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The global eradication of smallpox. Final report of the Global Commission for the Certification of Smallpox Eradication, Geneva, December 1979.
Geneva, Switzerland, WHO, 1980. 122 p. (History of International Public Health No. 4)The Global Commission for the Certification of Smallpox Eradication met in December 1978 to review the program in detail and to advise on subsequent activities and met again in December 1979 to assess progress and to make the final recommendations that are presented in this report. Additionally, the report contains a summary account of the history of smallpox, the clinical, epidemiological, and virological features of the disease, the efforts to control and eradicate smallpox prior to 1966, and an account of the intensified program during the 1967-79 period. The report describes the procedures used for the certification of eradication along with the findings of 21 different international commissions that visited and reviewed programs in 61 countries. These findings provide the basis for the Commission's conclusion that the global eradication of smallpox has been achieved. The Commission also concluded that there is no evidence that smallpox will return as an endemic disease. The overall development and coordination of the intensified program were carried out by a smallpox unit established at the World Health Organization (WHO) headquarters in Geneva, which worked closely with WHO staff at regional offices and, through them, with national staff and WHO advisers at the country level. Earlier programs had been based on a mass vaccination strategy. The intensified campaign called for programs designed to vaccinate at least 80% of the population within a 2-3 year period. During this time, reporting systems and surveillance activities were to be developed that would permit detection and elimination of the remaining foci of the disease. Support was sought and obtained from many different governments and agencies. The progression of the eradication program can be divided into 3 phases: the period between 1967-72 when eradication was achieved in most African countries, Indonesia, and South America; the 1973-75 period when major efforts focused on the countries of the Indian subcontinent; and the 1975-77 period when the goal of eradication was realized in the Horn of Africa. Global Commission recommendations for WHO policy in the post-eradication era include: the discontinuation of smallpox vaccination; continuing surveillance of monkey pox in West and Central Africa; supervision of the stocks and use of variola virus in laboratories; a policy of insurance against the return of the disease that includes thorough investigation of reports of suspected smallpox; the maintenance of an international reserve of freeze-dried vaccine under WHO control; and measures designed to ensure that laboratory and epidemiological expertise in human poxvirus infections should not be dissipated.
New York, UNFPA, 1980 Jul. 77 p.An overview of the examples of project types funded by the United Nations Fund for Population Activities (UNFPA) are presented along with a list of approved projects on women, population development, and a partial list of pending projects with particular reference to women. In choosing these examples of the UNFPA supported projects, the primary objective was to provide the reader with an indication of the wide range of project activities supported by the Fund. The following projects are reviewed: maternal and child health care and family planning; special programs for women; basic population data collection; population dynamics; formulation and evaluation of population policies and programs; implementation of policies and programs; communication and education; and related population and development activities in the 1980's. The UNFPA is increasingly working to include women in the development and strengthening of maternal and child health family planning systems--their management and evaluation, and including the development and application of fertility regulation methods. It is helping countries find ways and means for the reeducation of men and women on the importance of shared responsibility and authority in family planning decisions. Examples of approved maternal and child health care and family planning projects in Algeria, Bahrain, Bangladesh, Brazil, Costa Rica, Egypt, Jordan, Kenya, Morocco, Somalia, and the People's Democratic Republic of Yemen are briefly described. To ensure increased participation of women and their contribution to population/development related activities, the Fund created a new category of special programs for women. Programs in this category are generally classified as "status of women."
Report on an evaluation of the Expanded Programme on Immunization (EPI), Republic of Zaire (29 September -16 October 1980).
[Unpublished] 1980. 26 p. (EPI/GEN/80/8)Between September 29-October 16, 1980, a joint Government/WHO/CDC team visited Zaire to evaluate Expanded Programme on Immunization (EPI) activities and to assist in revising the EPI National Plan and in preparing the National EPI Training Plan. 1 working group reviewed pertinent documents at the central and regional levels. Another visited 46 EPI units and other health facilities in 6 of the 9 country regions (Kinshasa, Bas Zaire, Kasai Occidental, Shaba, Kivu, and Bandundu). The 3rd working group took part in 4 meetings on implementing EPI in the field. EPI began in Zaire in 1977. The program had exceeded its objectives by 1980. For example, EPI activities had expanded into 11 cities and several rural zones, even though officials expected them to be limited to Kinshasa and 14 other cities until 1984. The team expected EPI activities to continue to expand. For example, they noted excellent central EPI staff, dedicated and knowledgeable mobile team members, and high level of public and government support. EPI did not operate a separate central vaccine warehouse in Kinshasa, however. This made it difficult for EPI to monitor storage conditions and to have continual access to vaccines. The team recommended that such a EPI operated warehouse begin soon. Another area where EPI fell short was that it did not have access to immunization and vaccine related data from heath facilities not associated with EPI. Besides EPI activities were not integrated with primary health care (PC) programs at many locations. The team recommended that EPI soon replace the mobile team strategy with a strategy that integrates EPI and PC activities. It also suggested that a National EPI Training Plan be draw up and implemented in the rural zone of Kisantu. Training should begin with health zone Chief Medical Officers who could then train other staff.
Nairobi, Kenya, Family Planning Association of Kenya, 1980. , 164 p.The proceedings of the Second Management Seminar for senior volunteers and staff of the Family Planning Association of Kenya (FPAK), held in December 1979, with appendices, are presented. The 1st 3 days consisted of lectures and plenary discussions on topics such as communication strategies, family guidance, youth problems, and contraceptive methods; the last 2 days were group discussions, reports and summary evaluations. 40 participants took part in the evaluation, expressing satisfaction with knowledge gained in communications, family life education, and IPPF organization and skills. They expressed the need to learn more about family counseling, youth problems, population, and integrated approaches. The seminar recommended that FPAK be more innovative to retain volunteers, plan its communication strategy more carefully, train and involve volunteers in programming, study traditional family planning methods, provide family counseling services, fully exploit the media, and use it to clarify misconceptions and introduce community-based distribution.
[Washington, D.C.], U.S. Agency for International Development, 1980 May. 19 p. (A.I.D. Project Impact Evaluation Report No. 5)Since 1970, the Government of Kenya has been involved in a program to bring water to all its population. Although the investment has been high, the results have been disappointing. The government is still committed to the long term goal of universal supply, but recognizes that competing demands may now require a review of the long term objectives for water development. The lessons learned from past efforts are important for AID as it assists water supply projects in other countries. Kenya's national rural water program differs from that in most other countries in the size of the project and method of supplying water. The typical Kenyan water system is large. The aim of most systems is to supply water to individual families through metered private connections; because Kenyan communities are dispersed, long distribution lines are used. These complex systems are impeded by problems of design, construction and maintenance, making them unreliable. Maintenance problems are mainly due to low government funding levels. The government discourages the use of communal facilities by locating them inconveniently. AID has provided funding to self-help systems through CARE-Kenya. Recommendations include: insuring adequate funding for operation of systems, selecting technology from the full range of options available, and involving the community in the process of providing supplies. System reliability should be a primary concern. Rural water projects require varying amounts of institutional support based on the technology used.
[Unpublished] .  p. (XA/01472/00)The Regional Population Communication Unit for Africa, operational in Nairobi, Kenya in September 1974, and a sub-unit operational since 1977 in Dakar, Senegal, work closely with the population education office in Dakar and with other international, regional, and subregional organizations which are active in population, family planning research, rural development, women, youth, and educational matters. In the years ahead, the Regional Unit will concentrate its efforts on assisting individual member states in addition to activities at regional or subregional levels, which are considered by member states to have a multiplier effect. The Unit's main objectives include: to assist national governments in the development of their communication plans, policies, and projects in support of their population/family planning and overall development programs; to work out with regional and international organizations or agencies a practical and effective system of coordinating communication and education activities in support of population and development communication programs at the national, subregional, and regional levels; to develop regional and national institutions for training, research, and development of appropriate communication materials; and to establish a population communication clearinghouse to serve as an exchange center for population and development communication programs in the region. The immediate objectives are to assist member states in their quest for self sufficiency in the training and development of manpower in the field of population; to provide member states with technical support in the development of their population activities; to promote the exchange of information, experience, materials, and know-how in the region; to develop and evaluate innovative communication approaches, which could improve the performance of national programs; to develop, pretest, produce, and evaluate a variety of prototype educational materials for use at the national level; and to improve the capacity of the Regional Population Communication Unit to assist in providing advisory services to national governments. The Unit's program of activities concentrates on 4 areas at both national and regional levels -- training, research and studies, media development, and technical assistance and advisory services. The activities of the Unit are geared to provide support for existing projects and programs, study tours, regional specialized workshops, and seminars and participation in the training seminars and workshops. Training programs provided by the Unit include seminars, workshops, and conference on development support communication. The training strategy emphasizes training as a continuing activity.
New York, N.Y., United Nations Fund for Population Activities, 1980. vii, 82 p.Add to my documents.
In: Dondi NN, ed. Towards effective family planning programming. A report of proceedings of the second management seminar for senior volunteers and staff of the Family Planning Association of Kenya, including recommendations for post-seminar programming possibilities. [Nairobi], Family Planning Association of Kenya [FPAK], 1980. 53-8.In 1952 the International Planned Parenthood Federation (IPPF) was formed to organize family planning associations which existed at that time. Essentially a people's movement, IPPF comprises 4 main groups: volunteers, paid staff, donors, and clients. The purpose of IPPF is to provide services to clients. IPPF is an international nongovernmental and nonpolitical charitable organization and is a federation of 96 family planning associations from 6 regions of the world. Aims and objectives of IPPF include: to promote the education of the population of the world in family planning and responsible parenthood; to preserve and promote the good health of parents, children, and young people through supporting effective family planning services; to educate people about the demographic problems of their own communities; and to stimulate appropriate research in all aspects of human fertility and its regulation and to make widely known the findings of such research. The overall objective of the Africa Region of IPPF is to improve the quality of life through family planning programs and other related problems. IPPF membership is open to family planning associations which will agree to subscribe to the IPPF Constitution and which have no commercial tendencies. There are 3 kinds of membership: full membership, associate membership, and affiliate membership. IPPF Regional Offices have varying structures according to their varying needs and complexities. Policies differ from region to region. The Regional Council is the policymaking body, and it comprises 2 representatives of associations holding full membership, 1 representative from affiliated associations, 1 nonvoting member from affiliated governments, and 5 coopted members. The Council meets at least once a year. The Executive Committee manages the day-to-day affairs of IPPF Africa Region (IPPFAR). IPPFAR has 3 standing committees: finance, medical, and communication. Panels and boards include the Law Panel and the Advisory Board for the Center for African Family Studies. Currently, there is a unified secretariat and the IPPF Secretary General in London has powers over all the Regional Directors.
Migrant workers: summary of reports on conventions nos. 97 and 143 and recommendations nos. 86 and 151 (Article 19 of the Constitution). (International Labour Conference, 66th Session, 1980) Report III, part 2.
Geneva, Switzerland, ILO, 1980. 151 p.Article 19 of the Constitution of the International Labor Organization (ILO) provides that Members shall report to the Director General at appropriate intervals on the position of their law and practice in regard to the matters dealt with in unratified Conventions and Recommendations. The reports summarized in this volume concern the Migration for Employment Convention (Revised) (No. 97) and Recommendation (Revised) (No. 86), 1949, Migrant Workers (Supplementary Provisions) Convention, 1975 (No. 143) and Migrant Workers Recommendation, 1975 (No. 151). The governments of member States were asked to send their reports to the ILO Office by July 1, 1979, and this summary covers country reports received by the Office up to November 1, 1979. Reports are included for the following countries: Argentina, Austria, Belgium, Benin, Bolivia, Botswana, Brazil, Cameroon, Colombia, Congo, Cuba, Cyprus, Czechoslovakia, Dominican Republic, Egypt, El Salvador, Fiji, Finland, France, Gabon, German Democratic Republic, Guyana, Hungary, India, Japan, Kuwait, Lebanon, Luxembourg, Madagascar, Malaysia, Mali, Malta, Mauritius, Mexico, Mongolia, Morocco, Netherlands, Niger, Nigeria, Norway, Pakistan, Panama, Peru, Philippines, Poland, Portugal, Romania, Rwanda, Senegal, Sierra Leone, Singapore, Spain, Sri Lanka, Sudan, Surinam, Swaziland, Sweden, Switzerland, Tanzania, Turkey, USSR, UK, Uruguay, Venezuela, and Zambia.
In: Organisation of African Unity, International Institute for Labour Studies. What kind of Africa by the year 2000? Addis, Adaba, Ethiopia, Organisation of African Unity, 1980. 113-23.The UN Department of Technical Cooperation for Development is at the disposal of African countries to elaborate and implement jointly in integrated programs of technical cooperation in several sectors. In the area of mineral resources the department has helped governments in the development of the infrastructures needed to exploit natural resources and to expand their exploitation, including undertaking geological studies, laboratory technique training, training development, drafting legislation, and preparation of contracts. The department has also taken part in several studies dealing with energy, including those about oil production and dams, to make a general assessment of all the available sites if the countries so desire. In the Sahel subregion a study was undertaken to look for ways of reinforcing the planning and programming capacity of the states for better regional economic integration of their economy. In the field of research, science, and technology, major resources have been invested such as in the organization of the exchange of scientific information in research. The department has also developed an assistance program in the field of administration and public finance to help countries increase their administrative and financial management capacity for economic and social development; 1 activity is to follow up and examine changes in public administration and finance trends as well as the study of the role of the public sector in national development. Methods have been developed for analyzing administrative problems and setting up new administrative structures. Priority will be given to: 1) the development of human resources capable of implementing programs, and 2) the reinforcement of the appropriate institutions capable of providing the techniques necessary for the development and diffusion of the sciences dealing with population and demography in African countries.
New York, United Nations Fund for Population Activities; London, England, Croom Helm, 1980. 215 p.The Arab population, consisting of 20 states and the people of Palestine, was almost 153 million in 1978 and is expected to reach 300 million by the year 2000. Most Arab countries have a high population growth rate of 3%, a young population structure with about 50% under age 15, a high rate of marriage, early age of marriage, large family size norm, and an agrarian rural community life, along with a high rate of urban expansion. Health patterns are also similar with epidemic diseases leading as causes of mortality and morbidity. But there is uneven distribution of wealth in the region with per capita annual income ranging from US$100 in Somalia to US$12,050 in Kuwait; health care is also more elaborate in the wealthier countries. Fertility rates are high in most countries, with crude birthrates about 45/1000 compared with 32/1000 in the world as a whole and 17/1000 in most developed countries. In many Arab countries up to 30-50% of total investment is involved in population-related activities compared to 15% in European countries. There is also increasing pressure in the educational and health systems with the same amount of professionals dealing with an increasing amount of people. Unplanned and excessive fertility also contributes to health problems for mothers and children with higher morbidity, mortality, and nutrition problems. Physical isolation of communities contributes to difficulties in spreading health care availability. Urban population is growing rapidly, 6%/year in most Arab cities, and at a rate of 10-15% in the cities of Kuwait and Qatar; this rate is not accompanied by sufficient urban planning policies or modernization. A unique population problem in this area is that of the over 2 million Palestinians living in and outside the Middle East who put demographic pressures on the Arab countries. 2 major constraints inhibit efforts to solve the Arab population problem: 1) the difficulty of actually reallocating the people to achieve more even distribution, and 2) cultural and political sensitivities. Since in the Arab countries fertility does not correlate well with social and economic indicators, it is possible that development alone will not reduce the fertility of the Arab countries unless rigorous and effective family planning policies are put into action.
In: Wood C, Rue Y, ed. Health policies in developing countries. London, England, The Royal Society of Medicine, 1980. 167-72. (Royal Society of Medicine. International Congress and Symposium Series; No. 24)Research is the tool which can help accelerate control of filariasis including the most important, river blindness and elephantiasis. The principles for control include eliminating the vectors and changing the way of life of the people. However these methods do not take into account the different ecologies of the land, cultures of the people and technical and political differences of the endemic areas. The WHO Onchocerciasis Control Program in the Volta Basin has been highly successful, but reinvasion of vectors is possible and there is concern that unacceptable levels of pollution will occur. Several successful limited programs of control are cited, but the absence of suitable drugs to kill the parasites is evident. One of the areas of research is centering on the characterization of the parasites and their vectors. More studies of isoenzyme markers are needed to distinguish different species of filarial parasites. An important advance in the diagnosis of filariasis has been the application of membrane filtration techniques for detecting light infection. Some of the current vector research is noted. This is particularly important because the main vectors of filariasis in Africa are also the main vectors of malaria. WHO is encouraged to stimulate collaborative research in this area. Chemotherapy is currently the most encouraging aspect of research. WHO is supporting 4 major centers where old and new filaricides are being evaluated. Some experiments are indicating the possibility that resistance to the disease can be stimulated by using irradiated larvae as appear in a cat model. Testing is now underway in a bovine onchocerciasis model. The new laboratory developments must continue so they can be applied clinically.
In: Wood C, Rue Y, ed. Health policies in developing countries. London, England, The Royal Society of Medicine, 1980. 163-5. (Royal Society of Medicine. International Congress and Symposium Series; No. 24)The Onchocerciasis Control Program in the Volta Basin is aimed at reducing the transmission of the disease so that it is no longer a major risk to public health and an obstacle to socioeconomic development. Aerial spraying of insecticides has been carried out over 7 countries of West Africa where 10 million people live. The economic advantages of the program come from 2 production factors: labor and land. As far as labor is concerned, the program will increase productive capacities by reducing the production losses resulting from vision disorders or blindness in the laborforce, decrease the debilitating effects of the parasite which leaves people more vulnerable to other diseases, and increase ability of farmers to cultivate land near rivers without constant exposure to hundreds of bites a day. The major economic development will come from developing new land. Several reports are cited indicating projected kilometers of new land that would become available. The major concern is the best way to organize the utilization of the new land, taking into account organized and unorganized migration. It is apparent that various areas and countries within the program have different demographic pressures on their land as well as different structures and planning institutions. Considerable resources of men and financial means are required to finance these land development programs and must come from international sources. Some of the costs and cost evaluations are given. A belief in the cooperation among rich and poor countries for a program without boundaries has already demonstrated the cooperative nature of the Onchocerciasis Control Program.
In: Wood C, Rue Y, ed. Health policies in developing countries. London, England, The Royal Society of Medicine, 1980. 11-7. (Royal Society of Medicine. International Congress and Symposium Series; No. 24)In developing countries systems of "bare-foot doctor" health care are being used. The goal is to provide a health service that is within the reach of each individual and family in the community, is acceptable to participants, that entails their full participation at a cost suitable to the individual and the nation. As opposed to hospital oriented Western medicine, there is usually a health officer from the local community, trained and provided with a dispensary, who returns to the home community. 2 projects in progress which were having negative results, 1 in Zaire and 1 in Senegal, were evaluated. The principles which redirected the programs are discussed. Problems such as mobile centers versus fixed sites for health centers, single aim projects and self-administration of the centers are explored. The acceptance of responsibility by the local public by using funding and resources of its own was judged to run the least risk of failing in the long term. In Senegal a new law on administrative reform was passed which allowed district health committees dealing with about 100,000 people to be set up. With a system of self-financing, more than 500,000 people were treated in 3 years. The fees were modest and 65% of the income from fees was used to keep drug supplies up to date. 3 dangers were identified and overcome: risk of embezzlement by district treasurers, overconsumption of drugs, and stocking excessively expensive products. The basic conditions necessary to provide an efficient network of health services in a rural environment (Zaire) and an urban environment (Senegal) are joint financing of activities through contractual financial participation, local administration, improved medical personnel, standardized medical procedure, and continuous supervision in collaboration with non-professional health workers.
[Rome], Food and Agriculture Organisation, . 29 p.In this booklet devoted to Kenya, information is presented on the following: the country, its people and development; the demand on services and resources; government population policy and action; the long range objectives of the Programs for Better Family Living (PBFL); activities of the PBFL in Kenya; the Kenya National Family Planning Program over the 1974-79 period; and some background on the Food and Agricultural Organization (FAO) and the UN Fund for Population Activities (UNFPA). Improving the well being of the population and promoting the welfare of the individual calls for effective utilization of Kenya's natural resources. One of the most effective ways of achieving this is to help families and communities to make better use of existing resources and generate new resources. Since independence in 1963, the government and people have made considerable progress, demonstrated by rising living standards and an expanding economy. Yet, the plans for continued economic growth can be disrupted by a high rate of population growth. In 1973, Kenya's population was estimated at 12.5 million. The rate of population growth was 3.5%, 1 of the highest growth rates in the world. Such population growth creates problems in the areas of health, education, urbanization, employment, and investment and income growth. Recognizing the implications of Kenya's high population growth, in 1966 the government declared that it would pursue policies aimed at reducing the population growth rate through voluntary means. A program of education and motivation in regard to population and family planning was initiated, and family planning services were provided. Education and motivation about family size has been provided within the context of Kenya's maternal and child services. The program emphasizes the benefits in the health of mother and child that accrue from child spacing. The long range objectives of the PBFL are to help raise the level of rural welfare by educating families and communities through fostering an understanding of the relationship between family size and family and community welfare at all levels and improving the coordination of activities at all levels betwen those servicing ministries and nongovernmental organizations. The plan of the family planning program aims at recruiting about 640,000 new family planning acceptors over the 1974-79 period, with the goal of averting some 150,000 births and reducing Kenya's population growth rate to 3.25% by 1978-79.
[Unpublished] . 10 p.At this time the urgent need for a wide spectrum of population activities in developing countries is fully recognized as the legitimate concern of governments and the international community. Technical cooperation and financial assistance are provided to these countries from a large variety of intergovernmental, governmental, and nongovernmental sources of international population assistance. This discussion of international population assistance reviews the following: current levels of population assistance; sources of population assistance; types and areas of assistance; and setting priorities. Total international assistance for population activities amounted to only about US$2 million in 1960 and US$18 million in 1965. It increased rapidly to US$125 million in 1970 and to an estimated net amount, excluding double counting, of around US$450 million in 1970. In 1981 it passed the half billion dollar mark. This marked increase in population assistance is an indication of the growing commitment of many governments and international organizations concerned about collaborating in and contributing to tackling the urgent population problems of the developing world. Nearly 100 governments contributed in 1979 to international population assistance, but the major share comes from less than a dozen countries. The largest contributor, the US, provided US$182 million for population assistance in 1979 amounting to nearly 4% of its total net official development assistance. Over 120 developing countries, or nearly all such countries, received population assistance in some form in 1979. Almost all of them were supported by the UN Fund for Population Activities (UNFPA). The International Planned Parenthood Federation (IPPF) provided support for family planning associations or programs in around 80 developing countries. Almost all donors make their contributions to population assistance in grants, but a few governments also make loans available. Around 72% of total international population assistance is provided in support of family planning activities. The region of Asia and the Pacific received the largest part of the population assistance to countries, namely 50%, followed by Latin America, 19%; Africa, 11%; and the Middle East and Mediterranean, 7%. More and more attention is being devoted to setting priorities in assistance to population programs. This is due, in part, to the fact that the amount of population assistance has not increased sufficiently in recent years to keep up with the growing needs.
Population Bulletin of the Economic Commission for Western Asia. 1980; (19):69-80.The author cites problems in the definitions of different categories of economic activity and employment status which have been made by the UN. The term "casual workers" has never been clarified and these people were described as both employed and unemployed on different occasions; there is also no allowance for the term underemployed in the UN classification. The latter term, he concludes, is not included in most censuses. The UN in its Principles and Recommendations for Population Censuses, discusses sex-based stereotypes which he states are based on a set of conventions that are arbitrary, irrational, and complex. However on the basis of the UN rules it is possible to divide the population into 3 categories: 1) those who are economically active (black), 2) those who are not active (white), and 3) those whose classification is in doubt (gray). In developed countries most people are either in the black or the white area and the amount in the gray area is small, but in developing countries the gray area may be the majority of the population. In the Swaziland census no attempt was made to provide a clear picture of employment. In view of the complexity of the underlying concepts, the decisions as to whether a person should be classified as economically active or not should be left to the statisticians, not the census enumerators.
Geneva, Switzerland, WHO, 1980. 412 p.This report on the world health situation comes in 2 volumes, and this, the 2nd volume, reviews the health situation by country and area, with the additions and amendments submitted by the governments, and an addendum for later submissions. Information is presented for countries in the African Region, the Region of the Americas; the Southeast Asia Region, the European Region, the Eastern Mediterranean Region, and the Western Pacific Region. The information provided includes the following areas: the primary health problems, health policy; health legislation; health planning and programming; the organization of health services; biomedical and health services research; education and training of health manpower; health establishments; estimates of the main categories of health manpower; the production and sale of pharmaceuticals; health expenditures; appraisal of health services; demographic and health data; major public health problems; training establishments; actions taken; preventive medicine; and public health.
Brazzaville, Congo, World Health Organization, Regional Office for Africa, 1980. 86 p. (Health Development in Africa 1)Primary health care has been accepted by the 44 Member States and Territories of the African Region of the World Health Organization (WHO); the Health Charter for 1975-2000 was adopted in 1974 with its humanistic approach oriented to satisfying basic needs. Genuine technical cooperation between Member States is essential for health development and can be achieved on the regional level. By 1990 the following steps should be taken: 1) vaccination of all infants under 1 year against measles, pertussis, tetanus, poliomyelitis, diphtheria and tuberculosis, 2) supply of drinking water to all communities and 3) waging a war on hunger. Health development is seen as a social development policy requiring combined efforts in the fields of education, agriculture, transport, planning, economics, and finance as well as a national strategy which WHO can help to define. A new international economic order must aim at meeting basic needs of the poorest in the population and includes health needs. Basic health services must provide primary health care which includes preventive and curative care, promotional and rehabilitative care, maternal and child health, sanitation, health education, and systematic immunization. Secondary care includes outpatient services with specialized teams; tertiary care provides highly specialized services. These services must be geographically, financially, and culturally accessible to the community. Communication between health workers and community leaders is fundamental in setting up those services and group dynamics can be utilized in promoting change. WHO's 4 health priorities in Africa are: 1) epidemiological surveillance, 2) promotion of environmental health, 3) integrated development of health manpower and services, and 4) health development research promotion. The components of Africa's health care program are: 1) community education, 2) promotion of food supply and nutrition, 3) safe water and sanitation, 4) maternal and child health, 5) immunization, 6) disease prevention, 7) treatment of injuries and diseases and 8) provision of essential drugs. Proper training of personnel is crucial for the success of these steps, along with effective personnel management.
Brazzaville, Congo, World Health Organization, Regional Office for Africa, 1980. 16 p. (AFR/EXM/1)In this opening address of the 30th session of the Regional Committee for Africa of the World Health Organization (WHO), Dr. Quenum notes that new program policies already put into action include the substitution of technical cooperation for the idea of assistance, the improvement of managerial processes for health development and the promotion of primary health care to achieve health for all by the year 2000. He asserts that the latter idea is not utopian since regional strategy in Africa, although long-term, has already become a reality and that constant monitoring and evaluation will affect the needed changes. 2 aspects of health planning for Africa which must be kept in mind are unity with present generations and with those of the future. Regarding the correlation between health and politics he states that whereas it is not WHO's place to intrude in a country's government, health policy cannot be developed apart from the society which it is to affect. He asks if WHO must be concerned in the political will voiced by government and their health priorities and replies that it is WHO's duty to respect the political choices of member states of WHO if genuine technical cooperation is to be established peacefully, while concerning itself with social justice. Health must also be considered in developing socioeconomic policy and cannot make a contribution to establishing a new international economic order unless it is firmly integrated into a development process focused on people. Health for all by the year 2000 is a revolutionary idea, the author contends, since it implies radical changes in the delivery of health care involving international solidarity. In many African countries primary health care has gotten off to a good start through administrative reforms or the training of new health development workers, and enthusiasm for such work should not be allowed to dwindle. Knowledge of the primary importance of health should provide the impetus for these projects in order to reach the goal of health for all.
In: White KL, Bullock PJ, ed. The health of populations: a report of two Rockefeller Foundation conferences, March and May 1979. New York, Rockefeller Foundation, Sept. 1980. 139-44.The background, planning process, and structure of the McMaster University-Sierra Leone project are described and its progress after 1 year of operation is assessed. It was agreed that the University of Sierra Leone would establish a Department of Community Health in Freetown and would not develop a medical school, while the Ministry of Health would develop a paramedical training school. The Ministry of Health's mandatory 2-year training program for physicians educated abroad would have cooperative links with the Department of Community Health. A senior coordinating committee directly responsible to the president of Sierra Leone would be responsible for subsequent project planning. Establishment of an eduational base in the Department of Community Health is intended to develop expertise in clinical epidemiology, biostatistics, and related areas. Community-based continuing education programs for potential users of the new disciplines at district and chiefdom levels are planned. Considerable progress has been made in the first year, but some anticipated problems have arisen and some necessary local support has wavered. Experience with this project suggests that the size of external aid must be related to the potential for change rather than the health need; factors limiting potential for change may include government commitment, priority for health care, political stability, economic conditions, and societal acceptance. Planning should be flexible and iterative, and should consider recurring costs as well as initial development costs. Initial involvement at the community and village level is essential.
Alexandria, World Health Organization (WHO), Regional Office for the Eastern Mediterranean, 1980. 133 p.An assessment of health progress in the Eastern Mediterranean Region (EMR) is provided through narration and photographs. The renewed threat of malaria and efforts to control it are discussed. Other traditional diseases of the area examined in today's terms are schistosomiasis, cholera, tuberculosis, trachoma and smallpox. Modern health problems, including cancer, heart diseases, mental disorders and occupational hazards are explored. Environmental problems, or "the fall-outs of technology," are discussed, along with urban sprawl, water shortages, air and marine pollution and desertification. It is stressed that changing times demand changing attitudes towards the environment. Specific areas that need to be addressed, particularly food safety, are pointed out. WHO's work with EMR countries in health manpower development includes planning, educational development and support, and the actual training of individuals. The need for more health personnel is documented. Nursing as a profession in the EMR is discussed, as is its growth; 1 problem in education of nurses is the lack of textbooks in Arabic. The prospects of health for all by the year 2000 are discussed. The importance of using appropriate technology in providing primary health care is stressed. Family health and planning is examined, including child care priorities such as newborn care, the critical weaning period, and immunization. Current biomedical research in the EMR is discussed, including health services research, efforts for diarrhea and streptococcal infection control, drug utilization studies, tropical disease studies and the search for a malaria vaccine. MEDLINE, the regional health literature service, is described. Technical cooperation among the countries of the EMR is discussed. Profiles showing the population, medical manpower and health facilities of each country in the EMR are provided.
[Unpublished] 1981. 267 p. (Authorization: Ltr. AID/DS/POP: 2/12/81; Assgn. No. 582059)The major purposes of this evaluation were to assess Pathfinder's program of in-country assistance to family planning projects. A 2-part framework was followed. The general evaluation considered the organization's policy, including the composition and functions of the board, the project development strategy, and future planning; the management structure in Boston and in the field and program support; and project management. The country evaluation framework considered the country background in terms of demographics, overall family planning services, population policy, and laws and legislation; organizational structure and program support of Pathfinder management; several aspects of project management including project descriptions, design and selection, implementation and monitoring, and evaluation; and project effectiveness. Regional evaluations were separately prepared for Africa, Latin America, and Asia and the Middle East. Within the African region country reports and evaluations of specific projects in Nigeria, Kenya, and Zaire are presented; in Latin America reports are included for Brazil, Peru, Guatemala and Colombia; and in Asia and the Middle East reports were prepared for Indonesia, Bangladesh and Egypt. General recommendations are applicable to the overall program and recommendations and suggestions specific to a region, country or project are included in the individual regional reports. In general terms the team concluded that the Pathfinder Fund is using the USAID grant effectively. Specific projects are innovative, and no major insurmountable problems in the field were noted.
Consultation of regional coordinators of the Features Services on Women and Population, Paris, March 31-April 3, 1980.
Paris, UNESCO, 1980 Apr 18. 49 p. (SS.80/WS.10)UNESCO/UNFPA jointly sponsor studies and programs aimed at the development of women's participation in economic and social processes and improvement of women's status in general. In conjunction with this program, a Features Services on Women and Population was organized in 1978 to increase the flow of news and information on women in the developing world. There are regional Features Services branches in Africa, Latin America, and Asia. The Arab countries have been asked to form a branch. At a conference of regional coordinators for the Services, it became evident that, although some of the experiences were common, individual services faced somwhat different problems reflective of the different stages of development each had reached. Certain common difficulties are: 1) a lack of qualified women to write the features; 2) a diversity of languages in the service region; and 3) government censorship. The level of professionalism among women in many of these areas hampers the news services. In addition, women seem hesitant to broach controversial topics. It is also feared that certain of the women writers are using women's issues to further their own careers. It is assumed that the main audience for these articles will be women.
New York, UNFPA, July 1980. 142 p. (Report; No. 38)This report on areas in which Nigeria requires population assistance describes geographic, cultural, demographic, economic, and administrative features of the national setting, presents basic population data, assesses the status of population research in the country, discusses the formulation and implementation of population policies, and describes external assistance received by the country. Nigeria's very high rate of fertility and high but declining mortality yield a high population growth rate. Rural-urban and international migration contribute to differences in regional rates of growth. Exact data on population characteristics and processes are unavailable, and the Mission's recommendations accordingly focus on basic data needs and ways of improving data quality and availability. Closer liaison is needed between data suppliers and data users, and a clearinghouse for population research should be established. Recommendations were also made regarding legal provisions for age at marriage, internal migration and geographic distribution, international migration, labor force, employment, and school enrollment, population education and communication, and the role of women.