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  1. 1
    032447

    Oral rehydration salts: an analysis of AID's options.

    Elliott V

    [Columbia Maryland], Westinghouse Electric Corporation, Public Applied Systems, 1984 Sep. 26, [13] p. (Contract No. PDC-1406-I-02-4062-00, W.0.2; Project No. 936-5939-12)

    Westinghouse Health Systems, under a US Agency for International Development (USAID) contract, ass ssed the global supply and demand of oral rehydration salts (ORS) and developed a set of recommendations concerning USAID's future role as a supplier of ORS. 1.5 billion ORS packets (assuming each packet is equivalent to 1 liter of ORS solution) would be required to treat all ORS treatable cases of diarrhea which occur annually among the world's children under 5 years of age. Currently, about 200 million packets are manufactured/year. In 1983, international sources supplied slightly less than 37 million packets, and the remaining packets were produced by local or in-country manufacturers. UN Children's Fund (UNICEF), which currently provides 81% of the international supply, contracts with private firms to manufacture ORS and then distributes the packets to developing countries, either at cost or free of charge. UNICEF purchases the packets for about US$.04-US$.05. USAID provides about 12.3% of the international supply. Prior to 1981, USAID distributed UNICEF packets. Since 1981, USAID has distributed ORS packets manufactured by the US firm of Jianas Brothers. USAID must pay a relatively high price for the packets (US$.08-US$.09) since the manufacturer is required to produce the packets on an as needed basis. Other international suppliers of ORS include the International Dispensary Association, the Swedish International Development Authority, the International Red Cross, and the World Health Organization. Currently, 38 developing countries manufacture and distrubute their own ORS products. These findings indicate that there is a need to increase the supply of ORS; however, the supply and demand in the future is unpredictable. Factors which may alter the supply and demand in the future include 1) the development of superior alternative formulations and different type of ORS products, 2) a reduction in the incidence of diarrhea due to improved environmental conditions or the development of a vaccine for diarrhea, 3) increased production of ORS in developing countries, 4) increased commercial sector involvement in the production and sale of ORS products, and 5) the use of more effective marketing techniques and more efficient distribution systems for ORS products. USAID options as a future supplier of ORS include 1) purchasing and distributing UNICEF packets; 2) contracting with a US firm to develop a central procurement system, similar to USAID's current contraceptive procurement system; 3) contracting with the a US firm to establish a ORS stockpile of a specified amount; 4) promoting private and public sector production of ORS within developing countries; 5) including ORS as 1 of the commodities available to all USAID assisted countries. The investigators recommended that USAID should contribute toward increasing the global supply of ORS; however, given the unpredictability of the ORS demand and supply, USAID should adopt a short-term and flexible strategy. This strategy precludes the establishment of a central procurement system; instead, USAID should contract a private firm to establish an ORS stockpile and to fill orders from the stockpile. Consideration should be given to altering the ORS packets size and to alternative ORS presentations. USAID should also promote the production of quality ORS products within developing countries and continue to support research on other diarrhea intervention strategies. This report also discusses some of the problems involved in manufacturing and packaging ORS. The appendices contain 1) a WHO and UNICEF statement on the ORS formulation made with citrate instead of bicarbonate, 2) a list of developing countries which manufacture ORS, and 3) statistical information on distribution of ORS by international sources.
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  2. 2
    031969

    China: report of Mission on Needs Assessment for Population Assistance.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1984 May. xii, 156 p. (Report No. 67)

    A Needs Assessment and Program Development Mission visited the People's Republic of China from March 7 to April 16, 1983 to: review and analyze the country's population situation within the context of national population goals as well as population related development objectives, strategies, and programs; make recommendations on the future orientation and scope of national objectives and programs for strengthening or establishing new objectives, strategies, and programs; and make recommendations on program areas in need of external assistance within the framework of the recommended national population program and for geographical areas. This report summarizes the needs and recommendations in regard to: population policies and policy-related research; demographic research and training; basic population data collection and analysis; maternal and child health and family planning services; management training support for family planning services; logistics of contraceptive supply; management information system; family planning communication and education; family planning program research and evaluation; contraceptive production; research in human reproduction and contraceptives; population education and dissemination of population information; and special groups and multisectoral activities. The report also presents information on the national setting (geographical and cultural features, government and administration, the economy, and the evolution of socioeconomic development planning) and demographic features (population size, characteristics, and distribution, nationwide and demographic characteristics in geographical core areas). Based on its assessment of needs, the Mission identified mjaor priorities for assistance in the population field. Because of China's size and vast needs, external assistance for population programs would be diluted if provided to all provincial and lower administrative levels. Thus, the Mission suggests that a substantial portion of available resources be concentrated in 3 provinces as core areas: Sichuan, the most populous province (100,220,000 people by the end of 1982); Guandong, the province with the highest birthrate (25/1000); and Jiangsu, the most densely populated province (608 persons/square kilometer. In all the government has identified 11 provinces needing special attention in the next few years: Anhui, Hebei, Henan, Hubei, Hunan, Jilin, Shaanxi and Shandong, in addition to Guangdong, Jiangsu, and Sichuan.
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  3. 3
    030330

    Stopping population growth.

    Brown LR

    In: State of the world 1985. A Worldwatch Institute report on progress toward a sustainable society [by] Lester R. Brown, Edward C. Wolf, Linda Starke, William U. Chandler, Christopher Flavin, Sandra Postel, Cynthia Pollack. New York, New York, W.W. Norton, 1985. 200-21.

    The demographic contrasts of the 1980s are placing considerable stress on the international economic system and on national political structures. Runaway population growth is indirectly fueling the debt crisis by increasing the need for imported food and other basic commodities. Low fertility countries are food aid donors, and the higher fertility countries are the recipients. In most countries with high fertility, food production per person is either stagnant or declining. Population policy is becoming a priority of national governments and international development agencies. This discussion reviews what has happened since the UN's first World Population Conference in 1974 in Bucharest, fertility trends and projections, social influences on fertility, advances in contraceptive technology, and 2 major family planning gaps -- the gap between the demand for family planning services and their availability and the gap between the societal need to slow population growth quickly and the private interests of couples in doing so. The official purpose of the 1984 UN International Conference on Population convened in Mexico City, in which 149 countries participated, was to review the world population plan of action adopted at Bucharest. In Bucharest there had been a wide political schism between the representatives of industrial countries, who pushed for an increase in 3rd world family planning efforts, and those from developing countries, whose leaders argued that social and economic progress was the key to slowing population growth. In Mexico City this division had virtually disappeared. Many things had happened since Bucharest to foster the attitude change. The costly consequences of continuing rapid population growth that had seemed so theoretical in the 1974 debate were becoming increasingly real for many. World population in 1984 totaled 4.76 billion, an increase of some 81 million in 1 year. The population projections for the industrial countries and East Asia seem reasonable enough in terms of what local resource and life support systems can sustain, but those for much of the rest of the world do not. Most demographers are still projecting that world population will continue growing until it reaches some 10 billion, but that most of the 5.3 billion additional people will be concentrated in a few regions, principally the Indian subcontinent, the Middle East, Africa, and Latin America. What demographers are projecting does not mesh with what ecologists or agronomists are reporting. In too many countries ecological deterioration is translating into economic decline which in turn leads to social disintegration. The social indicator that correlates most closely with declining fertility across the whole range of development is the education of women. Worldwide, sterilization protects more couples from unwanted pregnancy than any other practice. Oral contraceptives rank second. The rapid growth now confronting the world community argues for effective family planning programs.
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