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Geneva, Switzerland, World Health Organization [WHO], 2012.  p.Millennium Development Goal (MDG) 5 Target 5A calls for the reduction of maternal mortality ratio by three quarters between 1990 and 2015. It has been a challenge to assess the extent of progress due to the lack of reliable and accurate maternal mortality data -- particularly in developing-country settings where maternal mortality is high. As part of ongoing efforts, the WHO, UNICEF, UNFPA and The World Bank updated estimates of maternal mortality for the years 1990, 1995, 2000, 2005 and 2010.
Bulletin of the World Health Organization. 2008 Jun; 86(6):460-466.This paper discusses the problems of defining and measuring late-fetal mortality (stillbirths). It uses evidence from 11 developed countries to trace long-term trends in fetal mortality. Issues associated with varying definitions and registration practices are identified, as well as the range of possible rates, key turning points and recent convergence. The implications for developing countries are spelt out. They emphasize the possible limitations of WHO estimation methods and survey-based data by examining the cross-sectional associations among 187 countries in the year 2000. The important role of skilled birth attendants is emphasized in both data sets, but the different effects on maternal mortality and late-fetal mortality are also noted. (author's)
Population 2005. 2002 Sep-Oct; 4(3):1, 8.AIDS will spread five times faster over the next 20 years than it has over the past two decades and will kill nearly 70 million people in 45 of the most affected countries, according to a recent U.N. report. Having swept Africa, the disease is expected to overwhelm China and India, the world’s two most populous countries, says the Report on Global HIV/AIDS Epidemic 2002 released during the U.N. Conference on HIV/AIDS in Barcelona, Spain, in July. The number of children orphaned by HIV/AIDS has risen threefold in six years and reached an all-time high of 13.4 million. India has the largest number of AIDS orphans anywhere in the world, standing at 1.2 million in 2001, and predicted to rise to 2 million in five years and 2.7 million in 10 years. (excerpt)
Population and Development Review. 2004 Sep; 30(3):507-517.World Population in 2300 (United Nations 2003b), reporting on the proceedings of a December 2003 expert group meeting on long-range population projections and presenting the results of a new set of United Nations population projections, bears out Hajnal's argument. Among his three propositions, the validity of the second is the most obvious. There has been a veritable outpouring of demographic projections during the last 50 years, prepared by various international organizations and national agencies, as well as by independent analysts. Among these, the United Nations Population Division's now biennially revised projections are by far the most detailed, best known, and most widely used. This well-deserved prominence reflects the Division's unparalleled access to national data, its in-house analytic experience and resources, and its willingness to draw on outside expertise whenever that might usefully complement its own. The most recent of the biennial projections, the 2002 Revision (United Nations 2003a), is the immediate predecessor of World Population in 2300, and indeed the former provides the year 2000 to 2050 component for the new set of long-term projections covering the next 300 years. This new set is not just one among the many. It is distinguished from the routine by an exceptionally brave ambition: to draw a picture of plausible demographic futures up to the year 2300 and to do so in extraordinary detail: country-by-country according to the political map of the early twenty-first century. (excerpt)
Implementation of the global strategy for Health for All by the Year 2000, second evaluation; and eighth report on the world health situation.
[Unpublished] 1992 Mar 6. 171 p. (A45/3)This 2nd evaluation of the global strategy for health for all (HFA) by 2000/8th report on the world health situation indicates a need for a new approach for sustainable health development which includes mobilizing resources for high priority populations and health needs, more effective and intersectoral health promotion and protection, and improving access to primary health care (PHC) via higher quality services and integrating health services into all social services. The data cover 96% of the world's population and the years 1985-90. The 1st chapter looks at the interaction among political, economic, demographic, and social development trends and their effects on health. It mentions the health development trend of increased involvement of individuals, communities, professional groups, and development agencies. The 2nd chapter centers on the progress of countries towards reaching HFA by examining the differences between the haves and the have nots. The 3rd chapter examines improvement and obstacles in health care coverage, PHC coverage, and quality of care. Chapter 4 reviews health resources including financial and human resources and health technology. The next chapter focuses on trends in mortality, morbidity, and disability and life style factors of health such as smoking. Chapter 6 examines policies and programs of environmental health, evaluation, and monitoring of environmental health hazards and risks, and environmental resources management. The 7th chapter brings together highlights and implications expressed in the previous chapters and states that health improvements have indeed occurred such as increased life expectancy. The last chapter uses the information in the preceding chapters to project future trends and mentions 5 challenges facing the world today.
Geographical variation in the major risk factors of coronary heart disease in men and women aged 35-64 years.
WORLD HEALTH STATISTICS QUARTERLY/RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1988; 41(3-4):115-40.This is an overview of the WHO MONICA project which was "designed to measure the trends in mortality and morbidity from coronary heart disease (CHD) and stroke, and to assess the extent to which they are related to changes in known risk factors in different populations in 27 countries. Risk-factor data are collected from population samples examined in at least two population surveys (one at the beginning of the study and the other at the end). The results of the baseline population surveys are presented." Risk factors considered include smoking, and blood pressure and cholesterol levels for men and women. (SUMMARY IN FRE) (EXCERPT)
Washington, D.C., World Bank, 1997. xi, 118 p. (World Bank Discussion Paper No. 356)In order to begin the process of assessing the effectiveness of the World Bank's work in the health, nutrition, and population sector (which has involved loans of nearly US$10 million in 89 countries since 1970), this report reviews this work and presents an assessment strategy. The introductory chapter is followed by a literature review on determinants of trends in fertility and mortality conducted to aid identification of evaluation benchmarks. Chapter 3 covers the tools and methods used to evaluate population and health policies, beginning with the methodology used to assess the effectiveness of family planning programs and moving on to broader considerations of health policy and program evaluation, cost benefit analyses, and service delivery evaluation. The fourth chapter sketches the World Bank's involvement in the health, nutrition, and population sector and summarizes the results of previous reviews of the World Bank's experience in this area. Chapter 5 presents an evaluation framework for assessing the World Bank's effectiveness in influencing the demand responsiveness of service delivery structures and institutional capacity in borrower settings as well as development effectiveness in terms of: 1) clinical/epidemiological effectiveness, 2) accessibility and equity, 3) quality and consumer satisfaction, and 4) economic efficiency. The proposed evaluation will provide a cross-country analysis of the World Bank's entire lending portfolio in this sector as well as country sector impact studies.
New York, New York, United Nations, 1994. vii, 49 p. (ST/ESA/SER.A/138)The 137 paragraphs in this United Nations report detail trends, as of 1993, in the areas of refugees, population growth and distribution, fertility and mortality, international migration, and the environment. A stagnation in the decline of total fertility and changes in the age structure of the population have caused the world population growth rate to remain at about 1.7% per year since 1975. However, the gap between the growth rates of more and less developed countries increased from 0.7% in 1950-55 to 1.5% in 1985-90. 61% of developing countries consider their current population growth rates to be too high, and this is reflected in the growing number of countries that have population policies explicitly aimed at curbing overpopulation. At present, 36 of Africa's 53 countries have adopted fertility reduction policies. From 1985 to 1993, the world's refugee population increased from 8.5 to 19 million. Most of these refugees resettled in developing countries; also observed was a trend toward increased asylum applications in developed countries. Safeguarding the global environment (land, forests, and water) is emerging as a major rationale for reducing population growth rates.
New York, New York, UNFPA, . v, 36 p. (Report)The former government of Romania sought to maintain existing population and accelerate population growth by restricting migration, increasing fertility, and reducing mortality. The provision and use of family planning (FP) were subject to restrictions and penalties beginning in 1986, the legal marriage age for females was lowered to 15 years, and incentives were provided to bolster fertility. These and other government policies have contributed to existing environmental pollution, poor housing, insufficient food, and major health problems in the country. To progress against population-related problems, Romania most urgently needs to gather reliable population and socioeconomic data for planning purposes, establish the ability to formulate population policy and undertake related activities, rehabilitate the health system and introduce modern FP methods, education health personnel and the public about FP methods, promote awareness of the need for population education, and establish that women's interests are served in government policy and action. These topics, recommendations, and the role of foreign assistance are discussed in turn.
[The health-for-all strategy: are we reaching our targets to reduce mortality?] Helse for alle-strategien--nar vi malene for redusert dodelighet?
Tidsskrift for den Norske Laegeforening. 1992; 112(1):57-63.The author examines Norway's efforts toward attaining the WHO goal of health for all by the year 2000. "This article presents and discusses the sub-goals for expectation of life and mortality, and analyzes the possibilities of reaching them." Consideration is given to reductions in mortality from accidents, cardiovascular effects, and cancer; age-specific mortality rates; and deaths from suicide and homicide. (SUMMARY IN ENG) (EXCERPT)
In: Disease and mortality in Sub-Saharan Africa, edited by Richard G. Feachem, Dean T. Jamison. Oxford, England, Oxford University Press, 1991. 31-6.This article is an overview of 4 chapters of part I of the 1991 World Bank publication entitled Disease and Mortality in Sub-Saharan Africa. It discusses what the health community currently knows about the levels, trends, and patterns of mortality in Sub-Saharan Africa. In fact, it points out that only limited data are currently available. Demographic techniques have evolved to overcome data limitations, however. These chapters also identify important information gaps that must be filled to plan interventions. These chapters reveal that mortality levels are higher in Sub-Saharan Africa than in other developing regions. Mortality of children <5 years old has decreased since the 1940s in most Sub-Saharan African countries, except for countries who have experienced war and civil unrest. Further Sub-Saharan Africa exhibits a specific mortality pattern: higher levels of infant, young child, and adult mortality exist in western Africa than in eastern or southern Africa. Nevertheless adult mortality in western Africa fell considerably between the 1950s-late 1970s, but it did not fall much in eastern African countries (their levels were lower initially though). This article suggests that donors could greatly contribute to developing planning ability in Sub-Saharan Africa by supporting the establishment of a vital registration system. Health planners often have access to hospital record and community survey data, however, but these data are biased. Further these chapters show that interventions to reduce mortality do not necessarily result in a reduction in morbidity. Rapid population growth and high fertility pose further problems for health planners.
The use of cause-of-death statistics for health situation assessment: national and international experiences.
WORLD HEALTH STATISTICS QUARTERLY/RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1990; 43(42):249-58.About 80 countries or areas regularly report detailed cause-of-death data to WHO based on the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD). These data refer to about 35% of all deaths estimated to occur in the world....This article describes the collection and use of these data by WHO for assessing the global and regional health situation, and for monitoring trends in health status. In addition, several issues in the use of mortality data and the ICD for national health situation assessment are discussed, including the need for documenting the quality and coverage of cause-of-death statistics, identifying biases and evaluating mortality trends. (SUMMARY IN FRE) (EXCERPT)
MEDICAL JOURNAL OF AUSTRALIA. 1990 Nov 5; 153(9):548-51.The importance of communication in public health is described with reference to recent experiences in Australia where good progress has been made with certain major public health problems. There has been a 30% fall in road accident deaths and a 40% drop in deaths from coronary heart disease. In addition a smoke--free environment has been established in both public areas and the workplace. These successes have been dependent on effective communication based on appropriate data. Evaluation data have also been used to keep the public informed and to reinforce the message. The cooperation of the media has been most crucial in stimulating a new awareness of health and the opportunities for self-help and community initiatives. In central australia, new initiatives involving the Central Australian Aboriginal Congress have led to improvements in the health of the Aborigines, their training as healthworkers, and the development of a Center for Appropriate Technology at the Alice Springs Celled of Technical and Further Education. At the international level, Australia sponsored a World Health Assembly resolution in 1986 which called for the elimination of iodine deficiency disorders. With the support of the Australian International Development Assistance Bureau and UNICEF, an international expert group of scientists and public health professionals, the International Council for Control of Iodine Deficiency disorders (ICCIDD), based in Adelaide, has worked with WHO and UNICEF in the development of an international public health program aimed at eliminating iodine deficiency disorders by the year 2000. The ICCIDD is a new model for communication and action in international health which is now being advocated for other areas. (author's)
In: Population perspectives. Statements by world leaders. Second edition, [compiled by] United Nations Fund for Population Activities [UNFPA]. New York, New York, UNFPA, 1985. 98-9.Liberia is characterized by a high fertility rate; its current total fertility rate of 6.7 children/woman is one of the highest in Africa. Also quite high is the country's 18/1000 mortality rate. Until the 1980s, Liberia was able to maintain a favorable balance between an increasing population and the gross domestic product. In more recent years, however, the economic growth rate has fallen behind the population growth rate, with a subsequent sharp decline in the standard of living. Economic recovery is currently the cornerstone of Liberia's development policy, and the protection and enhancement of the population's welfare by proper planning is a key goal. Population policies that will accelerate the pace of achieving national economic objectives are under consideration. Of particular concern is the massive migration of rural residents to urban areas. In response to this trend, development projects in rural areas are being expanded.
In: Mortality and health issues in Asia and the Pacific: report of a seminar held at Beijing in collaboration with the Institute of Population Research, People's University of China from 22 to 27 October 1986. New York, New York, United Nations, 1987. 107-32. (Asian Population Studies Series No. 78.; ST/ESCAP/485.)Around 1980, half of the population of the Economic and Social Commission for Asia and the Pacific (ESCAP) region was already living in countries where the average life expectancy at birth is 65 years. Impressive as this progress is, its interpretation as a proof for improvement of the health status of the populations has not remained unchallenged. Repeatedly, it has been argued that as a consequence of the import of sophisticated modern medical technology, as well as large-scale foreign aid inspired and financed public health programs, the reduction of mortality has outpaced improvements in health. Similar reservations against the use of mortality data as evidence for trends and differentials in health status have been put forward in the more developed countries of the ESCAP region, particularly vocally in Japan. The debate is not academic but concerns crucial policy issues. In many countries of the ESCAP region, the health care delivery system is neither sufficiently organized nor staffed, in numbers and qualifications, to cope with the problems raised by a rapidly increasing population, particularly in certain high risk groups such as pregnant women, infants, and children. This challenge is compounded by the fact that very often traditional health problems exist side by side with newly emerging hazards. The dominant conclusion of an analysis of all the available information is that in contrast to the significant advances in the control of mortality, the morbidity situation has either stagnated or, at any rate, failed to match the gains in longevity. Impressive advances in some areas and countries exist side by side with grave setbacks in others. On the whole, the diversity of national health conditions has increased, with some countries approaching a "modern" epidemiological scenario, others lagging behind, and another group tackling old and new disease problems concurrently. Likewise, within countries, similar differences exist or gradually emerge between urban and rural populations. Malnutrition, in synergistic action with diarrhoeal diseases and acute respiratory infections, as well as malaria, are the main challenge in the ESCAP region, particularly for the countries of Middle South Asia. Successful agricultural policies have laid the foundation for overcoming the age-old threat of mal- and undernutrition. As regards malaria, the current situation hardly justifies optimism. In the developed countries of the region, the common causes of illness are cardiovascular diseases, cancer, and accidents.
In: Mortality and health issues in Asia and the Pacific: report of a seminar held at Beijing in collaboration with the Institute of Population Research, People's University of China from 22 to 27 October 1986. New York, New York, United Nations, 1987. 33-105. (Asian Population Studies Series No. 78.; ST/ESCAP/485.)This study outlines the mortality transition in 6 developing countries: Bangladesh, China, Indonesia, Pakistan, the Republic of Korea, and Thailand. The path and pattern of the mortality transition in these countries is compared to the transition in other countries in the Economic and Social Commission for Asia and the Pacific (ESCAP) region. These 6 countries have striking similarities to others in the region: 1) they have all been exposed to colonialism in the past; 2) 30 or 40 years ago they were very similar in their demographic characteristics, and only in the last decade or so have they become increasingly heterogenous; and 3) they have suffered from the stagnation of economic growth and inflation. In at least 1 of the 6 countries, the Republic of Korea, mortality probably started declining early in this century. In Pakistan and Bangladesh, during the British colonial administration of the 1920s, the early decline of mortality was probably limited to urban areas. The onset of the mortality transition is more difficult to date in Thailand and Indonesia, but it probably did not begin before the mid-1940s. It is unlikely that major improvements in Chinese mortality began before the 1950s. In all 6 countries age and sex specific mortality rates declined, though the pattern of these changes varies greatly among them. In most instances, significant reductions in infancy and early childhood mortality occurred, lesser ones among adults, and least affected were older people. In some countries, the reduction of female mortality at some or all ages was proportionately greater than that of males, with a subsequent widening of the gap between the survival chances of males and females. There have been no major changes in the age and sex structure of the 6 populations other than those which have originated from the recent decline in fertility in some of them. The reduced numbers of higher order births, birth spacing, and the postponement of marriage and of births to very young mothers must have reduced infant, child, and maternal mortality. A significant contribution to the general decline of mortality accrues from 2 major trends: 1) rising urbanization, and 2) increasing adult literacy, especially of women. On the available evidence, it appears that in all the countries except Bangladesh the nutritional situation of the population has improved. Health care planning has been an integral part of developmental plans in all 6 countries of the ESCAP region. The health delivery systems in all 6 countries have greatly expanded in the last 35 years. 3 characteristics have made the mortality decline unique: the magnitude, speed, and universality of the decline.
In: Population strategy in Asia. The Second Asian Population Conference, Tokyo, November 1972. Report, declaration and selected papers, [compiled by] United Nations Economic Commission for Asia and the Far East [ECAFE]. Bangkok, Thailand, ECAFE, 1974 Jun. 69-130. (Asian Population Study Series No. 28; E/C.N.11/1152)The Economic Commission for Asia and the Far East (ECAFE) region currently includes 31 countries and territories. Since the first Asian Population Conference in 1963, there has been greater recognition of the adverse effects of rapid population growth on national development and on the standard of living of individual family units. By the year 2000, the population of the ECAFE region is expected to almost equal the total for the world in 1970, despite significantly slowed population growth in the East Asia subregion. During the periods 1900-1950 and 1950-2000, the average annual rates of growth for the population of the ECAFE region are estimated at 0.7% and 2.0%, respectively. The 4 largest countries in the region--China, India, Indonesia, and Japan--together hold 78% of the region's total population. Even in the countries where there has been a decline in fertility, it has not been sufficient to offset the effects of corresponding declines in mortality. The 1950 population of each country, except for China and Japan, will at least double itself by the year 2000. The number of preschool-aged children is expected to reach 356 million by 1980 and there will be 609 million school-aged children. Children ages 0-14 years currently comprise about 40% of the total population of the ECAFE region, producing a high dependency burden. The female population in the reproductive age group will grow from 474 million in 1970 to 593 million in 1980, implying that the fertility potential of the region will be accelerated. In addition, the population of persons aged 60 years and over will increase from 117 million in 1970 to 158 million in 1980, requiring significant investments in health facilities and social security. The urban population in the region is expected to increase from 25% in 1970 to 45% by 2000. Despite widespread awareness of the interrelation of population and development, no common approach among demographers, family plannes, and economic plannes has emerged.
Bangkok, Thailand, World Health Organization, Global Epidemiological Surveillance and Health Assessment, and Mahidol University, Faculty of Public Health, Institute for Population and Social Research, 1986. 546 p. (UNFPA Project No. INT/80/P09)This book on new developments in mortality analysis is a product of a joint WHO/UN research program. Part 1 examines mortality transition in terms of the causes and mechanisms of mortality decline in Europe and North America, reflecting on the study of development processes in countries now undergoing development. Part 2 deals with the use of mortality data in health planning and the use of mortality and other epidemiologic information in the assessment of preventable deaths. Attention is paid to the development of an index of preventable deaths. Part 3, Methodological Developments, examines intersectoral aspects of mortality projections (in terms of health care inputs), the measurement of social inequality and mortality, and maternal death and its impact on the female population. Part 4 deals with cause of death analysis: estimation of global mortality patterns by cause of death, trends and differentials in Thailand, and maternal mortality and differentiation by cause of death. Part 5 discusses nutrition, including a Southern Asia-based study of the relationship between nutritional deficiencies and infant and child mortality, and a study on advances in child nutrition and health that have taken place despite slow economic development. Part 6 discusses mortality change: achievements and failures in South and East Asia, a study on changing health in Japan, mortality decline in Mexico, and socioeconomic correlates of mortality in Pakistan. The section concludes with articles on trends and differentials in mortality in Malaysia and Thailand, and a study of the effects of declining mortality and population aging in rapidly-developing Jamaica.
[Unpublished] 1984. Paper presented at the Meeting on Analysis of Trends and Patterns of Mortality in the ESCAP Region, 13-19 November 1984, Bangkok.  p.Mortality has declined in all the countries of the Economic and Social Commission for Asia and the Pacific (ESCAP) region, but the declines have been far from uniform. Development may mean greater input into health services and public health, but it can also mean better transportation, more schools, higher wages, more job opportunities, and better housing. Each of these factors affects the health of the population. Mortality decline may be due to either a reduction of exposure to risk or an increased proportion of the population protected from the risk by immunization or other preventive measures. A disease may disappear, such as smallpox has, or a new treatment may substantially reduce case fatalities; both processes may be happening at once. The effective control of "preventable deaths" is the path to modern low mortality levels. Only a few ESCAP countries, those with reasonably accurate cause of death statistics, show modernized mortality levels. Deaths from infectious and parasitic diseases decline with modernization, and deaths from cancer increase. The U-shaped age pattern of mortality, in which infant and child deaths are predominant, becomes a J-shaped curve with greater mortality risk at older ages. Socioeconomic change affects mortality at national, community, and individual or household levels. Life expectancy at birth rises with per capita gross national product. On the individual level, mother's education, family income, family size, and child spacing all affect child mortality. Other sociobiological factors affect mortality risk on an individual level, such as late use of modern health services. Future mortality research needs to examine all these factors and cross discipinary lines.
[Unpublished] 1984. Paper presented at the Meeting on Analysis of Trends and Patterns of Mortality in the ESCAP Region, 13-19 November 1984, Bangkok.  p.In the Economic and Social Commission for Asia and the Pacific (ESCAP) region, life expectancy at birth varies from less than 45 years in Afghanistan, Bhutan, Democratic Kampuchea, Lao People's Democratic Republic, and Nepal to 70 years and above in Japan, Australia, and New Zealand. Generally, mortality has declined in the ESCAP region in the last 25 years. Early mortality improvements can largely be attributed to new disease control technologies, such as immunization and effective disease treatment. Large-scale epidemics became rare, as did large-scale famines. In countries where population was concentrated in urban areas, such as in Singapore and Hong Kong, and in countries where health services were extended to the rural sector, such as China, mortality fell to developed country levels. Health services are not the sole agent in this process; increasing literacy, social welfare policy, adequate housing and water supplies, sanitation, and economic growth are also participants. At the root of mortality differentials between and within countries are problems associated with differential rates of socioeconomic development, income distribution, and the inadequacy of health care systems to cope with their responsibilities. Health services alone may alleviate only some of the major health problems. The sophisticated approach of Western medicine may be inappropriate for these countries. The most prevalent health problems in the least developed countries of the ESCAP region are water and airborne infectious diseases, complicated by malnutrition. Treatment, although bringing immediate relief, may not have a lasting effect on the person who must return to a disease-ridden environment.
Population Bulletin of the United Nations. 1986; (18):34-40.The author uses U.N., Unesco, and World Bank data to examine factors contributing to the mortality decline in developing countries since the middle of the 1960s. The primary aim of the paper is to present an analysis of developments in the recent period similar to earlier studies by the same author concerning factors influencing mortality declines during the period from the 1930s to the 1960s. "The study finds that, contrary to previous periods, the social and economic variables of income, literacy and nutrition were the dominating factors in explaining mortality decline during the 1965-1969 to 1975-1979 decade....The exogenous factors appear to have operated with sharply reduced intensity in the more recent period. Reduced international commitment to health in developing countries may be one explanation; surely Governments and international agencies continue to have many tools available for improving health. Results also suggest the major role that can be played by educational change in fostering mortality gains." (EXCERPT)
In: Aspects of population change and development in some African and Asian countries. Cairo, Egypt, Cairo Demographic Centre, 1984. 43-56. (CDC Research Monograph Series no. 9)This paper examines the relationship between economic development and demographic change in the 13 states of the Economic Commission for West Asia (ECWA) region. Demographic variables considered include per capita income, proportion urban, proportion in urban areas with over 100,000 inhabitants, literacy among those over 15 years, and literacy among women. Unweighted rankings on these variables were added to produce a development ranking or general development index. Then this index was used to investigate the relationship between development and individual scores and rankings for various demographic indices. The development index exhibited a rough fit with the mortality indices, especially life expectancy at birth. Mortality decline appears to be most closely related to rise in income. At the same income level, countries that have experienced substantial social change tend to exhibit the lowest mortality, presumably because of a loosening in family role patterns. In contrast, the relationship between development and fertility measures seemed to be almost random. A far closer correlation was noted between the former and the general development index. It is concluded that economic development alone will not reduce fertility. Needed are 2 changes: 1) profound social change in the family and in women's status, achievable through increases in female education, and 2) government family planning programs to ensure access to contraception.
Joicfp Review. 1985 Oct; 10:44.The primary health care program in the Philippines today officially includes only the control of parasites which cause malaria and schistomiasis. Dr. Solon suggests that equal emphasis should be given to the control of all types of parasites. This paper presents excerpts from an interview with Dr. Solon. He expresses his opinion that in the past 20 years infant mortality has decreased markedly. In 1985, it was reduced to 58/1000 live births. He attributes this to a political will to support the health ministry in the implementation of its programs. The efforts to implement primary health care (PHC) has resulted in receiving the Kawaski Award given by Japan and the World Health Organization (WHO) to a country successfully implementing PHC. JOICFP has demonstrated the approaches used in the integration of family planning, nutrition and parasite control. Dr. Solon hopes that the integrated project would pave the way for the control of parasites other than schistostomiasis and malariasis. Less attention has been paid to the control of helminths such as ascaris, bookworm, trichuris t. and roundworm, which are common in the Philippines. Worms may cause deadly diseases such as pneumonia and bronchitis. JOICFP has shown that in several project areas in the country, use of the right personnel, equipment and anthelmintics can result in controlling these parasites.
Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 37-79. (International Conference on Population, 1984.; ST/ESA/SER.A/91)This paper reviews the major issues that have emerged in the analysis of mortality and health policy since the 1974 World Population Conference. The 1st part summarizes current mortality conditions in the major world regions and evaluates progress toward achieving the goals of the World Population Plan of Action. It is noted that the current mortality situation is characterized by continued wide disparities between the more developed and less developed regions, especially during the 1st year of life. The 2nd part focuses on the synergistic relationship between health and development, including social, economic, and health inequalities. It is asserted that mortality rates in developing countries are a function of the balance governments select between development strategies favoring capital accumulation and concentrated investments on the 1 hand and strategies oriented toward meeting basic needs and reducing inequalities in income and wealth. Data from developed countries suggest that economic development does not necessarily lead to steady gains in life expectancy. Some variations in mortality may reflect changes in family relationships, especially women's status, that are induced by social and economic development, however. The 3rd part of this paper analyzes the effect of health policies on mortality, including curative and preventive programs and primary health care. The lack of community participation is cited as a key factor in the weak performance of primary health care in many developing countries. In addition, there is strong evidence that the concepts and technologies of modern medicine must be adapted to existing systems of disease prevention and care to gain acceptability. The 4th section, on the implementation of health policies, discusses health care management, planning, and financing. It is noted that successful implementation of health policies is often hindered by scarcity, inadequate allocation, and inefficient utilization of health resources. Finally, more effective means to cope with rising costs of health care are needed.
In: Demographic trends in the European region: health and social implications, edited by Alan D. Lopez and Robert L. Cliquet. Copenhagen, World Health Organization, Regional Office for Europe, 1984. 5-67. (WHO Regional Publications, European Series No. 17; Project RMI/79/P05)This chapter presents an overview of recent demographic trends in Europe and discusses the implications of these trends for health and social services. The discussion is based on reports received from 15 of the 33 Member States of the European Region of the World Health Organization. The components of demographic change analyzed included population growth and structure, family formation, fertility, mortality, and population movement. Increases in the number and proportion of the elderly were noted and the traditional excess of births over deaths is expected to change in future years. Population aging is expected to continue to be a principal concern for the social services sector. The increasing emphasis on caring for rather than attempting to cure chronic illnesses among the aged suggests a need for more nursing homes and home-help services. Anticipation of future morbidity and mortality patterns implies a need to focus on specific risk groups, e.g. migrants, adult males, and those from lower socioeconomic groupings. With regard to fertility, adolescent sexual activity and the low use levels of contraception among teenagers comprise areas where greater service provision is necessary. In addition, there is a need for more vocational training for women, improved child care facilities, and full-time employment opportunities better suited to the needs of workers with dependent children. As a result of smaller families, increased divorce rates, the discrepancy between male and female survival, and greater regional mobility, markedly higher numbers of single individuals can be expected. Rapidly evolving changes in family formation, social norms, and underlying demographic trends will continue to alter European societies in the years ahead. The interrelationships between health and demographic phenomenon must continue to be probed to form a basis for future health and social planning.