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  1. 1

    Urbanization and its implications for child health. Potential for action.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 1988. vi, 80 p.

    This publication focuses on the action needed to improve child health in growing urban centers in the 3rd world and outlines the staggering problems that stand in the way. It also gives an overview of community and governmental efforts to make improvements. Lastly, summary conclusions are drawn and recommendations given. The unprecedented population growth that has taken place in urban areas has created serious housing and health problems. Many people are living in illegally constructed housing with little or no provision for piped water, sanitation, collection and disposal of household waste, or health care. Chapter 1 discusses the health problems and poor living conditions that are common in urban centers. Studies of low-income settlements have identified 3 major types of pathology: infectious and gastrointestinal diseases, chronic degenerative diseases, and pathogenic conditions. It is estimated that up to 44% of all deaths in children under 4 years of age is a result of diarrhoeal disease. Respiratory infections and nutritional deficiencies are the other 2 major causes of morbidity and mortality in young children. Malnutrition poses one of the most serious threats to clinical health. It is estimated that 145 million children under 5 have insufficient diets. In urban low income communities up to 50% of children may show signs of malnutrition, 10% of this group in severe form. Malnutrition is a complex problem that involves not only a shortage of food, but also inadequate preparation and storage of food and lack of knowledge about nutrition. Many urban centers within developing countries share these relevant difficulties in regard to child health, but it is important not to make sweeping generalizations. As the book points out, urbanization has taken a multitude of forms, and the health problems of these urban centers need a variety of approaches. This publication sees a growing gap between child health needs and the responses of government. The last century has seen tremendous growth in urban population, as well as tremendous growth in the associate urban problems. Local and national response has been slight at best. Further, approaches have primarily been "sectoral " instead of the "multi-sectoral" approach that this book recommends. A "multi-sectoral" approach addresses a combination of urban problems all at once. It is further recommended that those in need of help to be targeted and prioritized. Also, a systematic coordination of individuals, households, neighborhood groups, local government, national government, and aid agencies is strongly urged. Local governments are deemed particularly crucial in the fight for child health.
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  2. 2

    Draft National Health Policy: comments and suggestions of the Indian Medical Association.

    Indian Medical Association

    JOURNAL OF THE INDIAN MEDICAL ASSOCIATION. 1979 Mar 16; 72(6):137-43, 148.

    The International Conference on Primary Health Care called for urgent and effective national and international action to develop and implement primary health care throughout the world. All government agencies should support primary health care by channelling increased technical and financial support to health care systems. Any national health policy designed to provide for its people should recognise the right to health care as a fundamental right of people. The sociocultural environment of the people should be upgraded as a part of health care. The government's expenditure on health should be regarded as an investment, not as a consumption. Health should be a purchasable commodity. Medical education should be reoriented to the needs of the nation. The government should establish as its ultimate goal the provision of scientific medical service to every citizen. Industrial health and mental health disciplines should establish clear-cut methodologies to achieve the same objectives as medical science. Practitioners of indigenous systems of medicine should be allowed to practice only those systems in which they are qualified and trained. Integration of the modern and traditional systems has failed. In order to encourage people to adopt small family size, facilities for maternal and child welfare clinics, coupled with immunisation and nutrition programs, are needed.
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  3. 3

    Local responses to global problems: a key to meeting basic human needs.


    Washington, D.C., Worldwatch Institute, February 1978. (Worldwatch Paper No. 17) 64 p

    According 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.
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  4. 4

    Mali: report of mission on needs assessment for population assistance.

    United Nations Fund for Population Activities [UNFPA]

    New York, UNFPA, December 1978. (Report No. 8) 94 p

    This report is intended to diagnose the areas in which future population assistance is most needed by Mali in its efforts to solve its population problems as a step on the way to higher levels of social and economic devleopment. A summary of the recommendations of the Mission and the underlying reasons for those recommendations constitutes the 1st chapter of the report, followed in chapter 2 by a description of some outstanding aspects of the national setting relevant to planning for development; the objectives of the national plan; and an analysis of population issues and development planning in Mali. Subsequent chapters examine needs for assistance in respect of basic population data; population policy and research; and implementation of the national population policy (covering health and family planning and information, education and communications). External assistance to Mali for population is then reviewed briefly, and the report concludes with a statement of the Mission's views on the assistance needed in population, from UNFPA or from any other sources.
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  5. 5

    CBFPS (Community-based Family Planning Services) in Thailand: a community-based approach to family planning.


    Essex, Connecticut, International Council for Educational Development, 1978. (A project to help practitioners help the rural poor, case study no. 6) 91 p

    This report and case study of the Community-Based Family Planning Service (CBFPS) in Thailand describes and evaluates the program in order to provide useful operational lessons for concerned national and international agencies. CBFPS has demonstrated the special role a private organization can play not only in providing family planning services, but in helping to pioneer a more integrated approach to rural development. The significant achievement of CBFPS is that it has overcome the familiar barriers of geographical access to family planning information and contraceptive supplies by making these available in the village community itself. The report gives detailed information on the history and development of the CBFPS, its current operation and organization, financial resources, and overall impact. Several important lessons were learned from the project: 1) the successful development of a project depends on a strong and dynamic leader; 2) cooperation between the public and private sectors is essential; 3) the success of a project depends primarily on the effectiveness of community-based activities; 4) planning and monitoring activities represent significant ingredients of project effectiveness; 5) a successful project needs a sense of commitment among its staff; 6) it is imperative that a project maintain good public relations; 7) the use of family planning strategy in introducing self-supporting development programs can be very effective; 8) manning of volunteer workers is crucial to project success; and 9) aside from acceptor recruitment in the short run, the primary purpose of education in more profound matterns such as childbearing, womens'roles in the family, and family life should also be kept in mind. The key to success lies in continuity of communication and education.
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  6. 6

    The assault on world poverty: problems of rural development, education, and health.

    World Bank

    Baltimore, Maryland, Johns Hopkins University Press, 1975. 245 p.

    The common objective of the collection of papers in this volume is to analyze the causes of poverty in the developing world, to examine ways in which it can be alleviated, and to outline programs in which the World Bank plans to help. Although there has been encouraging economic growth in most of the developing countries over the past 3 decades, a very large proportion of their people have not shared in its benefits. On average, the poorest 40% of their societies is not much better off than it was. The largest number of the poor live in rural areas of the developing world. In the paper concerning "Rural Development" it is noted that the objectives of rural development extend beyond any 1 particular sector. Rural poverty is reflected in poor nutrition, inadequate shelter, and low health standards. All these affect the productivity of the rural poor and their quality of life. Needed are production improvements, and mutually reinforcing programs of better nutrition, preventive health, improved water supply, basic sanitation, and practical education. The papers on "Agricultural Credit and Land Reform" examine certain aspects of the productivity problem in more detail. Agricultural credit is a key element in aiding the poor to become more productive. Realistic land reform is consistent with the development objectives of increased agricultural production, more equitable distribution of income, and expanded employment. The papers on "Education and Health" focus on rural poverty, but not exclusively so. They also offer insights into the problems of poverty in the urban areas. The educational systems of developing countries are frequently inequitable, favoring urban residents and the relatively rich.
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