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  1. 1
    102728

    Strengthening nutrition through primary health care: the experience of JNSP in Myanmar.

    World Health Organization [WHO]. Regional Office for South-East Asia [SEARO]

    New Delhi, India, WHO, SEARO, 1991 Dec. [3], 35 p. (Regional Health Paper, SEARO, No. 20)

    The Joint WHO/UNICEF Nutrition Support Programme (JNSP) began operations in Myanmar in 1984 and expanded nationwide in three phases. A detailed situation analysis of nutrition conditions and nutrition programs in primary health care (PHC) were conducted prior to JNSP activities. They served as the rationale for the decision to implement JNSP activities nationally. These activities are almost entirely administered through the Ministry of Health. JNSP redesigned nutrition training for village workers, their supervisors, and district health personnel. It has strengthened nutrition units at the central and regional levels. All JNSP-technical activities revolve around nutrition monitoring and counseling. JNSP participated in the establishment and operations of a food and nutrition surveillance system. It facilitated implementation of the nutrition and nutrition-related aspects of the People's Health Plan. The JNSP was evaluated in 1989. During the JNSP period, mortality among children less than 3 years old fell. 3-year-old children grew at a faster rate than prior to JNSP. Improvements were also noted in young child feeding practices, health seeking behavior of mothers, counseling by voluntary workers, and health staff performance. The evaluators concluded that JNSP directly benefitted the health and nutrition of children less than 3 years old. External costs of JNSP added up to US$5.63 million. The government put in another US$5.43 million. The communities contributed US$2.9 million. JNSP covers 30% of the total population. Per capita annual costs were US$1.67. These low per capita costs suggest that JNSP is sustainable and replicable. JNSP's further expansion depends on expansion of the health delivery system. All levels regularly provide support and supervision. Planned evaluation and feedback is the norm.
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  2. 2
    099432

    Government of Sierra Leone. National report on population and development. International Conference on Population and Development 1994.

    Sierra Leone. National Population Commission

    Freetown, Sierra Leone, National Population Commission, 1994. [4], 15, [4] p.

    The government of Sierra Leone is very concerned about the poor health status of the country as expressed by the indicators of a high maternal mortality rate (700/100,000), a total fertility rate of 6.2 (in 1985), a crude birth rate of 47/1000 (in 1985), an infant mortality rate of 143/1000 (in 1990), and a life expectancy at birth of only 45.7 years. A civil war has exacerbated the already massive rural-urban migration in the country. Despite severe financial constraints, the government has contributed to the UN Population Fund and continues to appeal to the donor community for technical and financial help to support the economy in general and population programs in particular. Sierra Leone has participated in preparations for and fully supports the 1994 International Conference on Population and Development. This document describes Sierra Leone's past, present, and future population and development linkages. The demographic context is presented in terms of size and growth rate; age and sex composition; fertility; mortality; and population distribution, migration, and urbanization. The population policy planning and program framework is set out through discussions of the national perception of population issues, the national population policy, population in development planning, and a profile of the national population program [including maternal-child health and family planning (FP) services; information, education, and communication; data collection, analysis, and research; primary health care, population and the environment; youth and adolescents and development; women and development; and population distribution and migration]. The operational aspects of the program are described with emphasis on political and national support, FP service delivery and coverage, monitoring and evaluation, and funding. The action plan for the future includes priority concerns; an outline of the policy framework; the design of population program activities; program coordination, monitoring, and evaluation; and resource mobilization. The government's commitment is reiterated in a summary and in 13 recommendations of action to strengthen the population program, address environmental issues, improve the status of women, improve rural living conditions, and improve data collection.
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  3. 3
    115394

    Progress towards health for all: third monitoring report. Progres vers la sante pour tous: troisieme rapport de suivi.

    World Health Organization [WHO]

    WORLD HEALTH STATISTICS QUARTERLY. RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1995; 48(3-4):174-249.

    In 1977, the World Health Assembly designated the year 2000 as the time by which it should be possible for all citizens of the world to obtain a level of health that would permit them to be socially and economically productive. This document, which assesses implementation of health-for-all strategies during 1991-93, is the third report to monitor progress toward this goal. The report opens with an introduction describing the monitoring process and the data upon which the assessment was based. The second section of the report describes population and socioeconomic trends and considers such issues as patterns in population growth, longterm trends in births and deaths, social change, age structure, migration, urbanization, refugees and displaced persons, and trends in education. The third section discusses trends in the provision of a healthy environment and promotion of healthy life styles. Section 4 summarizes health status data on life expectancy, mortality rates, causes of death, morbidity trends, disability trends, and the nutritional status of children. Implementation of primary health care (PHC)is covered in the next section, which looks at health education and promotion, food supply and proper nutrition, safe water and basic sanitation, maternal and child care, control of locally endemic diseases, immunization, treatment of common diseases, and PHC coverage. The sixth section assesses the development of health systems based on PHC and looks at national health policies, strategies, and legislation; organization and management of health systems based on PHC, intersectoral collaboration, community involvement, health systems research, technology for PHC delivery, international support for health system development, sustainable development initiatives, and emergency preparedness and relief. Section 7 is devoted to health resources in the areas of financial activities, human resources, the physical infrastructure, and logistics and supplies. The concluding section of the report summarizes the status of 1) the major determinants of health, 2) the implementation of PHC and the development of health systems, and 3) the distribution of health resources. The next in-depth analysis of progress toward health-for-all is scheduled to begin in 1997.
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