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  1. 1

    [Crisis in human resources for health: millennium development goals for maternal and child health threatened] Tekort aan gezondheidswerkers in Afrika: millenniumdoelstellingen voor moeder- en kindzorg in gevaar.

    Beltman JJ; Stekelenburg J; van Roosmalen J

    Nederlands Tijdschrift Voor Geneeskunde. 2010; 154(5):A1159.

    International migration of health care workers from low-income countries to the West has increased considerably in recent years, thereby jeopardizing the achievements of The Millennium Development Goals, especially number 4 (reduction of child mortality) and 5 (improvement of maternal health).This migration, as well as the HIV/AIDS epidemic, lack of training of health care personnel and poverty, are mainly responsible for this health care personnel deficit. It is essential that awareness be raised amongst donors and local governments so that staffing increases, and that infection prevention measures be in place for their health care personnel. Western countries should conduct a more ethical recruitment of health care workers, otherwise a new millennium development goal will have to be created: to reduce the human resources for health crisis.
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  2. 2

    Eradication of indigenous transmission of wild poliovirus in the Americas. Plan of action, July 1985.

    Pan American Health Organization [PAHO]. Expanded Program on Immunization [EPI]

    [Washington, D.C.], PAHO, 1985 Jul. 26 p. (EPI-85-102; CD31/7 Annex II)

    The Pan American Health Organization (PAHO) appointed a Technical Advisory Group (TAG) which met in July 1985 to plan eradication of wild poliovirus in the Americas by 1990 by immunization and surveillance. The strategies to be adopted are mobilization of national resources; vaccine coverage of 80% or more of the target population; surveillance to detect all cases; laboratory diagnosis; information dissemination; identification and funding of research needs; development of a certification protocol; and evaluation of ongoing program activities. The expanded immunization program (EPI) will be organized at the country level by setting up National Work Plans, with inventories of resources and identification of participating agencies and donors, under the guidance of national EPI offices. The TAG will be composed of a core of 5 experts on immunization, with additional consultants as needed, meeting quarterly, semi-annually or annually to review progress and publish recommendations. Regional EPI offices will coordinate eradication activities between the Ministries of Health, the 10-11 epidemiologists/technical advisors in each country and all agencies affiliated with the PAHO. Support personnel will be available at the sub-regional and regional level, including support virologists to assist the laboratory network. Appendices are attached showing estimated costs for regional and regional personnel, vaccines, laboratories, and program activities, predicting that the effort will pay for itself 2.3 times over by 2000.
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  3. 3

    [World Health Organization [WHO]: nursing must be strengthened] WHO: sygeplejen skal styrkes.

    Ravn K

    SYGEPLEJERSKEN. 1992 Jun 10; 92(24):4-6.

    The World Health Organization's General Assembly in 1992 reiterated the importance of nursing and midwifery in the execution of health for all strategies. Already the 1989 General Assembly made clear that these should be strengthened, but there has not been much progress. A work group was organized with the objective to make proposals about priorities and coordination with other international organizations. The WHO also supports the idea of primary health care (PHC), making sure that there is adequate political and economic backing accorded to it. Committee A dealt with health-related objectives and Committee B with political and budget-related goals. The numerous goals included health questions, education of people, prevention and control of drugs and alcohol, prevention of handicaps, vaccination programs, health and the environment, neonatal health, nutrition and development, and global strategy for the prevention and control of AIDS. With respect to nursing, the aim was to recruit qualified personnel, and training on all levels. In 1991 there was a WHO report prepared at the headquarters comparing progress to 1989. The number of nurses had decreased in WHO programs since 1989, and engagement had slackened. Priorities include cooperation with member countries, a solution to personnel shortage, support to countries in the development of strategic planning relating to manpower, policy development, workshop development, and support to the WHO information system in the area of nursing. The 1992 proposals contain a multiprofessional advisory group for general direction to cooperate in all activities of nursing and midwifery in WHO and the cooperate in all activities of nursing and midwifery in WHO and the member countries. 400 experts discussed the topic of women's health across age and frontiers illustrating the state of women's health in the world with graphs and photos. There was a long list of socioeconomic issues compared to the status of men. 36 nurses and midwives took part in the WHO assembly with inspired interest, lobbying, and resolution preparation, expressing commitment to follow up on these resolutions.
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  4. 4

    Selected UNFPA-funded projects executed by the WHO/South East Asian regional office (SEARO).

    Sobrevilla L; Deville W; Reddy N

    New York, New York, UNFPA, [1992]. v, 69, [2] p. (Evaluation Report)

    In 1991, a mission in India, Bhutan and Nepal evaluated UNFPA/WHO South East Asian Regional Office (SEARO) maternal and child health/family planning (MCH/FP) projects. The Regional Advisory Team in MCH/FP Project (RT) placed more emphasis on the MCH component than the FP component. It included all priority areas identified in 1984, but did not include management until 1988. In fact, it delayed recruiting a technical officer and recruited someone who was unqualified and who performed poorly. SEARO improved cooperation between RT and community health units and named the team leader as regional adviser for family health. The RT team did not promote itself very well, however, Member countries and UNFPA did request technical assistance from RT for MCH/FP projects, especially operations research. RT also set up fruitful intercountry workshops. The team did not put much effort in training, adolescent health, and transfer of technology, though. Further RT project management was still weak. Overall SEARO had been able to follow the policies of governments, but often its advisors did not follow UNFPA guidelines when helping countries plan the design and strategy of country projects. Delays in approval were common in all the projects reviewed by the mission. Furthermore previous evaluations also identified this weakness. In addition, a project in Bhutan addressed mothers' concerns but ignored other women's roles such as managers of households and wage earners. Besides, little was done to include women's participation in health sector decision making at the basic health unit and at the central health ministry. In Nepal, institution building did not include advancement for women or encourage proactive role roles of qualified women medical professionals. In Bhutan, but not Nepal, fellowships and study tours helped increase the number of trained personnel attending intercountry activities.
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  5. 5
    Peer Reviewed

    To prescribe or not to prescribe: on the regulation of pharmaceuticals in less developed countries.

    Hammer JS

    Social Science and Medicine. 1992 May; 34(9):959-64.

    Insufficient information contributes to failure in markets. Government officials also use it to justify intervention in the health sector in the developing countries. Further, in these countries,health care workers have misused pharmaceuticals considerable as well as make improper diagnoses. Moreover both health practitioners and the general public do not always follow instructions on drug use. A shortage of information on appropriate use may indeed cause these problems. A staff member of the World Bank proposes a methodology to use to balance 2 competing risks. Either public health officials allow drugs to be available to consumers over the counter or they require a prescription from a licensed health professional. The risks include obvious diagnostic errors made my consumers untrained in medicine and patients not receiving needed, potentially life saving, drugs. Since there is a shortage of medical personnel in most developing countries, people face considerable obstacles (e.g., travel time and expense) when it comes time to go to a licensed medical facility. The proposed methodology to evaluate the tradeoff between the 2 risks involves looking at the problems as one of determining the value of a more accurate diagnosis through the intervention of a skilled professional as a specific and costly mechanism for acquiring an accurate diagnosis. The article applies the model to illustrative examples to identify the information to answer the regulatory issue question. Further the model also allows public health policy makers to determine the appropriate level of training needed for medical professionals and to evaluate projects which improve public access to information on the use of drugs.
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  6. 6

    International migration and development in Sub-Saharan Africa. Volume I.

    Russell SS; Jacobsen K; Stanley WD

    Washington, D.C., World Bank, 1990. [11], 168 p. (World Bank Discussion Paper 101; World Bank Discussion Papers. Africa Technical Department Series)

    International migration affects almost every aspect of development in which the World Bank works. Accordingly, this paper investigating international migration in sub-Saharan Africa as it relates to development was designed and produced to provide World Bank staff with a greater understanding of country-specific settings for which World Bank projects are designed. Analysis of previously collected and published data from a host of sources was used to aid staff in policy analysis, sector work, loan preparation, and evaluation of the consequences of structural adjustment. 35 million of a total 80 million worldwide international migrants are estimated to be in sub-Saharan Africa. This figure represents approximately 8% of the region's 1983 population of 443 million. International migration, whether gradual or sudden and unexpected, surely affects countries' development. Changes in remittances impact demand for education and health services, structural adjustment, and labor markets to mention just a few potential interactions. This study was designed to consider international migration for employment, but internal migration and refugee flows are also examined. Using data on migrant stock, the study looks at migration scale, trends, and characteristics as they relate to development issues in selected sectors. Migration trend interaction is considered with remittances, labor markets, highly skilled manpower, education, health, and agriculture. Country policy toward international migration in the region are considered. The authors envisage no significant reduction in regional international migration in the future.
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  7. 7

    Meeting health needs.

    Al-Awadi AR

    WORLD HEALTH. 1987 Aug/Sep; 28-9.

    This article by the Health Minister of Kuwait addresses the question of how to meet the health manpower needs of developing nations. Tactics suggested include retraining and utilizing the surplus of physicians in developed nations to provide health care in developing nations. This program could be overseen by international health organizations such as WHO and UNESCO. It could hopefully foster greater coordination and cooperation between these agencies and achieve a better and more effective system for the procurement of health manpower at all levels, not just physicians, for the benefit of developing countries around the world.
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  8. 8

    [National Conference on Population Distribution, Migration and Development, Guadalajara, Jalisco, May 11, 1984] Reunion Nacional sobre Distribucion de la Poblacion, Migracion y Desarrollo, Guadalajara, Jalisco, 11 de mayo de 1984.

    Mexico. Consejo Nacional de Poblacion [CONAPO]

    Mexico City, Mexico, CONAPO, 1984. 107 p.

    Proceedings of a national conference on population distribution, migration, and development held in Guadalajara, Mexico, in May 1984 in preparation for the 1984 World Population Conference are presented. 2 opening addresses explain the objectives and relevance of the national conference, while the 1st conference paper outlines the recommendations of the World Population Plan of Action and of an expert meeting sponsored by the UN in Tunisia in 1983 on the topic of population distribution, migration, and development. The main conference papers discuss recent evolution of population distribution in Mexico; migration, labor markets, and development, including migratory flows and the economic structure of Mexico, recommendations of the World Population Conference of 1974, the migration policy of the Mexican National Development Plan, and the National Employment Service as an instrument of migration policy; and reflections on the World Population Conference, the Mexican government, and the design of an international migration policy, including commentarty on the recommendations of the expert committee on international migration convened in preparation for the World Population Conference, and comments on problems in design of migration policy. The main recommendations of the conference were 1) the principles of the World Population Plan of Action, particularly in regard to respect for fundamental human rights, be reaffirmed; 2) policies designed to influence population movement directly be supplemented by and coordinated with other social and economic policies likely to produce the same effect; 3) coordination among all sectors be improved to ensure effective implementation of policy goals; 4) efforts be undertaken to provide more detailed information on internal migratory movements; 5) laws governing migration and population distribution in Mexico be carefully analyzed and possibly modified; and 6) a clear and realistic international migration policy be formulated which would take into account the need for more detailed data on international migration, a clear definition of policy objectives in international migration, respect of basic human rights, and coherence between external and internal international migration policies.
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  9. 9

    ICARA II and refugee aid and development.

    Clark DL; Stein BN

    Migration Today. 1985; 13(1):33-8.

    This article reviews the issues and changed conditions of 2 separate meetings dealing with assistance to refugees in developing countries--the UN High Commissioner for Refugees (UNHCR), and the International Conferences on Assistance to Refugees in Africa (ICARA). The 1979 UNHCR report states that African host countries were not receiving international assistance for 60% of their refugee burden. The donor countries' emphasis on durable solutions represents the reverse perspective from the concerned countries' emphasis on burden sharing; with international burden sharing, host governments might have reduced sense of responsibility for the refugees, thus impeding efforts to find durable solutions. As a result of these meetings the refugees and development discussion have developed important principles and issues, the main line of reasoning is as follows: 1) refugee problems demand durable solutions because failure to act really means prolonged suffering, dependence, and higher costs to hosts and the international community, 2) there is a need to avoid dependence and promote refugee productivity through self help activities, and 3) the only alternative to permanent dependence on relief is to create income generating opportunities on a large scale. 7 key issues and principles of refugee assistance in developing countries have emerged: 1) equitable burden sharing, 2) spontaneously settled refugees mixed among the local population are central to requests for new forms of refugee assistance, 3) aid to both refugees and locals, 4) projects should be additional to, not at the expense of, the country's other development programs, 5) development oriented assistance, 6) durable solutions, and 7) new institutional arrangements will be needed to put these new principles into action.
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  10. 10

    Health development planning.

    Mahmoud SH

    In: Methodological foundations for research on the determinants of health development, by World Health Organization [WHO]. [Geneva, Switzerland], WHO, Office of Research Promotion and Development, 1985. 1-7. (RPD/SOC/85)

    Health development planning is part of overall development planning and is influenced by the total development process. Those dealing with health planning may present the health sector's development as the most important aspect of development whereas there may be more urgent problems in other sectors. All socioeconomic plans aim at improving the quality of life. There is some correlation between spending on health programs and the health indices. The health indices are poor in countries which accord low priority to health. A table gives measure of health status by level of GNP/capita in selected countries. No direct correlation appears between income and mortality. This paper examines the functions of health development planning; health development plans; intersectoral collaboration; health information; strategy; financial aspects; implementation, evaluation and reprogramming; and manpower needs. A health development plan usually includes an analysis of the current situation; a review of the immediate past plan and previous plans; the objectives, strategy, targets and physical infrastructure of the plan; program philosophy with manpower requirements; financial implications; and the role of the private sector and nongovernment organizations and related constraints. The main health-related determinants include: education, increased school attendance, agriculture and water, food distribution and income, human resources programs and integrated rural development. The strategy of health sector development today is geared towards development of integrated health systems. Intercountry coordination may be improved with aid from the WHO. Health expenditures in countries including Bangladesh, India and Norway is presented.
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  11. 11

    Annual report of the director, 1984.

    Pan American Health Organization [PAHO]

    Washington, D.C., PAHO, Pan American Sanitary Bureau/Regional Office of the World Health Organization, 1985. xix, 265 p. (Official Document No. 201)

    Efforts to meet the goal of health for all by the year 2000 have been hampered by the internal and external problems faced by many countries of the Americas. The pressures of external debt have been accompanied by a reduction in the resources allocated to social sector programs, including health programs. In addition, the conflict in Central America has constrained solutions to subregional problems. The health sector suffers from uncoordinated services, lack of trained personnel, and waste. Thus 30-40% of the population do not have access to basic health services. In 1984, the governments in the region, together with the Pan American Health Organization (PAHO), undertook projects in 5 action areas: new approaches and technology, development, intra- and intersectoral linkages, joint activities by groups of countries, mobilization of national resources and external financing, and preparation of PAHO to meet the needs of these processes. New approaches include the expansion of epidemiological capabilities and practices, the use of low-cost infant survival strategies, the improvement of rural water supplies, and the development of domestic technology. Interorganizational linkages are aimed at eliminating duplication and filling in gaps. Ministers of health and directors of social security programs are working together to rationalize the health sector and extend coverage of services. Similarly, countries have grouped to deal with common problems and offer coordinated solutions. The mobilization of national resources involves shifting resources into the health field and increasing their efficiency and effectiveness by setting priorities. External resources are recommended if they supplement national efforts and are short-term in nature. In order to enhance these strategies, PAHO has increased the managerial and operating capacity of its central and field offices. This has required consolidating programs, retraining staff, and instituting information systems to monitor activities and budgets. The report summarizes health indicators and activities by country, for all nations under PAHO.
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  12. 12

    Evaluation mission on "Assistance to the Manpower Division (Ghana)" October-November 1974. Report.

    Vavra Z

    [Unpublished] [1974]. 51 p.

    The purpose of the Evaluation Mission of the Project, Assistance to the Manpower Division, Ghana, was as follows: to evaluate the project activities with particular attention to the implementation of the project's immediate and longterm objectives; to identify the factors which may adversely influence the project implementation and the use of project outputs for national planning and manpower policies; and to describe the current institutional framework for manpower planning and policies. The Evaluation Mission took place between October 14 and November 2, 1974. This report covers the evaluation of the project (formulation of the project and project implementation, work plan, experts' working relationships, the project coordinator, the UN volunteers, the participation of national counterparts in the implementation of the project, the implementation of the fellowship program, the delivery of vehicles and other equipment, training of the national counterparts, and a seminar for government officials); and institutional framework for manpower planning in Ghana (the Ghana Manpower Board, the Committee of the Manpower Board, the meetings of the Board, the role of the manpower division, the manpower division responsibilities in relation to the project, and the future trend in the development of the manpower division). It was the impression of the Evaluation Mission that the Project as a whole is still not in full operation. Only limited progress has been made toward achieving the immediate objectives of the UN Fund for Population Activities (UNFPA) and International Labor Organization (ILO) assistance to the Manpower Division, Ministry of Economic Planning. There was general agreement that the implementation of the Project outlined in the work plan is not proceeding satisfactorily, and urgent action must be taken to improve the management of the project, to define accurately the administrative and executive responsibilities, and to strengthen the efficiency of day-to-day working activities. A serious shortcoming is the inherent inconsistency of the final Project Document. The links between the long range and the immediate objectives are, to a certain extent, represented by the training activities but have received no attention by the Project Coordinator. The Project's fellowship program is behind schedule. UN volunteers are not being well utilized. Detailed recommendations are included.
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  13. 13

    Viet Nam: report of Second Mission on Needs Assessment for Population Assistance.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, 1983. 59 p. (Report No. 53)

    An estimated 53.7 million people lived in Vietnam in 1980. The government wants to lower the rate of population growth as soon as possible. Its short-term goal, to lower the annual rate to 1.7% by 1986, is to be met through the national family planning program. The government wishes to get more married women in the reproductive age group to use contraception--from 20% at present to 50-65% by the year 2000. 2nd major population goal is resettle 10 million people from the northern to the southern part of the country by the end of the century. Efforts should be made to improve the vital registration system. Population research is concentrated in the State Planning Committee, the research arms of various ministries, and in Government research agencies. This research needs to be strengthened. Overseas training and study tours should be provided for strengthening staff capabilities. Assistance should be provided for the government's primary health care approach with emphasis on community participation. Urgently needed are essential drugs and contraceptives--especially condoms. A factory for testing and packing condoms should be built, once the quality of locally produced latex improves. The Mission recommends that a systematic manpower development analysis be undertaken to aid the government in determining training needs of health personnel; their curricula should include more population and family planning content, and motivational and communication techniques. An audiovisual (AV) center was established in Hanoi; however the information, education, and communication (IEC) program needs strenthening. Aid should also be given for low-cost media production in the AV subcenter being started in Ho Chi Minh City. Perservice training of primary and secondary teachers will include population education. Women's activities should be promoted.
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  14. 14

    Thailand: report of Second Mission on Needs Assessment for Population Assistance.

    United Nations Fund for Population Activities [UNFPA]

    New York, New York, UNFPA, May 1983. 74 p. (Report No. 55)

    Reports on the need for population assistance in Thailand. Areas are identified which require assistance to achieve self-reliance in formulating and implementing population programs. Thailand has had a family planning program since 1970 and UNFPA has been assisting population projects and programs in Thailand since 1971. A Basic Needs Assessment Mission visited the country in April 1981. Thailand is experiencing a rapid decline in the population growth rate and mortality rates have been declining for several decades. The Mission makes recommendations for population assistance and identifies priority areas for assistance, such as population policy formation; data collection; demographic research; health and family planning; population information, education, and communication; and women and development. The Mission recommends that all population efforts be centralized in a single agency with no other function. Thailand is also in need of more personnel in key agencies dealing with population matters. The Mission also recommends that external aid be sought for technical assistance and that population projections be revised based on the 1980 census. Thailand has made a great deal of progress in developing its health infrastructure and services, but some problems still remain, especially in areas of staff recruitment and deployment and in providing rural services. The Mission also recommends that external assistance be continued for short term training seminars and workshops abroad for professionals. Seminars should be organized to assist officials in understanding the importance of population factors in their areas.
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  15. 15

    [Report of the Latin American regional meeting conducted in preparation for the International Conference on Population within the framework of the 7th session of the Committee of High-Level Government Experts] Informe de la reunion regional Latino Americana preparatoria de la Conferencia Internacional sobre Poblacion, realizada en el marco del septimo periodo de sesiones del Comite de Expertos Gubernamentales de Alto Nivel.

    Comite de Expertos Gubernamentales de Alto Nivel [CEGAN]

    Notas de Poblacion. 1983 Dec; 11(33):141-64.

    The meeting adopted 3 resolutions. 1) Adopt the Regional Population Program proposed by the Latin American Center for Demography (CELADE) in its document E/CEPAL/CEGAN/POB.2/L.5, as ammended, and include the study, promotion, and preservation of the families as 1 of the activities of the Regional Program. 2) Expedite the decentralization of the activities of the Economic Commission for Latin America (ECLA) with respect to population; strengthen CELADE's work program; foster the participation of the community and of institutions of higher education in CELADE's actities; deploy national personnel with expertise in demography and related areas to CELADE; and promote the creation of a regional fund to be administered by ECLA for the sponsoring of technical assistance and training programs. 3) A summary of the Latin American position at the International Conference on Population reaffirming the principles adopted in the World Population Plan of Action. It recommends the adoption of a final report containing a statement of principles and universal recommendations; the formulation and implementation of population policies as a sovereign right of each nation; the development of a population policy within a development framework; the initiation of regional activities in accordance with the WPPA; the fostering of voluntary meand of population control, in accordance with social and cultural values; the control of disease and the development of nutrition programs; the developing of regional policies with respect to internal migration; the training of human resources in the areas of population, demography, health, migration, and related fields; improving demographic research; and the strenghtening of all UN regional bodies related to population planning.
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