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Food and Nutrition Bulletin. 2004; 25 Suppl 1:S60-S65.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) African site was Accra, Ghana. Its sample was drawn from 10 affluent residential areas where earlier research had demonstrated the presence of a child subpopulation with unconstrained growth. This subpopulation could be identified on the basis of the father's education and household income. The subjects for the longitudinal study were enrolled from 25 hospitals and delivery facilities that accounted for 80% of the study area's births. The cross-sectional sample was recruited at 117 day-care centers used by more than 80% of the targeted subpopulation. Public relations efforts were mounted to promote the study in the community. The large number of facilities involved in the longitudinal and cross-sectional components, the relatively large geographic area covered by the study, and the difficulties of working in a densely populated urban area presented special challenges. Conversely, the high rates of breastfeeding and general support for this practice greatly facilitated the implementation of the MGRS protocol. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S66-S71.The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) Asian site was New Delhi, India. Its sample was drawn from 58 affluent neighborhoods in South Delhi. This community was selected to facilitate the recruitment of children who had at least one parent with 17 or more years of education, a key factor associated with unconstrained child growth in this setting. A door-to-door survey was conducted to identify pregnant women whose newborns were subsequently screened for eligibility for the longitudinal study, and children aged 18 to 71 months for the cross-sectional component of the study. A total of 111,084 households were visited over an 18-month period. Newborns were screened at birth at 73 sites. The large number of birthing facilities used by this community, the geographically extensive study area, and difficulties in securing support of pediatricians and obstetricians for the feeding recommendations of the study were among the unique challenges faced by the implementation of the MGRS protocol at this site. (author's)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S78-S83.The World Health Organization (WHO) Multicentre Growth Study (MGRS) Middle East site was Muscat, Oman. A survey in Muscat found that children in households with monthly incomes of at least 800 Omani Rials and at least four years of maternal education experienced unconstrained growth. The longitudinal study sample was recruited from two hospitals that account for over 90% of the city's births; the cross-sectional sample was drawn from the national Child Health Register. Residents of all districts in Muscat within the catchment area of the two hospitals were included except Quriyat, a remote district of the governorate. Among the particular challenges of the site were relatively high refusal rates, difficulty in securing adherence to the protocol's feeding recommendations, locating children selected for the cross-sectional component of the study, and securing the cooperation of the children's fathers. These and other challenges were overcome through specific team building and public relations activities that permitted the successful implementation of the MGRS protocol. (author's)
BMJ. British Medical Journal. 1992 May 30; 304(6839):1392-3.The role of physicians in dealing with global poverty and environmental destruction is through education of the medical community and others, research, campaigning, and individual, concerted action. The World Bank has issued a warning that world poverty is increasing and is associated with environmental destruction. The World Bank further states that it is morally necessary to lessen poverty as a prerequisite to sustaining the environment. An estimate of $75 billion/year until the year 2000 was given as essential for water and sanitation programs, electricity, infrastructure, carbon dioxide emissions, agriculture, population, and female education. The ideological split is no longer East vs. West but rich vs. poor. World survival is at stake. The rich have an important role to play in redirecting resources to the developing world, easing the debt crisis, and meeting costs of environmental improvement. Carefully planned economic development should reduce pollution. Situations such as the US ceasing use of coal to reduce carbon dioxide emissions being offset by the Chinese doubling coal consumption by the year 2000 should not occur. Rich countries must become involved in global poverty not only because it is wrong that almost 2 billion people are without enough food and water but also countries with power and resources have a responsibility to take the lead. Global economic conditions created the debt crisis. Money was loaned eagerly by commercial banks in the 1970 when the banks were flooded with oil dollars. The crisis came in 1980 when the US government forced up interests rates. The result was that in 1990 developing countries had to pay back 34.5 million pounds in interest on their debt after receiving 28.3 billion pounds in aid. The poor paid 17.40 pounds/person. Debt exceeded gross national product in some countries. The International Monetary Fund pressured governments to cut public spending, consumer subsidies, and wages. Educational expenditures in 37 very poor countries declined by 25%. Efforts have been made through the 1989 Brady plan and in 1990 John Major's Trinidad plan to ease poor countries debt obligations. The "Economist" recommends that governments force banks to write off the debts.
In: International Union for the Scientific Study of Population. Economic and demographic change: issues for the 1980's. Proceedings of the Conference, Helsinki, 1978. Vol. 2. Liege, Belgium, IUSSP, 1979. 279-91.A set of rural-urban migration national indicators for developing countries has been developed by the U.N. Population Division for Africa, Asia, and Latin America. Asian countries have a rural out-migration rate that is higher, by 2-3/1000, than the rate for Latin American countries. Latin American countries have higher crude rates of out-migration than Asian, but the differences are explicable by other variables. Net rural out-migration is faster the higher the initial economic levels. Rural-urban migration is accelerated by high rates of economic growth, of agricultural productivity growth, and rural natural increase. In combination, these variables account for about 60% of the variance in levels of rural-urban migration in a sample of 29 developing countries with a population of 1.3 billion. When these factors are controlled, initially large regional differences are reduced to insignificance. Urbanization is closely associated with economic structural factors. Although the high rates of urbanization may cause alarm, antimigration policies should be made with the understanding that migration is an integrated role of locational changes in the modernization process. Rising levels of personal income, demand for agricultural products, and greater efficiency of production will continue to contribute to rural-urban migration. (Summary in FRE)
Population and Development Review. 1979 Mar; 5(1):1-27.The United Nations constructed a global economic model with which to assess the "income gap" between developed and developing nations. The model divides the world into 15 regions under 3 group categories. The developed regions are North America, Eastern Europe, Western Europe (high and medium income), the Soviet Union, Japan, Oceania, and South Africa. They are characterized by advanced industrialization and high average per capita income. The developing regions, the Middle East, Venezuela, some Andean countries, parts of Tropical and Northern Africa, are rich in natural resources. The rest have few resources. The 2,625 equations in the model provide a description of the structural relationships governing the intersectoral relationships among the 15 regions. A shift from a low to high population level in the developed countries would lead to a 5.1% downward shift in their per capita gross domestic product. Population increases generally instigate a less than proportional increase in total gross domestic product. Any number of scenarios, however, can be constructed on the basis of the model. Developing countries in the resource poor group will increase per capita income growth if their population increases slowly. The data which is missing is a quantitative description of the effect of economic variables on the demography of the individual regions and corresponding population growth rates.