young child feeding, including the BFHI, into all health-worker curricula, whether facility- or community-based health workers; and recognize that the BFHI has a major role to play in child survival and more so in the context of HIV/AIDS. The World Health Organization and UNICEF strongly recommend using this new set of materials to ensure solid and full implementation of the BFHI global criteria and sustain progress already made. It is one way of improving child health and survival, and it is moving ahead to put the Global Strategy for Infant and Young Child Feeding in place, thus moving steadily to achieving the Millennium Development Goals.
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  2. 2
    172123

    World health report 1995 -- executive summary.

    World Health Organization [WHO]

    [Geneva, Switzerland], WHO, 1995. [17] p.

    The purpose of the report is to highlight such inequities and to tackle the wider question: what are the global health priorities? It also tries to answer other crucially important questions. Which are the major diseases, the major causes of death, handicap, disability and diminution of the quality of life? Which conditions cause most misery, although they may not be fatal? Which countries, or communities within countries, have the greatest health needs? Where should health resources be targeted? The report, for the first time, has attempted to examine the burden of ill-health not just by disease, by also by age, as the impact of illness differs across the age spectrum. Where possible, the analysis of health status has been carried out for infants and children, adolescents, adults and the elderly. On the basis of the data available and considered to be reasonably reliable, ten leading causes of death, illness and disability have been identified. There is also an explanation of what WHO is doing to bridge the gaps in health, an attempt to assess health trends in the coming years, and an effort to chart a health future for mankind-a future in which a baby lives, not dies, in it mother's arms. (excerpt)
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  3. 3
    166779

    U.N. says millions of children, caught in poverty, die needlessly.

    Olson E

    New York Times. College Resources for Students and Faculty. 2002 Mar 14; [3] p..

    According to UN officials, almost 11 million children, most of them babies, die annually of preventable causes. The WHO and the UN Children's Fund (UNICEF) said diarrhea, malaria, measles, pneumonia, HIV/AIDS and malnutrition were main causes of death and resulted from the impoverished conditions of 600 million children around the world. UNICEF and the health organization said that progress had been made in the 1990s, citing immunization programs, and that the overall total of preventable deaths had been reduced from 14 million. Contributing to this progress has been the increase in the percentage of mothers who breastfeed infants. However, UNICEF Director Carol Bellamy noted that, except for Nordic nations, contributions by rich countries for development aid have gone down, leaving the poorest countries struggling to meet their populations' basic needs.
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  4. 4
    049146

    WHO Consultation on HIV and Routine Childhood Immunization, Geneva, 12-13 August 1987.

    World Health Organization [WHO]. Special Programme on AIDS

    [Unpublished] 1987. 9 p. (WHO/SPA/GLO/87.3)

    A consultation in August 1987, co-sponsored by the World Health Organization (WHO) Special Program on Acquired Immunodeficiency Syndrome (AIDS) and the Expanded Program on Immunization (EPI), was called to review available information on human immunodeficiency virus (HIV) infection and immunization guidelines. Of particular concern was the safety and efficacy of the 6 EPI vaccines in children with HIV infection. Concerns have been raised that children infected with HIV who receive routine childhood immunizations may have decreased immune responses and be at greater risk of adverse effects or acceleration of HIV-induced immunosuppression. Available data, although limited, suggest that there is no risk of accelerating HIV infection by the simultaneous administration of multiple antigens, except perhaps in the case of Bacille Calmette-Guerin (BCG) immunization. In areas where exposure to measles and poliomyelitis is high, the benefits of immunization far outweigh the risks of adverse effects from immunization, even in the presence of symptomatic HIV infection. Overall, consultation participants affirmed the validity of the following EPI guidelines developed in 1986: 1) in countries where HIV infection is problematic, children should be immunized with EPI antigens according to the standard schedule, including children with asymptomatic HIV infection; and 2) unimmunized individuals with clinical AIDS in countries where the EPI target diseases remain serious risks should not receive BCG, but should be given the remaining 5 vaccines. Since vaccine-related adverse effects are minimized and vaccine responses optimized by beginning immunization before the progression of HIV-induced immunosuppression, children should be immunized as early in life as possible.
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  5. 5
    046823

    The state of the world's children 1988.

    Grant JP

    Oxford, England, Oxford University Press, 1988. [9], 86 p.

    The 1988 UNICEF report on the world's children contains chapters describing the multi-sectorial alliance to support child health, the current emphasis on ORT and immunization, the effect of recession on vulnerable children, family rights to knowledge of basic health facts, and support for women in the developing world. Each chapter is illustrated by graphs. There are side panels on programs in specific countries, including Senegal, Syria, Colombia, Bangladesh, Turkey, India, Honduras, Japan and Southern Africa, and highlighted programs including immunization, AIDS, ORT, breast-feeding and tobacco as a test of health. The SAARC is a new regional organization of southern Asian countries committed to immunization and other health goals. Tables of health statistics of the world's nations, divided into 4 groups by "Under 5 Mortality Rate" present basic indicators, nutrition/malnutrition data, health information, education, literacy and media data, demographic indicators, economic indicators and data pertaining to women. The absolute numbers of child deaths had fallen to 16 million in 1980, from 25 million in 1950. Saving children's lives will not exacerbate the population problem because, realizing that their children will survive, families will have fewer children. Furthermore, the methods used to reduce mortality, such as breast feeding and empowerment of families to control their lives, are known to reduce fertility.
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  6. 6
    036373

    Accelerated immunization programmes and CSDR: their meaning and broader implications for development [editorial]

    Mandl PE

    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.
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