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Geneva, Switzerland, World Health Organization [WHO]. 2011.  p.This recently published book highlights actions to improve health equity based on findings from the nine global Knowledge Networks that were established during the WHO Commission on Social Determinants of Health. Their task was to synthesize existing evidence and identify effective and appropriate actions to improve health equity in nine thematic areas: globalization; gender; social exclusion; early child development; urban settings; employment conditions; health systems; public health programs; and measurement and evidence. The evidence reinforces the fundamental impact of social determinants on health outcomes and in creating health inequities.
Untangling Gordian knots: improving tuberculosis control through the development of “programme theories.”
International Journal of Health Planning and Management. 2004; 19:217-226.We argue that if the lessons from tuberculosis control programmes are to be drawn effectively then a more nuanced understanding is needed that takes account of the complex health system environment within which they sit. We suggest that a conceptual framework that draws upon the World Health Organization’s DOTS strategy can be harnessed to assist the systematic analysis of programmes in a way that links this vertical, disease specific strategy to horizontal health system factors so that comparisons can be made. This multi-disciplinary, multimethod approach to the evaluation builds upon the work of others including Pawson and Tilley and their ‘programmes theories’. This work has informed the application of an evaluation toolkit which has been successfully applied in a number of settings and assisted in the sustainable implementation of a DOTS strategy in Russia. (author's)
Science. 2003 Dec 12; 302(5652):1919-1920.Attaining sustainability will require concerted interactive efforts among disciplines, many of which have not yet recognized, and internalized, the relevance of environmental issues to their main intellectual discourse. The inability of key scientific disciplines to engage interactively is an obstacle to the actual attainment of sustainability. For example, in the list of Millennium Development Goals from the United Nations World Summit on Sustainable Development, Johannesburg, 2002, the seventh of the eight goals, to "ensure environmental sustainability," is presented separately from the parallel goals of reducing fertility and poverty, improving gains in equity, improving material conditions, and enhancing population health. A more integrated and consilient approach to sustainability is urgently needed. (author's)
Ann Arbor, Michigan, University of Michigan, Dept. of Population Planning and International Health, . xxxiii, 134 p.In August 1989, scientists and leaders of international and national groups met at the international symposium for the Survival of Mankind in Tokyo, Japan, to discuss ideas about the interrelationship between population, environment, and development and obstacles to attaining sustainable development. The President of the Worldwatch Institute opened the symposium with a talk about energy, food, and population. Of fossil fuels, nuclear power, and solar energy, only the clean and efficient solar energy can provide sustainable development. Humanity has extended arable lands and irrigation causing soil erosion, reduced water tables, produced water shortages, and increased salivation. Thus agricultural advances since the 1950s cannot continue to raise crop yields. He also emphasized the need to halt population growth. He suggested Japan provide more international assistance for sustainable development. This talk stimulated a lively debate. The 2nd session addressed the question whether the planet can support 5. 2 billion people (1989 population). The Executive Director of UNFPA informed the audience that research shows that various factors are needed for a successful population program: political will, a national plan, a prudent assessment of the sociocultural context, support from government agencies, community participation, and improvement of women's status. Other topics discussed during this session were urbanization, deforestation, and international environmental regulation. The 3rd session covered various ways leading to North-South cooperation. A Chinese participant suggested the establishment of an international environmental protection fund which would assist developing countries with their transition to sustainable development and to develop clean energy technologies and environmental restoration. Another participant proposed formation of a North-South Center in Japan. The 4th session centered around means to balance population needs, environmental protection, and socioeconomic development.
[Unpublished] 1994. Presented at the 1994 Southern Demographic Association Annual Meeting, Atlanta, Georgia, October 20-22, 1994. , 40, 10 p.This analysis uses two different measures of the parity progression ratio (PPR) in a period analysis of fertility and the impact of the family planning program on fertility in Kenya. The study is part of a UNFPA project including 14 other developing countries. Survey data from the 1978 World Fertility Survey and the 1989 Demographic and Health Survey provide data for the analysis. PPR is calculated first by a life table technique using birth probabilities specific for parity and birth interval in a period. PPR in the second calculation is an age-parity-adjusted progression based on schedules produced by Feeney. Results are presented for marital unions, first birth, birth intervals, parity progression, the impact of the family planning program, and socioeconomic differences. The results show an increase in age at first birth during the 1970s and 1980s. There is also a decrease in first births among adolescents between the 1960s and the late 1980s. A new finding is a reverse trend; a 1 year decrease in median age at first marriage occurred in urban areas between 1981-85 and 1985-89. The decrease is attributed to an increase in adolescent marriage in the late 1980s. By the 1980s families were being built at older ages, and births were being spaced farther apart. Adolescent first births and high parity births declined between the 1960s and 1980s. The trends reflect a clear and consistent pattern of modernization and better health with decreased population growth. Fertility is expected to reach replacement level soon. The family planning program contributed to the decline in progression to 6th and higher parities by 5% over 30 years. Higher marriage age and later age at first birth were related to higher educational status, although rural marriage age was higher by 0.7 years than urban marriage age. There was a high rate of adolescent marital unions, particularly informal unions, in urban areas. Teenage births were higher in rural areas. Urban women had a lower PPR in all birth orders than rural women. Median birth interval did not vary with educational level. A shorter than 24 month birth interval for 2nd and low order births occurred among the most educated and those in urban areas.
Washington, D.C., World Bank, 1990. xvi, 97 p. (World Bank Discussion Papers 107)The interactions within and between the determinants and consequences of rapid population growth in Kenya are analyzed with a view to fostering a research agenda and proving insights for the creation of a population strategy during the next decade. Despite Kenya's long-standing concern about checking its rapid population growth, annual growth rates reach 4%. However, Kenya may be entering a new demographic phase of declining growth rates. Population pressure, through both reduced benefits and increasing costs of children to the household, may be responsible for moderate demographic change. Fertility declines with an eventually sustainable balance between population numbers and the economy and the environment depend upon factors motivating parents to desire fewer offspring. These motivating factors, in turn, depend upon the interrelations among population growth, society, economy, and population policy and programming. While the time frame for demographic transition remains elusive, population programming undertaken thus far, though failing to effect change up to now, may hold the key to future successes. Health delivery and family planning systems are already in place and will influence the pace of population growth decline during future decades. Population and economic trends, population policies and programs for the period 1965-89, research, strategy, and recommendations are discussed at length.
Social Science and Medicine. 1991; 33(8):959-62.An investigation on the "jidda," the traditional birth attendant (TBAs) of Yemen, was undertaken in 1989 because WHO training of TBAs in Yemen was regarded to have had mixed results. Information was collected through semistructured interviews between July and November 1989 in villages in the Anis region of the central highlands of Yemen: Taalibi, Hamaan Ali, Dhi Hud, Al Mashahidhah, and Al Masna'ah. Taalibi and Hamaan Ali were two of the original training sites, at which all 16 TBAs were trained. Of these, 14 TBAs plus approximately 28 untrained TBAs and village women were selected at random and interviewed. Quantitative data on the number of deliveries made before and after the training by 7 of the TBAs were made available. The term "jidda" was designated as the appropriate Yemini Arabic name for TBA and was generally accepted within the Primarily Health Care (PHC) terminology within Yemen. The term literally means grandmother. WHO policy assumes that the training of one or two TBAs in each village will provide all women with basic mother and child health care. Initially a confusing mixture of terms was used in the villages to refer to women who assist at deliveries. These terms included references to the woman who cut the cord. A final understanding was reached that the term "jidda" will mean WHO project-trained women. Nontrained women are called "those who cut the cord." The term "jidda" as a person with specialized knowledge and experience with deliveries is not connected to traditional terms for women, who of old, assisted at deliveries. Assistance at delivery is provided by variety of kin, neighbors, and related women living proximate to the women delivering. Remuneration is the promise of rewards in the afterlife. The job is not a fulltime occupation. The delivery process is describe, and it is clear that the assistant provides emotional support and literally cuts the cord. Providing an image of professionally and specialization and the bag of instruments to a few "jidda" has lead to inequality and confusion. "Jidda" still cut the cord, and the 7 trained "jidda" have not expanded their area outside if their neighborhoods. It is suggested that training be given to midwives and that research into the local situation occur prior to training activities in order for objectives to be achieved. In this situation less sophisticated training should be given to all women assisting in deliveries.
Maternal mortality and the right of the child to survival, protection and development. Perspectives on southern and eastern Africa in light of international law.
In: The effects of maternal mortality on children in Africa: an exploratory report on Kenya, Namibia, Tanzania, Zambia, and Zimbabwe, [compiled by] Defense for Children International-USA. New York, New York, Defense for Children International-USA, 1991. 97-143.How international law documents such as the Convention on the Rights of the Child establish a legal framework within which to promote child survival in Southern and Eastern Africa, emphasizing the documents' significance for maternal mortality, the most important factor affecting child survival, is examined. In November 1989, the UN General Assembly unanimously adopted the Convention, a comprehensive treaty that establishes the rights of children and their families, outlining the responsibilities of governments and adults in securing those rights. By September 1990, most countries in Southern and Eastern Africa had ratified the treaty; the remaining countries had pledged to approve it. The Convention not only obligates governments to allocate greater resources to the most vulnerable members of society, but also requires a higher level of international cooperation, including greater commitment from industrialized countries and greater participation at the grassroots level. The economic, social, and cultural dimensions of maternal mortality and its impact on child survival are discussed, as well as the maternal and child survival issues addressed by the Convention: 1) maternal-child health services; 2) traditional practices harmful to the mother and child (in this case, female circumcision and child marriage); and 3) survival and development through international cooperation. The implications of the Convention on the primary health care model are also discussed. The impact of other international documents on maternal mortality and child health is examined.
POPULATION GEOGRAPHY. 1989 Jun-Dec; 11(1-2):86-96.This paper surveys the contributions of the International Geographic Union (IGU) and the International Cartographic Association (ICA) to the field of population studies over the past 3 decades. Reviewing the various focal themes of conferences sponsored by the organizations since the 1960s, the author examines the evolution of population studies in IGU and ICA. During the 1960s, IGU began holding symposia addressing the issue of population pressure on the physical and social resource in developing countries. However, it wasn't until 1972, at a meeting in Edmonton, Canada, when IGU first addressed the issue of migration. But since then, migration has remained on the the key concerns of IGU. In 1978, the union hosted a symposium on Population Redistribution in Africa -- the first in a series of conferences focusing on the issue of migration. As an outgrowth of migration, the IGU also began addressing the related issue of population education. The interest in migration has continued through the 1980s. In addition to studies of regional migration, the IGU has also focused on conceptual issues such as migrant labor, environmental concerns, women and migration, and urbanization. In 1984, IGU began cooperating with ICA in the areas of census cartography and population cartography. The author concludes his review of IGU and ICA activities by discussing the emerging trends in population studies. The author foresees a more refined study of migration and more sophisticated population mapping, the result of better study techniques and the use of computer technology.