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Global Health Action. 2015 Sep 18; 8:29034.Background: Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective: This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design: We outline the scope, content, and intended uses / application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions: The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level. Copyright: 2015 World Health Organization. Open Access.
The World Health Organization European Health in Prisons project after 10 years: persistent barriers and achievements.
American Journal of Public Health. 2005 Oct; 95(10):1696-1700.The recognition that good prison health is important to general public health has led 28 countries in the European Region of the World Health Organization (WHO) to join a WHO network dedicated to improving health within prisons. Within the 10 years since that time, vital actions have been taken and important policy documents have been produced. A key factor in making progress is breaking down the isolation of prison health services and bringing them into closer collaboration with the country’s public health services. However, barriers to progress remain. A continuing challenge is how best to move from policy recommendations to implementation, so that the network’s fundamental aim of noticeable improvements in the health and care of prisoners is further achieved. (author's)
From Bangkok to Mexico: towards a framework for turning knowledge into action to improve health systems [editorial]
Bulletin of the World Health Organization. 2004 Oct; 82(10):720-721.As a follow-up to the International Conference on Health Research for Development that took place in Bangkok, Thailand, in 2000, WHO convened a Ministerial Summit on Health Research to be held in Mexico City in November 2004, to review progress to date and reflect on emerging opportunities in the global field of health research. In 1990, the Commission on Health Research for Development recommended that all countries should undertake essential national health research; it stipulated that international partnerships are the foundations for progress and that financing for these efforts should be mobilized from both international and national sources. In 1996, WHO'S Ad Hoc Committee on Health Research Relating to Future Intervention Options outlined a five-step priority-setting approach to decide how health research funds should be allocated. It identified "best buys" for the development of products and procedures in several key areas, including childhood infections, malnutrition, microbial threats, noncommunicable diseases and health systems. Overall, progress has been slow and there is much more to be done to deal with major health challenges. (excerpt)
London, FPA, 1972. 48 p.Currently, public authorities pay for almost 2/3 of the family planning consultations conducted by the Family Planning Association, and this is the most significant development since the publication of the last Family Planning Association Report. Additionally, more local health authorities are operating direct clinic and domiciliary services. The Family Planning Association handed over the management of 39 clinics to public authorities in the 1971-1972 year. However, despite this progress, family planning service provision by public authorities throughout England continues to be uneven in quality and extent. Spending by local health authorities for each woman at risk varies from 1 penny per woman at risk in Burnley (excluding the city of London) to 179 pence at Islington. In addition to the problem of inconsistency in spending, there appears to be no immediate prospect of a comprehensive family planning service - one that is available to all, is free of charge, and is backed by an adequate education campaign. Although government help for the extension of domiciliary family planning service is impressive, it should not obscure the false economies in spending on other contraceptive delivery services such as general practitioners, specialist clinics, and specialized advisory centers. Until the government announces the details of its plans for family planning services within the National Health Service beginning April 1974, the Family Planning Association's own detailed planning cannot be exact. The Association's basic policy continues to be to turn over the responsibility for the management of clinic and domiciliary contraceptive services as quickly and as smoothly as possible to the public authorities. Already there is concern that some clinic services managed by public authorities may become less attractive, particularly to young people, and that differences in the quality of service will increase under local public management as well as that backup services will be neglected. Also existing is the realization that the public authorities do not do enough to attract people to the use of contraception.
In: Population policies and programmes. Proceedings of the United Nations Expert Group Meeting on Population Policies and Programmes, Cairo, Egypt, 12-16 April 1992. New York, New York, United Nations, 1993. 114-20. (ST/ESA/SER.R/128)The paper addresses: 1) national population principles and objectives; 2) the population dimension of national development policy; 3) national population programs; 4) the rationale, opportunities and needs for external donor support; and 5) processes for population program needs assessment based on the work of one bilateral donor, the United Kingdom Overseas Development Administration. The population dimension to national development policy formulation is most important in relation to policies on: 1) provision of social services (health, education, family planning); 2) environment; 3) development planning and resource allocation; 4) poverty alleviation; 5) labor force and human resource development (youth employment, child labor); 6) social security for the elderly; and 7) the status of women. A population program establishes the strategies to implement the national population policy. Effective family planning programs recognize diverse needs for contraception (youth adults, couples wishing to space their children, those who have completed their families). Ready access to family planning can be achieved through: 1) integrating family planning into clinic-based maternal and child health services; 2) community-based activities; and 3) the retail sector using social marketing. Other population activities include effective dissemination of data including population education in schools. United Kingdom development donor assistance and wider development policies includes: 1) public expenditure rationalization for structural adjustment; 2) civil service reform; 3) health system restructuring; and 4) decentralization. External assistance would include: 1) technical assistance, using local and international expertise; 2) training, in-country and overseas; 3) supplies, including contraceptives; 4) renovation of the existing health infrastructures; and 5) local costs, such as salaries. For donors, one model is the UNFPA program review and strategy development process.
NUOVI ANNALI D IGIENE E MICROBIOLOGIA. 1987 Sep-Dec; 38(5-6):471-6.Community medicine (CM) addressing the global problems of human health has been intensifying in concert with primary health care (PHC) in developing countries, especially since the 1977 session of the WHO launched a program called "Heath for all by 2000" whose central component was PHC. An international conference in Alma Ata in 1978 on PHC stressed essential health care for all communities supported by practical methods that were scientifically valid and socially acceptable, assistance that was accessible to all members of the community. The objectives of PHC were: promotion of proper nutrition, safe water supplies, basic hygiene, maternal-child hygiene, vaccination against major infectious diseases, prevention and control of endemic local diseases, health education, and proper treatment of common diseases and injuries. A PHC post on the village level of Cm would have 1 community health worker (CHW) and 1 traditional birth assistant (TBA) providing health care for 500-1500 people. On the district level, a PHC unit would have 2 CHWs and 2 TBAs for 10,000 people. On the regional level, a PHC center would have 1 physician, 2 attendant nurses, 2 obstetricians, 1 technician, 1 pharmacist, and 1 administrator. Finally, on the national level, hospitals would take care of health needs. The lack of properly trained staff and resources poses the biggest problem in the organizational structure of Cm, but this could be overcome by collaborating with rural medicine and traditional medicine.
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.
Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1986 Jun. , 31,  p. (USAID Contract No. DPE-5927-C-00-5068-00)In the mid 1980s, the Government of The Gambia (GOTG) sought funds from the World Bank and other donors to restructure and strengthen its health system. Since the World Bank thought that recurrent cost obligations that the GOTG would find unacceptable should accompany the implementation of the National Health Project (NHP), this study was undertaken. The Italian Government agreed to fund US $9.8 million to NHP, most of the funds going to renovating and refurbishing the pediatric ward and central laboratory at Royal Victoria Hospital in Banjul. Trends in health sector expenditures showed that the devaluation of the dalasi continued to bring about shortfalls in nonsalary costs, especially in drugs and dressings. Therefore the GOTG must address the shortfalls before even considering expansion of the already inefficient health delivery system. It also needs to develop a cost recovery system for drugs which maintains a reliable source and adequate supplies of drugs in the proper amounts, effectively distributes the drugs, and manages the finances effectively. The GOTG should also develop the Ministry of Health's ability to coordinate donor support and to develop a process of budgeting, spending, and planning. The study team also recommended consolidating staff rather than expand staff in light of financial constraints. A flotation policy and exchange rates less favorable to the dalasi may grant the GOTG more access to exchange within the banking system.
[Unpublished] 1984 Aug. Background note presented to the International Conference on Population held in Mexico City, August 6-13, 1984. 4 p.The United Kingdom's birth rate has been below replacement level since 1973. Average family size is becoming smaller; the most popular size is 2 children. Women are postponing births to a later date, and age at marriage has risen. Problems of providing support and services for the growing number of very elderly are being studied by the government. Size of population is of less concern than well-being to the government. They provide assistance with family planning through the National Health Service, but believe that decisions about fertility and childbearing are each couple's to make. Population figures are taken into account in making economic and social policy, but there is no attempt to influence overall size and components of change except in the area of immigration where they lose more people by emigration than they gain from immigration.
Alternative approaches to meeting basic health needs in developing countries: a joint UNICEF/WHO study.
Geneva, World Health Organization, 1975. 116 p.Based on the failure of conventional health services and approaches to make any appreciable impact on the health problems of developing populations, this study examined successful or promising systems of delivery of primary health care to identify the key factors in their success and the effect of some of these factors in the development of primary health care within various political, economic, and administrative frameworks. In the selection of new approaches for detailed study, emphasis was placed on actual programs that are potentially applicable in different sociopolitical settings and on programs explicitly recognizing the influence of other social and economic sectors such as agriculture and education on health. Information was gathered from a wide range of sources; including members, meeting reports, and publications of international organizations and agencies, gathered country representatives, and field staff. The 1st section, world poverty and health, focuses on the underprivileged, the glaring contrasts in health, and the obstacles to be overcome--problems of broad choices and approaches, resources, general structure of health services, and technical weasknesses. The main purpose of the case studies described in the 2nd part was to single out, describe, and discuss their most interesting characteristics. The cases comprised 2 major categories: programs adopted nationally in China, Cuba, Tanzania, and, to a certain extent, Venezuela, and schemes covering limited areas in Bangladesh, India, Niger, and Yugoslavia. Successful national programs are characterized by a strong political will that has transformed a practicable methodology into a national endeavor. In all countries where this has happened, health has been given a high priority in the government's general development program. Enterprise and leadership are also found in the 2nd group of more limited schemes. Valuable lessons, both technical and operational, can be derived from this type of effort. In all cases, the leading role of a dedicated individual can be clearly identified. There is also evidence that community leaders and organizations have given considerable support to these projects. External aid has played a part and apparently been well used. Every effort should be made to determine the driving forces behind promising progams and help harness them to national plans.
[Unpublished] 1979. Paper prepared for the Technical Workshop on the Four Country Maternal and Child Health/Family Planning Projects, New York, Oct. 31-Nov. 2, 1979. (Workshop Paper No. 2) 10 p.An integrated health care system which combined the maternal/child health with other services was undertaken in the Yozgat Province of Turkey from 1972-77. The objective was to train midwives in MCH/FP and orient their activities to socialization. The first 2 years of the program was financed by UNFPA. 52 health stations were completed and 18 more are under construction. The personnel shortage stands at 33 physicians, 21 health technicians, 30 nurses, and 67 midwives. Yozgat Province is 75% rural and has about a 50% shortage of roads. The project was evaluated initially in 1975 and entailed preproject information studies, baseline health practices and contraceptive use survey, dual record system, and service statistics reporting. The number of midwives, who are crucial to the program, have increased from an average 115 in 1975 to 160 in 1979. Supervisory nurses are the link between the field and the project managers. Their number has decreased from 17 to 6. Until 1977 family planning service delivery depended on a handful of physicians who distributed condoms and pills. The Ministry of Health trained women physicians in IUD insertions. The crude death rate in 1976 was 13.2/1000; the crude birth rate was 42.7/1000. The crude death rate in 1977 was 14.8/1000; birth rate, 39.9/1000. Common child diseases were measles, enteritis, bronchopneumonia, otitis, and parasitis.
Washington, D.C., Worldwatch Institute, February 1978. (Worldwatch Paper No. 17) 64 pAccording to a World Bank estimate, large scale international efforts to improve social and economic conditions in developing countries would cost 47.1 billion dollars between 1980-2000. Since rich countries have not been disposed in the past to contribute heavily toward solving these problems, it is unlikely that they will commit themselves to this type of financial help in the future. Collective, self-help efforts on the local level may offer a feasible alternative for aleviating global problems of inadequate housing, food shortages, insufficient medical care, and energy shortages. Small scale efforts which enlist community involvement in the initiation, planning, and carrying out of projects are frequently more effective in creating uplift than are larger efforts controlled by individuals outside the community. Attempts to provide better housing for the poor through building large public housing complexes are costly and tend to create non-livable conditions for many of the poor; self-help efforts such as homesteading and rehabilitation, on the other hand, have been more successful. In developing areas massive national programs to relocate squatters have failed. Efforts to help squatters improve the dwellings they presently inhabit may be a more fruitful approach. The recent emphasis on garden plots for urban dwellers and small labor intensive family farms along with marketing cooperatives in the rural areas may reduce malnutrition and protect the poor from inflationary food prices. At the present time 1/5 of the world's population is still without medical care and many others have inadequate health care. The mobilization of individuals for self care, especially in regard to disease prevention, and the decentralization of health services through the establishment of neighborhood health centers, family planning clinics, and systems utilizing barefoot doctors can help overcome present health deficiencies. The energy problem can be partially solved by individual efforts to conserve resources. Many individuals and communities are developing local solar, wind, and water sources and are thus reducing reliance on the highly centralized energy industries.
Prepared for World Population Society Meeting, Washington, D.C., December 6, 1976. 28 pWHO, in response to resolutions adopted at the World Population Conference, will give highest priority to developing new and alternative approaches to the promotion of the health of the underserved and vulnerable groups, especially in rural areas of developing countries. 4 annexes reflect WHO's policy, program areas, and activities. Annex 1 outlines the WHO Sixth General Programme of Work, which covers 5 major areas: 1) development of comprehensive health services, 2) disease prevention and control, 3) promotion of environmental health, 4) health manpower development, and 5) promotion and development of biomedical and health services research. Annex 2 lists quotations from relevant paragraphs of the World Population Plan of Action concerning health-related aspects of population. Annex 3 contains a list of WHO-supported activities in population 1976-1977 and 1978-1979 by field of activity and description of activity. Annex 4 details collaborative activites of WHO with member states and lists WHO collaborative efforts with country projects funded by UNFPA.
In: World Health Organization (WHO). The second ten years of the World Health Organization, 1958-1967. Geneva, Switzerland, WHO, 1968. 1-36.The health problems and developments in the 6 regions of WHO are summariezed with some reference to WHO's work during the decade. Demographic data show decreases in general and infant mortality and increases in the expectation of life at birth while preventable diseases, especially communicative diseases, such as malaria, yaws, and polio myelitis are decreasing. The last 10 years have been directed toward the development of long-term national plans for integrated health services. Plans such as the strengthening of maternal and child health services, the promotion and accelaration of education and training of all categories of staff from auxiliaries to postgraduates, and the development of epidemiological services, health laboratories, and health statistics have been undertaken. The plans also provide for promotion of environmental health with emphasis on sanitary engineering, education, and community water supply and sewerage projects in selected rural and urban areas.
In: World Health Organization (WHO). Third report on the world health situation, 1961-1964. Geneva, Switzerland, WHO, April 1967. 28-35. (Official Records of the World Health Organization No. 155)The specific replies of 86 governments to the questionnaire for the Third Report are analyzed. The questionnaire asked for 3 things; 1) a description of the major public health problems still to be solved in order of magnitude; 2) how that assessment had been made; and 3) assignment of, where possible, priorities to the solving of the problems. The 46 problems cited fell into the following 10 major groups, listed in order of importance; environmental deficiencies, malaria, tuberculosis, malnutrition, helminthiases (including bilharziasis), communicable diseases (exclusive of malaria, tuberculosis and venereal diseases), chronic degenerative diseases and accidents, administrative and organizational deficiencies (including personnel deficiencies), venereal diseases, and mental health. Though the health record for each country was different, common patterns tended to emerge on a regional basis. The African region profile was drawn from the experience of 28 countries, and the general picture was of a region where effort needed to be concentrated on the control of communicable diseases, requiring large expenditures in basic sanitation, training of personnel and administrative and organizational improvements. In Canada and the U.S. the major problems were cardiovascular diseases, cancer, and accidents, and the organization and financing of health care services. The Central and South American and the Caribbean profile was drawn from the replies of 36 countries. Their problems in order of importance were: 1) malnutrition, 2) environmental deficiencies and diarrheal and venereal diseases, and 3) malaria. 7 countries in the Southeast Asia region provided information. Major problems there were environmental deficiencies, diarrheal diseases and dysentary, communicable diseases, and to a lesser extent population pressure. In the European region, priority was given to problems of administration and organization, followed fairly closely by cancer, cardiovascular disease, venereal diseases, tuberculosis, respiratory virus diseases, and infectious hepatitis. In the Eastern Mediterranean malaria and tuberculosis were the outstanding diseases and half the respondents had important administrative and organizational problems. In the Western Pacific, Australia, Japan, and New Zealand have problems comparable to those of the developed countries of Europe and North America. In the other countries in the region the emphasis was on communicable diseases with tuberculosis in the lead. Other problems mentioned that did not fit under 1 of the 10 headings were human rabies, alcoholism, dental health, and problems associated with urbanization and industrialization. Problems of population pressure and manpower deficiencies in the health field are also discussed on a regional basis.