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Strengthening the capacity of the public health workforce in support of the essential public health functions and the Millennium Development Goals. Consultation with experts, San Jose, Costa Rica, 16-18 August 2005.
Washington, D.C., PAHO, Health Systems Strengthening Area, Human Resources for Health Unit, 2006 Dec. 50 p. (HR Series No. 45; USAID Award No. LAC-G-00-04-00002-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ADJ-697)The main objective of this Consultation is to generate social recognition for the improvement and protection of human resources and the development of the health systems and well being of the populations of the Region of the Americas. There is no clear guiding principle in the conceptualization of human resources in health, or about its relationship to the PHWF. Human resources in health are currently facing a serious crisis, and public health should play a leading role in strengthening the capacities of this key resource in the Region. The causes and the magnitude of the problem are reflected in the lack of certain categories of personnel, the inequitable distribution of resources within countries, and institutional planning, management and education of these resources that are de-contextualized and focused on technical aspects. These considerations call for this presentation of the objectives of the Consultation to be accompanied by a recognition that learning to work together is not easy, but that this is precisely what is needed, i.e. the creation of strong partnerships, and the fact that public health work should be conceived in terms of cooperation in this area. (excerpt)
International Journal of Health Planning and Management. 2006 Oct-Dec; 21(4):297-312.After the break-up of the Soviet Union, the country of Georgia suffered from intense civil unrest and socio-economic deterioration, which particularly affected the health sector. To remedy the situation, the government initiated health sector reform, which introduced major changes in healthcare financing in Georgia: the previously free healthcare model was replaced by social insurance, and patients were required to pay out-of-pocket for services not covered by insurance. This paper is an attempt to determine if the health system of Georgia is reaching the WHO health system goals of improved health status, responsiveness to patients' needs (consumer satisfaction), and financial risk protection as a result of health reforms. (author's)
Cahiers du Médecin. 2002 Dec; 6(58):45-46.This article presents a report from the macroeconomic and health committee to determine the place of health in economic and social development created by the WHO in the year 2000. The main conclusions for all aspects were presented when the report was submitted to the WHO general assembly in 2002. The observations thus raised indicated that economic losses linked to poor health have been underestimated, especially in developing countries and that the role of health in economic growth has been strongly undervalued. Because of this several pathologies are still responsible for a high percentage of avoidable deaths, particularly maternal and perinatal pathologies and infectious diseases in children. It is also noted that the level of health expenses is insufficient and that the recommended financing strategy is based on growth in budgetary credits consecrated to health and to an increase in donor subsidies. The report emphasizes the different essential actions capable of reaching disadvantaged populations and on the correct steering by the public authorities of contributions from donors in the public and private sectors. Other remarks were collected about the various financing mechanisms on the global scale to combat certain endemic infections, specifically AIDS, tuberculosis, and malaria. Efforts to improve access by the populations to essential and indispensable drugs are also being made. The report underlines the need for the signing of a health pact between governments and development agencies in order to increase resources allocated to health. For the development of health in Morocco, the author emphasizes all aspects raised in this report and suggests the creation of a "Health and development" commission as advised by the WHO.
International Conference on the Implications of AIDS for Mothers and Children: technical statements and selected presentations. Jointly organized by the Government of France and the World Health Organization, Paris, 27-30 November 1989.
[Unpublished] 1991. , 64 p.The International Conference on the Implications of AIDS for Mothers and Children was organized by the World Health Organization (WHO) in cooperation with the French Government. Co-sponsors included the United Nations organizations UNDP, UNICEF, and UNESCO, along with the International Labor Organization (ILO), the World Bank, and the Council of Europe. Following assorted introductory addresses, statements by chairmen of the conference's technical working groups are presented in the paper. Working group discussion topics include virology; immunology; epidemiology; clinical management; HIV and pregnancy; diagnoses; implications for health, education, community, and social welfare systems; and economic and demographic impact. Chairman statements include an introduction, discussion of the state of current knowledge, research priorities, implications for policies and programs, and recommendations. The Paris Declaration on Women, Children and Acquired Immunodeficiency Syndrome concluded the conference.
Washington, D.C., World Bank, Population, Health and Nutrition Dept., 1986 Dec 31. 124 p.In the current environment of general budget stringency in developing countries, it is unrealistic to push for more public spending for health services. The answer to this health crisis is to relieve government of much of the responsibility for financing those kinds of health services for which the benefits to society as a whole (as opposed to direct benefits to the users of the service) are low, freeing public resources to finance those services for which benefits are high. The intent is to relieve government of the burden of spending on health care for the rich, freeing public resources for more spending for the poor. Individuals with sufficient income should pay for their curative care. The financing and provision of these "private" health services should be shifted to a combination of the nongovernment sector and a public sector reorganized to be more financially self-sufficient. A shift such as this would increase the public resources available for those types of health services which are "public goods" and currently are underfunded "public" health programs, such as immunization, vector control, some prenatal and maternal care, sanitary waste disposal, and health education. Also such a shift would increase the public resources available for simple curative care and referral for the poor who now only have limited access to low quality services of this nature. Government efforts to cover the full costs of health care for everyone from general public revenues have contributed to 3 sets of problems in the health systems of many countries: an allocation problem -- insufficient spending on cost-effective health activities; an internal efficiency problem -- inefficient public programs; and an equity problem -- inequitable distribution of benefits from health services. 4 policies for health financing are proposed to raise revenues for important health programs, increase the efficiency of public health services, and make the system better serve the poor. These are: charging users of public health facilities; providing insurance or other risk coverage; strengthening nongovernmental health activities; and decentralizing government health services. A table summarizes the effects of each of the 4 options for reform in alleviating health sector problems.
WORLD HEALTH FORUM. 1988; 9(2):143-6.This article summarizes the activities and the philosophy of WHO in its effort to improve worldwide health care since its inception some 40 years ago. At the 1st World Health Assembly in 1948 it was pointed out that little could be achieved by medical services unless the existing economic, social and other relations among peoples have been improved. The immediate priorities of the new Organization were more limited: to build up health services in the areas destroyed by the war, and to fignt the spread of the big infectious killer diseases. It took almost 30 years before the WHO really got down to trying to do something about the economic, social and other conditions which lie at the heart of most health problems. The Alma-Ata Declaration in 1978 heralded a new era in health. The concept of primary health care and the global health-for-all strategy to implement it are now rapidly gaining ground. In villages, towns and districts, people are waking up to the fact that they can contribute to their own health destiny. As WHO embarks on its 5th decade, there are grounds for optimism: health is moving in the right direction in spite of major obstacles.
Paris, France, Organisation for Economic Co-operation and Development [OECD], 1988. 90 p. (Demographic Change and Public Policy)This is the first in a planned series of volumes published by the Organisation for Economic Co-operation and Development (OECD) concerning the economic and social consequences of demographic aging in OECD member countries. "This detailed statistical analysis of demographic trends in the 24 OECD countries examines the implications for public expenditure on education, health care, pensions and other social areas, and discusses the policy choices facing governments." Data are from official sources. (EXCERPT)
Washington, D.C, Pan American Health Organization, 1983. x, 145 p. (Scientific Publication No. 435)This document, prepared by the Pan American Health Organization (PAHO), reviews health in the Americas in the period 1905-47, provides a more detailed assessment of progress in the health sector during the 1970s, and then outlines prospects for the period 1980-2000 in terms of meeting the goal of health for all by the year 2000. The main feature of this goal is its comprehensiveness. Health is no longer viewed as a matter of disease, but as a social outcome of national development. Attainment of this goal demands far-reaching socioeconomic changes, as well as revision of the concepts underlying national health systems. It seems likely that the coming period in Latin America and the Caribbean will be characterized by intense urban concentration and rapid industrialization, with a trend toward increasing heterogeneity. If current development trends continue, the gap in living standards between urban and rural areas will widen due to sharp differences in productivity. Regionally based development planning could raise living standards and reduce inequalities. In the type of development expected, the role of social services is essential. It will be necessary to determine whether the objective is to provide the poor with access to services that are to be available to all or to provide special services for target groups. The primary health care strategy must be applicable to the entire population, not just a limited program to meet the minimal needs of the extreme poor. Pressing issues regarding health services in the next 2 decades include how to extend their coverage, increase and strengthen their operating capacity, improve their planning and evaluation, increase their efficiency, and improve their information systems. Governments and ministries must be part of effective infrastructures in which finance, intersectoral linkages, community participation, and intercountry and hemispheric cooperation have adequate roles. One of PAHO's key activities must be systematic monitoring and evaluation of strategies and plans of action for attaining health for all.
Statement by the Head of Delegation of the Republic of Korea at the International Conference on Population (ICP).
[Unpublished] 1984 Aug. Presented at the International Conference on Population, Mexico City, August 6-13, 1984. 3 p.In a 5-year plan, the Korean government has integrated family planning programs, including maternal and child health, medical insurance, and social welfare programs, into its primary health ervices in order to reach its hard-core low-income residents in both urban and rural areas. The Korea Women's Development Institute was established in 1982 to enchance the status of women, and the Labor Standard Law has been revised to try to overcome deep-rooted son-preference among Korean parenst. Migration out of rural areas is creating rural manpower problems, and stepped-up rural community development programs are planned. Population predictions by the mid-21st century stand at 61 million, too great for a country with such limited natural resources to support. Korea recommends an exchange of information on population and development between all countries, the setting aside of 1% of each country's annual budget for national population programs, and convening the world population conference every 5 instead of every 10 years so that more progress can be made in solving the problem.
General survey of the reports relating to conventions nos. 97 and 143 and recommendations nos. 86 and 151 concerning migrant workers. (International Labour Conference, 66th Session, 1980) Report III (Part 4B).
Geneva, Switzerland, ILO, 1980. 189 p.In accordance with article 19 of the International Labor Office (ILO) Constitution, the Governing Body decided at its 201st Session (November 1976) to request reports on the Migration for Employment Convention (Revised), 1949 (No. 97), and the Migrant Workers (Supplementary Provisions) Convention, 1975 (No 143) from governments which have not ratified them, as well as reports on the Migration for Employment Recommendation (Revised), 1949 (No. 86), and the Migrant Workers Recommendation, 1975 (No. 151). These reports, dealing with the state of law and practice in relation to the standards laid down by the instruments in question, and the reports supplied under article 22 of the Constitution by govenments that have ratified 1 or both of the Conventions, have enabled the Committee of Experts to make a general survey of the situation. Reports have been received from 109 countries either under article 19 of the Constitution of the ILO on Conventions Nos. 97 and 143 and Recommendations Nos. 86 and 151 or under article 22 on the 2 Conventions when they have ratified them. An appendix provides detailed information on the countries that have communicated reports. The plan adopted for this present survey is as follows: preliminary measures of protection--information and assistance and recruitment, introduction, and placement of migrant workers; protection against abusive conditions (migrations in abusive conditions, the illegal employment of migrant workers, and minimum standards of protection); equality of opportunity and treatment and social policy; and certain aspects of the employment, residence, and departure of migrant workers. The vast range of subjects covered illustrates the complexity of the subject of migration for employment. The measures needed for the protection of migrant workers extend beyond their period of actual employment and must cover the initial phase of information, recruitment, travel, and settlement into the country of employment and the regulation of rights arising out of the employment but continuing after its termination. During the period of employment, they go beyond measures dealing exclusively with conditions of work to cover various other aspects of conditions of life which affect the context in which the migrant worker has to work and form the broader framework of the conditions of work and life of migrant workers. Thus, it is possibly understandable that few governments have covered all the subjects dealt with in the instruments in their reports. Convention No. 97 has been ratified to date by 34 countries and Convention 143 has been ratified by 8 States. Problems exist in many member States in affording to migrant workers the guarantees provided for in the instruments.
Migrant workers: summary of reports on conventions nos. 97 and 143 and recommendations nos. 86 and 151 (Article 19 of the Constitution). (International Labour Conference, 66th Session, 1980) Report III, part 2.
Geneva, Switzerland, ILO, 1980. 151 p.Article 19 of the Constitution of the International Labor Organization (ILO) provides that Members shall report to the Director General at appropriate intervals on the position of their law and practice in regard to the matters dealt with in unratified Conventions and Recommendations. The reports summarized in this volume concern the Migration for Employment Convention (Revised) (No. 97) and Recommendation (Revised) (No. 86), 1949, Migrant Workers (Supplementary Provisions) Convention, 1975 (No. 143) and Migrant Workers Recommendation, 1975 (No. 151). The governments of member States were asked to send their reports to the ILO Office by July 1, 1979, and this summary covers country reports received by the Office up to November 1, 1979. Reports are included for the following countries: Argentina, Austria, Belgium, Benin, Bolivia, Botswana, Brazil, Cameroon, Colombia, Congo, Cuba, Cyprus, Czechoslovakia, Dominican Republic, Egypt, El Salvador, Fiji, Finland, France, Gabon, German Democratic Republic, Guyana, Hungary, India, Japan, Kuwait, Lebanon, Luxembourg, Madagascar, Malaysia, Mali, Malta, Mauritius, Mexico, Mongolia, Morocco, Netherlands, Niger, Nigeria, Norway, Pakistan, Panama, Peru, Philippines, Poland, Portugal, Romania, Rwanda, Senegal, Sierra Leone, Singapore, Spain, Sri Lanka, Sudan, Surinam, Swaziland, Sweden, Switzerland, Tanzania, Turkey, USSR, UK, Uruguay, Venezuela, and Zambia.
[Unpublished] . Presented at the Western Hemisphere Conference of Parliamentarians, 4 December 1982, Brasilia. 11 p.In this address to Western hemisphere parlimentarians, the Executive Director of the United Nations Children's Fund (UNICEF) urged conference participants from Latin American countries to serve as advocates for the children in their countries by 1) promoting national policies to reduce infant and child mortality through the implementation of oral rehydration therapy and nutrition surveillance programs; 2) encouraging their respective countries to implement and maintain the International Code on Marketing of Breastmilk Substitues; and 3) lending their support to UNICEF's newly proposed programs to help abandoned children. UNICEF's mission is to help the millions of children trapped by proverty. In line with this goal, UNICEF urges the Latin American countries to focus attention on 1) the 20 million Latin American children, aged 0-4 years, living in poverty and at high risk of death, malnutrition, and serious mental and physical disability; and 2) on the 30 million Latin American street children who have either no ties or only weak family ties. In reference to the 1st group of children, UNICEF urges countries which have not already done so to implement low cost oral rehydration therapy and nutritional surveillance programs and to adopt policies which will reverse the trend toward bottlefeeding. These activities cost little and involve little or no political risk, however, they can siginificantly reduce infant and child death rates. Reductions in the death rate will not, as some fear, increases the population growth problem; indeed, the opposite is true. Historically it has been demonstrated that in countries with an overall death rate of 14-15/1000 population, for each subsequent decline in the death rate there is a larger decline in the birth rate. For example, in Brazil between 1960-80 a 5 point decline in the death rate was accompanied by a 13 point decline in the birthrate. In reference to the 30 million street children, UNICEF is currently developing special programs aimed at providing care and training for these children. Institutionalizing street children is costly and does not provide the home-like environment these children require. Innovative programs, such as group homes, children's cooperative villages, and other community based approaches are less costly and provide the type of support these children need to become productive and adjusted members of society. UNICEF is undertaking a cost benefit analysis of these alternative strategies. UNICEF expects to present a proposal at the 1983 session of the Executive Board to develop a major regional program in Latin America to assist street children and to prevent child abandonment. The program will require siginificant financial support and government support if it is to achieve its goals.
[Nairobi, Kenya], International Planned Parenthood Federation, Africa Region, . 28 p.This profile of Sierra Leone discusses the following: geographical features; neighboring countries; ethnic and racial groups and religion; systems of government; population, namely, size, distribution, age/sex distribution, and women of reproductive age; socioeconomic conditions -- agriculture, industry, exports, imports, employment, education, health, and social welfare; family planning/population -- government policies, programs, Planned Parenthood Association of Sierra Leone (PPASL), nongovernment organizations and voluntary agencies, private organizations, sources of funding, and future trends of policies and programs; and the history, constitution, and structure and administration of the PPASL. According to the 1974 census, the population of Sierra Leone totaled 2,735,159. In 1980 it was estimated to have grown to 3,474,000. With an average annual growth rate of about 2.7%, it is expected to reach 6 million in 2000 and to have doubled in 27 years. Sierra Leone has a population density of 48 people/sq km. In 1974, 27.5% of the population lived in urban centers with 47% living in Freetown alone. The indigenous population includes 18 major ethnic groups; the Temne and Mende are the largest of these. The percentage of nonnationals increased from 2.7% in 1963 to 2.9% in 1974 and includes nationals mainly from the West African subregion with a sprinkling of British, Lebanese, Americans, Indians, and others. In 1974 the sex ratio was 98.8 males/100 females. In 1981 it was estimated that 41% of the total population was under age 15 and 5% over age 65, making the dependency burden very high. Agriculture is now the main focus of the government's development policy. Minerals are an important source of foreign exchange. It was estimated in 1980 that the total economically active population would reach 1.2 million, of whom the majority would be employed in agriculture. Women made up approximately 1/3 of the economically active population in 1970. The adult literacy rate recently has been estimated at 12% of the population. The government allows the PPASL to freely operate in the country, but it has not as yet declared a population policy. In 1973 the government did recognize the effects of rapid population growth on the nation's socioeconomic development. As a pioneering organization in family planning, the PPASL has made considerable effort in promoting the concept of responsible parenthood. Its motivational programs are geared towards informing and educating the public on the need for having only those children whom individuals and couples can adequately provide for in terms of health, nutrition, education, clothing, and all other basic necessities. Family planning services are provided to meet the demand thus created to enable families and individuals to exercise free and informed choice for spacing or limiting of children. Between 1971 and 1983 the UN Fund for Population Activities (UNFPA) provided financial assistance to Sierra Leone for population activities in the amount of US$2,659,382.