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Washington, D.C., World Bank, 1989. 55 p. (World Bank Technical Paper No. 102)After a brief explanation of the impact of breastfeeding on fertility worldwide, inaccurate assumptions about the decline of breastfeeding are explored to point out the need for renewed promotion of breastfeeding by World Bank projects. Breastfeeding, by inhibiting fertility through lactational anovulation, is one of the most important determinants of fertility, especially for 83% of couples in developing countries who do not use modern contraception. Many believe that breastfeeding does not need promoting in areas where it is the norm, yet this belief does not take into account the need for supporting breastfeeding women, teaching them to breastfeed exclusively and frequently for the 1st 4 months. The belief that declines in breastfeeding are inevitable is belied by recent evidence in developed countries. The reliability of breastfeeding as a contraceptive for individual women varies: poor, undernourished women who breastfeed extensively may be protected up to 21.7 months (Bangladesh). Advantages of breastfeeding include significant savings of money, foreign exchange, scarce contraceptive supplies, medical treatment of diarrhea and malnutrition in infants, and possibly mothers' time. In contrast, other caregivers can prepare milk substitutes, but breastfeeding can be encouraged in the work setting, or milk expressed for later use. A review of 68 World Bank Projects revealed that 37% of all Population, Health and Nutrition projects, enumerated in an appendix, contained explicit actions to promote breastfeeding. 10 recommendations for promoting breastfeeding end the report.
The Population Council's research program on infant and child mortality in Southeast Asia: a case study of the relationship between contamination of infant weaning foods, household food handling practices, morbidity, and growth faltering in a rural Thai population.
Bangkok, Thailand, Population Council, Regional Office for South and East Asia, 1986 Aug. 24 p. (Population Council Regional Research Papers. South and East Asia)This booklet describes the overall plan of the research program on infant and child mortality in Southeast Asia, sponsored by the Population Council, the Ford Foundation, the Australian Development Assistance Bureau, and the Canadian International Development Research Center. The objectives are to gain scientific knowledge about the socioeconomic, behavioral and medical factors in mortality; to increase awareness through networking and publication; and to evaluate the effectiveness of interventions at the household and community levels. It is assumed that a small number of simple techniques will prevent over half of child deaths. Applied social science or operations research will be used primarily, rather than clinical or demographic studies. Statistical sociological correlations between a variety of environmental characteristics and mortality as the dependent variable will point to determinants of mortality. The 5 chief determinants are: maternal factors, environmental contamination, nutrient deficiencies, injury, and personal illness controls. The concerns reflected in the projects funded so far include: to focus on some combination of determinants of child survival; to focus on a specific location; to use multiple approaches to data collection; to produce results that can be applied as interventions. As an example, the study on the relationship of contamination of infant weaning foods to morbidity and infant growth in a rural Thai population is summarized.