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  1. 1
    055213

    Updated guidelines for UNFPA policies and support to special programmes in the field of women, population and development.

    United Nations Population Fund [UNFPA]. Special Unit for Women, Population and Development

    [Unpublished] 1988 Apr. [2], 8 p.

    The United Nations Fund for Population Activities (UNFPA) has been mandated to integrate women's concerns into all population and development activities. Women's status affects and is affected by demographic variables such as fertility, maternal mortality, and infant mortality. Women require special attention to their needs as both mothers and productive workers. In addition to integrating women's concerns into all aspects of its work, the Fund supports special projects targeted specifically at women. These projects have offered a good starting point for developing more comprehensive projects that can include education, employment, income generation, child care, nutrition, health, and family planning. UNFPA will continue to support activities aimed at promoting education and training, health and child care, and economic activities for women as well as for strengthening awareness of women's issues and their relationship to national goals. Essential to the goal of incorporating women's interests into all facets of UNFPA programs and projects are training for all levels of staff, participation of all UNFPA organizational units, increased cooperation and joint activities with other UN agencies, and more dialogue with governmental and nongovernmental organizations concerned with the advancement of women. Specific types of projects to be supported by UNFPA in the period ahead are in the following categories: education and training, maternal health and child care, economic activities, awareness creation and information exchange, institution building, data collection and analysis, and research.
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  2. 2
    027442

    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.

    Israel. Ministry of Health

    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.
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  3. 3
    056565

    AIDS: a global report.

    Mann JM

    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.
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  4. 4
    201506

    Inventory of population projects in developing countries around the world, 1986/87.

    United Nations Population Fund [UNFPA]

    New York, New York, United Nations Population Fund, 1988. xi, 850 p. (Population Programmes and Projects Vol. 2.)

    The purpose of this 14th edition of the INVENTORY is to show, at a glance, by country, internationally-assisted projects funded, inaugurated, or being carried out by multilateral, bilateral, and non-governmental and other agencies and organizations during the reporting period. The time frame for this edition is for projects carried out during the period from 1 January 1986 through 30 June 1987. Whenever possible, projects that may have been funded prior to 1986 and that were still being carried out in 1986/1987 are shown. The entry for each country includes 1) demographic facts, 2) government's views regarding population, and 3) assistance organized by type of organization. The basic source of demographic data for individual countries is the "World Population Prospects, Estimates and Projections As Assessed in 1984," United Nations, New York, 1986, except for some island countries and/or territories for which no updated information was available and information was provided from other sources. The basic sources of information for the government's views regarding population is the Population Division and its publication, POPULATION POLICY BRIEFS: THE CURRENT SITUATION IN DEVELOPING COUNTRIES AND SELECTED TERRITORIES, 1985. The dollar value of projects or total country program is given where such figures were available.
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  5. 5
    046408

    Project agreement between the Employers Confederation of the Philippines (ECOP) and ILO/Labour and Population Team for Asia and the Pacific (LAPTAP).

    Employers Confederation of the Philippines [ECOP]; International Labour Office [ILO]. Labour and Population Team for Asia and the Pacific [LAPTAP]

    [Unpublished] 1987. [29] p. (Project No. PHI/87/EO1)

    This project agreement between the Employers Confederation of the Philippines (ECOP) and the International Labor Organization (ILO)/Labor and Population Team for Asia and the Pacific (LAPTAP) continues support to the Population Unit of ECOP for an additional 2 years (July 1987-89). Economic uncertainties in the Philippines resulting from the past period of political turmoil necessitated this extension in ILO funding. After 1989, ECOP will absorb the population education officer into its regular staff. Continued funding of the ECOP program is based on several favorable factors, including the evident commitment of the ECOP directors to population activities, contact made with individual employers and business associations since 1985, and the production high-quality IEC materials. The long-term objective of this project is to promote smaller families through educational and motivational programs that emphasize the close relationship of family planning and living standards and to link such activities with existing health services at the plant level. Specific objectives are to disseminate information on family planning and family welfare to workers and to educate employers in the industrial sector about the relevance of family planning to labor force development. Project activities will include monthly seminars for employers and meetings with member associations of ECOP.
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  6. 6
    046823

    The state of the world's children 1988.

    Grant JP

    Oxford, England, Oxford University Press, 1988. [9], 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.
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  7. 7
    039142

    Basis for the definition of the organization's action policy with respect to population matters.

    Pan American Health Organization [PAHO]

    [Unpublished] 1984 May 8. 31 p. (CE 92/12)

    This report shows how demographic information can be analyzed and used to identify and characterize the groups assigned priority in the Regional Plan of Action and that it is necessary for the improvement of the planning and allocation of health resources so that national health plans can be adapted to encompass the entire population. In discussing the connections between health and population characteristics in the countries of the region, the report covers mortality, fertility and health, and fertility and population increase; spatial distribution and migration; and the structure of the population. Focus then moves on to health, development, and population policies and family planning. The final section of the report considers the response of the health sector to population trends and characteristics and to development-related factors. The operations of the health sector must be revised in keeping with the observed demographic situation and the projections thereof so that the goal of health for all by the year 2000 may be realized. In several countries of the region mortality remains high. In 1/3 of them, infant mortality during the period 1980-85 exceeds 60/1000 live births. If measures are not taken to reduce mortality 55% of the population of Latin America in the year 2000 will still be living in countries with life expectancies at birth of under 70 years. According to the projections, in the year 2000 the birthrate will stand at around 29/1000, with wide differences between the countries of the region, within each of them, and between socioeconomic strata. High fertility will remain a factor hostile to the health of women and children and a determinant of rapid population growth. Some governments view the present or predicted growth rates as excessive; others want to increase them; and some take no explicit position on the matter. The countries would be well advised to assign values to their birthrate, natural increase, and periods for doubling their populations in relation to their development plans and to the prospects for improving the standard of living and health of their populations. An important factor in urban growth is internal migration. These migrants, like some of those who move to other countries, may have health problems requiring special care. Regardless of a country's demographic situation, the health sector has certain responsibilities, including: the need to promote the framing and adoption of population and development policies, in whose implementation the importance of health measures is not open to question; and the need to favor the intersector coordination and articulation required to ensure that population aspects are considered in national development planning.
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  8. 8
    045148

    USAID in Nepal.

    Weiss D

    FRONT LINES. 1987 Sep; 27(8):8-9, 11.

    The USAID's mission in Nepal is to assist development until the people can sustain their own needs: although the US contributes only 5% of donor aid, USAID coordinates donor efforts. The mission's theme is to emphasize agricultural productivity, conserve natural resources, promote the private sector and expand access to health, education and family planning. Nepal, a mountainous country between India and Tibet, has 16 million people growing at 2.5% annually, and a life expectancy of only 51 years. Only 20% of the land is arable, the Kathmandu valley and the Terai strip bordering India. Some of the objectives include getting new seed varieties into cultivation, using manure and compost, and building access roads into the rural areas. Rice and wheat yields have tripled in the '80s relative to the yields achieved in 1970. Other ongoing projects include reforestation, irrigation and watershed management. Integrated health and family planning clinics have been established so that more than 50% of the population is no more than a half day's walk from a health post. The Nepal Fertility Study of 1976 found that only 2.3% of married women were using modern contraceptives. Now the Contraceptive Retail Sales Private Company Ltd., a social marketing company started with USAID help, reports that the contraceptive use rate is now 15%. Some of the other health targets are control of malaria, smallpox, tuberculosis, leprosy, acute respiratory infections, and malnutrition. A related goal is raising the literacy rate for women from the current 12% level. General education goals are primary education teacher training and adult literacy. A few descriptive details about living on the Nepal mission are appended.
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  9. 9
    047220

    The population problem in Turkey (as seen from the perspective of a foreign donor).

    Holzhausen W

    NUFUSBILIM DERGISI/TURKISH JOURNAL OF POPULATION STUDIES. 1987; 9:63-73.

    From the perspective of the UN Fund for Population Activities, Turkey has a population problem of some magnitude. In 1987 the population reached 50 million, up from 25 million in 1957. Consistent with world trends, the population growth rate in Turkey declined from 2.5% between 1965-73 to 2.2% between 1973-84; it is expected to further decrease to 2.0% between 1980 and 2000. This is due primarily to a marked decline of the crude birthrate from 41/1000 in 1965 to 30/1000 in 1984. These effects have been outweighed by a more dramatic decline in the death rate from 14/1000 in 1965 to 9/1000 in 1984. Assuming Turkey to reach a Net Reproduction Rate of 1 by 2010, the World Bank estimates Turkey's population to reach some 109 million by the middle of the 21st century. The population could reach something like 150 million in the mid-21st century. Some significant progress has been made in Turkey in recent years in the area of family planning. Yet, some policy makers do not seem fully convinced of the urgency of creating an ever-increasing "awareness" among the population and of the need for more forceful family planning strategies. Government allocations for Maternal and Child Health and Family Planning (MCH/FP) services continue to be insufficient to realize a major breakthrough in curbing the population boom in the foreseeable future. Most foreign donors do not consider Turkey a priority country. It is believed to have sufficient expertise in most fields and to be able to raise most of the financial resources it needs for development. The UNFPA is the leading donor in the field of family planning, spending some US $800,000 at thi time. Foreign inputs into Turkey's family planning program are modest, most likely not exceeding US $1 million/year. Government expenditures are about 10 times higher. This independence in decision making is a positive factor. Turkey does not need to consider policy prescriptions that foreign donors sometimes hold out to recipients of aid. It may be difficult for foreign donors to support a politically or economically motivated policy of curtailing Turkey's population growth, but they should wholeheartedly assist Turkey in its effort to expand and improve its MCH/FP services. Donors and international organizations also may try to persuade governments of developing countries to allocate more funds to primary education and to the fight against social and economic imbalances. Donors should continue to focus on investing in all sectors that have a bearing on economic development.
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  10. 10
    043085

    Population and development.

    ASIA-PACIFIC POPULATION JOURNAL. 1987 Mar; 2(1):65-7.

    The Economic and Social Commission for Asia and the Pacific (ESCAP) recently organized a workshop to develop an analytical framework for population research and development planning. The workshop goal was to enable study directors to review and discuss research methodology and guidelines for a series of country studies to be undertaken as part of a large project devoted to integrating population and development. The overall project objective is to provide individual national entities with current and scientifically sound descriptions, analyses, and interpretations of significant population and development trends and their interrelationships along with assessments of the implications of such trends and relationships for the formulation and improvement of public policy. 1 reason for the limited progress in the integration of population and development planning is the lack of useful and applicable scientific information for responsible planners as well as a lack of analytical frameworks. If the results of the research are to be made useful for decisionmaking purposes, processing of the information is required. The need exists for current critical analysis and synthesis of available information at the country level on significant population and development trends and their interrelationships and an assessment of their implications for the formulation and improvement of public policy and programs. In regard to an analytical framework, much work has been done in the areas of population development interrelationships and their modelling. Bangladesh, Nepal, the Philippines, and Thailand are the countries which have been selected for investigation for the ESCAP project. The comparative analysis that is to be conducted will facilitate understanding of current population development research activities and the future needs of these countries.
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  11. 11
    041551

    UNESCO/IPDC Regional Seminar on the Media and the African Family, Livingstone, Zambia, 6-10 January 1986. Report.

    UNESCO. International Programme for the Development of Communication

    [Unpublished] 1986 Jan. v, 63 p.

    A seminar was planned and conducted by UNESCO's Population Division during January 1986 to promote increased media attention to issues which affect family stability and welfare. Especially important are the social, economic, and health problems created by high rates of population growth, urbanization, and migration. The seminar intended to give participants an opportunity to: examine the changing characteristics and emergin problems of the African family; review and appraise both past and current efforts on the part of the media to promote understanding of the interrelationships between socioeconomic conditions and family welfare, composition, stability, and size; and develop plans to increase the involvement and effectiveness of the media in promoting understanding of these interrelationships and in enabling families to make decisions and take action to enhance their welfare and stability. This report of the seminar is presented in 2 sections. The 1st section presents the participants' review of the changing nature of the African family over recent decades and the socioeconomic and sociocultural problems which have emerged as a consequence of these changes. Additionally, the 1st section reviews the extent to which communication systems in the region have tried to deal with the population related issues which affect family welfare. A "Communication Plan of Action" is proposed by the participants as a logical outcome of their 2 analyses and as a synthesis of their recommendations for the manner in which communication systems in the region must develop in order to meet ongoing and future population-family life changes. The Plan of Action identifies the following strategies as necessary to realize the increased involvement of the media in family issues and problems: institutionalizing population family life content within the curricula of media training institutions within the region; intensifying preservice and inservice training of media personnel to enable them to deal effectively with the demographic, social, and economic issues which impinge upon family welfare; highlighting population family life communication matters; ensuring that research on population family life issues be widely disseminated to media personnel and media based organizations; sensitizing political and administrative decisionmakers to population family life issues so that media communication can be supported and opportunities for media coverage can be extended; emphasizing in national development plans the importance of the media in generating public awareness of and response to the constraints placed upon national development and improved family welfare by rapid population growth and large-scale urban migration; and encouraging the involvement of community organizations in media programs. The 2nd section of the report includes the participants examination of the communication planning process.
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  12. 12
    041365

    Expanded Programme on Immunization: progress and evaluation report by the Director-General.

    World Health Organization [WHO]

    [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.
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  13. 13
    036373

    Accelerated immunization programmes and CSDR: their meaning and broader implications for development [editorial]

    Mandl PE

    ASSIGNMENT CHILDREN. 1985; 69-72:vii-xxvi.

    This editorial introduces a special issue of "Assignment Children" devoted to the theme of universal child immunization by 1990. Not only will this campaign significantly reduce morbidity and mortality from 6 childhood diseases, but it will also, through the experience of massive public participation, create conditions favorable for achieving development goals in areas other than health care. Immunization is a means for enabling those who have grasped the concept of protection of one's children to carry this effort into other areas for other goals. If families are to be empowered in this way, the knowledge and know-how held by the experts at the top must be melded with traditional knowledge and the wish of parents to protect their children from disease and death. The usual concept of development conveys ethnocentric and central power biases as well as a fragemented and sectoral approach. In contrast, accelerated immunization programs represent an example of action within a new development paradigm. This approach addresses not just symptoms, but fundamental causes of underdevelopment in the areas of health and survival. Although the underlying causes of poverty are only marginally affected by such campaigns, the validation of important goals of the majority of the population can release social energy and increase individuals' control over other aspects of their life.
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  14. 14
    038090

    The role of women managers in family planning and population programs.

    Sadik N

    Washington, D.C., Centre for Development and Population Activities, 1986 Apr. 14 p. (CEDPA Tenth Anniversary Lecture Series)

    This discussion of the role of women managers in family planning and population programs begins with an overview of the participation of women in development and population. It then directs attention to the need for women in management, increasing women's role in development programs, and changing attitudes about women's roles. 1 of the major achievements of the Decade for Women has been the recognition by most governments of the need to integrate women more fully into the process of national socioeconomic development. More and more governments are making a concerted effort to increase the participation of women and to integrate them into development. An area in which opportunities for women have not increased as much as they could is in management. The role and involvement of women in population and family planning are particularly important. Family planning programs in many areas of the world are directed to women, involve women, and are utilized by women, yet women are not in the policy-making or management position, deciding what should be done for them. In management, the 5 basic concerns are authority to make decisions, communication within organizations, the opportunity to introduce change, the productivity of the operation, and staff morale. The most important positions for women managers are at the policy-making and decision-making levels, but few women are at those levels in most developing country programs. Women's knowledge of local customs, norms, and needs can be used in designing programs and in selecting methods and services. Many programs now are designed, and family planning methods selected, without a clear understanding of the local situations or local customs. Women managers have the responsibility to educate others about how to design, implement, and evaluate programs and projects that are sensitive to the needs of women. Thus, the family planning sector in particular must involve women in all stages and levels of program design and implementation. The UN Fund for Population Activities (UNFPA) developed some guidelines on women, population, and development following the 1975 conference in Mexico inaugrating International Women's Year. The guidelines call for special attention to the needs and concerns of women and for participation of women in all stages and aspects of the UNFPA program. Since 1984, UNFPA has been examining how it can address the involvement of women in population programs and ways to improve the role and status of women. It tires to suppport projects in 2 major categories: projects aimed directly at improving the role and status of women by increasing their access to educational training and skills development and their participation in the community; and activities aimed at increasing the participation of women in all UNFPA-supported projects, which must be designed with consideration to the needs and concerns of women.
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  15. 15
    034877

    Toward 2000: the quest for universal health in the Americas.

    Acuna HR

    Washington, D.C, Pan American Health Organization, 1983. x, 145 p. (Scientific Publication No. 435)

    This document, prepared by the Pan American Health Organization (PAHO), reviews health in the Americas in the period 1905-47, provides a more detailed assessment of progress in the health sector during the 1970s, and then outlines prospects for the period 1980-2000 in terms of meeting the goal of health for all by the year 2000. The main feature of this goal is its comprehensiveness. Health is no longer viewed as a matter of disease, but as a social outcome of national development. Attainment of this goal demands far-reaching socioeconomic changes, as well as revision of the concepts underlying national health systems. It seems likely that the coming period in Latin America and the Caribbean will be characterized by intense urban concentration and rapid industrialization, with a trend toward increasing heterogeneity. If current development trends continue, the gap in living standards between urban and rural areas will widen due to sharp differences in productivity. Regionally based development planning could raise living standards and reduce inequalities. In the type of development expected, the role of social services is essential. It will be necessary to determine whether the objective is to provide the poor with access to services that are to be available to all or to provide special services for target groups. The primary health care strategy must be applicable to the entire population, not just a limited program to meet the minimal needs of the extreme poor. Pressing issues regarding health services in the next 2 decades include how to extend their coverage, increase and strengthen their operating capacity, improve their planning and evaluation, increase their efficiency, and improve their information systems. Governments and ministries must be part of effective infrastructures in which finance, intersectoral linkages, community participation, and intercountry and hemispheric cooperation have adequate roles. One of PAHO's key activities must be systematic monitoring and evaluation of strategies and plans of action for attaining health for all.
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  16. 16
    038633

    Population growth and policies in sub-Saharan Africa.

    World Bank

    Washington, D.C., World Bank, 1986 Aug. x, 102 p.

    This report provides a comprehensive assessment of the magnitude and underlying causes of Africa's rapid population growth and suggests a framework to help African leaders design policies to address this problem. The report has 3 themes. The 1st theme is that rapid population growth in Africa is slowing economic development and reducing the possibility of raising living standards. Africa's population growth rate, the highest in the world, has accelerated from an average of 2.8%/year in 1970-82 to 3.1%/year in 1985. Population growth is expected to continue to rise for at least another 5-10 years. In addition to undermining economic growth and per capita income growth, the population explosion implies higher child and maternal morbidity and mortality, further degradation of the natural environment, constraints on expanding education and health care services, and falling wages. A comprehensive population policy in African countries must include efforts both to slow this growth and to cope with its consequences. A 2nd theme is one of cautious hope arising from recent indications of a change in ideas and behavior regarding fertility. More and more African governments are expressing alarm about population growth and are supporting family planning measures. Improvements in women's status, especially in female education, are occurring and can be expected to have a fertility reducing effect. Increased availability and accessibility of family planning services could raise Africa's contraceptive prevalence rate from its current level of 3-4% to 25% in the next decade. The 3rd theme is that strategic reorientation of the direction and nature of government involvement in the area of population policy is required. Although governments should not seek to be the only provider of family planning services, they must take the lead in generating a climate of legitimacy for family planning. An increase in external assistance will be necessary if family planning is to become a realistic option for Africans.
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  17. 17
    034048
    Peer Reviewed

    Joint UNICEF/WHO consultation on primary health care in urban areas.

    Lancet. 1986 Jan 25; 1(8474):223.

    This article summarizes the conclusions and recommendations of a joint UNICEF/WHO consultation on primary health care in urban areas. The meeting, which was held in Guayaquil, Ecuador, in October 1984, was attended by representatives from 9 countries: Brazil, Colombia, Ecuador, Ethiopia, Guatemala, India, Philippines, Republic of Korea, and Peru. 5 priorities were emphasized: the need for comprehensive rather than partial coverage, the use of simple 1st-line remedies such as oral rehydration, the reallocation of resources, intersectoral and interinstitutional collaboration, and the supporting responsibility of governments and international agencies. Community participation is an essential component of primary health care. Once the process of community development is launched, the balance within the existing health care system must be adjusted to prepare for the explosive tempo of urbanization. Cities, regions, and countries must move with sustained determination toward full primary health care coverage for the urban poor. Ongoing close collaboration between UNICEF and WHO is of great importance to the future of primary health care. Specifically, the consultation recommended: 1) consciousness raising activities to make governments, the world public, international organizations, and nongovernmental organizations aware of the scale of the need; 2) continuing support to projects and the informal network of people dedicated to the development of primary health care and the subsequent transformation of health systems; and 3) help with scaling up the health care system.
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  18. 18
    033365

    United Nations Children's Fund: report of the Executive Board (15-26 April 1985).

    UNICEF. Executive Board

    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.
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  19. 19
    032626

    Planned Parenthood and Women's Development. Experiences from Africa: Ghana, Kenya, Lesotho and Mauritius.

    Nturibi DN

    Nairobi, Kenya, International Planned Parenthood Federation, Africa Regional Office, 1985. [5], 54 p.

    This report, prepared as part of International Planned Parenthood Federation's (IPPF) Planned Parenthood and Women's Development (PPWD) program, analyzes selected program projects in Kenya, Mauritius, Lesotho, and Ghana. Projects were in the areas of income generation, community service provision, skill training, health education, and community issues. In all, over 40 projects have been assisted in Africa since the PPWD program was begun in 1977. Information on these projects, their activities, impact, and future needs is presented in tabular form. Members of the women's groups described are becoming outspoken advocates of family planning. Those who have limited their family size claimed to have more time to devote to self and family. Groups that have achieved high levels of acceptance of family planning methods attribute their success to the linkage of family planning and maternal-child health, family economics, nutrition, education, and future prospects. Community-based distribution of nonclinical contraceptives is viewed as a logical outgrowth of women's projects, and many group members are willing to be trained as volunteer motivators. In cases where PPWD funding periods have ended, Family Planning Associations have continued to support projects from their own resources. This is an encouraging trend, since the continuation and expansion of PPWD projects depends on groups being helped to become self-reliant, to seek government support for services, to develop strong leadership, and to link up with development plans for their areas. Revolving funds, rather than group grants, should be encouraged to extend the benefits of limited funding to more groups. Overall, the PPWD program has taken in Africa, and demands for expansion and further funding can be anticipated. It is important that the family planning objective remain central in these projects.
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  20. 20
    032605

    [Ivory Coast: report of the Mission on Needs Assessment for Population Assistance] Cote d'Ivoire: rapport de Mission sur l'Evaluation des Besoins d'Aide en Matiere de Population.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1984 Sep. viii, 57 p. (Report No. 69)

    Conclusions and recommendations are presented of the UN Fund for Population Activities (UNFPA) Mission which visited the Ivory Coast from February 20-March 15, 1983 to assess population assistance needs. Ivory Coast officials believe that the population, estimated at 8,034,000 in 1980, is insufficient given the country's economic needs. Its very rapid rate of growth is estimated at over 4.5%/year, of which 1.5% is due to foreign immigration. 42% of the population is urban. The country has undergone exceptional economic growth in the past 2 decades, and the per capita income is now estimated at over $US1000 annually. Social development does not seem to have kept pace, however, and the mortality rate of 15.4/1000 is that of a country with only 1/2 the per capital income. The 1981-85 Ivory Coast Plan proposes a change from a growth economy to a society in which individual and collective welfare is the supreme goal. Up to date data on the size, structure, and dynamics of the population will be needed to aid in preparation of the 1986-90 and 1991-95 plans. A 2nd national population census is planned for 1985. Until the present, rapid population growth had been considered a boon, but problems are arising of massive rural exodus, high rates of urban unemployment coupled with manpower shortages in agriculture, and growing demographic pressure on health, educational, and social infrastructures, especially in the cities. The government has maintained its pronatalist stance, and government health programs have been directed only to mortality and maternal and child health. The need to control fertility and to use birth spacing as a tool to combat maternal and infant mortality is being increasingly felt, and a private family welfare association was able to form in 1979. A policy of maternal and child health encouraging spacing to improve family welfare would probably be welcomed in the Ivory Coast. The Mission recommended that a population policy be formulated which would correspond to the national demographic reality and development objectives. Basic demographic data collection should focus on the 1985 general census, which should have high priority. The civil registration system should be reorganized. A planned migration survey should cover the whole year to take into acconnt seasonal variations, but preparations should not begin until the census is completed. A multiple objective survey could be undertaken in 1988 to determine the nature and scope of interrelationships between demographic variables and economic and sociocultural variables, and a survey of infant mortality on a small sample could be done in 1989. The planned manpower and employment survey should be completed. Population research should receive high government priority. In regard to maternal and child health, the government should take an official position on the problem of birth spacing as a means of combatting maternal and infant deaths. IEC activities should be expanded, and efforts should be made to encourage the participation of women in development.
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  21. 21
    030193

    Women in health and development: the view from the Americas.

    Who Chronicle. 1984; 38(6):249-55.

    This article highlights the central features of the 5-Year Regional Plan of Action on Women in Health and Development, adopted by the Pan American Health Organization (PAHO) in 1981. Although the Plan does not mandate specific actions, it encourages certain activities and establishes an annual reporting system concerning these activities. The Plan recognizes that women's health depends upon numerous factors outside of medicine, including women's employment, education, social status, and accepted roles, access to economic resources, and political power. The low status of women is reinforced by the sexual double standard that makes women responsible for the reproductive process yet denies them the right to control that process. The Plan advocates an incremental approach, in which projects 1st focus on priority areas and groups and then expand to provide more general benefits. Programs exclusively for women are not advocated; encouraged, instead, is the integration of women's health and development activities into the mainstream of general activities promoting health. Among the areas targeted for action are the collection of statistics on women's health, women's nutritional problems, environmental health, maternal-child health services, screening for breast and cervical cancer, and family planning . Community participation is proposed as a good vehicle for local action and an essential tool in the campaign for health for all. Efforts must be made to enlist women's support in identifying community needs, planning health actions, selecting appropriate resources and personnel, establishing and administering health services, and evaluating the results. Overall, the Plan provides a solid basis upon which health authorities of the Americas can build.
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  22. 22
    028145

    The family planning movement within the African Region of the International Planned Parenthood Federation. Le mouvement pour la planification familiale dans la Region Afrique de la Federation Internationale pour la Planification Familiale.

    Sozi MK

    Africa Link. 1984 Sep; 1, 3-11.

    The African Region of International Planned Parenthood Federation (IPPF) was established in 1971 to: encourage and sustain voluntary groups, provide information about family planning as a basic right, provide limited family planning services where acceptable and needed, and eventually influence change in public opinion so that governments could accept some responsibility for family planning programs. Today almost all of Anglophone Africa is covered by IPPF-funded activities, progress is being made in Francophone Africa, and Lusophone Africa is a target for the 1980s. National family planning associations and the IPPF have laid a firm foundation for family planning and raised its credibility to acceptable levels. However, both inadequate logistic infrastructures for the smooth flow of services and overcaution in adopting innovative methods such as community-based delivery systems to those not easily reached by coventional delivery systems have led service to lag behind demand. Leaders at all levels must join efforts to solve this dilemma. Family planning associations are the best suited channels for family planning work in the African Region, but they lack the capacity to cover all needs. As a result, these associations are shiftingg their efforts toward supplementing government work in this area. Although the government response has been far from uniform, governments have shown an ability to accommodate the operations of family planning organizations and have integrated family planning into national health services. Although 19 governments in the Region consider the fertility levels in their countries to be satisfactory and a few consider fertility too low, family planning is accepted as an instrument for the promotion of family welfare. The importance of national leadership in promoting and implementing family planning programs is increasingly recognized. Parliamentarians can formulate national policies favorable to family planning, promote awareness among their constituencies, and vote for more resources for the family planning effort.
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  23. 23
    030537

    Statement.

    Grant JP

    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, [1983]. 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.
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  24. 24
    032644

    Planned Parenthood and Women's Development: the needs and concerns of young women.

    Wainaina N

    [Unpublished] 1983. Presented at the International Planned Parenthood Federation Programme Committee Meeting, June 3-5, 1983. 8 p.

    The Planned Parenthood Women's Development (PPWD) program rests on the assumption that family planning will be more meaningful and acceptable to women when integrated with other programs centered around the development needs of women and their families. The program's 6 year history lends support to the expectation that when women become involved in development work, family planning is a vital component of their lives. The program has further demonstrated the role organized women's groups and existing organizations can play as the nuclei for community development programs. Although some have argued that this approach targets women who are past childbearing age, older women play an important role as decision makers and opinion leaders in the family and the broader community. Nonetheless, it is conceded that the program has failed to reach young women before they enter into parenthood. Programs for young people face the barrier of inflexible social structures that fail to promote young people's participation, skill development, and self-reliance. Groups that merit special attention include single mothrs, urban slum dwellers and rural poor, out-of-school youth, and young wives. The task of identifying problems and possible solutions must always rest with the young women themselves and their communities. A core of volunteers should be cultivated in each community and trained to mobilize others. The PPWD program has demonstrated that women's groups can form an important link with projects for youth, men, and community services. Other important lessons include the need for interagency collaboration and the pioneering role that can be played by nongovernmental organizations. Family planning should be presented to young women as part of the broader concept of life planning. On the basis of full information and knowledge about contraception, young women should be persuaded to make choices. Finally, it is noted that the International Planned Parenthood Federation may want to consider increasing young women's involvement in the family planning movement's decision making structures.
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  25. 25
    034566

    Annual report 1983.

    International Planned Parenthood Federation [IPPF]. Western Hemisphere Region [WHR]

    New York, New York, IPPF, [1983]. [32] p.

    This Annual Report 1983 of the Western Hemisphere Region International Planned Parenthood Federation (IPPF) presents a selection of activities of all 43 associations. The annual meeting of the Western Hemisphere Regional Council offered a striking contrast to the 1st meeting in 1953. In 1983, the total regional enterprise contained some 3500 paid employees and even larger number of active volunteers. It involved large numbers of cooperating physicians, the direct participation of universities, hospitals, and other community institutions, and had the support of thousands of community distributors. These were people operating a total of 2044 clinics and 11,894 community distribution posts. Their messages went out through press, raido, and television and reached 3/4 of the Hemisphere's population. The comparison of the 2 meetings 30 years apart testifies to the successes realized by the associations in the Western Hemisphere. Their accomplishments serve to reveal the full measure of the task they set for themselves. This was to demonstrate that family planning is the strongest single correlate of family health. It was to establish family planning as a human right and to show that the practice of family planning helps to develop attitudes of mind in which people reassert control over their lives. Yet the full task calls for constantly new approaches in which success has not yet been won. This report comments on a number of these, of which the following are a partial list: the integration of family planning with other development strategies, including broad-scale community development; the addition to family planning of other elements of primary health care; the incorporation into family planning programs of a direct attack on infant mortality through vaccinations, oral rehydration therapy, and the promotion of breastfeeding; a renewed emphasis on the advancement of women; and the elaboration of fresh approaches to national leadership. Success is always partial, yet it can lead to the mistaken idea that the ultimate answers have been found. The family planning associations in Latin America and the Caribbean have had to pay a price for their achievements -- in complacencies on the part of international donors and official sectors that have come to see the Region's population problems as essentially "solved." On the other hand, the regional network is firmly established and subject to a constant review that seeks to improve service delivery. The trend toward program integration directs the associations toward new and challenging activities.
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