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Journal of Family Planning and Reproductive Health Care. 2008 Oct; 34(4):269-70.User choice is central to contraceptive practice, as opposed to therapeutic care where the view of the prescriber tends to prevail. Provider organisations have to make difficult decisions in selecting the methods of contraception that are offered, particularly with the multitude of new products and the controversies that have surrounded the value of some of them. The World Health Organization (WHO) Model List of Essential Medicines is a valuable tool in strengthening the provision of contraceptive commodities as part of international development efforts.
Improvement of oral health in Africa in the 21st century -- the role of the WHO Global Oral Health Programme.
African Journal of Oral Health. 2004; 1(1):2-16.Chronic diseases and injuries are overtaking communicable diseases as the leading health problems in all but a few parts of the world. This rapidly changing global disease pattern is closely linked to changing lifestyles which include diet rich in sugars, widespread use of tobacco and increased consumption of alcohol. These lifestyle factors also significantly impact oral health, and oral diseases qualify as major public health problems owing to their high prevalence and incidence in all regions of the world. Like all diseases, they affect primarily the disadvantaged and socially marginalized populations, causing severe pain and suffering, impairing functionability and impacting quality of life. Traditional treatment of oral diseases is extremely costly even in industrialized countries and is unaffordable in most low and middle-income countries. The WHO Global Strategy for prevention and control of noncommunicable diseases and the "common risk factor approach" offer new ways of managing the prevention and control of oral diseases. This report outlines major characteristics of the current oral health situation in Africa and development trends as well as WHO strategies and approaches for better oral health in the 21st century. (author's)
Global HealthLink. 2000 Mar-Apr; 102: p..A shift has been occurring in the family planning field from a focus on demographic goals and contraceptive prevalence to a more client-centered focus and recognition of the broader sexual and reproductive health (SRH) needs of clients. The 1994 International Conference on Population and Development’s Programme of Action and the 1995 United Nations Fourth World Conference on Women in Beijing have fueled rapid shifts in programs and policies toward a broader SRH approach, with particular emphasis on prevention of HIV and other sexually transmitted infections (STIs). Integration of HIV/STI prevention in family planning programs has been seen as important because family planning programs reach large numbers of sexually active people, and are often the only contact that women have with the health-care system. Although family planning programs are in a unique position to provide HIV/STI prevention services, many still concentrate almost entirely on contraceptive acceptance. (excerpt)
Implementation of the global strategy for Health for All by the Year 2000, second evaluation; and eighth report on the world health situation.
[Unpublished] 1992 Mar 6. 171 p. (A45/3)This 2nd evaluation of the global strategy for health for all (HFA) by 2000/8th report on the world health situation indicates a need for a new approach for sustainable health development which includes mobilizing resources for high priority populations and health needs, more effective and intersectoral health promotion and protection, and improving access to primary health care (PHC) via higher quality services and integrating health services into all social services. The data cover 96% of the world's population and the years 1985-90. The 1st chapter looks at the interaction among political, economic, demographic, and social development trends and their effects on health. It mentions the health development trend of increased involvement of individuals, communities, professional groups, and development agencies. The 2nd chapter centers on the progress of countries towards reaching HFA by examining the differences between the haves and the have nots. The 3rd chapter examines improvement and obstacles in health care coverage, PHC coverage, and quality of care. Chapter 4 reviews health resources including financial and human resources and health technology. The next chapter focuses on trends in mortality, morbidity, and disability and life style factors of health such as smoking. Chapter 6 examines policies and programs of environmental health, evaluation, and monitoring of environmental health hazards and risks, and environmental resources management. The 7th chapter brings together highlights and implications expressed in the previous chapters and states that health improvements have indeed occurred such as increased life expectancy. The last chapter uses the information in the preceding chapters to project future trends and mentions 5 challenges facing the world today.
Copenhagen, Denmark, WHO, Regional Office for Europe, Sexuality and Family Planning Unit, 1986 May. 12 p.In 1965, the World Health Assemble gave the World Health Organization (WHO) a mandate to offer advice on family planning to member states and later states that family planning is an important part of basic health services. In 1884 the 33 members of the European region adopted a plan of action for a consolidated health policy. The goal of this plan and strategy, is for people to have access to health services that will make it possible to have socially and economically productive lives. There will be 4 main areas of effort including, promotion of healthy lifestyles, prevention medicine, better primary health care systems, and more effective political, managerial, technical, manpower, and research to ensure the above. There are ongoing studies to consider sexual health in a variety of cultures. These will assess changing sex roles, information interchange on lifestyle factors and demographic trends, ideas on childrearing styles, and recommendations on the development of healthy sexual relationships. There will be assessments of harmful sexual behavior and the reduction of sexually transmitted diseases. To improve basic health care systems, this program will help[ clarify concepts, investigate needs, analyze present services, get client input, compare information, and draw up guidelines. Methods will be examined to improve information exchange and the distribution of research and other pertinent material. There will be guidelines for legislative proposals in relation to lifestyles that promote better health by 1991. The development of ways to integrate family planning programs and services and connect them to key areas of society, is a goal to be reached by 1993. Also training programs to improve the various aspects of family planning and sexuality, including the attitudes of health professionals is needed.
Progress towards health for all: third monitoring report. Progres vers la sante pour tous: troisieme rapport de suivi.
WORLD HEALTH STATISTICS QUARTERLY. RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1995; 48(3-4):174-249.In 1977, the World Health Assembly designated the year 2000 as the time by which it should be possible for all citizens of the world to obtain a level of health that would permit them to be socially and economically productive. This document, which assesses implementation of health-for-all strategies during 1991-93, is the third report to monitor progress toward this goal. The report opens with an introduction describing the monitoring process and the data upon which the assessment was based. The second section of the report describes population and socioeconomic trends and considers such issues as patterns in population growth, longterm trends in births and deaths, social change, age structure, migration, urbanization, refugees and displaced persons, and trends in education. The third section discusses trends in the provision of a healthy environment and promotion of healthy life styles. Section 4 summarizes health status data on life expectancy, mortality rates, causes of death, morbidity trends, disability trends, and the nutritional status of children. Implementation of primary health care (PHC)is covered in the next section, which looks at health education and promotion, food supply and proper nutrition, safe water and basic sanitation, maternal and child care, control of locally endemic diseases, immunization, treatment of common diseases, and PHC coverage. The sixth section assesses the development of health systems based on PHC and looks at national health policies, strategies, and legislation; organization and management of health systems based on PHC, intersectoral collaboration, community involvement, health systems research, technology for PHC delivery, international support for health system development, sustainable development initiatives, and emergency preparedness and relief. Section 7 is devoted to health resources in the areas of financial activities, human resources, the physical infrastructure, and logistics and supplies. The concluding section of the report summarizes the status of 1) the major determinants of health, 2) the implementation of PHC and the development of health systems, and 3) the distribution of health resources. The next in-depth analysis of progress toward health-for-all is scheduled to begin in 1997.
PLANNED PARENTHOOD BULLETIN. 1994 Mar; 41(9):1, 4.This summary of a draft document for the UN Conference on Population and Development scheduled for September 1994 in Cairo indicates that draft provides guidelines on what financial resources are needed to meet unmet family planning need and on the complexity of the issues. The document establishes, most importantly, the following goals for the future: 1) education, particularly for girls; 2) infant, child, and maternal mortality reduction; and 3) universal access to family planning and reproductive health services. Family planning goals should be in terms of unmet need for information and services rather than in terms of demographic targets. The principle of informed free choice must prevail. A desired outcome of 69% contraceptive use could be reached if family planning needs were met, the status of women improved, and child mortality reduced. Success will depend to a great extent on "changes in lifestyles, social norms, and government policies" and less on additional resources. The desired financial commitment from donor countries in the year 2000 is an increase to 4% of Official Development Assistance, or $13.2 billion annually from the present 1.4% or $1 billion. Present operating expenditures are $4.5 billion, of which developing countries would continue to provide about 66%. The sharp increase in desired funding would accommodate an increase in population needs for an additional 90 million sexually active people and expanded services for reproductive health. The 83-page draft document provides perspectives on the interrelationships between population, the environment, and economic growth over the next 20 years and the national and international resources required. The cost of access to family planning for every man and woman would amount to under $3.00 per year.
JOURNAL OF GENERAL INTERNAL MEDICINE. 1990 Sep-Oct; 5(5 Suppl):S132-5.The lessons learned from developing countries which are applicable equally to developed countries include the recognition that poverty and social justice are an integral part of a health strategy, that disease prevention involved active participation of the population, that better cost effective measures are desirable, and that individual and community involvement need to be encouraged. Prior to 1940, health care strategy involved the doctor as the locus of care for curing disease. Thereafter, through the agenda of the WHO, there was a shift towards emphasis on community health, environmental sanitation, health education, and prevention; the goal was health for all. The 1978 WHO meeting in Alma-Ata set goals for the year 2000 as 1) health care users being actively involved in caring for themselves, 2) the implementation of cost effective strategies, 3) expanding the health team to other disciplines, and 4) achieving equity in services provided and outcomes. Primary health care approaches have successfully reduced infant and child mortality through immunization, clean water and sanitation efforts, breast feeding, household involvement in treatment of diarrhea, and monitoring growth and nutrition. The lesson to be learned from developed countries is that prevention is more cost effective than illness management, particularly with the availability of new expensive technologies. Education and other primary prevention efforts can be successful in reducing smoking, auto fatalities, environmental contamination, and AIDS. Health in the US: 50-100 years ago was similar to that in developing countries today, and the shift from infectious disease to chronic disease was not smooth. Countries like Mexico are already straining under the difficulties of both disease patterns, while Brazil's public resources spent on illness treatment have jumped from 36% in 1965 to 85% in 1982, or 6% of the GNP. This could easily expand to the US figure of 12% due to similar problems with injuries, heart and cerebrovascular disease, cancer, dietary patterns of high salt and fat intake inadequate exercise and obesity, and environmental risks.
WORLD HEALTH FORUM. 1993; 14(2):207-9.An analysis conducted by WHO in 1991 and 1992 indicated that death rates from diseases related to diet and life-style (heart conditions, cancer, and diabetes) have increased significantly in many countries during the past 30 years, largely owing to changes in diet and life-style. 40 high-income countries have diet-related disorders, and as many as 80 middle-income nations may have both undernutrition and overnutrition problems. Undernutrition is widespread in some 50 low-income countries and is associated with a high incidence of stunting and micronutrient deficiencies (especially iron, iodine, and vitamin A). Diet-related deficiencies affect 2000 million people. WHO scientists reviewed data from 26 developed and 16 developing countries from the period 1960-89: 20 countries showed increases ranging up to 160% in death rates from diet-related and life-style-related causes. The biggest decreases were in Australia, Canada, Japan, and the USA where education advised people to limit intakes of fat, saturated fat, and salt as well as to increase exercise and reduce smoking. Data on food availability for 1988-90 showed that an estimated 786 million people in developing countries were chronically undernourished. Hunger and malnutrition affect many of the 123 million people living in 11 countries where the food situation is critical. Some 192 million children <5 years of age suffer from protein-energy malnutrition characterized by retardation of physical growth and lowered resistance to infections. 55 million of these underweight children are in south Asian countries. In these countries, about half of all deaths occur before 5 years of age, and the majority of these deaths are caused by diarrheal disease. It is estimated that up to 70% of diarrhea cases are food-borne in origin. There are 1500 million episodes of diarrhea annually in children <5 years of age, killing 3 million of them.
MEDICAL JOURNAL OF AUSTRALIA. 1990 Nov 5; 153(9):548-51.The importance of communication in public health is described with reference to recent experiences in Australia where good progress has been made with certain major public health problems. There has been a 30% fall in road accident deaths and a 40% drop in deaths from coronary heart disease. In addition a smoke--free environment has been established in both public areas and the workplace. These successes have been dependent on effective communication based on appropriate data. Evaluation data have also been used to keep the public informed and to reinforce the message. The cooperation of the media has been most crucial in stimulating a new awareness of health and the opportunities for self-help and community initiatives. In central australia, new initiatives involving the Central Australian Aboriginal Congress have led to improvements in the health of the Aborigines, their training as healthworkers, and the development of a Center for Appropriate Technology at the Alice Springs Celled of Technical and Further Education. At the international level, Australia sponsored a World Health Assembly resolution in 1986 which called for the elimination of iodine deficiency disorders. With the support of the Australian International Development Assistance Bureau and UNICEF, an international expert group of scientists and public health professionals, the International Council for Control of Iodine Deficiency disorders (ICCIDD), based in Adelaide, has worked with WHO and UNICEF in the development of an international public health program aimed at eliminating iodine deficiency disorders by the year 2000. The ICCIDD is a new model for communication and action in international health which is now being advocated for other areas. (author's)
WORLD HEALTH FORUM. 1990; 11(1):14-31.Health is often seen in strip cartoons (SCs). However, its images convey their own properties. SCs are distributed globally. They are produced in Algiers, Dakar, and Bangui. The SC generally goes from humor to adventure stories. Health enters SCs in 3 ways: 1) the portrayal of life styles; 2) health as a suspenseful element; and 3) medical adventures emphasizing a doctor. Adventure stories with doctors for heroes are common. WHO is the basis for many SCs. Humor and adventure are the 2 basic themes in SCs; they are not mutually exclusive. 1 way that SCs portray health is the "stretched-out time of soap opera." These are stories of poor, talented doctors and devoted nurses. The SC is a graphic expression of world concerns. Healthy or unhealthy life styles may be seen in SCs. Food, tobacco, and alcohol are just parts of a story. Positive heroes are never alcoholics, because alcoholism is a potential vice. Habitual drinkers are usually secondary characters. Early in the 20th century, tobacco played a big role in developing SCs in Mexico. Breaking society's rules for a healthy life style leads to all kinds of consequences in SCs. There was no educational intent to having Popeye eat spinach. Spinach contains iron and is associated with strength. Scurvy is an enemy of many sailors, and this shows up in SCs on disease. It alternates with cholera as an element of adventure in sea stories. An imaginative story devoted to health education shows a medical and social confrontation with naval captains who are not too bright. SCs are neither good nor bad in themselves.