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Geneva, Switzerland, WHO, 2012. 41 p.Postpartum haemorrhage (PPH) is a major cause of mortality, morbidity and long term disability related to pregnancy and childbirth. Effective interventions to prevent and treat PPH exist and can largely reduce the burden of this life-threatening condition. Given the availability of new scientific evidence related to the prevention and treatment of PPH, this document updates previous WHO recommendations and adds new recommendations for the prevention and treatment of PPH. The primary goal of this guideline is to provide a foundation for the implementation of interventions shown to have been effective in reducing the burden of PPH. Health professionals responsible for developing national and local health policies constitute the main target audience of this document. Obstetricians, midwives, general medical practitioners, health care managers and public health policy-makers, particularly in under-resourced settings are also targeted. This document establishes general principles of PPH care and it is intended to inform the development of clinical protocols and health policies related to PPH.
Southern Med Review. 2011 Dec; 4(2):15-21.Objectives: Although poor reproductive health constitutes a significant proportion of the disease burden in developing countries, essential medicines for reproductive health are often not available to the population. The objective was to analyze the guiding principles for developing national Essential Medicines Lists (EML). The second objective was to compare the reproductive health medicines included on these EMLs to the 2002 WHO/UNFPA list of essential drugs and commodities for reproductive health. Another objective was to compare the medicines included in existing international lists of medicines for reproductive health. Methods: The authors calculated the average number of medicines per clinical groups included in 112 national EMLs and compared these average numbers with the number of medicines per clinical group included on the WHO/UNFPA List. Additionally, they compared the content of the lists of medicines for reproductive health developed by various international agencies. Results: In 2003, the review of the 112 EMLs highlighted that medicines for reproductive health were not consistently included. The review of the international lists identified inconsistencies in their recommendations. The reviews' outcomes became the catalyst for collaboration among international agencies in the development of the first harmonized Interagency List of Essential Medicines for Reproductive Health. Additionally, WHO, UNFPA and PATH published guidelines to support the inclusion of essential medicines for reproductive health in national medicine policies and EMLs. The Interagency List became a key advocacy tool for countries to review their EMLs. In 2009, a UNFPA/WHO assessment on access to reproductive health medicines in six countries demonstrated that the major challenge was that the Interagency List had not been updated recently and was inconsistently used. Conclusion: The addition of cost-effective medicines for reproductive health to EMLs can result in enhanced equity in access to and cost containment of these medicines, and improve quality of care. Action is required to ensure their inclusion in national budget lines, supply chains, policies and programmatic guidance.
Telemedicine: opportunities and developments in Member States: report on the second global survey on eHealth, 2009.
Geneva, Switzerland, WHO, 2010.  p.The telemedicine module of the 2009 survey examined the current level of development of four fields of telemedicine: teleradiology, teledermatogy, telepathology, and telepsychology, as well as four mechanisms that facilitate the promotion and development of telemedicine solutions in the short- and long-term: the use of a national agency, national policy or strategy, scientific development, and evaluation. Telemedicine -- opportunities and developments in Member States discusses the results of the telemedicine module, which was completed by 114 countries (59% of Member States). Findings from the survey show that teleradiology currently has the highest rate of established service provision globally (33%). Approximately 30% of responding countries have a national agency for the promotion and development of telemedicine, and developing countries are as likely as developed countries to have such an agency. In many countries scientific institutions are involved with the development of telemedicine solutions in the absence of national telemedicine agencies or policies; while 50% of countries reported that scientific institutions are currently involved in the development of telemedicine solutions, 20% reported having an evaluation or review on the use of telemedicine in their country published since 2006. (Excerpt)
Research Triangle Park, North Carolina, FHI, 2008.  p.In order to help nonmenstruating clients safely initiate their method of choice, Family Health International (FHI) developed a simple checklist for use by family planning providers. Although originally the Pregnancy Checklist was developed for use by family planning providers, it can also be used by other health care providers who need to determine whether a client is not pregnant. For example, pharmacists may use this checklist when prescribing certain medications that should be avoided during pregnancy (e.g., certain antibiotics or anti-seizure drugs). The checklist is endorsed by the World Health Organization (WHO) and is based on criteria established by WHO for determining with reasonable certainty that a woman is not pregnant. Evaluation of the checklist in family planning clinics has demonstrated that the tool is very effective in correctly identifying women who are not pregnant. Furthermore, recent studies in Guatemala, Mali, and Senegal have shown that use of the checklist by family planning providers significantly reduced the proportion of clients being turned away due to menstrual status and improved women's access to contraceptive services.
Bulletin of the World Health Organization. 2007 Sep; 85(9):650.The WHO Model List of Essential Medicines, used by many countries to guide drug procurement and supply, has been a global standard for 30 years. Although this list has included some paediatric medicines, a children's list has not been systematically developed until now. To address this shortcoming, a subcommittee of the WHO Expert Committee on Selection and Use of Essential Medicines met in July 2007, to develop a list of essential medicines for children. In May 2007, the 60th World Health Assembly passed a resolution on Better Medicines for Children (WHA60.20) that described several strategies to improve access to essential medicines of adequate quality for children. As has been described in several reviews, the main causes of mortality in children can be treated by essential medicines such as antibiotics for infections or oral rehydration solution and zinc for diarrhoea. To apply this knowledge effectively requires that these medicines be available; yet suitable zinc tablets, for example, are still not included in many national essential medicines lists. (excerpt)
Lancet. 2004 Apr 3; 363(9415):1160.Amir Attaran and colleagues highlight a very serious public-health issue. Provision of ineffective drugs for a life-threatening disease is indefensible. There is no doubt that chloroquine is now ineffective for the treatment of falciparum malaria in nearly all tropical countries, and that its usual successor, sulfadoxine-pyrimethamine, is falling fast to resistance. As a result, malaria mortality in eastern and southern Africa, where hundreds of thousands of children die each year from the infection, has doubled in the past decade. We have failed to roll back malaria, and we in the developed world bear the responsibility for this humanitarian disaster. Malaria is not an insoluble problem. We already have the tools (insecticides, bednets, highly effective drugs) to reduce substantially the terrible death toll. But we are not providing them to the people who need them desperately, but who cannot pay for them. Only a tiny fraction of the millions with malaria today receive highly effective treatments. The donors must take some responsibility for this failure. Given the choice between receiving donor support for ineffective chloroquine or sulfadoxine-pyrimethamine and receiving nothing, most countries have naturally opted for the former. It is not easy to protest, particularly when the main donors, and the representatives of international organisations, both claim these drugs are still “programmatically effective”. (excerpt)
Bulletin of the World Health Organization. 2003 Oct; 81(10):774-775.A landmark deal that waives international trade rules may work if implemented in good faith, experts say. Poor countries with no manufacturing capability of their own will be allowed to import cheap copies of patented essential drugs under a complex procedure. (excerpt)
Journal of Adolescent Health. 2003 Oct; 33(4):240-251.The contemporary health problems of young people occur within the context of the physical, social, cultural, economic, and political realities within which they live. There are commonalities and differences in this context among developed and developing countries, thus differing effects on the individual’s personal as well as national development. Internationally, the origins and evolution of health care for adolescents can be viewed as an unfolding saga taking place particularly over the past 30 years. It is a story of advocacy and subsequent achievement in all corners of the world. This paper reviews the important developments in the international arena, recognizes major pioneers and milestones, and explores some of the current and future issues facing the field. The authors draw heavily on their experiences with the major nongovernmental adolescent health organizations. The special roles of the World Health Organization, Pan American Health Organization, and United Nations Children’s Fund (UNICEF) are highlighted, and special consideration is given to the challenge of inclusion through youth participation. (author's)
Lancet. 2003 Sep 6; 362(9386):830-831.There are more than one billion adolescents (age 10–19 years) in the world today and their importance as a demographic group is increasing, especially in the developing world as the age distribution of populations changes over time. Despite their numbers, they have not traditionally been considered a health priority since they have lower morbidity and mortality than older and younger groups. Nonetheless, in some areas such as mental and sexual health, adolescents suffer disproportionately. The consequences of poor health at this age also stretch into the future, affecting their prospects and those of their children. In addition, health-related behaviours, such as smoking, eating habits, sexual behaviours, and help-seeking behaviours developed during adolescence often endure into later life. (excerpt)
In: War and public health, edited by Barry S. Levy, Victor W. Sidel. Washington, D.C., American Public Health Association [APHA], 2000. 254-278.War has always been disastrous for civilians, and the Persian Gulf War was no exception. Yet the image that has been perpetuated in the West is that the Gulf War was somehow "clean" and fought with "surgical precision" in a manner that minimized civilian casualties. However, massive wartime damage to Iraq's civilian infrastructure led to a breakdown in virtually all sectors of society. Economic sanctions further paralyzed Iraq's economy and made any meaningful post-war reconstruction all but impossible. Furthermore, the invasion of Kuwait and the subsequent Gulf War unleashed internal political events that have been responsible for further suffering and countless human fights violations. The human impact of these events is incalculable. In 1996, more than five years after the end of the war, the vast majority of Iraqi civilians still subsist in a state of extreme hardship, in which health care, nutrition, education, water, sanitation, and other basic services are minimal. As many as 500,000 children are believed to have died since the beginning of the Persian Gulf War, largely due to malnutrition and a resurgence of diarrheal and vaccine- preventable diseases. Health services are barely functioning due to shortages of supplies and equipment. Medicines, including insulin, antibiotics, and anesthetics, are in short supply. The psychological impact of the war has had a damaging and lasting effect on many of Iraq's estimated eight million children. (excerpt)
International Journal of STD and AIDS. 2003 Mar; 14(3):174-178.The special requirements for HIV-prevention programmes by armed forces or insurgency groups in very poor countries that are in active conflict have not been well described. Customary military programme components include: education on sexually transmitted diseases, condom distribution, and HIV testing. Programmes for these armed forces must address: a command structure that may not prioritize this activity, severe resource and logistical constraints, weak health systems for treating sexually transmitted illness, beliefs in traditional medicines for symptoms of sexually transmitted illness, illiteracy that diminishes the utility of educational pamphlets, rape and sexual bartering by soldiers, battlefield transfusions, tattooing and the co-epidemic of tuberculosis. (author's)
Report to the Prime Minister. UK Working Group on Increasing Access to Essential Medicines in the Developing World. Policy recommendations and strategy.
London, England, Department for International Development [DFID], 2002 Nov 28.  p.This report outlines the discussions and conclusions of the Working Group. It supports specific action on the R&D agenda, and outlines an ambitious international agenda to facilitate a framework for voluntary, widespread, sustainable, and predictable differential pricing as the operational norm1. It proposes, as a short-term goal, to have significant international commitment to an overarching framework for differential pricing in place in time for the 2003 G8 Summit in France. (excerpt)
Updated guidelines for UNFPA policies and support to special programmes in the field of women, population and development.
[Unpublished] 1988 Apr. , 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.
Report of the European Region on Immunization Activities. (Global Advisory Group EPI, Alexandria, October 1984). WHO/Expanded Immunization Programme and the European Immunization Targets in the Framework of HFA 2000.
[Unpublished] 1984. Presented at the EPI Global Advisory Group Meeting, Alexandria, Egypt, 21-25 October 1984. 3 p. (EPI/GAG/84/WP.4)Current reported levels of morbidity and mortality from measles, poliomyelitis, diphtheria, tetanus, and tuberculosis in most countries in the European Region are at or near record low levels. However, several factors threaten successful achievement of the Expanded Program on Immunization (EPI) goal of making immunization services available to all the world's children by the year 2000, including changes in public attitudes as diseases pose less of a visible threat, declining acceptance rates for certain immunizations, variations in vaccines included in the EPI, and incomplete information on the incidence of diseases preventable by immunization and on vaccination coverage rates. To launch a more coordinated approach to the EPI goals, a 2nd Conference on Immunization Policies in Europe is scheduled to be held in Czechoslovakia. Its objectives are: 1) to review and analyze the current situation, including achievements and gaps, in immunization programs in individual countries and the European Region as a whole; 2) to determine the necessary actions to eliminate indigenous measles, poliomyelitis, neonatal tetanus, congenital rubella, and diphtheria; 3) to consider appropriate policies regarding the control by immunization of other diseases of public health importance; 4) to strengthen existing or establish additional systems for effective monitoring and surveillance; 5) to formulate actions necessary to improve national vaccine programs in order to achieve national and regional targets; 6) to reinforce the commitment of Member Countries to the goals and activities of the EPI; and 7) to define appropriate activities for the Regional Office for Europe of the World Health Organization to achieve coordinated action.
Report of the Expanded Programme on Immunization Global Advisory Group Meeting, 20-23 October 1980, Geneva.
[Unpublished] 1980. 39 p. (EPI/GEN/80/1)This report of the Expanded Program on Immunization (EPI) Global Advisory Group Meeting, held during October 1980 in Geneva, Switzerland, presents conclusions and recommendations, global and regional overviews, working group discussions, and outlines global advisory group activities for 1981. In terms of global strategies, the EPI confronts dual challenges: to reduce morbidity and mortality by providing immunizations for all children of the world by 1990; and to develop immunization services in consonance with other health services, particularly those directed towards mothers and children, so they can mutually strengthen the approach of primary health care. Increased resources are needed to support the expansion of immunization services and to establish them as permanent elements of the health care system. The Global Advisory Group affirms the importance of setting quantified targets as a basic principle of management and endorses the principle of setting targets for the reduction of the EPI diseases at national, regional, and global levels. The primary focus for the World Health Organization (WHO) in promoting the EPI continues to be the support to national program implementation in all its aspects. The Group reviewed current EPI immunization schedules and policies and concurs in the following: for measles, for most developing countries, the available data support the current recommendations of administering a single dose of vaccine to children as early as possible after the child reaches the age of 9 months; for DPT, children in the 1st year of life should receive a series of 3 DPT doses administered at intervals of at least 1 month; for tetanus toxoid, the control of neonatal and puerperal tetanus by immunizing women of childbearing age, particularly pregnant women, is endorsed; for poliomyelitis, the Group endorses the "Outline for WHO's Research on Poliomyelitis, Polioviruses and Poliomyelitis Vaccines" prepared by the WHO Working Group convened in October 1980, i.e., for oral (live) vaccines, a 3-dose schedule, administered simultaneously with DPT vaccine, is recommended again; and for BCG concurred with the Advisory Committee on Medical Research conclusion that the use of BCG as an anti-tuberculosis measure within the EPI should be continued as at present. The implementation of programs at the national level remains the foremost priority for the EPI. National commitment, evidenced in part by the designation of a national manager, the establishment of realistic targets, and the allocation of adequate resources, is essential if programs are to succeed.
Provisional summary record of the fifteenth meeting, WHO headquarters, Geneva, Thursday, 16 January 1986, at 14h30.
[Unpublished] 1986 Jan 16. 4 p. (EB77/SR/15)This summary record details the progress and evaluation report of the Expanded Program on Immunization (EPI). Professor Menchaga noted that the 1990 coverage goal was ambitious and would be difficult to realize under present circumstances. Dr. Henderson, (EPI director) directed attention to the EPI's dilemma, which arises because substantial program acceleration will be required to meet the goal in many countries, and heroic measures will be called for in a few nations. Yet, the level of political commitment which is being achieved and publicized makes it difficult for national managers to plan for anything less than total short-term success, even if this means risking the long-term viability of the program. Dr. Henderson went on to make the point that while all partners in the immunization effort are aware of this dilemma, none have easy solutions to propose. The World Health Organization (WHO) has an especially important role to play and should be able to offer support to immunization planning taking place at the national level. This maximizes the chances that acceleration strategies adopted in the short term are in conformity with, and help support, national strategies for realizing for all by the year 2000. It was noted that there should be no backing away from the 1990 immunization goal. The necessary political commitment and financial resources are being mobilized, and the goal seems to be attainable in most countries of the world. Innovative immunization strategies will be required. In reply to Dr. Adou's question regarding the role of inactivated polio vaccine in EPI, Dr. Henderson responded that the WHO was encouraging operational research to gain further experience with the use of that vaccine but continued to recommend the oral vaccine as the routine for most immunization programs in developing countries.
Eradication of indigenous transmission of wild poliovirus in the Americas. Plan of action, July 1985.
[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.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1980; (651):1-19.This document reports the discussions of a Scientific Group on Vaccination Against Tuberculosis, cosponsored by the Indian Council of Medical Research and the World Health Organization (WHO), that met in 1980. The objectives of the meeting were to review research on Bacillus Calmete-Guerin (BCG) vaccination, assess the present state of knowledge, and determine how to advance this knowledge. Particular emphasis is placed in this document on the trial of BCG vaccines in South India. In this trial, the tuberculin sensitivity induced by BCG vaccination was highly satisfactory at 2 1/2 months but had waned sharply by 2 1/2 years and the 7 1/2-year follow up revealed a high incidence of tuberculous infection in the study population. It is suggested that the protective effect of BCG may depend on epidemiologic, environmental, and immunologic factors affecting both the host and the infective agent. Studies to test certain hypotheses (e.g., the immune response of the study population was unusual, the vaccines were inadequate, the south Indian variant of M tuberculosis acted as an attenuating immunizing agent, and mycobacteria other than M tuberculosis may have partially immunized the study population) are recommended. A detailed analysis should be made when results from the 10-year follow up of the south Indian study population are available.
The global eradication of smallpox. Final report of the Global Commission for the Certification of Smallpox Eradication, Geneva, December 1979.
Geneva, Switzerland, WHO, 1980. 122 p. (History of International Public Health No. 4)The Global Commission for the Certification of Smallpox Eradication met in December 1978 to review the program in detail and to advise on subsequent activities and met again in December 1979 to assess progress and to make the final recommendations that are presented in this report. Additionally, the report contains a summary account of the history of smallpox, the clinical, epidemiological, and virological features of the disease, the efforts to control and eradicate smallpox prior to 1966, and an account of the intensified program during the 1967-79 period. The report describes the procedures used for the certification of eradication along with the findings of 21 different international commissions that visited and reviewed programs in 61 countries. These findings provide the basis for the Commission's conclusion that the global eradication of smallpox has been achieved. The Commission also concluded that there is no evidence that smallpox will return as an endemic disease. The overall development and coordination of the intensified program were carried out by a smallpox unit established at the World Health Organization (WHO) headquarters in Geneva, which worked closely with WHO staff at regional offices and, through them, with national staff and WHO advisers at the country level. Earlier programs had been based on a mass vaccination strategy. The intensified campaign called for programs designed to vaccinate at least 80% of the population within a 2-3 year period. During this time, reporting systems and surveillance activities were to be developed that would permit detection and elimination of the remaining foci of the disease. Support was sought and obtained from many different governments and agencies. The progression of the eradication program can be divided into 3 phases: the period between 1967-72 when eradication was achieved in most African countries, Indonesia, and South America; the 1973-75 period when major efforts focused on the countries of the Indian subcontinent; and the 1975-77 period when the goal of eradication was realized in the Horn of Africa. Global Commission recommendations for WHO policy in the post-eradication era include: the discontinuation of smallpox vaccination; continuing surveillance of monkey pox in West and Central Africa; supervision of the stocks and use of variola virus in laboratories; a policy of insurance against the return of the disease that includes thorough investigation of reports of suspected smallpox; the maintenance of an international reserve of freeze-dried vaccine under WHO control; and measures designed to ensure that laboratory and epidemiological expertise in human poxvirus infections should not be dissipated.
Arlington, Virginia, John Snow, Inc., Resources for Child Health Project, 1988.  p.The Resources for Child Health (REACH) has produced an IMMUNIZATION DIRECTORY which describes the immunization-related roles played by the host country governments, the major donors, and the (primarily US-based) private voluntary organizations on a country-by-country basis. The primary countries highlighted in this directory are those designated by the Agency for International Development as the 22 "Child Survival Emphasis" countries. The basic data for each country includes 1) basic demographic data, 2) national policies, 3) delivery strategies, 4) technical aspects, 5) the official immunization schedule, and 5) the activities of various international agencies. Data is included for Cameroon, Kenya, Madagascar, Malawi, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sudan, Uganda, Zaire, Zimbabwe, Bangladesh, Egypt, India, Indonesia, Morocco, Nepal, Pakistan, Philippines, Yemen, Bolivia, Ecuador, Guatemala, Haiti, Honduras, and Peru.
Report of the Expanded Programme on Immunization Global Advisory Group Meeting, 21-25 October 1984, Alexandria.
[Unpublished] 1985. 51 p. (EPI/GEN/85/1)This report of the Expanded Program on Immunization Global Advisory Group Meeting, held during October 1984, contains the following: conclusions and recommendations; a summary of the global and regional programs; a review of the Expanded Program on Immunization (EPI) in the Eastern Mediterranean Region; a review of country programs in Denmark, Brazil, and India; a report on the epidemiology and control of pertussis; and discussion of sentinel surveillance, surveillance of neonatal tetanus, polio, and measles, and research and development; and proposals for the 1985 meeting of the Global Advisory Group. The Global Advisory Group concluded that national immunization programs have made much progress, realizing some 30% coverage in developing countries with a 3rd dose of DPT. Yet, the lack of immunization services continues to extract a toll of 4 million preventable child deaths annually in the developing world. The Global Advisory Group indicated that the acceleration of existing programs is essential if immunization services are to be provided for all children of the world by 1990. Such acceleration calls for continued vigorous action to mobilize political support and financial resources at national and international levels. Considerable experience has been gained in most countries regarding implementation of immunization programs. The knowledge now exists to bring about major improvements in program achievement, yet gaps in knowledge exist in both technical and administrative areas. Action is needed in the following areas if programs are to accelerate sufficiently to meet the target: management of existing resources; use of intensified strategies; program evaluation; coordination with other components of primary health care; collaboration among international agencies; and regional and country meetings. To take maximum advantage of the benefits offered by vaccine, each country should take the necessary steps to include all relevant antigens in its national program. In particular, the universal use of measles vaccine should be encouraged. It also is of concern that some countries are not yet using polio vaccine and that others omit pertussis vaccine from their programs. Countries are urged to review their current practices about the anatomical site of intramuscular immunization. Taking into account the criteria of safety and ease of administration, thigh injection for DPT and arm injection for TT are recommended strongly. The Global Advisory Group reaffirmed its 1983 recommendation to use every opportunity to immunize eligible children.
Provisional summary record of the fourteenth meeting, WHO headquarters, Geneva, Thursday, 16 January 1986, at 9h30.
[Unpublished] 1986 Jan 16. 20 p. (EB77/SR/14)This document provides a progress and evaluation report of the Expanded Program on Immunization (EPI), a summary record of the 14th Meeting, held in Geneva, Switzerland during January 1986. Dr. Uthai Sudsukh began by saying that the Program Committee had undertaken a review and evaluation of immunization against the major infectious diseases in relation to the goal of health for all and primary health care. This was the second in a series of evaluations and reviews of World Health Organization (WHO) programs corresponding to the essential elements of primary health care. The Program Committee had requested the Secretariat to revise the progress and evaluation report in light of its observations as well as those of the EPI Global Advisory Group. The revised report was before members in document EB77/27, which contained a draft resolution proposed for submission to the 39th World Health Assembly in May 1986. Dr. Hyzler indicated that the revised report provided an excellent picture of the present situation, and he supported the recommendations of the EPI Global Advisory Committee and the draft resolution proposed for submission to the Health Assembly. The underlying concern that was expressed in the report was that EPI might become isolated as a vertical program at the expense of encouraging infrastructure development. Consequently, it was important to ensure that rapid increases in EPI coverage were sustained through mechanisms that also strengthened the delivery of other primary health care interventions. The efficiency of EPI was linked closely to the efficacy of maternal and child health services. The real commitment to the success of immunization that was needed was that of the health workers providing day-to-day care to mothers and children and their families. Those countries that had realized the most progress in immunization had done so because of a very strong maternal and child health component in their national health services. Dr. Otoo made the point that 1 of the major constraints in EPI programming was the shortage of managerial skills and that more effort must be made to improve managerial capabilities. Comments of other participants in the 14th Meeting are included in this summary document.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (749):1-86.This report makes a special effort to present practical information on the control of intestinal parasitic infections. It covers the following: public health significance of intestinal parasitic infections (methods of assessment, helminthic infections, and protozoan infections); the costs of not having a control program (nutrition, growth, and development; work and productivity; and medical care); prevention and control strategies (epidemiological foundation, objectives and general approaches, implementation strategies, costs and financing, methodologies and tools, and strategy for prevention and control); national programs (justification; objectives and strategies; planning; program and implementation; training, education, and dissemination of information; program monitoring and evaluation; and technical guidance); and program support (the role of the World Health Organization, technical and research organizations, funding agencies, industry, and information flow). Current experience suggests that intestinal parasite control programs are appropriate and socially advantageous because people can actually see the effects of primary health care intervention and start to learn some simple facts about health care by watching their village or community become healthier as a result of the control measures. There are 3 major areas in which the lack of control program is responsible for significant losses: nutrition, growth, and development; work and productivity; and medical care costs. Countries in which intestinal parasitic infections and diseases constitute a significant health problem need to consider adopting a national policy for their prevention and control. Recent experience in various countries has demonstrated the effectiveness of periodic deworming and standard case management at the primary health care level in reducing most of the problems associated with intestinal parasitic infections. Support can come from outside the country as well as from national authorities. Support from the outside may be available in the areas of management, technical expertise (which includes research), funding, and exchange of relevant information. The World Health Organization can provide both technical and managerial expertise in the design of programs.
[Final reports, 96th and 97th meetings of the Executive Committee of the Pan American Health Organization, Washington, D.C., 28 September 1985 and 23-27 June 1986. XXII Pan American Sanitary Conference XXXVIII meeting, WHO Regional Committee for the Americas, Washington, D.C., 22-30 September 1986] Informes finales, 96 y 97 Reuniones del Comite Ejecutivo de la Organizacion Panamericana de la Salud, Washington, D.C., 28 de septiembre de 1985 y 23-27 de junio de 1986. XXII Conferencia Sanitaria Panamericana, XXXVIII Reunion, Comite Regional de la OMS para las Americas, Washington, D.C., 22-30 de septiembre de 1986
Washington, D.C., PAHO, 1986. v, 173 p. (Official Document No. 211)The 96th Meeting of the Executive Committee of the Pan American Health Organization was held at the Headquarters buiding in Washington, D.C., on 28 September 1985. The 97th Meeting of the Executive Committee of the Pan American Health Organization was held at the Headquarters building in Washington, D.C., from 23 to 27 June 1986. The XXII Pan American Sanitary Conference, XXXVIII Meeting of the Regional Committee of the World Health Organization for the Americas, was held at the Headquarters building in Washington, D.C., from 22 to 27 September 1986. This document contains the final reports of these 3 conferences including all the participants and resolutions.
Hospitals and health for all. Report of a WHO Expert Committee on the Role of Hospitals at the First Referral Level.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1987; (744):1-82.The World Health Organization (WHO) Expert Committee on the Role of Hospitals at the First Referral Level met from December 9-17, 1985, to review the role of the hospital in the broader context of a health system. The Expert Committee recognized that different strategies could be used to define the role of hospitals in relation to primary health care and that, for example, it would be possible to begin by analyzing what hospitals currently are doing with respect to primary health care, describe the different approaches being used, and then formulate guidelines to be followed by hospitals that are seeking to strengthen their involvement in primary health care. A shortcoming of this strategy is that it is based on what hospitals are already doing in particular circumstances, rather than helping people to decide what is required in a wide range of different settings. Consequently, the Expert Committee undertook to provide an analysis of primary health care, particularly in relation to the principles of health for all, to specify the components of a district health system based on primary health care, and to use this information as a basis for describing the role of the hospital at the first referral level in support of primary health care. This report of the Expert Committee covers the following: hospitals versus primary health care -- a false antithesis (the need for hospital involvement, the evolution of health services, expanding the role of hospitals, delineation of primary health care, hospitals and primary health care, and the common goal of health for all); components of a health system based on primary health care (targeted programs, levels of service delivery, and the functional infrastructure of primary health care); role and functions of the hospital in the first referral level (patient referral, health program coordination, education and training, and management and administrative support); the district health system; and approaches to some persistent problems (problems of organization and function; problems of attitudes, orientation, and training; and problems of information, financing, and referral system). The report includes recommendations to WHO, to governments, to nongovernmental organizations, and to hospitals. The Expert Committee considered that the conceptual focal point for organizational and functional integration should be the district health system encompassing the hospital and all other local health services. Further, the Expert Commitee was convinced that organizational and functional interaction (focused on the district health system) is imperative if full and effective use is to be made of the resources of the hospitals at the first referral level and if the health needs of the population are to be met.