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  1. 1
    Peer Reviewed

    Access to sexual and reproductive health services: Rights, priorities, commitments and actions.

    Edouard L; Shaw D

    International Journal of Gynecology and Obstetrics. 2007 Jun; 97(3):227-228.

    The Alliance for Women's Health is a FIGO-based interagency consortium, comprising the World Health Organization, United Nations Population Fund, World Bank, UNICEF, International Planned Parenthood Federation, International Confederation of Midwives and International Pediatric Association. In conjunction with the XVIII World Congress of Gynecology and Obstetrics in Kuala Lumpur in November 2006, the Alliance held a precongress workshop examining access in five priority emerging issues: human papillomavirus vaccine/cervical cancer screening, emergency contraception, adolescent reproductive health, emergency obstetric care and sexually transmitted infections. Reports from the five working groups, published in this and subsequent issues of the International Journal of Gynecology and Obstetrics, provide current evidence-based recommendations on improving access to sexual and reproductive health services supported by applicable rights. The World Bank presented a framework for the discussion during theopening plenary session. The importance of sexual and reproductive health services is well recognized and was articulated in the Programme of Action of the International Conference on Population and Development which was held in Cairo in 1994. However, the inclusion of universal access to reproductive health as a target for the Millennium Development Goals (MDGs) only occurred in October 2006 after prolonged negotiations reflecting the reluctance, in circles of influence, to provide support where there are certain sociopolitical sensitivities. (excerpt)
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  2. 2

    Natural resources committee calls for global water plan - UN Committee on Natural Resources second session, Feb 22-Mar 4, 1994 addresses water management and sustenance if mineral resources.

    UN Chronicle. 1994 Jun; 31(2):[2] p..

    A worldwide plan to avert an impending global water crisis was called for by the Committee on Natural Resources at its second session (22 February-4 March, New York). The strategy should define specific areas of priority to diminish significantly by the year 2010 the threat to freshwater resources, the 24-member expert body said in asking the UN Commission on Sustainable Development to undertake that task. "Water shortages are becoming a common occurrence in industrialized and developing countries alike", stated a report examined by the Committee. "The world may be reaching a water crisis situation of global proportions." The Committee also asked Governments to establish a dynamic and multisectoral approach to water resources management, including assessing and protecting potential sources of freshwater. As for mineral resources--another major concern--the Committee wanted the Commission to forge a dialogue between the UN system and the international mining industry to develop new approaches to ensure a sustainable supply of mineral resources. Workshops on mineral resource assessment projects were recommended. A report was asked on key advances in state-of-the-art technologies to minimize environmental degradation resulting from mining and related processing. (excerpt)
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  3. 3

    Mobilizing communities to achieve 3 by 5.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2003. 2 p. (WHO/HIV/2003.15)

    In accordance with the overall 3 by 5 strategic framework, the objective of the 3 by 5 Community Mobilization Plan is to strengthen the capacity of community and faith-based organizations to be fully involved at all levels of the planning and implementation of ART programmes. This involvement is potentially very broad, and could range from participating in the design of national ART scale-up plans and acting as treatment supporters for family members and friends living with HIV/AIDS to conducting programme evaluation, including quality assurance and operational research. The plan was developed in consultation with community-based treatment advocates, practitioners and other experts in the community sector, as well as individuals within and outside the United Nations system. Many partner groups also contributed. (excerpt)
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  4. 4

    Tribal children are most exploited - UNICEF.

    REPROWATCH. 1998 Nov 16-30; 17(4):5.

    A workshop sponsored by the UN Children's Fund in the Philippines examined the status of the children of indigenous people and found that exploitation of the assets of indigenous people in the name of development has resulted in social inequalities that have damaged the indigenous children. As examples of the disregard for the human rights of the children, participants cited projects in Davao, Boracay, and Benguet that have displaced native children. These include mining schemes that have "raped" ancestral lands, large-scale agricultural enterprises, promotion of tourism, and creation of hydroelectric dams. The children rarely benefit at all from any of these projects as their families are moved from a position of isolated independence to one of exploited dependence. Social changes accompanying development ruin traditional culture without providing a better or even similar basis of existence.
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  5. 5

    Laos multi-sectoral workshop puts down roots.

    JOICFP NEWS. 1998 Jul; (289):3.

    A multisectoral IEC workshop was held in Laos, in May 1998, to conduct a needs assessment of reproductive health IEC materials, to review the IEC Work Plan, and to coordinate implementation of IEC activities. The workshop was organized under the auspices of the Japanese Organization for International Cooperation in Family Planning and the UN Population Fund's (UNFPA) Reproductive Health (RH) subprogram. This subprogram, which will operate from 1998-2000, is an umbrella for 4 projects that seek: 1) to strengthen RH services through the primary health network, 2) to strengthen RH by emphasizing advocacy and enhancing awareness of gender disparity, 3) to promote RH among adolescents, and 4) to promote formal and informal population, RH, and sexuality education. During the workshop, an UNFPA advisor gave a presentation on the role of IEC in the provision of RH services and a consultant offered recommendations for development of IEC material in Laos, based on a needs assessment conducted in March. In addition, a Technical Advisor from Thailand's Ministry of Health covered training personnel on IEC delivery. An IEC task force will be formed to continue planning and implementation of IEC projects.
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  6. 6

    Lessons learned: providing communication technical assistance in FGM programs.

    Corso C

    [Unpublished] [1996]. [2] p.

    This document relays 10 lessons learned in providing communication technical assistance in programs designed to eradicate female genital mutilation (FGM). 1) The community must identify FGM as an issue they are interested in working on, and the local implementing agency must request technical assistance. 2) Agencies providing technical assistance to FGM eradication programs must avoid high visibility. 3) Technical assistance is most appropriately given by local staff living and working in the particular country. 4) International agencies should strengthen the skill base of their local counterparts so the local groups can acquire the necessary communication skills to work toward eradication. 5) The local implementing organization must conduct research to guide the intervention and the target communities must be involved in designing the interventions. 6) Interventions must be very local in nature and design. 7) Workshops provide good settings for providing technical assistance and training. 8) Local-level project staff need assistance in skills training and individual-level support to deal with their sense that they are betraying their own culture. 9) Skills training helps local staff work through individual behavior change issues in order to help communities adopt behavior changes. 10) The process of behavior change takes time and requires continuity. Donors and local implementing agencies must understand that it may take as long as a generation to eradicate FGM.
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  7. 7

    Sexual reality. The gap between family planning services and clients' needs.

    Gordon G

    In: Learning about sexuality: a practical beginning, edited by Sondra Zeidenstein and Kirsten Moore. New York, New York, Population Council, 1996. 363-79.

    IPPF's AIDS Prevention Unit (APU) conducted HIV prevention training workshops for key staff of family planning associations (FPAs) in West Africa. The experience of these workshops and the findings of a 1992 needs assessment among selected FPAs have articulated the nature of the gap between clients' needs and social norms and providers' values in relation to sexual behavior. This chapter of the book entitled Learning about Sexuality: A Practical Beginning examines how sexual options to minimize the risk of HIV infection (condom use, abstinence, fidelity within marriage, and nonpenetrative sex) correspond with the realities of the attitudes and sexual lives of different client groups. It also addresses how effective these options are in preventing HIV/AIDS. Another discussion revolves around the extent providers help clients determine the best HIV prevention strategy for themselves. The book also covers whether providers help clients overcome gender inequalities that place them at risk of HIV infection or reinforce gender stereotypes. Significant obstacles among the work of the APU include providers' long-standing attitudes, biases, and perception; consideration of counseling and education as if the clients can freely decide what to do about sex; providers' concern for social and moral well-being of clients; and conflict between contraceptive targets and the mandate to provide clients with the information needed to make informed choices about reproductive and sexual health. The book provides four steps to address these obstacles and to change the behavior of both FPA staff and clients in order to close the gap between their goals and perception: structured sessions on gender issues in FPA staff training and actively challenge gender discrimination and attitudes that result in sexual ill health; structured activities on religion, traditional sexual culture, and sexual health in FPA staff training; pilot projects that test the feasibility of FPAs using a participatory community development approach in sexual health; and network with groups that have resources to address some underlying determinants of sexual health.
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  8. 8
    Peer Reviewed

    Global child health: challenges and goals in the 1990s.

    Reid RS

    TURKISH JOURNAL OF PEDIATRICS. 1994 Apr-Jun; 36(2):93-6.

    The UNICEF message to the pediatricians and child health experts attending the Regional Pediatric Congress of the Union of National Pediatric Societies of Turkish Republics is that the way children are conceptualized in the development process has a major impact on poverty. UNICEF argues that human resource development is the safest way out of population pressure, vanishing forests, and despoiled rivers. Thailand, South Korea, Taiwan, and Singapore are examples of countries that "sacrificed, deferred consumer gratification of the elites, and disciplined themselves" in order to provide better care for their children in terms of good nutrition, good health care, and rigorous primary and secondary education for all children. Family planning was available to all parents. The emphasis was on hygiene, immunization, clean water supplies, and sanitation. Lower infant and child mortality created confidence in child survival and parental willingness to have fewer children. The working population is healthier due to the state nutrition programs and a better skilled labor force due to education and training. These countries are no longer underdeveloped because of the priority on children for over a generation and a half. Robert Heilbroner has described this strategy for development as based on social development, human development, and protection of children aged under 5 years. The Alma Ata conference in 1976 was instrumental in focusing on the health of the child by setting a standard of health for all by the year 2000. Many countries are moving in the direction proposed in these agendas. The result has been a 33% reduction in child mortality within 10 years and greater immunization in some developing countries than in Europe and North America. Immunization rates in Ankara, Turkey; Calcutta, India; Lagos, Nigeria; and Mexico City are higher than in Washington, D.C. or New York City. The 1990 World Summit for Children found that the following rules are applicable to development. 1) Hospitals do not mean health. 2) National wealth does not make health. 3) 75% of child mortality is attributable to a small number of controllable causes of death. 4) Mobilization of all sectors of society is a necessary strategy to combat child death and illness. UNICEF and the World Health Organization are prepared to provide support, if countries are willing to follow the example of Turkey in mobilizing against these deaths.
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  9. 9

    Orientation of FPAN executives.

    FPAN NEWSLETTER. 1994 May-Jun; 14(3):1-2.

    The International Planned Parenthood Federation (IPPF) in conjunction with the Nepal Family Planning Association sponsored an orientation program for about 50 branch executives from Valley, Kavre, Chitwan, and Nawalparasi in May 1994. Other orientations were held in Pokhara, Dhangadhi, Surkhet, Dhanusha, and Morang on other occasions and in other locations for branch managers. The aim was to unveil the new 10 year strategic plan and to provide for the informing of volunteers and branch chiefs about the new plan's objectives. One objective was to facilitate the coordination between volunteers and family planning branch staff. The orientation program highlighted the importance of voluntarism in plan implementation and how to improve existing leadership and cooperation between levels and between staff and volunteers. The Central President of the Association provided well wishes for successful program implementation and reiterated that the role of volunteers had always been important and that the staff and volunteers complemented each other. The Senior Program Advisor of IPPF also gave his best wishes for the implementation of the strategic plan and commended the Nepal Association as the first to conduct an orientation program to familiarize its constituency about the IPPF objectives. Cooperation between volunteers and staffs was considered instrumental to program success. A description was provided of IPPF's organizational structure, funding, and operational system. The Central Treasurer of the Association spoke about the history of the Nepal program since its inception in 1959.
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  10. 10

    Science academies call for zero population growth.

    Nandan G

    BMJ. British Medical Journal. 1993 Nov 6; 307(6913):1161.

    The first population summit for 56 of the world's scientific academies was held in New Delhi in late 1993. Participants at the three day meeting recommended that governments adopt an integrated policy on population and sustainable development. The African Academy of Science, co-sponsored of the event, did not endorse the recommendation. The African Academy of Sciences considered its large population as an important resource necessary for the exploitation of natural resources and productivity. Family planning that was fertility regulation alone was considered simplistic by the African Academy. The recommendation was separately endorsed by the national governments of Egypt, Ghana, and Nigeria. The aim of the summit was to provide input to the upcoming UN World Conference on Population and Development scheduled for Cairo in 1994. The population projection of 7.8 billion by 2050 with a reduced fertility of 1.7 children per woman early in the 21st century was still considered too large. The summit spent considerable time on the issue of funding for contraceptive research and development, which was low at 3% of annual sales globally. The distinction was made that family planning services should be part of a broader strategy of improving the quality of human life. There was less agreement on depletion of resources and environmental degradation. China, India, and Indonesia were considered to be depleting natural resources. However, excessive consumption was identified in the United States, Germany, and Japan. The US population of 250 million had a resource demand index 50 times higher than Indonesia's population of 188 million. The summit statement urged developed countries to be more resourceful in resource use and eliminate waste. An Oxford academician's considered opinion was that it was easier to reduce population size than to reduce affluence, lifestyles, and wastefulness.
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  11. 11
    Peer Reviewed

    Expert Committee on Maternal and Child Health and Family Planning in the 1990s and Beyond: recent trends and advances, World Health Organization, Geneva 7-13, December 1993.

    Thompson A

    MIDWIFERY. 1994 Mar; 10(1):49-50.

    This article provides a description of the World Health Organizations Expert Committee on Maternal and Child Health meeting held in 1993. The last meeting was held before the Alma Ata Declaration on Health For All 18 years ago. The recent meeting aimed to clarify the health and development conditions of women and children worldwide, policies impacting on maternal and child health and family planning (MCH/FP), trends and future program directions, shortcomings in MCH/FP, and strategies for improving MCH/FP through monitoring and evaluation. The committee participants included 10 persons who represented fields in pediatrics, public health, and obstetrics and other representatives of UN agencies. The International Confederation of Midwives and International Council of Nurses was represented. The objective of the eight-day meeting was to produce a report and recommendations. Recommendations were made to broaden the classic MCH/FP model in order to provide more comprehensive services, which are client-determined rather than provider-assigned, and to give a variety of services at health care centers. The "one stop, supermarket" approach is desired. This approach requires an appropriate design, equipment, and staffing of health care centers and a multidisciplinary and multisectoral direction. Attention must be given to adolescent needs, to health promotion and protection of the girl child, and to policy development that includes an integrated approach. The Expert Committee recommended that women's health issues be combined with family planning, HIV/AIDS prevention, pregnancy, childbirth, and perinatal health. The role of the midwife was identified as instrumental in first referral services and as an effective link to the community. The midwife is viewed as providing the role of educator and supervisor of traditional birth attendants and other primary health care workers and volunteers associated with MCH/FP services. Legislation may need to be changed to allow better use of a midwife's skills in reducing maternal mortality and to develop a flexible, appropriate, community-based approach for continuing and first-level education. The final document includes a listing of available instruments and conventions on the rights of the child and the elimination of discrimination against women.
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  12. 12

    Small islands, big human issues.

    Grant JP

    CHILDREN IN FOCUS. 1994 Apr-Jun; 6(2):1, 9.

    UNICEF, in its capacity as supporter of the Global Conference on Sustainable Development of Small Island Developing Countries, is particularly concerned about islands with acute poverty and underdevelopment and about islands with middle and high incomes. It is recommended that all the states ratify the Convention on the Rights of the Child; establish national programs of action for child survival and welfare; support primary environmental care; and support (20% of total budget) nutrition, primary health care, basic education, safe water, and family planning. Most states contribute only about 10% of their national budgets to child welfare programs. 20% of international development assistance should also be devoted to nutrition, primary health care, basic education, safe water, and family planning. The global social agenda must be directed to women and children. Island characteristics include a preponderance of subsistence agriculture with fishing and cash cropping. Tourism provides for foreign exchange. There is heavy dependence on external aid and remittances. Urbanization is increasing, but the islands are isolated by distance and communication. Sanitation and inadequate water supplies pose serious problems. Diarrhea and malaria are major diseases of childhood. Malnutrition and undernutrition are increasing. The example of the Maldives has shown that political will can lead to gains in child survival and human development. Barbados is a good example of gains in social development, which could be deleteriously affected by economic and trade policies, environmental problems, or natural disasters. Small island countries are vulnerable because of insufficient reserves and the short-term nature of advances. Protective strategies may be adoption of sustainable models for health care, quality and relevant education, and provision of technical and social skills for young people. The issue is no longer just meeting basic needs but improving the quality of life and reducing in poverty.
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  13. 13

    Cairo work schedule, procedures outlined in letter to governments.

    ICPD 94. 1994 Jun; (16):1, 4-5.

    A brief description of key points of a May 25, 1994, letter from Dr. Nafis Sadik to countries participating in the 1994 International Conference on Population and Development (ICPD) was provided. The letter indicated the draft provisional rules of procedure for the ICPD and included some comments and suggestions. The UN General Assembly resolution 47/176 stipulated that the head of each delegation should be a government minister or higher public official. Heads of State and Foreign Ministers were asked to provide the names of each delegate well in advance of the ICPD and to submit credentials at least a week beforehand. On August 25, 1994, delegates will be formally registered on site. Dr. Sadik strongly urged that delegations be gender-balanced and include representatives of nongovernmental organizations, various sectors, and national groups involved with population and development strategies. The traditional agenda includes preliminary meetings on September 3 and 4 for discussion of procedural and organizational issues. The provisional agenda includes opening remarks, election of the president, adoption of rules of procedure, adoption of the agenda, election of other officers, organization of work, credentials of representatives to the ICPD, experiences in population and development strategies, Programme of Action of the ICPD, and adoption of the report of the ICPD. The general debate will be conducted during plenary sessions from September 5-9, with a focus on item 8 of the provisional agenda. The Main Committee will meet concurrently to complete negotiations on the Programme of Action (item 9), and then submit its report to the plenary. The report adopted at the ICPD will be submitted to the UN General Assembly one week after the conference ends. The draft Programme of Action was a result of PrepCom III deliberations among the delegations and countries represented. Dr. Sadik expects the Egyptian President and the UN Secretary General to address the plenary session of the ICPD.
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  14. 14

    Shanghai declaration on non-communicable diseases [letter]

    Dobson SA; Dwyer T; Chen HZ; Gao YT; Gu XQ; Hu JH; Yan HQ; Qu ZP; Wang KA; Mateo-de-Acosta O

    BMJ. British Medical Journal. 1993 Feb 27; 306(6877):588.

    Mainstream public health issues have not focused on prevention and control of noncommunicable diseases. There is a need for monitoring disease and risk factors in order to understand the effects of environmental and genetic factors on health. Whereas, since the 1940s there has been a rapid increase in noncommunicable diseases, country-wide health improvements have occurred in areas related to communicable diseases such as sanitation, infection and vector control, nutrition, vaccinations, and maternal and child health programs. In developing countries, the rise in noncommunicable diseases poses problems when public health institutions are also faced with infectious and nutritional diseases. Current monitoring based on death certificates, is only marginally helpful in prevention and control. Programs need to be directed to occupational, environmental, and genetic factors, and death certificates do not contain this information. Directors and key officials in WHO noncommunicable disease collaborating centers declared that a concerted effort is needed to develop regional and national non-communicable disease plans which will lessen the financial cost and human cost in suffering in the future. The aging of the population worldwide will exacerbate the problem. WHO directors of collaborating centers made this declaration in Shanghai, China, in March, 1992.
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  15. 15
    Peer Reviewed

    Population, natural resources and development. Recognition of the problems: a step in the direction of solving them.

    Lindahl-Kiessling K; Landberg H

    AMBIO. 1992 Feb; 21(1):4-5.

    A brief summary is provided of international efforts related to the issues of population growth and limitation. The 1970s is remembered as the time the UN Expert Group on Population and the Environment met in Stockholm (1973) and the first UN Conference on Population took place in Bucharest (1974). The 1980s marked the second World Conference on Population, the UN Expert Group meeting in Geneva, and publication of the Brundtland report, "Our Common Future." The 1990s saw the Earth Summit, which brought together a variety of professional to discuss the issues of population, the environment, and development. The UN conference on the Environment and Development (UNCED) in 1992 included the issue of population due to the efforts of representatives of the Royal Swedish Academy of Sciences and the Swedish Council for Planning and Coordination of Research. These representatives discovered that population issues were not included in the conference agenda and felt strongly that all essential global issues needed to be addressed. Within the time available, the conference agenda was set to overcome interdisciplinary problems and to engage in scientific discussion of essential issues. The goal was also to present scientific information in a way that was suitable for political audiences. There was to be comprehensive analysis and a set of recommendations which addressed linkages between population, the environment, and development. Success was achieved in maintaining open, positive, and searching debate among the economists, ecologists, sociologists, demographers, and others in attendance. There was no direct confrontation or territorial dispute. The Conference Statement generated a comprehensive analysis and wide reaching proposals for future action. The next Conference on Population and Development is scheduled for 1994. The environment will be firmly on the agenda, and the primary focus will be the human population and its future.
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  16. 16
    Peer Reviewed

    The roles of international institutions in promoting sustainable development.

    Kunugi T

    AMBIO. 1992 Feb; 21(1):112-5.

    The UN can set standards and provide a framework for collaborative projects, but sustainable development will require the full participation of many sectors of society, both public and private. This review of sustainable development considers the role of UN-sponsored special conferences in the past 20 years, identifies a conceptual tool for assessing options, and suggests a global action plan that radically restructures the UN, based on popular sovereignty. The concern is for the protection of popular rights and welfare that could be ignored by powerful governments and powerful transnational corporations beyond government control; responsibility for the environment, natural resources, technologies, and other global issues cannot be overlooked. The concept is to develop an "international public sector for the management of interdependence" which can correct, as necessary the "international market process and ensure equitable distribution of resources." The Stockholm Conference on the Human Environment in 1972 marked the beginning of special conferences dealing with sustainable development. The UN General Assembly in 1974 adopted a mandate and programs for increasing the pace of economic and social development. In 1980 and 1990 further UN development strategies were adopted. The most recent strategy incorporated much from the Brundtland Commission Report but did not urge the change in attitudes and orientation of political and economic institutions. The Assembly of the World Conservation Union (IUCN) adopted strategies for conservation and development in 1990. Nongovernmental organizations have united to cooperate in the global effort to achieve sustainable development. However, there are 5.4 billion people and an increase of 2 billion expected in 20 years. Bureaucratic rivalry and the inherent weakness of the UN has lead to splintering of objectives and irrelevant decision making. After concept development, which is a noteworthy effort, there must be negotiation with government delegates and policy planners and decision makers. The priorities are to shift from economic development to social development, to shift from maximum use of inappropriate technologies to resource efficient and saving technologies, and integration of population with national environmental strategies.
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