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UN Chronicle. 1989 Sep; 26(3): p..Children are paying the third world debt with their lives: that is the alarming news carried in the hard-hitting 1989 "State of the World's Children", issued, symbolically, for the first time in a third world capital--New Delhi, India. More than war, flood or famine, the ravages of poverty have caused at least half a million children to die over the last 12 months, as families in developing countries slide back into poverty as a result of these nations' crushing external debt. Two thirds of these deaths have been in Africa, the rest in Latin America, where higher average incomes mask "the grossest inequalities of any continent", UNICEF reports. (excerpt)
Health and health services in Judaea, Samaria and Gaza 1983-1984: a report by the Ministry of Health of Israel to the Thirty-Seventh world Health Assembly, Geneva, May 1984.
Jerusalem, Israel, Ministry of Health, 1984 Mar. 195 p.Health conditions and health services in Judea, Samaria, and Gaza during the 1967-83 period are discussed. Health-related activities and changes in the social and economic environment are assessed and their impact on health is evaluated. Specific activities performed during the current year are outlined. The following are specific facets of the health care system that are the focus of many current projects in these districts; the development of a comprehensive network of primary care programs and centers for preventive and curative services has been given high priority and is continuing; renovation and expansion of hospital facilities, along with improved staffing, equipment, and supplies for basic and specialty health services increase local capabilities for increasingly sophisticated health care, and consequently there is a decreasing need to send patients requiring specialized care to supraregional referral hospitals, except for highly specialized services; inadequacies in the preexisting reporting system have necessitated a continuting process of development for the gathering and publication of general and specific statistical and demographic data; stress has been placed on provision of safe drinking water, development of sewage and solid waste collection and disposal systems, as well as food control and other environmental sanitation activities; major progress has been made in the establishment of a funding system that elicits the participation and financial support of the health care consumer through volunary health insurance, covering large proportions of the population in the few years since its inception; the continuing building room in residential housing along with the continuous development of essential community sanitation infrastructure services are important factors in improved living and health conditions for the people; and the health system's growth must continue to be accompanied by planning, evaluation, and research atall levels. Specific topics covered include: demography and vital statistics; socioeconomic conditions; morbidity and mortality; hospital services; maternal and child health; nutrition; health education; expanded program immunization; environmental health; mental health; problems of special groups; health insurance; community and voluntary agency participation; international agencies; manpower and training; and planning and evaluation. Over the past 17 years, Judea, Samaria, and Gaza have been areas of rapid population growth and atthe same time of rapid socioeconomic development. In addition there have been basic changes in the social and health environment. As measured by socioeconomic indicators, much progress has been achieved for and by the people. As measured by health status evaluation indicators, the people benefit from an incresing quantity and quality of primary care and specialty services. The expansion of the public health infrastructure, combined with growing access to and utilization of personal preventive services, has been a key contributor to this process.
In: AIDS and associated cancers in Africa, edited by G. Giraldo, E. Beth-Giraldo, N. Clumeck, Md-R. Gharbi, S.K. Kyalwazi, G. de The. Basel, Switzerland, Karger, 1988. 6-10.The global acquired immunodeficiency syndrome (AIDS) epidemic has, in fact, been comprised of 3 successive epidemics. The 1st of these epidemics is infection with human immunodeficiency virus (HIV), which has already affected 5-10 million people worldwide. The 2nd epidemic, following the 1st but with a delay of several years, is the epidemic of AIDS and other related conditions. By September 1987, a total of 59,563 cases of AIDS had been reported to the World Health Organization (WHO) from 123 countries. However, given the reluctance of some countries to report AIDS and underrecognition of the syndrome, WHO believes the actual number of global AIDS cases is closer to 100,000. 10-30% of HIV-infected persons appear to develop AIDS within a 5-year period, suggesting that 500,000-3 million new cases of AIDS will emerge during the next 5 years. The 3rd epidemic is the wave of economic, social, and political reaction to the 1st 2 epidemics. Since AIDS most often affects individuals in the most economically and socially productive age groups, it can be expected to have a devastating effect on social and economic development in Third World countries. In areas where 10% or more of pregnant women are infected with HIV, projected gains in infant and child health anticipated through child survival initiatives will be cancelled out. AIDS is also having a devastating effect on the health care system in Third World countries as AIDS patients consume limited supplies of drugs, require costly diagnostic tests, and occupy limited numbers of hospital beds. Fear and ignorance about AIDS has threatened free travel between countries and open international exchange and communication. WHO believes the spread of AIDS can be stopped, but only through a sustained, longterm commitment that extends beyond the boundaries of individual countries. AIDS control will require both committed national AIDS programs and strong international leadership, coordination, and cooperation.
In: The 1984 International Conference on Population: the Liberian experience, [compiled by] Liberia. Ministry of Planning and Economic Affairs. Monrovia, Liberia, Ministry of Planning and Economic Affairs, . 232-47.This paper summarizes those aspects of the 1984 World Development Report which deal with population prospects and policies in Liberia. Sub-Saharan Africa is the only area of the world where there has not yet been any decline in the rate of growth of the population, and Liberia with a population of 2 million and growing at the rate of 3.5%/year has 1 of the highest growth rates in that area. The birth rate is 50/1000 of the population, and the death rate is 14/1000. The fertility rate is nearly 7 children/woman and is not expected to decline to replacement level before year 2030. Infant mortality is 91/1000, and half of all deaths occur among children under 5. Projecting these demographic trends into the future leads to the conclusion that the population will double in 20 years and exceed 6 million by 2030. Although fertility will begin to decline in the 1990s, the population will continue to increase for a few years with the growth rate declining to 2%/year by 2020 and 1.2%/year by 2045. Such rapid population growth will cause great stress on the country's ability to provide food, schools, and health care. For the children themselves, large, poor families, with births spaced too close together, means malnutrition, poor health , and lower intellectual capacity. And the cycle of poverty continues over the generations as the families save less and expend more on the immediate needs of their children. In macroeconomic terms, a growth rate of l2%/year means a massive explosion of need for food, water, energy, housing, health services and education, with a gross domestic product (GDP) growth of only 2%/year; and this projection is probably optimistic. The rural sector will not be able to support the 23% additional rural labor force, which will migrate to the towns, adding to the already high urban growth rate of 5.7%/year from natural increase. In this society, where literacy is only 20% and secondary education completed by only 11% of the girls, it is estimated that only %5 of eligible couples practice birth control despite the fact that it costs less than $1.00 per capita. Government must step in to ensure that resources exist for population planning at county and local levels. Government is responsible for making demographic data accessible and for coordinating population program inputs. Government should also make sure that family planning programs can be implemented through integration with existing health services. A project including restructuring of health care management, financing and delivery, as well as development of a national population policy, has been proposed for World Bank and other international agencies' support.
Oxford, England, Oxford University Press, 1988. , 86 p.The 1988 UNICEF report on the world's children contains chapters describing the multi-sectorial alliance to support child health, the current emphasis on ORT and immunization, the effect of recession on vulnerable children, family rights to knowledge of basic health facts, and support for women in the developing world. Each chapter is illustrated by graphs. There are side panels on programs in specific countries, including Senegal, Syria, Colombia, Bangladesh, Turkey, India, Honduras, Japan and Southern Africa, and highlighted programs including immunization, AIDS, ORT, breast-feeding and tobacco as a test of health. The SAARC is a new regional organization of southern Asian countries committed to immunization and other health goals. Tables of health statistics of the world's nations, divided into 4 groups by "Under 5 Mortality Rate" present basic indicators, nutrition/malnutrition data, health information, education, literacy and media data, demographic indicators, economic indicators and data pertaining to women. The absolute numbers of child deaths had fallen to 16 million in 1980, from 25 million in 1950. Saving children's lives will not exacerbate the population problem because, realizing that their children will survive, families will have fewer children. Furthermore, the methods used to reduce mortality, such as breast feeding and empowerment of families to control their lives, are known to reduce fertility.
[Unpublished] 1985 Nov 19. Presented to the Executive Board, Seventy-seventh Session, Provisional Agenda Item 18. 20 p. (EB77/27)The Expanded Program on Immunization (EPI) has made major public health gains in the past decade. The central EPI strategy has been to deliver immunization in consonance with other health services, particularly those directed toward mothers and children. However, in the least developed countries and many other developing countries, it does not appear likely that national budgets will be sufficient by 1990 to support full immunization coverage on a sustained basis or that an adequate number of national managers can be assembled to staff effective programs. At the November 1985 meeting of the EPI Global Advisory Group, recommendations were made to accelerate global progress. These recommendations reflect optimism that the 1990 goal of reducing morbidity and mortality by immunizing all children of the world can be achieved, but also acknowledge that many fundamental problems of national program management remain to be resolved. 3 general actions needed are: 1) promote the achievement of the 1990 immunization goal at national and international levels through collaboration among ministries, organizations, and individuals in both the public and private sectors; 2) adopt a mix of complementary strategies for program acceleration; and 3) ensure that rapid increases in coverage can be sustained through mechanisms which strengthen the delivery of other primary health care interventions. The 4 specific actions needed are: 1) provide immunization at every contact point, 2) reduce drop-out rates between first and last immunizations, 3) improve immunization services to the disadvantaged in urban areas, and 4) increase priority for the control of measles, poliomyelitis, and neonatal tetanus. Continued efforts are also required to strengthen disease surveillance and outbreak control, reinforce training and supervision, ensure quality of vaccine production and administration, and pursue research and development.
New York, New York, United Nations, 1985. v, 58 p. (Economic and Social Council Official Records, 1985. Supplement No. 10; E/1985/31; E/ICEF/1985/12)The major decisions of the UN Children's Fund Executive Board in their 1985 session were to: approve several new program recommendations and endores a major emergency assistance program for several African countries; approve initiatives to accelerate the implementation of child survival and development actions, particularly towards the goal of achieving universal immunization of children against 6 major childhood diseases by 1990; adopt a comprehensive policy framework for UN International Children's Emergency Fund (UNICEF) programs concerning women; approve UNICEF revised budget estimates for 1984-85 and budget estimates for 1986-87; and make a number of decisions on ways to improve the administration and the role of the Board. The Board members both reported on and heard evidence of the encouraging results of recent efforts to implement national child survival and development programs. Reports of the successful immunization campaigns in Burkina Faso, Colombia, El Salvador, and Nigeria were welcomed, along with the news that half a million children were saved during the year through the use of oral rehydration therapy. Stronger efforts were encouraged to improve results in the areas of breastfeeding and growth monitoring. Implementation issues in connection with child survival and development actions were a continuing focus of Board attention during the session. The accelerated implementation of child survival and development actions was accorded the highest priority in approving the medium-term plan for 1984-88. The Board also adopted a resolution that sought to draw the attention of world leaders, during their observance of the 40th anniversary of the UN, to the importance of reaffirming their commitment to accelerate the implementation of the child survival and development resolution and realizing universal immunization by 1990. Delegations commended the results of the World Health Organization/UNICEF joint nutrition support program but noted that malnutrition among women and children appeared to be increasing. Water supply and sanitation activities were encouraged, and the Board stressed that those actions should be linked with health and hygiene education. The Board endorsed the report on recent UNICEF activities in Africa. Many delegations spoke in support of the increased aid to Africa. Major emphasis was given to linking emergency responses with ongoing UNICEF programs. The Board approved new multi-year commitments from general resources totalling $303,053,422 for 28 country and interregional programs and noted 32 projects totaling $223,215,000 to be funded from specific-purpose contributions. The Board stressed the importance of ensuring that child survival and development actions were integrated with continuing efforts in other of UNICEF action. The Board approved a commitment of $252,550,443 for the budget for the biennium 1986-87.
[Unpublished] 1984 Jul. , 520, 20 p.This 2-volume, 520-page report represents the 1st attempt at a situation analysis of Ghana. Its focus is the effect of Ghana's economic crisis on women and children. Volume I characterizes the macroeconomic situation in Ghana, the dimensions of poverty in the country, recent demographic trends, and the factors affecting infant, child, and maternal nutrition and mortality. Volume II discusses environmental sanitation, Ghana's health sector, education, general living conditions of families, and social services available for children. It is concluded that external assistance is needed to address the massive and widespread problems created by poverty in Ghana. Since the immediate problems of children and mothers are social, assistance is particularly needed in the form of outright grants or official development assistance. It is suggested that UNICEF should support both local and national interventions. There must be clear indications that all projects or programs are within government priorities. In the case of area-specific projects, local support should be assured and the main beneficiaries should be women and children. Finally, 4 possible areas of interventions are outlined: health, water and sanitation, education, and programs for slums. In the area of health, it is recommended that UNICEF devote particular attention to nutrition, immunization, oral rehydration, growth monitoring, and infection control within the context of general support to the development of primary health care.
New York, UNICEF, 1984 May. 280 p.The data in this set of 135 country profiles for 1981 are made up from 9 major sources and cover the countries and territories with which the UN International Children's Emergency Fund (UNICEF) cooperates. In terms of infant morttality, countries are divided into 5 infant mortality groups: a very high infant mortality (a) group of countries, with a 1981 infant mortality rate (IMR) estimate of 150 (rounded) or more deaths per 1000 live births; a very high infant mortality (b) group of countries with a 1981 IMR estimate between 110 (rounded) and 140 (rounded); a high infant mortality group of a middle infant mortality group of countries, with a 1981 IMR estimate of between 26 and 50 (rounded); and a low infnat mortality group of countries, with a 1981 IMR estimate of 25 or less. For each country data are also presented on nutrition, demographic, education, and economic indicators.
In: The Tenth Asian Parasite Control/Family Planning Conference. Proceedings. Under the joint auspices of the Asian Parasite Control Organization, the Japanese Organization for International Cooperation in Family Planning, the Japan Association of Parasite Control and the International Planned Parenthood Federation. Tokyo, Asian Parasite Control Organization, . 63-70.Economic depression affects children in 3 major ways: disposable family incomes drop sharply, with the most severe consequences for poor people and their children; government budgets for social services, particularly those affecting young children and including nutrition, health, and education, are the first to be cut back; and national and international levels of development assistance stagnate as a consequence of the restrictive budgetary policies adopted by industrialized countries. Despite the first welcome signs of an economic recovery in some industrialized nations, most indications are that the worldwide recovery may be relatively shallow in the mid-1980s and that significant beneficial impacts on many low income countries and families will be long delayed. Thus, in the absence of special measures to accelerate health progress, millions more children and mothers are likely to die in the in low income areas than was thought likely at the beginning of the decade. Possibly the only hopeful sign is that the restrictions imposed by the world recession have stimulated the search for innovative and cost effective ways to protect and improve the health of children and mothers. Within a decade, low cost advances could be saving the lives of 20,000 children daily and preventing the crippling of another 20,000. What is in question is the priority of this kind of progress -- among governments, among international assistance sources and networks, and in developing countries. The strategy adopted by JOICFP in its Integrated Family Planning, Nutrition, and Parasite Control Projects offers one such way. The projects are based on the concept that family planning programs will be more acceptable if combined with related services, which the community readily perceives as beneficial and useful. What most contributes to making parasite control a good entry point is that the process of examination and the effects of treatment are immediately visible. Possibly more important that the biological and medical effects of parasite control is its effectiveness as a tool for community health and education motivation. The UN International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) and multilateral and bilateral agencies are promoting 4 simple and relatively inexpensive measures to reduce malnutrition, illness, and death among the world's children: the use of growth charts; oral rehydration therapy; breastfeeding and proper weaning practices; and immunization against major childhood diseases. Ways to achieve accelerated progress for the protection and survival of children are identified.