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  1. 1

    Health and health services in Judaea, Samaria and Gaza 1983-1984: a report by the Ministry of Health of Israel to the Thirty-Seventh world Health Assembly, Geneva, May 1984.

    Israel. Ministry of Health

    Jerusalem, Israel, Ministry of Health, 1984 Mar. 195 p.

    Health conditions and health services in Judea, Samaria, and Gaza during the 1967-83 period are discussed. Health-related activities and changes in the social and economic environment are assessed and their impact on health is evaluated. Specific activities performed during the current year are outlined. The following are specific facets of the health care system that are the focus of many current projects in these districts; the development of a comprehensive network of primary care programs and centers for preventive and curative services has been given high priority and is continuing; renovation and expansion of hospital facilities, along with improved staffing, equipment, and supplies for basic and specialty health services increase local capabilities for increasingly sophisticated health care, and consequently there is a decreasing need to send patients requiring specialized care to supraregional referral hospitals, except for highly specialized services; inadequacies in the preexisting reporting system have necessitated a continuting process of development for the gathering and publication of general and specific statistical and demographic data; stress has been placed on provision of safe drinking water, development of sewage and solid waste collection and disposal systems, as well as food control and other environmental sanitation activities; major progress has been made in the establishment of a funding system that elicits the participation and financial support of the health care consumer through volunary health insurance, covering large proportions of the population in the few years since its inception; the continuing building room in residential housing along with the continuous development of essential community sanitation infrastructure services are important factors in improved living and health conditions for the people; and the health system's growth must continue to be accompanied by planning, evaluation, and research atall levels. Specific topics covered include: demography and vital statistics; socioeconomic conditions; morbidity and mortality; hospital services; maternal and child health; nutrition; health education; expanded program immunization; environmental health; mental health; problems of special groups; health insurance; community and voluntary agency participation; international agencies; manpower and training; and planning and evaluation. Over the past 17 years, Judea, Samaria, and Gaza have been areas of rapid population growth and atthe same time of rapid socioeconomic development. In addition there have been basic changes in the social and health environment. As measured by socioeconomic indicators, much progress has been achieved for and by the people. As measured by health status evaluation indicators, the people benefit from an incresing quantity and quality of primary care and specialty services. The expansion of the public health infrastructure, combined with growing access to and utilization of personal preventive services, has been a key contributor to this process.
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  2. 2

    The World Bank and family planning.

    Thurshen M

    WIPHN NEWS. 1994 Winter; 17:1.

    The World Bank has assumed first place in world health assistance and states that one reason for lending in health is that its presence in the health sector enables it to pressure governments to control population growth. The Bank believes that rapid population growth slows development, and to achieve its goal of lower birth rates in low-income countries, it recommends that governments provide an essential "clinical" package, which consists of perinatal and delivery care, family planning services, management of the sick child, treatment of tuberculosis, and case management of sexually transmitted diseases. "Clinical" in this context means services provided in a health clinic by nurses and midwives, not physicians. Sick children are the main beneficiaries of the package because it is assumed that families will limit the number of births only after child mortality falls. The treatment of tuberculosis is included to save the lives of children. The Bank has predicted that the AIDS epidemic will not result in negative population growth in Africa and has emphasized family planning services in the essential package. The World Bank seems to have made family planning the new, reductionist version of primary health care.
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  3. 3

    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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  4. 4

    Global overview: the Expanded Programme on Immunization, Cartagena, Colombia, 14-16 October 1985.

    World Health Organization [WHO]. Expanded Programme on Immunization [EPI]

    [Unpublished] 1985. 15 p.

    This paper reviews the development of the global Expanded Program on Immunization (EPI) initiative, reports on program progress since the 1984 EPI conference, and identifies actions needed to meet the goal of providing immunization services to all children of the world by 1990. The central EPI strategy to date has been to deliver immunization in consonance with other health services, particularly those aimed at mothers and children. The long-term goal of such efforts is to strengthen the health infrastructure so as to ensure the continuous provision of immunization and other primary health care services. Simply by reinforcing existing health services, a coverage level of 60-70% will be achieved in developing countries by 1990. If universal coverage is to be achieved, external funds will have to be provided to meet operational costs and train national managers. Acceleration of existing efforts constitutes the main EPI priority at present. Specific areas suggested for immediate action include provision of information about immunization at every health contact; a reduction in the drop-out rates between 1st and last immunization; increased attention to the control of measles, poliomyelitis, and neonatal tetanus; improved immunization services to the disadvantaged in urban areas; and, where appropriate, acceleration of the EPI through approaches such as national immunization days. Ongoing actions that need to be pursued include strengthening disease surveillance and outbreak control, reinforcing training and supervision, and pursuing applied research and development. Overall, management capacity within national programs remains the most severe constraint for the EPI.
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  5. 5

    Expanded Programme on Immunization: progress and evaluation report by the Director-General.

    World Health Organization [WHO]

    [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.
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  6. 6

    Expanded Programme on Immunization progress report by the Director-General.

    World Health Organization [WHO]

    [Unpublished] 1978 Mar 31. Presented to the Thirty-first World Health Assembly provisional agenda item 2.6.10. 13 p. (A31/21)

    This report summarizes progress in 1977-78 in the planning and implementation of the Expanded Program on Immunization (EPI). The EPI's long-term objectives are: 1) to reduce morbidity and mortality from diphtheria, pertussis, measles, poliomyelitis, and tuberculosis by providing immunization against these diseases to every child in the world by 1990; 2) to promote countries' self-reliance in the delivery of immunization services within the context of comprehensive health services; and 3) to promote regional self-reliance in matters of vaccine quality control and production. The present EPI program strategy is to develop managerial competence at the senior and middle levels to serve as a foundation for solid, enduring program implementation. Regional and national authorities have been made a part of the global planning process. An EPI Global Advisory Group has been established to assist in operational implementation, develop prototype training curricula and educational materials, develop and transfer appropriate technologies, establish a 2-way information system to obtain global data on the target diseases, and attract and coordinate extrabudgetary resources. Recent training activities have included a course on EPI planning and management, middle management training at the national level, training in cold chain management, and preparation of an EPI field manual. Research and development efforts have focused on improving the equipment used in the cold chain. Work continues on the development of more stable, more potent, less reactogenic vaccines. 42 developing countries, in which a total of 57 million children are born every year, have been identified as expanding their immunization programs in active collaboration with the World Health Organization. As more countries actively expand their immunization coverage, a larger level of resource input will be required to sustain this expansion.
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  7. 7

    United Nations Children's Fund: report of the Executive Board (15-26 April 1985).

    UNICEF. Executive Board

    New York, New York, United Nations, 1985. v, 58 p. (Economic and Social Council Official Records, 1985. Supplement No. 10; E/1985/31; E/ICEF/1985/12)

    The major decisions of the UN Children's Fund Executive Board in their 1985 session were to: approve several new program recommendations and endores a major emergency assistance program for several African countries; approve initiatives to accelerate the implementation of child survival and development actions, particularly towards the goal of achieving universal immunization of children against 6 major childhood diseases by 1990; adopt a comprehensive policy framework for UN International Children's Emergency Fund (UNICEF) programs concerning women; approve UNICEF revised budget estimates for 1984-85 and budget estimates for 1986-87; and make a number of decisions on ways to improve the administration and the role of the Board. The Board members both reported on and heard evidence of the encouraging results of recent efforts to implement national child survival and development programs. Reports of the successful immunization campaigns in Burkina Faso, Colombia, El Salvador, and Nigeria were welcomed, along with the news that half a million children were saved during the year through the use of oral rehydration therapy. Stronger efforts were encouraged to improve results in the areas of breastfeeding and growth monitoring. Implementation issues in connection with child survival and development actions were a continuing focus of Board attention during the session. The accelerated implementation of child survival and development actions was accorded the highest priority in approving the medium-term plan for 1984-88. The Board also adopted a resolution that sought to draw the attention of world leaders, during their observance of the 40th anniversary of the UN, to the importance of reaffirming their commitment to accelerate the implementation of the child survival and development resolution and realizing universal immunization by 1990. Delegations commended the results of the World Health Organization/UNICEF joint nutrition support program but noted that malnutrition among women and children appeared to be increasing. Water supply and sanitation activities were encouraged, and the Board stressed that those actions should be linked with health and hygiene education. The Board endorsed the report on recent UNICEF activities in Africa. Many delegations spoke in support of the increased aid to Africa. Major emphasis was given to linking emergency responses with ongoing UNICEF programs. The Board approved new multi-year commitments from general resources totalling $303,053,422 for 28 country and interregional programs and noted 32 projects totaling $223,215,000 to be funded from specific-purpose contributions. The Board stressed the importance of ensuring that child survival and development actions were integrated with continuing efforts in other of UNICEF action. The Board approved a commitment of $252,550,443 for the budget for the biennium 1986-87.
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  8. 8

    The World Health Organization's Expanded Programme on Immunization: a global overview. Le Programme Elargi de Vaccination de L'Organization Mondiale de la Sante: apercu mondial.

    World Health Organization [WHO]. Expanded Programme on Immunization [EPI]

    World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1985; 38(2):232-52.

    In recognition that immunization is an essential element of primary health care, the World Health Organization (WHO), with other agencies, is sponsoring the Global Program on Immunization whose goal is to reduce morbidity and mortality from vaccine-preventable diseases by providing immunization for all children of the world by 1990. A global advisory group of experts meets yearly to review the program. This paper summarizes the most salient features of the 1984 meeting. The major event for the Expanded Program on Immunization (EPI) in 1984 was the Bellagio Conference on protecting the world's children. Activities undertaken as a result of this conference are discussed. 1 outcome was the formation of the Task Force for Child Survival whose main objective is to promote the reduction of childhood morbidity and mortality through acceleration of key primary health care activities. Focus is on supporting Colombia, India and Senegal in accelerating the expansion of their immunization programs and strengthening other elements of primary health care, such as diarrheal diseases control, family planning and improved nutrition. The 5-point action program consists of the following components: promoting EPI within the context of primary health care; investing adequate human resources in EPI; ensuring that programs are continuously evaluated and adapted so as to achieve high immunization coverage and maximum reduction in target-disease deaths and cases; and pursuing research efforts as part of program operations. EPI has continued to collaborate with other programs to help assure that immunization services are provided to support delivery of other services. Integration of EPI in Africa, the Americas, the Eastern Mediterranean Region, Europe, the South-East Asia Region, and the Western Pacific Region is examined.
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  9. 9

    Proceedings of the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C.

    Cash RA

    Washington, D.C., Agency for International Development [AID], Bureau for Science and Technology, 1983. 210 p. (International Conference on Oral Rehydration Therapy, 1983, proceedings)

    With over 600 participants from more than 80 countries, the International Conference on Oral Rehydration Therapy (ICORT) was a testimony to the international health community's recognition of the seriousness of diarrheal disease, the value of oral rehydration therapy, and the commitment to primary health care. The conference, initiated by the Agency for International Development, was cosponsored by the International Center for Diarrheal Disease Research, Bangladesh, the United Nations Children's Fund, and the WHO. The conference focused on oral rehydration therapy, an important treatment of diarrhea. 1 out of 10 children born in developing countries dies from the effects of diarrhea before the age of 5. A 70% reduction in the mortality rate can result from ORT--a major breakthrough for primary health care. Excellent laboratory investigation, well-conducted clinical studies, and careful field observation have led to this effective therapy. Many papers presented at the conference demonstrated the effectiveness of ORT. Participants agreed on the best formula for ORT in terms of electrolyte content and on the need for an international commitment to expand implementation of ORT. Problems in implementing oral therapy programs are discussed. Possible areas of investigation include: 1) improving the solution through the addition of glycine, other amino acids, or cereal-based substrates; 2) developing methods for teaching ORT; and 3) investigating better methods of program evaluation. Innovative approaches to informing the public about the use and benefits of oral therapy were also discussed. Participants, recognizing that problems are shared among many different programs and nations, exchanged ideas and addresses, pledging to keep each other abreast of their ORT research and implementation efforts. The conference closed with a strong call for action to attain near universal availability of ORT in the next 10 years.
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  10. 10

    World Health Day 1984. Children's health--tomorrow's wealth.

    Mahler H

    Who Chronicle. 1984; 38(3):109-15.

    The theme of the 1984 World Health Day--children's health, tomorrow's wealth--provides an occasion to convey to a worldwide audience the message that children are a priceless resource, and that any nation which neglects them does so at its peril. World Health Day 1984 spotlights the basic truth that the healthy minds and bodies of the world's children must be safeguard, not only as a key factor in attaining health for all by 2000, but also as a major part of each nation's health in the 21st century. An investment in child health is a direct entry point to improved social development, productivity, and quality of life. Care of child health starts before conception, through postponement of the 1st pregnancy until the mother herself has reached full physical maturity, and through spacing of births. It continues from conception on, through suitable care during pregnancy, childbirth, and childhood. In the developing countries the child must be protected by all available means, particularly from the killer diseases. What happens in the immediate family and community around the mother and child, and even far away in the world, can have a direct impact on the health and security of both of them. The mother and child need to be placed in an environment that will ensure their health by protecting the overall setting in which they live. This means providing clean water, disposing of waste, and helping to improve shelter. Nothing can diminish the importance of good food, enough food, and proper nutrition for children and their mothers. Beyond the immediate physical needs are the equally important needs for love and understanding which stimulate the healthy development of the child. The emergence of new health problems of mothers and children in developing and developed countries should be kept in mind. Better health services must be made available to all who need them. The World Health Organization (WHO) provided resource material on World Health Day issues for dissemination throughout the world. Extracts from 4 articles on this year's theme are reproduced. The articles report on the success of the Rural Health Center in Ballabhgarh (India) in reducing maternal and infant mortality, the value of breastfeeding as 1 of the simplest and safest ways of ensuring adequate spacing of births, Tunisia's integration of a program of immunization into the routine activities of the health care system, and the needs of the healthy child.
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  11. 11

    Medicine in the Third World [letter]

    Levi G

    BMJ. British Medical Journal. 1984 May 26; 288(6430):1611-2.

    In response to an article on disease among children in the Third World, the author of this letter outlines the efforts of the World Health Organization (WHO) to both alleviate disease in delveloping countries and promote an approach to health suited to current realities in these countries. WHO has become increasingly aware that the diseases affecting the Third World can be eradicated only through a broad, integrated approach that places health in the wider context of social and economic development. WHO has adopted a primary health care strategy to tackle the control of tropical diseases and the reduction of mortality and morbidity among Third World children. Central to this approach is the use of appropriate health technology and the participation of families and communities in the health services. A primary health care orientation further addresses theproblem of how Third World countries can best allocate scarce health resources. In its specific action programs such as control of diarrheal diseases and immunization, WHO aims to help countries and communities to improve their own health. It is the application of existing knowledge thatis needed in the Third World, not new knowledge or technology.
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  12. 12


    Grant JP

    In: The Tenth Asian Parasite Control/Family Planning Conference. Proceedings. Under the joint auspices of the Asian Parasite Control Organization, the Japanese Organization for International Cooperation in Family Planning, the Japan Association of Parasite Control and the International Planned Parenthood Federation. Tokyo, Asian Parasite Control Organization, [1983]. 63-70.

    Economic depression affects children in 3 major ways: disposable family incomes drop sharply, with the most severe consequences for poor people and their children; government budgets for social services, particularly those affecting young children and including nutrition, health, and education, are the first to be cut back; and national and international levels of development assistance stagnate as a consequence of the restrictive budgetary policies adopted by industrialized countries. Despite the first welcome signs of an economic recovery in some industrialized nations, most indications are that the worldwide recovery may be relatively shallow in the mid-1980s and that significant beneficial impacts on many low income countries and families will be long delayed. Thus, in the absence of special measures to accelerate health progress, millions more children and mothers are likely to die in the in low income areas than was thought likely at the beginning of the decade. Possibly the only hopeful sign is that the restrictions imposed by the world recession have stimulated the search for innovative and cost effective ways to protect and improve the health of children and mothers. Within a decade, low cost advances could be saving the lives of 20,000 children daily and preventing the crippling of another 20,000. What is in question is the priority of this kind of progress -- among governments, among international assistance sources and networks, and in developing countries. The strategy adopted by JOICFP in its Integrated Family Planning, Nutrition, and Parasite Control Projects offers one such way. The projects are based on the concept that family planning programs will be more acceptable if combined with related services, which the community readily perceives as beneficial and useful. What most contributes to making parasite control a good entry point is that the process of examination and the effects of treatment are immediately visible. Possibly more important that the biological and medical effects of parasite control is its effectiveness as a tool for community health and education motivation. The UN International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) and multilateral and bilateral agencies are promoting 4 simple and relatively inexpensive measures to reduce malnutrition, illness, and death among the world's children: the use of growth charts; oral rehydration therapy; breastfeeding and proper weaning practices; and immunization against major childhood diseases. Ways to achieve accelerated progress for the protection and survival of children are identified.
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