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Updated guidelines for UNFPA policies and support to special programmes in the field of women, population and development.
[Unpublished] 1988 Apr. , 8 p.The United Nations Fund for Population Activities (UNFPA) has been mandated to integrate women's concerns into all population and development activities. Women's status affects and is affected by demographic variables such as fertility, maternal mortality, and infant mortality. Women require special attention to their needs as both mothers and productive workers. In addition to integrating women's concerns into all aspects of its work, the Fund supports special projects targeted specifically at women. These projects have offered a good starting point for developing more comprehensive projects that can include education, employment, income generation, child care, nutrition, health, and family planning. UNFPA will continue to support activities aimed at promoting education and training, health and child care, and economic activities for women as well as for strengthening awareness of women's issues and their relationship to national goals. Essential to the goal of incorporating women's interests into all facets of UNFPA programs and projects are training for all levels of staff, participation of all UNFPA organizational units, increased cooperation and joint activities with other UN agencies, and more dialogue with governmental and nongovernmental organizations concerned with the advancement of women. Specific types of projects to be supported by UNFPA in the period ahead are in the following categories: education and training, maternal health and child care, economic activities, awareness creation and information exchange, institution building, data collection and analysis, and research.
Final reports, 98th and 99th meetings of the Executive Committee of the Pan American Health Organization, Washington, D.C., 27 September 1986 and 22-26 June 1987. XXXII meeting of the Directing Council of PAHO, XXXIX meeting, WHO Regional Committee for the Americas, Washington, D.C., 21-25 September 1987.
Washington, D.C., 1987. 136 p. (Official Document No. 219)The 98th and 99th Meetings of the Executive Committee of the Pan American Health Organization, the XXXII Meeting of the Directing Council of the Pan American Health Organization, and the XXXIX Meeting of the World Health Organization (WHO) Committee for the Americas were all held in Washington, D.C., between 9/86 and 9/87. This document contains the final reports of these conferences, including lists of all participants, and complete texts of all resolutions. The 99th Meeting resulted in Resolution VI, urging member countries to implement plans to control Aedes albopictus implicated in dengue, yellow fever, and california encephalitis. Resolution VII on Women, Health and Development, urging member nations to improve public and private comprehensive health care for women, and calling for increased participation of women in professional posts and representative roles within the organization; Resolution VIII, on Emergency Preparedness and Disaster Relief Coordination; and Resolution XII on AIDS Prevention and Control, which called for a WHO Special Program on AIDS and urged member countries to increase efforts at prevention and control, to provide information to WHO, and to permit free international travel for infected people. The XXXII Meeting contained Resolution IX on Women, Health and Development; Resolution X on Emergency Preparedness and Disaster Relief Coordination; Resolution XI on the Coordination of Social Security and Public Health Institutions; and Resolution XII on Acquired Immunodeficiency Syndrome (AIDS) in the Americas.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1980; (651):1-19.This document reports the discussions of a Scientific Group on Vaccination Against Tuberculosis, cosponsored by the Indian Council of Medical Research and the World Health Organization (WHO), that met in 1980. The objectives of the meeting were to review research on Bacillus Calmete-Guerin (BCG) vaccination, assess the present state of knowledge, and determine how to advance this knowledge. Particular emphasis is placed in this document on the trial of BCG vaccines in South India. In this trial, the tuberculin sensitivity induced by BCG vaccination was highly satisfactory at 2 1/2 months but had waned sharply by 2 1/2 years and the 7 1/2-year follow up revealed a high incidence of tuberculous infection in the study population. It is suggested that the protective effect of BCG may depend on epidemiologic, environmental, and immunologic factors affecting both the host and the infective agent. Studies to test certain hypotheses (e.g., the immune response of the study population was unusual, the vaccines were inadequate, the south Indian variant of M tuberculosis acted as an attenuating immunizing agent, and mycobacteria other than M tuberculosis may have partially immunized the study population) are recommended. A detailed analysis should be made when results from the 10-year follow up of the south Indian study population are available.
The global eradication of smallpox. Final report of the Global Commission for the Certification of Smallpox Eradication, Geneva, December 1979.
Geneva, Switzerland, WHO, 1980. 122 p. (History of International Public Health No. 4)The Global Commission for the Certification of Smallpox Eradication met in December 1978 to review the program in detail and to advise on subsequent activities and met again in December 1979 to assess progress and to make the final recommendations that are presented in this report. Additionally, the report contains a summary account of the history of smallpox, the clinical, epidemiological, and virological features of the disease, the efforts to control and eradicate smallpox prior to 1966, and an account of the intensified program during the 1967-79 period. The report describes the procedures used for the certification of eradication along with the findings of 21 different international commissions that visited and reviewed programs in 61 countries. These findings provide the basis for the Commission's conclusion that the global eradication of smallpox has been achieved. The Commission also concluded that there is no evidence that smallpox will return as an endemic disease. The overall development and coordination of the intensified program were carried out by a smallpox unit established at the World Health Organization (WHO) headquarters in Geneva, which worked closely with WHO staff at regional offices and, through them, with national staff and WHO advisers at the country level. Earlier programs had been based on a mass vaccination strategy. The intensified campaign called for programs designed to vaccinate at least 80% of the population within a 2-3 year period. During this time, reporting systems and surveillance activities were to be developed that would permit detection and elimination of the remaining foci of the disease. Support was sought and obtained from many different governments and agencies. The progression of the eradication program can be divided into 3 phases: the period between 1967-72 when eradication was achieved in most African countries, Indonesia, and South America; the 1973-75 period when major efforts focused on the countries of the Indian subcontinent; and the 1975-77 period when the goal of eradication was realized in the Horn of Africa. Global Commission recommendations for WHO policy in the post-eradication era include: the discontinuation of smallpox vaccination; continuing surveillance of monkey pox in West and Central Africa; supervision of the stocks and use of variola virus in laboratories; a policy of insurance against the return of the disease that includes thorough investigation of reports of suspected smallpox; the maintenance of an international reserve of freeze-dried vaccine under WHO control; and measures designed to ensure that laboratory and epidemiological expertise in human poxvirus infections should not be dissipated.
Report of the Expanded Programme on Immunization Global Advisory Group Meeting, 21-25 October 1984, Alexandria.
[Unpublished] 1985. 51 p. (EPI/GEN/85/1)This report of the Expanded Program on Immunization Global Advisory Group Meeting, held during October 1984, contains the following: conclusions and recommendations; a summary of the global and regional programs; a review of the Expanded Program on Immunization (EPI) in the Eastern Mediterranean Region; a review of country programs in Denmark, Brazil, and India; a report on the epidemiology and control of pertussis; and discussion of sentinel surveillance, surveillance of neonatal tetanus, polio, and measles, and research and development; and proposals for the 1985 meeting of the Global Advisory Group. The Global Advisory Group concluded that national immunization programs have made much progress, realizing some 30% coverage in developing countries with a 3rd dose of DPT. Yet, the lack of immunization services continues to extract a toll of 4 million preventable child deaths annually in the developing world. The Global Advisory Group indicated that the acceleration of existing programs is essential if immunization services are to be provided for all children of the world by 1990. Such acceleration calls for continued vigorous action to mobilize political support and financial resources at national and international levels. Considerable experience has been gained in most countries regarding implementation of immunization programs. The knowledge now exists to bring about major improvements in program achievement, yet gaps in knowledge exist in both technical and administrative areas. Action is needed in the following areas if programs are to accelerate sufficiently to meet the target: management of existing resources; use of intensified strategies; program evaluation; coordination with other components of primary health care; collaboration among international agencies; and regional and country meetings. To take maximum advantage of the benefits offered by vaccine, each country should take the necessary steps to include all relevant antigens in its national program. In particular, the universal use of measles vaccine should be encouraged. It also is of concern that some countries are not yet using polio vaccine and that others omit pertussis vaccine from their programs. Countries are urged to review their current practices about the anatomical site of intramuscular immunization. Taking into account the criteria of safety and ease of administration, thigh injection for DPT and arm injection for TT are recommended strongly. The Global Advisory Group reaffirmed its 1983 recommendation to use every opportunity to immunize eligible children.
Provisional summary record of the fourteenth meeting, WHO headquarters, Geneva, Thursday, 16 January 1986, at 9h30.
[Unpublished] 1986 Jan 16. 20 p. (EB77/SR/14)This document provides a progress and evaluation report of the Expanded Program on Immunization (EPI), a summary record of the 14th Meeting, held in Geneva, Switzerland during January 1986. Dr. Uthai Sudsukh began by saying that the Program Committee had undertaken a review and evaluation of immunization against the major infectious diseases in relation to the goal of health for all and primary health care. This was the second in a series of evaluations and reviews of World Health Organization (WHO) programs corresponding to the essential elements of primary health care. The Program Committee had requested the Secretariat to revise the progress and evaluation report in light of its observations as well as those of the EPI Global Advisory Group. The revised report was before members in document EB77/27, which contained a draft resolution proposed for submission to the 39th World Health Assembly in May 1986. Dr. Hyzler indicated that the revised report provided an excellent picture of the present situation, and he supported the recommendations of the EPI Global Advisory Committee and the draft resolution proposed for submission to the Health Assembly. The underlying concern that was expressed in the report was that EPI might become isolated as a vertical program at the expense of encouraging infrastructure development. Consequently, it was important to ensure that rapid increases in EPI coverage were sustained through mechanisms that also strengthened the delivery of other primary health care interventions. The efficiency of EPI was linked closely to the efficacy of maternal and child health services. The real commitment to the success of immunization that was needed was that of the health workers providing day-to-day care to mothers and children and their families. Those countries that had realized the most progress in immunization had done so because of a very strong maternal and child health component in their national health services. Dr. Otoo made the point that 1 of the major constraints in EPI programming was the shortage of managerial skills and that more effort must be made to improve managerial capabilities. Comments of other participants in the 14th Meeting are included in this summary document.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (755):1-61.This is a WHO technical report reviewing how control of disease vectors may be integrated into the primary health care system. The concept of vector is defined broadly as any primary or intermediate invertebrate or vertebrate host or animal reservoir of human disease. The section headings are: present magnitude and status of vector control; means of delivering vector control in primary health care at the community level; communication, feedback and epidemiology; suitability of specific control measures for primary health care; human resource development and the core concept; research topics and recommendations. It is estimated that the size of the problem is hundreds of millions of cases of vector-born disease, with malaria, chagas disease, schistosomiasis, filariasis probably leading the list. Recent efforts on the community level, in Africa for example, have garnered enthusiastic support of villagers, while many nationally sponsored programs on the Health Department level have been less effective. Dozens of specific examples of how vectors may be controlled at the household and village level are cited. Some of these are bed-nets, repellents, aerosols and fumigants, fly traps, water filters, clean-up, biological control agents such as larvivorous fish . In many cases the peridomestic hosts are inhabiting man-made environments, such as thatched roofs, poorly stored food or discarded containers. The primary health care model includes planning at the local level, intersectorial cooperation, and a district management team. Information flow should involve use of the microcomputer and simple flow charts or algorithms, to facilitate feedback between the core group in the central government and the local district health management team. The operations aspects of vector control are emphasized, in both the research needs and the broad agenda of recommendations that end the report.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (749):1-86.This report makes a special effort to present practical information on the control of intestinal parasitic infections. It covers the following: public health significance of intestinal parasitic infections (methods of assessment, helminthic infections, and protozoan infections); the costs of not having a control program (nutrition, growth, and development; work and productivity; and medical care); prevention and control strategies (epidemiological foundation, objectives and general approaches, implementation strategies, costs and financing, methodologies and tools, and strategy for prevention and control); national programs (justification; objectives and strategies; planning; program and implementation; training, education, and dissemination of information; program monitoring and evaluation; and technical guidance); and program support (the role of the World Health Organization, technical and research organizations, funding agencies, industry, and information flow). Current experience suggests that intestinal parasite control programs are appropriate and socially advantageous because people can actually see the effects of primary health care intervention and start to learn some simple facts about health care by watching their village or community become healthier as a result of the control measures. There are 3 major areas in which the lack of control program is responsible for significant losses: nutrition, growth, and development; work and productivity; and medical care costs. Countries in which intestinal parasitic infections and diseases constitute a significant health problem need to consider adopting a national policy for their prevention and control. Recent experience in various countries has demonstrated the effectiveness of periodic deworming and standard case management at the primary health care level in reducing most of the problems associated with intestinal parasitic infections. Support can come from outside the country as well as from national authorities. Support from the outside may be available in the areas of management, technical expertise (which includes research), funding, and exchange of relevant information. The World Health Organization can provide both technical and managerial expertise in the design of programs.
[Final reports, 96th and 97th meetings of the Executive Committee of the Pan American Health Organization, Washington, D.C., 28 September 1985 and 23-27 June 1986. XXII Pan American Sanitary Conference XXXVIII meeting, WHO Regional Committee for the Americas, Washington, D.C., 22-30 September 1986] Informes finales, 96 y 97 Reuniones del Comite Ejecutivo de la Organizacion Panamericana de la Salud, Washington, D.C., 28 de septiembre de 1985 y 23-27 de junio de 1986. XXII Conferencia Sanitaria Panamericana, XXXVIII Reunion, Comite Regional de la OMS para las Americas, Washington, D.C., 22-30 de septiembre de 1986
Washington, D.C., PAHO, 1986. v, 173 p. (Official Document No. 211)The 96th Meeting of the Executive Committee of the Pan American Health Organization was held at the Headquarters buiding in Washington, D.C., on 28 September 1985. The 97th Meeting of the Executive Committee of the Pan American Health Organization was held at the Headquarters building in Washington, D.C., from 23 to 27 June 1986. The XXII Pan American Sanitary Conference, XXXVIII Meeting of the Regional Committee of the World Health Organization for the Americas, was held at the Headquarters building in Washington, D.C., from 22 to 27 September 1986. This document contains the final reports of these 3 conferences including all the participants and resolutions.
Hospitals and health for all. Report of a WHO Expert Committee on the Role of Hospitals at the First Referral Level.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (744):1-82.The World Health Organization (WHO) Expert Committee on the Role of Hospitals at the First Referral Level met from December 9-17, 1985, to review the role of the hospital in the broader context of a health system. The Expert Committee recognized that different strategies could be used to define the role of hospitals in relation to primary health care and that, for example, it would be possible to begin by analyzing what hospitals currently are doing with respect to primary health care, describe the different approaches being used, and then formulate guidelines to be followed by hospitals that are seeking to strengthen their involvement in primary health care. A shortcoming of this strategy is that it is based on what hospitals are already doing in particular circumstances, rather than helping people to decide what is required in a wide range of different settings. Consequently, the Expert Committee undertook to provide an analysis of primary health care, particularly in relation to the principles of health for all, to specify the components of a district health system based on primary health care, and to use this information as a basis for describing the role of the hospital at the first referral level in support of primary health care. This report of the Expert Committee covers the following: hospitals versus primary health care -- a false antithesis (the need for hospital involvement, the evolution of health services, expanding the role of hospitals, delineation of primary health care, hospitals and primary health care, and the common goal of health for all); components of a health system based on primary health care (targeted programs, levels of service delivery, and the functional infrastructure of primary health care); role and functions of the hospital in the first referral level (patient referral, health program coordination, education and training, and management and administrative support); the district health system; and approaches to some persistent problems (problems of organization and function; problems of attitudes, orientation, and training; and problems of information, financing, and referral system). The report includes recommendations to WHO, to governments, to nongovernmental organizations, and to hospitals. The Expert Committee considered that the conceptual focal point for organizational and functional integration should be the district health system encompassing the hospital and all other local health services. Further, the Expert Commitee was convinced that organizational and functional interaction (focused on the district health system) is imperative if full and effective use is to be made of the resources of the hospitals at the first referral level and if the health needs of the population are to be met.
Health systems research in maternal and child health including family planning: issues and priorities. Report of the meeting of the Steering Committee of the Task Force on Health Systems Research in Maternal and Child Health including Family Planning, New Delhi, 12-15 March 1984.
[Unpublished] 1985. 23 p. (MCH/85.8)In a series of general discussions aimed at establishing health systems research priorities, the Steering Committee of the Task Force on the Risk Approach and Program Research in Maternal-Child Health/Family Planning Care identified 9 major issues: 1) health services and health systems, 2) research and service to the community, 3) involving the community, 4) evaluation, 5) information systems, 6) interdisciplinary nature of health systems research, 7) appropriateness in technology and research, 8) funding and collaboration between agencies, and 9) implications for research program strategies. Background considerations regarding subject priorities for health systems research include the policies, goals, and programs of WHO, especially the goal of health for all by the year 2000. Of particular importance is the joining of training in health systems research with the research itself given the shortage of workers in this area. The sequence of events in the management of research proposals includes approach by an applicant, the WHO response, information to the appropriate WHO regional office, the beginning of technical dialogue, development of protocol, submission of grant application, contractual agreement, initial payments, regular monitoring of progress, proposed training strategy, annual reports, final report, and assistance in disseminating results. 3 subject areas were identified by the Steering Committee for additional scrutiny: 1) the dissemination of results of health systems research in maternal-child health/family planning, 2) the implementation of health services research and the studies to be funded, and 3) the coordination and "broker" functions of the Steering Committee.
[Unpublished] 1985. 114 p.This document is a practical guide to help those Planned Parenthood Associations which want to establish contraception and counseling services for young people. It draws its examples from the considerable experience of selected European countries in what can be controversial and difficult areas. In the section devoted to adolescent sexuality and contraception, contributors cover culture and subculture, health and sexuality, sexual behavior and contraceptive services, the adolescent experience, the question of opposition to services for adolescents, and statistical indices. 1 section is devoted to examples of contraceptive counseling services for adolescents in Sweden, Italy, France, the UK, and Poland. Another section summarizes service provision examples. The 5th section presents methodology for the establishment of adolescents services and the final section discusses methodology testing of new projects. This report contends that the case for the rapid development of contraceptive/counseling services, tailored to the needs and desires of young people, is justified on moral as well as on sociological, psychological, and health grounds. It rejects totally the argument that any measure which could facilitate the sexual debut of the unmarried or legally dependent adolescent should be resisted. It does recognize public concern about family breakdown and the potential health risks of sexual activity but considers the examples given as measures designed to combat rather than ignore these. Taking into account sociological, psychological, and medical evidence, the contributors to this report challenge the following presumptions: sexual activity among the young is always and necessarily morally unacceptable and socially destructive; adolescents will resort to promiscuous sexual activity in the absence of legal deterrents such as refusal of access to contraceptive/counseling services; the potential health risks of sexual activity and use of contraceptives during adolescence provide sufficient justification for deterrent measures, including refusal of contraceptive/counseling services; and the scale of sexual ignorance and prevalence of unplanned pregnancy among adolescents can only be reduced by disincentives and deterrents to sexual activity itself. The case for the provision of contraceptive/counseling services rests on their potential to help adolescents to recognize and resist repressive forms of sexual activity, which are destructive of humanmanships. Evidence suggests that it is not difficult to attract a large cross-section of an adolescent public to use contraceptive/counseling services, where established.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1974; (552):1-40.This document represents the work of a World Health Organization (WHO) Expert Committee on Tuberculosis, which met in Geneva in 1973. Chapters in this volume focus on epidemiology, Bacillus Calmette-Guerin (BCG) vaccination, case finding and treatment, national tuberculosis programs, research, WHO activities in this field, and the activities of the International Union against Tuberculosis and voluntary groups. The Committee emphasized that tuberculosis still ranks among the world's major health problems, particularly in developing countries. Even in many developed countries, tuberculosis and its sequelae are a more important cause of death than all the other notifiable infectious diseases combined. The previous WHO report, issued in 1964, set forth the concept of a comprehensive tuberculosis control program on a national scale. The implementation of this approach has encountered many problems, including deficiencies in the health infrastructure of many countries (shortages of financial, material, and physical resources and a lack of trained manpower) and resistance to change. However, many countries have instituted comprehensive programs and tuberculosis control has become a widely applied community health activity. A priority will be control of pulmonary tuberculosis. The Committee stressed that national programs must be countrywide, permanent, adapted to the expressed demands of the population, and integrated in the community health structure. Steps involved in setting up such programs include planning and programming, selection of technical policies, implementation, and evaluation. Research priority areas identified by the Committee include epidemiology, bacteriology and immunology, immunization, chemotherpy, the systems analysis approach to tuberculosis control, and training methods and instructional materials.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1985; (728):1-113.This document represents the work of a World Health Organization (WHO) Expert Committee on the Control of Schistosomiasis which met in Geneva in 1984. Chapters in this volume focus on epidemiology, disease due to schistosomiasis, methods of control, progress in national control programs, and a strategy for morbidity control. At present, the aim is to control the morbidity due to schistosomiasis rather than to control its transmission. The simplicity of diagnostic techniques, the safety and ease of administering oral antischistosomal drugs, the use of snail control measures based on specific epidemiologic criteria, and precise methods of data collection and analysis mean that control activities can be adapted to suit any level of the health care delivery system. Drug treatment reduces the prevalence and intensity of infection, prevents or reduces pathologic manifestations in infected persons, and is generally the most cost-effective way of achieving schistosomiasis control. On the basis of the severity of schistosomiasis in the area, its priority rating as a public health problem, and available resources, those operational approaches most suited to a particular area should be identified. Active community participation is necessary to ensure that the maximum benefits are derived from chemotherapy. Maintenance of transmission control by the primary health care system, through monitoring of both parasitologic indexes and clinical signs and measurements, is essential. In most endemic areas, schoolchildren are regarded as the most appropriate target group for monitoring. The WHO Expert Committee has recommended that schistosomiasis control programs be integrated into primary health care and noted the need for greater administrative and managerial expertise in schistosomiasis control. Improvement in socioeconomic conditions in endemic areas provides the longterm solution to schistosomiasis control.
ASSIGNMENT CHILDREN. 1985; 69-72:155-6.In its Resolution passed on October 24, 1985, the League of Red Cross and Red Crescent Societies recognized its unique position to play a role in strengthening the provision and utilization of national immunization programs. The League of Red Cross and Red Crescent Societies appreciates that an involvement with national immunization programs would add substance to previous resolutions in support of primary health care, would complement recent initiatives directed toward nutrition and diarrheal diseases, and would strengthen the emergency and relief responses of national socieities. It invites national societies to determine ways in which they could become more actively involved in the control of vaccine-preventable diseases through their participation in national immunization programs, based on their existing resources and current activities, and requests the Secretary-General of the League identify ways of stimulating and supporting the activities of national societies for the control of vaccine-preventable diseases and to ensure that such activities are coordinated with those of the World Health Organization, the UN International Chidren's Emergency Fund, and other organizations involved with the control of vaccine-preventable diseases.
WHO Programme in Maternal and Child Health and Family Planning. Report of the second meeting of the WHO Programme Advisory Committee in Maternal and Child Health, Geneva, 21-25 November 1983.
[Unpublished] 1984. 95 p. (MCH/84.5)The objectives of the 2nd meeting of the Program Advisory Committee (PAC) for the World Health Organization's (WHO's) Program in Maternal and Child Health, including Family Planning (MCH/FP) were to 1) assess the MCH/FP program's achievements since the 1st PAC meeting in June, 1982, 2) determine the level of scientific and financial resources available for the program, and 3) to examine the role of traditional birth attendants (TBAs) in the delivery of MCH/FP services. The committee reviewed the activities and targets of the program's 4 major areas (pregnancy and perinatal care, child health, growth, and development, adolescent health, and family planning and infertility), and developed a series of recommendations for each of these areas. Specific recommendations were also made for each of the major program areas in reference to the analysis and dessimination of information and to the development and use of appropriate health technologies. Upon reviewing the role of TBAs in the delivery of MCH/FP services, PAC recommended that all barriers to TBA utilization be removed and that training for TBAs should be improved and expanded. PAC's examination of financial support for MCH/FP activities revealed that for a sample of 26 countries, the average annual amount allocated to MCH activities was less than US$3/child or woman. This low level of funding must be taken into account when setting program targets. International funding agencies did indicate their willingness to increase funding levels for MCH programs. The appendices included 1) a list of participants, 2) an annotated agenda, 3) detailed information on the proposed activities of the program's headquarters for 1986-87, and 4) a description of the the function, organizational structure, and technical management of the MCH/FP program. Also included in the appendices was an overview of the current status of MCH and a series of tables providing information on infant, child, and maternal health indicators. Specifically, the tables provided information by region and by country on maternal, child, and infant mortality; causes of child deaths; maternal health care coverage; contraceptive prevalence; infant and child malnutrition; the number of low weight births; adolescent health; teenage births; breast feeding prevalence and duration; and the proportion of women and children in the population.
[Washington, D.C.], Population Reference Bureau [PRB], 2002. 3 p.In its efforts to eradicate polio from the planet, the WHO developed a public health initiative that includes routine immunization coverage, staging annual mass immunization drives, increasing surveillance for cases and wild poliovirus, and conducting door-to-door immunization in high-risk areas. In effect, the number of cases has reduced from 35,251 in 1988 to 5186 by 1997. It was noted that the success to the polio eradication strategy is attributed to: 1) selection of a virus that can be eradicated; 2) support from variety of donors and organizers; 3) global consensus regarding priority; 4) organization and transportation sufficient to reach the most remote places; 5) surveillance; and 6) low vaccine cost. However, the WHO notes that polio eradication efforts still face problems in securing access to all children, obtaining funds, and maintaining political commitment.
Zimbabwe AIDS directory -- 1995: non-governmental organisations, AIDS service organisations, support groups, funders, resources.
Harare, Zimbabwe, Zimbabwe AIDS Network, 1995. ix, 126 p.As the AIDS epidemic has unfolded in Zimbabwe, a number of organizations have developed AIDS programs for awareness and prevention and to help people cope with HIV infection. This Directory aims to provide information on the nongovernmental organizations (NGO), AIDS service organizations, support groups and donors involved in AIDS work in Zimbabwe. It also identifies information sources and materials available internationally, particularly those available free or at low cost, and with special relevance for Africa. Entries are listed alphabetically by name and acronym. It is hoped that the Directory will assist many organizations within the NGO community and beyond to identify resources and improve links with sister organizations, donors, and others responding to the demands of the AIDS epidemic. Most importantly, it is hoped that it will help people directly affected by or infected with HIV/AIDS to gain better access to services and support.
Lancet. 1999 Nov 13; 354(9191):1663-4.The value of health targets in Europe was addressed from national and international perspectives at a conference in Paris on September 23-24. WHO (European region) adopted a new strategy for the century, "Health 21", a health promotion program grounded on the principles of Health for All that has fewer population health targets. Moreover, this program emphasizes equity and national and local intersectoral collaboration. Countries adopting health targets, which include Netherlands, England, Poland, and Germany, seem to be reaping benefits from it. Despite the ability of health targets to provide a focus for delivering health care by being specific, quantified, and monitorable, some features of ill health are difficult to quantify and can result to confusing overlap between target setting, debates on rationing, and priority setting. The process of setting health targets is as important as the targets. Politicians have to discuss measures of achieving health status rather than simply improving care of diseases involving professionals, funding agencies, business, patients, and other nongovernmental organizations. Targets are projections towards the future; thus they should be rooted on public policies that can achieve change.
In: Workshop proceedings, 20-21 May 1999. Issues in establishing postabortion care services in low-resource settings, edited by Anita Ghosh, Dana Lewison, Enriquito R. Lu. Baltimore, Maryland, JHPIEGO, 1999 Oct. 31-41. (USAID Award No. HRN-A-00-98-00041-00)This document presents a global update on postabortion care (PAC) programs, which is a summary of the workshop proceedings on issues in the establishment of PAC services in low-resource settings. The PAC programs, which were initially implemented and designed in 1993, include emergency treatment of complications of spontaneous and unsafely induced abortion, provision of postabortion family planning, and other reproductive health services. Conclusions gathered at the meeting include: the need to build a common framework for PAC, a strategic plan on PAC services, better coordination of PAC programs, and collaboration on common advocacy strategies that emphasize the missions, country leaders, other donors and PAC programs. Several steps have been identified as the key elements of a comprehensive approach to PAC services involving the organization of services, communication, providers, policy and management. Various steps were emphasized as critical in the development of PAC program such as the development of common strategic approach, sharing of lessons learned, focus on fewer countries, address on sustainability and measurement of impact, increase success awareness, mobilization of human and financial resources, clarification of PAC roles and leadership, and collaboration with other donors.
Community participation in international health: practical recommendations for donor and recipient organizations.
Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 1999 Mar; 5(3):137-43.This article discusses the need for donor agencies and recipient organizations to involve target communities in the conceptualization, development, monitoring, and implementation of health services and programs in international health. According to the Pan American Health Organization, community participation in health programs is a key to recognize the impact of health and non-health issues to the health status of vulnerable groups. In the face of dwindling public sector dollars for health services and growing influence of commercially driven health systems, donor agencies are the important players in providing services to the at-risk populations. Donors can work closely with the formal health system and the target communities to ensure that the health priorities of the communities are addressed and that local residents are eventually empowered to take charge of their health status. This paper assumes that most donor organizations are based in industrialized countries. Given that resources are finite in both developed and developing countries, the article briefly reviews the trend of declining public funds for health systems and the increasing role for privately funded health services worldwide. Finally, it also discusses practical steps to involve local populations in community-based health planning and management in international health.
In: Materiales del "Segundo Seminario de Comunicacion en Poblacion" organizado por AMIDEP, Lima, 23-27 de marzo de 1987, [compiled by] Asociacion Multidisciplinaria de Investigacion y Docencia en Poblacion [AMIDEP]. Lima, Peru, AMIDEP, 1987. 71-84. (Cuadernos de Comunicacion AMIDEP No. 1)The UN Children's Fund (UNICEF) has substituted the infant mortality rate for per capita income in determining its plans for cooperation with poor countries. More than 15 million infants under 1 year die each year from such causes as dehydration during diarrhea, malnutrition, illnesses preventable by immunization, and immunological deficiencies caused by early weaning. In 1984 a 4-pronged approach to control of infant mortality was announced by UNICEF. It called for treatment of dehydration by oral rehydration therapy, immunization against 6 killing diseases, use of growth charts by mothers, and promotion of breast feeding. UNICEF based the strategy on a number of elements not directly related to public investment, including a high level political commitment, consensus of the most dynamic social forces, intense social mobilization of the priority sectors for application of the strategy, and full support of the mass media. Most of the interventions in which UNICEF has cooperated have been of the campaign type, raising questions about the permanence of the actions. Compromises were believed to be needed to ensure that activities go on in circumstances that would otherwise overwhelm the public health services. The job of communication in such circumstances is to find ways of guaranteeing that the new health behaviors become routinized and incorporated into the everyday life of the target population. The communication program for the vaccination campaign in Peru in 1985 faced specific challenges: understanding the relationship between mass communication and social mobilization, and providing mass media for a single campaign that would be valid for the entire country in its geographic and social diversity. Although no formal pretesting was done of the mass communication materials, the impact of the messages, music, slogans, and images was informally measured in the early phase of diffusion. Messages for the 1st vaccination day were created for radio, television, and the press that tried to maintain a festival atmosphere while attracting parents of infants and children under 5, dispelling their resistence, furnishing information on the location of vaccination posts, and emphasizing the date. Themes stressed for the 2nd vaccination day were the need to attend all 3 days to be fully protected, changes in location of posts, and continuing need to overcome fear of side effects. It became clear that more stress was also needed on the risks and consequences of not being vaccinated. The festival atmosphere was maintained in the numerous social mobilization activities held at the local level to publicize the vaccination days.
Boston, Massachusetts, John Snow, Inc., 1989 Jan. 222 p. (Population Projects Database)This issue of the semi-annual Population Project Database Report contains short narrative summaries describing AID-funded population and family planning subprojects primarily as a management toil for the Office of Population; however, it may be useful for the entire international population community. The introduction begins with a discussion of AID population assistance -- how the funds are administered, where the support for activities comes from, and what types of projects are supported by AID's grants and contracts. The 1987 expenditures and 1988 commitments by cooperating agencies for in-country subproject activities are presented followed by a summary of AID subproject activities. This FY1987-FY1988 report includes information on 2,070 AID subproject activities in 94 countries. Of these, 30% concentrate on family planning service delivery, 24% on training-oriented activities, and 17% emphasize research to develop improved contraceptive methods. An additional 8% focus on education, information and communications with regard to family planning, and 7% are primarily concerned with operations research aimed at developing improved ways to deliver family planning services in developing countries. The data in this report were assembled from the Population Projects Database (PPD), a computer-based information system for the Agency for international Development. The bulk of the report is presented in tables which detail AID and IPPF funded population activities in FY1987 and FY1988 by cooperating agency, country and the following regions: Africa, Asia/Near East, Latin America/Caribbean, US/Canada, Europe/Australia, and inter regional. New charts showing the number and types of subproject activities in each region are also include.
1987 report by the Executive Director of the United Nations Population Fund. State of world population 1988. UNFPA in 1987.
New York, New York, UNFPA, 1988. 189 p.Of major significance to the United Nations Fund for Population Activities (UNFPA) in 1987 was the fact that the world's population passed the 5 billion mark in that year. Although population growth rates are now slowing, the momentum of population growth ensures that at least another 3 billion people will be added to the world between 1985-2025. This increasing population pressure dictates a need for development policies that sustain and expand the earth's resource base rather than deplete it. Successful adaptation will require political commitment and significant investments of national resources, both human and financial. It is especially important to extend the reach of family planning programs so that women can delay the 1st birth and extend the intervals between subsequent births. Nearly all developing countries now have family planning programs, but the degree of political and economic support, and their effective reach, vary widely. In 1987, UNFPA assistance in this area totalled US$73.3 million, or 55% of total program allocations. During this year, UNFPA supported nearly 500 country and intercountry family planning projects, with particular attention to improving maternal-child health/family planning services in sub-Saharan Africa. As more governments in Africa became involved in Family planning programs, there was a concomitant need for all types of training programs. Other special program interests during 1987 included women and development, youth, aging, and acquired immunodeficiency syndrome (AIDS). This Annual Report includes detailed accounts of UNFPA program activities in 1987 in sub-Saharan Africa, Arab States and Europe, Asia and the Pacific, and Latin America and the Caribbean. Also included are reports on policy and program coordination, staff training and development, evaluation, technical cooperation among developing countries, procurement of supplies and equipment, multibilateral financing for population activities, and income and expenditures.
INDOCHINA ISSUES. 1988 Jan; (78):1-7.A campaign promoting "1 or at most 2 children" was launched officially in 1982 in Vietnam, a country which ranked 12th most populous in the world in 1987, with the 7th largest annual growth rate. Although major municipalities have registered less than 1.7% annual growth rates, in rural areas, particularly in the southern provinces, the growth rate ranges from 2.3-3.4%; 80% of the population resides in such locales. In April 1986, the Hanoi City People's Committee issued regulations designed to encourage the practice of birth control. Cash awards were offered to couples with only 1 child and payments for sterilization after the birth of a 2nd child. The birth of a 3rd child triggers higher maternity clinic charges, and an escalating scale of birth registration fees has been introduced to discourage failure to practice family planning. The most significant statistic to emerge from the birth control program is the gradual increase in the number of family planning acceptors over the past 5 years, slightly over 1 million couples estimated in 1981 to 4.5 million acceptors estimated for 1987. Between 1981-87 there was more than a doubling of acceptors for sterilization and IUD insertion. The IUD is used by 75% of couples practicing birth control, followed in popularity by the condom. Agencies in a UN triumvirate with special population concerns in Vietnam include the UN Fund for Population Activities (UNFPA), the UN International Children's Emergency Fund (UNICEF), and the World Health Organization (WHO). In the 3 years preceding 1987, several new UNICEF-supported public information projects were implemented, including the creation of an extensive maternal and child care network. This network was used to train cadres from the Women's Union as family planning motivators. In mid-1986, an experimental and innovative pilot project on "family life" or "parenting information" was initiated by UNICEF, UNFPA, and the Vietnamese Committee for the Protection of Mothers and the Newborn (CPMN). The desired growth rate of 1.1% by 2000 will have to rely on a variety of current program innovations. Surveys now being conducted in various regions of Vietnam reveal attitudinal problems in promoting smaller families. A survey of the members of 300 farming cooperatives in various areas of Vietnam in 1986 found that 60% of those questioned believed that the more children they had the better it would be for their family economy. Cooperative Vietnamese and UN efforts, particularly the innovative surveys and field research, represent valuable approaches, but considerable need remains for improvement in birth control knowledge and application and in the means to reduce child morbidity and mortality rates.