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Geneva, Switzerland, World Health Organization [WHO], 2010.  p. (Discussion Paper Series on Social Determinants of Health No. 1)Today an unprecedented opportunity exists to improve health in some of the world's poorest and most vulnerable communities by tackling the root causes of disease and health inequalities. The most powerful of these causes are the social conditions in which people live and work, referred to as the social determinants of health (SDH). The Millennium Development Goals (MDGs) shape the current global development agenda. The MDGs recognize the interdependence of health and social conditions and present an opportunity to promote health policies that tackle the social roots of unfair and avoidable human suffering. The Commission on Social Determinants of Health (CSDH) is poised for leadership in this process. To reach its objectives, however, the CSDH must learn from the history of previous attempts to spur action on SDH. This paper pursues three questions: (1) Why didn't previous efforts to promote health policies on social determinants succeed? (2) Why do we think the CSDH can do better? (3) What can the Commission learn from previous experiences -- negative and positive -- that can increase its chances for success? (Excerpt)
In: Women in the Third World: an encyclopedia of contemporary issues, edited by Nelly P. Stromquist. New York, New York, Garland Publishing, 1998. 477-85. (Garland Reference Library of Social Science Vol. 760)After an introduction that describes the UN Decade for Women (1976-85) as a catalyst to development of the global women's movement, this essay reviews the legal instruments and world conferences that led up to the Decade for Women. Selected conventions of concern to women from 1949 are tabulated to illustrate the number of ratifications received as of September 1993, and eight milestones in the UN effort to advance women are listed. The discussion then focuses on the Convention on the Elimination of All Forms of Discrimination Against Women, on the Nairobi Forward-Looking Strategies, and on the Fourth World Conference on Women and its Platform for Action. The next section of the essay describes the feminist networking that has flourished since the first women's conference in 1975 and received enough encouragement at the second conference in 1985 to spawn a global feminist movement. The essay continues with a review of the status of academic research into gender issues and of shifting policy in the UN system and other donor agencies as a result of adoption of a "Women in Development" approach. The essay then reviews the UN's 1994 World Survey on the Role of Women in Development to illuminate the role of women in a changing global economy and covers UN publications that seek to explicate women's positions in various regions in the 1990s. The essay concludes that the UN Decade for Women helped create common ground between activists in the North and the South, fostered networking, legitimized activities to promote women's rights, and inspired the UN to take action to advance women within its system.
Tokyo, Japan, Asian Population and Development Association, 1996 Dec. 33 p. (APDA Resource Series 2)This paper presents an overview of the distinguishing features of the 20th century by focusing on the decades between the first and third World Population Conferences (1974-94). The essay opens with a prologue which describes the increasing concern about population growth which served as the background to the development of the progressive World Population Plan of Action (WPPA) in 1974 and presents current population projections and annual growth rate data. The next topic is the adoption of the WPPA, with its last minute attention to family planning programs, at the Bucharest Conference. This is followed by consideration of the "Bucharest effect" which included reversals by China and India which led to their adoption of new policies to control growth. Discussion of the "quiet gathering" at Mexico City which adopted recommendations to further implement the WPPA in 1984 is augmented with a look at the ripple caused by the denial of the US delegation of the possibility of achieving demographic goals before achieving economic development. The three global upheavals experienced in the 20th century after the watershed of World War II are then identified as the world population explosion, the destruction of the global environment, and the conflicts which followed the fall of the Berlin Wall. The ensuing discussion then considers the three most important aspects of the world population crisis: the population growth rate, the size of the annual increases, and total global population. Finally, the paper looks at the Fourth International Conference on Population and Development during which the WPPA became a Programme of Action which embraced a revolutionary strategy calling for the empowerment of women to achieve population stability and development, emphasizing reproductive health care, and establishing targets to reduce death rates. The essay concludes by calling for a revolution in thinking to derive ways to cope with the upcoming 30 years of rapid population growth.
In: Vaccines for fertility regulation: the assessment of their safety and efficacy. Proceedings of a Symposium on Assessing the Safety and Efficacy of Vaccines to Regulate Fertility, convened by the WHO Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, June 1989, edited by G.L. Ada, P.D. Griffin. Cambridge, England, Cambridge University Press, 1991. 5-11. (Scientific Basis of Fertility Regulation)The predecessor of the WHO Task Force on Vaccines for Fertility Regulation chose to commit most of its resources to research and development of a vaccine directed against human chorionic gonadotropin (hCG). Task force members made this choice in 1978 because scientists tended to already know the amino acid sequence and general structure of hCG and a vaccine against hCG would prevent implantation of the fertilized ovum. Specifically they focused on the unique sequence of C-terminal 37 amino acid peptide of the beta chain of hCG because this method would not allow production of antibodies cross reacting with human luteinizing hormone and would reduce the risk of autoimmune pathology and other effects of cross reactivity of antibodies. They also defined the various parameters and the methodology to assess the safety of the approach which still is a useful guide to development of hCG and other antifertility vaccines. The Task Force strongly recommended that target antigens should be temporary and in relatively low amounts and limited to gametes and/or early products of fertilization. A Phase I clinical trial in sterilized women has already been conducted and a limited efficacy trial in fertile women is planned. In June 1989, WHO hosted a symposium in Geneva, Switzerland to review the safety and efficacy of antifertility vaccines based on past and current research and development. This symposium focused much attention on immunological and endocrine considerations. WHO forecasted that recommendations coming from the symposium would not only guide future research on vaccines against self-antigens but maybe even antitumor vaccines.
CEYLON MEDICAL JOURNAL. 1990 Dec; 35(4):136-42.The story of the Sri Lankan Family Planning movement is told from its inception in 1953, prompted by a visit by Margaret Sanger 1952. The Family Planning Association of Sri Lanka was founded with the health of women and children, and both contraception and infertility treatment as its policies. The first clinic, called the "Mothers Welfare Clinic," treated women for complications of multiparity: one woman was para 26 and had not menstruated in 33 years. The clinic distributed vaginal barriers, spermicides and condoms, but the initial continuation rate was <5% year. Sri Lanka joined the IPPF in 1954. In 1959, after training at the Worcester Foundation, and a personal visit by Pincus, the writer supervised distribution of oral contraceptives in a pilot project with 118 women for 2 years. Each pill user was seen by a physician, house surgeon, midwife, nurse and social worker. In 1958 Sweden funded family planning projects in a village and an estate that reduced the birth rate 10% in 2 years. The Sri Lankan government officially adopted a family planning policy in 1965, and renewed the bilateral agreement with Sweden for 3 years. In 1968 the government instituted an integrated family planning and maternal and child health program under its Maternal and Child Health Bureau. This was expanded in 1971 to form the Family Health Bureau, instrumental in lowering the maternal death rate from 2.4/1000 in 1965 to 0.4 in 1984. During this period IUDs, Depo Provera, Norplant, and both vasectomy and interval female sterilizations, both with 1 small incision under local anesthesia, and by laparoscopic sterilization were adopted. Remarkable results were being achieved in treating infertile copies, even from the beginning, often by merely counseling people on the proper timing of intercourse in the cycle, or offering artificial insemination of the husband's semen. Factors contributing to the success of the Sri Lankan planned parenthood program included 85% female literacy, training of health and NGO leaders, government participation, approval of religious leaders, rising age of marriage to 24 years currently, and access of all modern methods.
[Unpublished] 1989 Nov. 126 p. (A/E/BD/4/Sec. II)UNFPA has published a comprehensive document on the state of the art of maternal and child health and family planning (MCH/FP) worldwide. This paper mostly focuses on family planning because that is UNFPA's mandate, but since MCH/FP services are often delivered in an integrated fashion the recommendations and strategies for the management and administration of FP in this paper can also apply to MCH services. This document is a practical and useful historical analysis that traces past, current and future trends in family planning. It discusses issues and strategies, controversies, conflicts, advantages and disadvantages of population/FP issues by region and between developed and developing countries. The reader gets a comprehensive overview in MCH/FP during the past 3 decades. Major conferences, policies and events focusing on MCH/FP issues are interwoven into the multiple factors involved in FP practice and future needs. There are 9 chapters and 14 tables of valuable data. The chapters include: 1) Introduction; 2) Current FP practice and future needs in developed and developing countries; 3) Macro-environmental factors affecting provision of services; 4) Approaches to service delivery in the public and private sectors; 5) Current and future contraceptive technology; 6) Strategic issues; 7) Administrative issues; 8) Special challenges; and 9) Future priorities.
Report of the Executive Director on the policy implications of the findings and conclusions of the UNFPA's review and assessment of population programme experience.
New York, New York, United Nations Population Fund [UNFPA], 1989 Apr. 14. 25 p. (DP/1989/37; A/E/BD/1)This 20 year review and assessment of UNFPA's population experience and operations. 3 major areas focusses on: 1) population data, policy development and planning; 2) maternal and child health and family planning (MCH/FP); 3) and information, education and communication. Even though 82% of the developing world's population live in countries where current rates of population growth are considered too high; where 84% live in countries were fertility rates are considered too high; where 91% live in countries where levels of life expectancy are too low and where close to 90% live in countries where population patterns of distribution are unacceptable, most of the governments have not been able to implement population policies effectively. There is an urgent need for more rigorous population interventions in the future by developing clear and achievable goals, activities to improve program effectiveness and mobilization of required resources for the 1990's at national and international levels. UNFPA's 4 major population program goals for the 1990's are: 1) development of comprehensive population policies to help achieve sustainable development; 2) decelaration of rapid population growth through the expansion of information, education and services for FP; 3) lowering the current levels of infant, child and maternal mortality rates; and 4) improvement of the role, status and participation of women. Means to success include obtaining political commitment; introducing strategic planning and programming; diversifying the agents for demographic change; and strengthening resource mobilization. The international donor community must raise the amount and quality of assistance provided and improve donor cooperation and collaboration.
In: Proceedings of the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C., edited by Richard Cash. Washington, D.C., Agency for International Development [AID], Bureau for Science and Technology, 1983. 4-5. (International Conference on Oral Rehydration Therapy, 1983, proceedings)The Honorable Margaret Heckler, secretary of Health and Human Services, presents the goal of the conference--discussion of the remarkable potential of oral rehydration therapy and its importance to the health of infants and children throughout the world. The conference celebrates the scientific advances of recent years that give new hope for millions of children every year. Over 500 million episodes of diarrhea afflict infants in developing countries each year; each year, some 5 million children lose their lives to these diseases. In Europe, and in North America as well, diarrhea is the 6th most common cause of death among small children. At the turn of the century, mortality due to cholera was 60%. A scientist in Calcutta and 1 in Manila developed methods of intravenous therapy that reduced mortality dramatically to 20%. Treatment of the disease remained relatively unchanged until the middle of the century when work in Egypt and Asia resulted in a therapy method that reduced mortality for cholera to less than 1%. The crucial discovery of an effective cholera agent occurred in India in 1959. In 1962, scientists in Manila established the vital role of oral glucose in the absorption of sodium and water. The large-scale use of oral rehydration therapy was demonstrated in Dhaka and Calcutta in the 1960s, when 100s of cholera cases were managed under field conditions during a rural epidemic. A massive epidemic during a refugee crisis in 1971 was well-coped with by the Johns Hopkins group in Calcutta by treating 3700 patients over an 8-week period. This was one of the 1st large-scale uses of prepackaged materials for oral hydration, costing only US$750. In Dhaka and Calcutta in the early 1970s the critical discovery that noncholera diarrheal diseases could be treated with the oral rehydration therapy developed for cholera was made. The discovery of the role of glucose in accelerating the absorption of salt and water was underscored in the British journal "Lancet" as being potentially the most important medical advance of this century. A strong coalition of interest exists between governments and scientists of many nations as well as the international organizations to promote oral rehydration therapy. WHO, UNICEF, USAID and other agencies are playing an extremely important part in discovering how oral rehydration therapy can best be incorporated into broader health services, and how to prevent diarrheal diseases from occurring.