Your search found 24 Results
Intermediating development assistance in health: prospects for organizing a public/private investment portfolio.
Washington, D.C., Family Health, 1980 July 23. 162 p.The objective of this study is to identify and assess the potential role of intermediary organizations in furthering AID health assistance objectives. The 1st section of this report is an introduction to the potential roles of intermediaries through health assistance via the private voluntary community. A background of the private voluntary organizations is discussed along with some of the constraints that may impede their activity, such as competing interests, values and priorities. The following section defines what is and should be an intermediary organization along with examples of certain functions involved; a discussion of the experience of AID in the utilization of intermediaries follows. 3 models of utilization of intermediaries are analyzed according to the rationale involved, strategy, advantages and constraints. The 3rd section attempts to define and identify AID's needs for programming its health assistance in regard to primary health care, water and sanitation, disease control and health planning. A detailed analysis of the potential roles of intermediary organizations is discussed in reference to policy development, project development and design, project implementation, research, training and evaluation. The 4th section identifies the programming strengths and interests among listed private voluntary organizations in the US. The 5th section discusses the potential of intermediaries in health assistance in reference to the options for funding them in health and the constraints to direct AID funding of intermediary organizations. The last section discusses a series of recommendations made in regard to the development and funding of an international effort to marshall private resources in support of health assistance. Problems and constraints, as well as resources and opportunities, for the development of this international effort are further discussed.
PUBLIC HEALTH REPORTS. 1980 Sep-Oct; 95(5):422-6.The implications of the eradication of smallpox in the context of epidemiology are presented. Eradication of disease has been conceived since the 1st smallpox vaccination was developed in the 18th century. Since then, attempts to eradicate yellow fever, malaria, yaws and smallpox have been instituted. Most public health professionals have been rightfully skeptical. Indeed, the success with smallpox was fortuitous and achieved only by a narrow margin. It is unlikely that any other disease will be eradicated, lacking the perfect epidemiological characteristics and affordable technology. The key to success with smallpox was the principle of surveillance. This concept has a vigorous developmental history in the discipline of epidemiology, derived from the work of Langmuir and Farr. It involves meticulous data collection, analysis, appropriate action and evaluation. In the case of smallpox, only these techniques permitted the key observations that smallpox vaccination was remarkably durable, and that effective reporting was fundamental for success. The currently popular goal of health for all, through horizontal programs, is contrary to the methods of epidemiology because its objective is vague and meaningless, no specific management structure is envisioned, and no system of surveillance and assessment is in place.
[Unpublished] 1980.  p.This meeting of the ASEAN Heads of Population Program (AHPP) convened to to review and consider the earlier Report of the Experts consisting of the following: Phase I ASEAN Population Program; the Pre-Implementation Meeting Report of the Phase II ASEAN Population Program; interrelationships between and among Phase I and II projects; and the rules and procedures for the implementation of the ASEAN/Australia Population Project. It was generally agreed that the implementation of Phase I has stimulated greater cooperation and collaboration among the member countries in the field of family planning and population through important contacts and exchange of expertise. More ASEAN experts and expertise in the population field have resulted. Though it is too early to assess the impact of these projects, experiences gained in their implementation have already been applied to national programs in most countries. Efforts must be made to maximize the utilization of the findings of these projects, including making available financial and other resources to analyze, disseminate and utilize information. A structured mechanism to sustain and maintain a link between researchers and program managers needs to be designed.
International co-operation for global development, commencement address made to the University of Maryland, University College, College Park, Maryland, 20 December 1980.
New York, N.Y., UNFPA, . 8 p. (Speech Series No. 60)Though most of the industrial world is moving towards zero population growth, the global population will still grow from the present 4.4 billion to 6.2 billion by the year 2000 due to the high rate of population growth in the developing countries. By the end of this century, nearly 4/5 of the world's population will be living in the developing countries. Though the rate of population growth is declining in these countries as a result of adopting population planning strategies, they face serious setbacks to their development plans which are mostly based on resource-intensive models of development. UNFPA was created to achieve global awareness of the dimensions of the population problem, and to promote international partnership for the balanced development of population resources and the environment. In its 11 years of existence the Fund has transferred some US$700 million in resources, thanks to the unwavering support of the developed countries, of which the United States is a leading donor. The developing countries have themselves spent more than US$2 billion on population programs. Only co-ordinated long-term planning can ensure a smooth transition from the 20th to the 21st century. In this partnership for global development, the United States should not, and cannot, abdicate its responsibilities.
Population and global future, statement made at the First Global Conference on the Future: through the '80s, Toronto, Canada, 21 July 1980.
New York, N.Y., UNFPA, . 6 p. (Speech Series No. 57)The United Nations has always considered population variables to be an integral part of the total development process. UNFPA has developed, in response to national needs, a core program of population assistance which has found universal support and acceptance among the 130 recipient countries and territories. Historically, these are: family planning, population policy formulation and population dynamics. The following emerging trends are foreseeable from country requests and information available to the Fund: 1) migration from rural to urban areas and increased growth in urbanization; 2) an increased proportion of aged which has already created a number of new demands for resources in both developing and developed countries; 3) a move toward enabling women to participate in economic and educational activities; and 4) a need for urgent concern over ecological issues which affect the delicate balance of resources and population.
Women, population and development, statement made at the World Conference of the United Nations Decade for Women: equality, development and peace, Copenhagen, Denmark, 15 July 1980.
New York, N.Y., UNFPA, . 5 p. (Speech Series No. 56)The World Population Plan of Action adopted in Bucharest in 1974 and the World Plan of Action adopted at the Mexico Conference in 1975 had one common goal--the full integration of women in the development process. Women today play a limited role in many national communities. If this role is to be strengthened and expanded, it will be necessary to focus on eliminating discrimination and removing obstacles to their education, training, employment and career advancement. Within this framework, UNFPA has given support to projects in 5 specific areas: 1) education and training in health, nutrition, child care, family planning, and vocational skills; 2) increasing participation of rural women in planning, decision-making and implementation at the community level; 3) income generating activities, such as marketing, social service occupations, and in the legal, educational and political systems; 4) educating women about their social and legal rights; and 5) widening women's access to communication networks. Between 1969 and 1979, approximately US$22 million was provided by UNFPA to projects dealing with the status of women. Projects in areas such as nutrition, maternal and child health services and family planning received more than US$312 million, which constitutes more than 50% of the total UNFPA programs.
UNFPA and the resident representatives: a continuing relationship, statement made at the Global Meeting of UNDP Resident Representatives, Tunis, Tunisia, 12 July 1980.
New York, N.Y., UNFPA, . 10 p. (Speech Series NO. 55)This statement outlines the dimensions of the population problem and UNFPA's goals for its resolution. Aiding UNFPA in the execution of its programs are the UNDP Resident Representatives. To facilitate the work of the Resident Representatives in those countries where projects are directly executed, UNFPA has provided and will provide administrative and clerical support, whenever possible. UNFPA posts Field Coordinators to assist the Resident Representatives, and, increased cooperation has developed as a result. It is urged that the representatives and coordinators inform and assist each other in those activities where a combined effort would be to the mutual benefit of all concerned. At the headquarters level, in order to avoid duplication and for reasons of economy, efficiency and better coordination, UNFPA will continue to avail itself of administrative services of UNDP headquarters, including personnel, travel, financial processing (including computer time) and other services in the amount of US$300,000. There will be no charge for this arrangement.
The World Fertility Survey: a basis for population and development planning, statement made at the World Fertility Survey Conference, London, England, 7 July 1980.
New York, N.Y., UNFPA, . 5 p. (Speech Series No. 54)The World Fertility Survey (WFS) is the largest social science research survey undertaken to date. From its inception in 1972 the WFS has received the full support of the UN and the UNFPA. This program has not only enhanced considerably our knowledge of fertility levels and fertility regulation practices in developing as well as developed countries but has also provided the UN system with internationally comparable data on human fertility on a large scale for the 1st time. The methodology developed by the WFS has made it possible to collect data on the individual and the household as well as the community. Information has become available not only on fertility levels, trends and patterns but also on fertility preferences and nuptiality as well as knowledge and use of family planning methods. Initial findings document the rather dramatic fertility decline taking place in many developing countries under various socioeconomic and cultural conditions. They also show the magnitude of existing unmet needs for family planning in the developing world which must be continuously brought to the attention of the governments of all countries. A most encouraging effect of the program, however, has been the fact that 21 industrialized countries have carried out, entirely with their own resources, fertility surveys within the WFS framework and in accordance with its recommendations, making it truly an internationally collaborative effort.
The expanding nature of the population field, statement made at the International Seminar on Planned Population Distribution for Development: The Hokkaido experience, Sapporo, Hokkaido, Japan, 19 May 1980.
New York, N.Y., UNFPA, . 11 p. (Speech Series No. 53)Decisions on overall plans and strategies need to be undertaken and implemented by governments, but it is the individuals whose lives are affected by the plans and strategies who must be given adequate knowledge, information and facilities. In this way, they will be able to make meaningful choices. The UNFPA's mandate is: builiding knowledge, promoting planning, promoting human rights aspects of family planning, extending assistance, and coordinating projects supported by the Fund. UNFPA provides assistance in 8 areas: basic data collection, population dynamics, implementation of policies, family planning communication and education, special programs and multisector activities, and formulation and evaluation of population policies. Each project funded by UNFPA is tailored to meet local or special needs. More and more projects are being implemented by governments themselves. UNFPA is now the largest multilateral funding source of population activities. Although clear signs of fertility decline exist, we should not believe the world's population problem has been solved. The majority of developing nations have found their population distribution patterns unfavorable for achieving socioeconomic development goals. Consequently they are concerned with the redistribution of population in a planned manner. Another type of migration which has become an international issue is the problem of refugees from various countries. Large scale migration of population for political reasons is becoming commonplace in the world today. Another problem is growth in urban areas. Yet another concern is the problem of aging caused by the decline of fertility rates and prolongation of life expectancy. It is necessary to discuss these structural changes in population at all levels so appropriate policies, institutions, training facilities, and programs may be developed to deal effectively with these problems in the future.
The food, population and development equation, statement made at Southeastern Dialogue on the Changing World Economy, Atlanta, Georgia, 25 October 1980.
New York, N.Y., UNFPA, . 8 p.The 1st type of assistance asked for from developing countries is the collection of basic data. The 2nd type of program is family planning. Countries must formulate their family planning themselves based on assessment of needs. The 3rd area that has evolved is that of population dynamics--the study of demographic variables and their consequences. The 4th area is the field of communication and education to support family planning and population programs. The 5th area is in population policies. Finally, there is the residual category of special activities concerned with youth, women and the aged. Population, therefore, represents a broad core area of 5 to 6 categories. The UNFPA is a voluntary organization which provides assistance only to developing countries. The projections of the UN indicate that, as a result of efforts in population, there is for the 1st time in the history of mankind a decline in the population growth rate of developing countries. Nevertheless, mankind must be prepared for an additional 2 billion people by the turn of the century. Population efforts in the end must aim at the stabilization of total world numbers to enable individuals to develop to their full capacity and to improve the quality of life for all.
Washington, D.C., International Monetary Fund, 1980. 84 p. (Pamphlet Series No. 34)This pamphlet describes the obejctives and modus operandi of the International Monetary Fund's compensatory financing facility. It summarizes the main features of the facility, analyzes the nature of export earnings fluctuations, and explains how the facility operates. The pamphlet includes 4 appendixes which reproduce the compensatory financing decision adopted in August 1979 and list purchases made under the facility until March 1980, illustrate the statistics required for a compensatory financing request, present an algebraic analysis of expert shortfalls, and compare the main features of STABEX with those of the compensatory financing facility. The facility was established by the Fund to provide additional assistance to member countries experiencing balance of payments difficulties arising from expert shortfalls, provided the latter are temporary and largely attributable to circumstances beyond the member's control. Ideally, the facility should enable the member to borrow when its export earnings and financial reserves are low and to repay when they are high, so that its import capacity is unaffected by fluctuations in export earning caused by external events. Assistance extended to the Fund under the compensatory financing facility is additional to other forms of Fund assistance. Because the facility's aim is to cushion the adverse effects which could otherwise have resulted from temporary export shortfalls, assistance under the facility should be provided as soon as the existence of a shortfall can be established. When the shortfall results primarily from a decline in the volume of exports, it is not always easy to determine whether it is due mainly to circumstances beyond the member's control or to inappropriate policies which need to be corrected. The member is generally given the benefit fo the doubt in borderline cases, especially if it has been cooperating with the Fund to find appropriate solutions to its balance of payments difficulties. As with any other drawing from the Fund, a member can draw under the compensatory financing facility only if it has a need to do so in terms of its balance of payments or reserve position or because of developments in its reserves. The amount that a member can draw under the facility is based on the net shortfall in its total export earnings.
[Unpublished] 1980 Dec. 183 p. (ADSS AID/DSPE-C-0053)A general report follows the "Executive Summary" of this evaluation of the World Fertility Survey (WFS). The general report covers the following: previous evaluations, terms of references, and composition and itinerary for the Evaluation Mission; background and objectives of WFS (origin of the program; objectives, priorities, and strategies); organization aspects of the WFS program (headquarters, country participation, operating procedures, survey organization, and coordination); inputs (scope of support to the program, procedures for provision of funds, headquarters costs, costs of country surveys, and complementary support to the program); methodological aspects of the program (sampling procedures; questionnaires, survey procedures, and basic documentation; data processing and archives; and production of the 1st country report); execution of national surveys (nature, character, and significance of WFS assistance; implementation of survey procedures); analysis (evaluative, illustrative, 2nd stage, and comparative analyses); building the national capability (contribution to survey taking capability, contribution to data processing capability, and contribution to analatical capability); dissemination of survey results (national meetings, limits of WFS participation in national dissemination activities, actual and potential audience for WFS survey results, and libraries in the WFS despository system); and use of WFS survey results. Conclusions are reported, recommendations are made, and country reports are included for the Dominican Republic, Mexico, Jordan, Kenya, Nepal, and the Philippines. The 1st objective of the WFS is to help countries acquire scientific information that will allow them to describe and interpret their populations' fertility, to identify meaningful differentials in patterns of fertility and fertility regulation, and to provide improved data in order to facilitate efforts in economic, social, and health planning. As of July 1980, a total of 36 less developed countries had completed fertility survey fieldwork, and of these 21 had published their First Country Report. The following were among the conclusions reached concerning this 1st objective: the sampling, training, field supervision, editing, and data processing standards set by the WFS for the national executing agencies were higher than those which characterized previous surveys; data processing was the major bottleneck in the participating countries during the surveys; and at all stages of the survey there was a conflict between the time constraints on completing the survey and getting the report out and the desire to rely as much as possible on local personnel. As far as utilization of WFS data, at this stage the Mission was able to evaluate only the short range use of the results.
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. 63-70. (Royal Society of Medicine. International Congress and Symposium Series; No. 24)While developing countries make a relatively substantial investment in health care, health research is sorely lacking. A WHO Special Programme for Research and Training in Tropical Diseases was established in 1974-5 in an attempt to harness scientific resources on a global scale. Along with the United Nations Development Program and the World Bank, its objectives are: research and development of new and improved tools for the control of tropical infections and the strengthening of the research capabilities of the affected countries. The Special Program assumes that the developing countries must have a leadership role in research, that they use multidisciplinary scientific working groups (SWG's) and that institutions and scientists from the affected countries must be included in the research. The Special Program focuses on 6 tropical diseases: malaria, schistosomiasis, filariasis, trypanosomiasis, leishmaniasis, and leprosy. The research activities center on the search for new approaches to the control of disease vectors, simple diagnostic tests, epidemiology, vector control, biomedical and social and economic research applicable to most or all of the 6 diseases. Research proposals are supported on the basis of relevance to the SWG's plans as judged by peers and must be carried out by national institutions and scientists who are from developing countries. WHO is responsible for the program's overall management. 2 charts illustrating the functional structure of the Special Program and the structure of the Joint Coordinating Board are given. The Special Programs, based on specific national needs, with policy and financial decisions made collectively by groups of cooperating governments and agencies appear to work well and could provide the pattern for other research programs.
Establishment of a regional network of health literature, library and information services (HELLIS).
New Delhi, WHO, South East Asia Region, May 1980. 117 p.Summary of intercountry consultative meeting of administrators, librarians, and users of health libraries from the Southeast Asia region called to consider the establishment of a network of health libraries and information services in the region. Discussion centers on strengthening of libraries at the national level to provide a base for linkage and permit integration into international information retrieval systems. The major outcome of the meeting was a proposal for the establishment of flexible regional and national networks functioning on the principle of resource sharing and Country focal points. A WHO Regional Coordinating Center would act as liaison between the national level and international organizations. The intended availability of these services to all levels of health personnel, and the equal partnership of all participants in the network are stressed. Assessment of user needs would be a necessary part of the development of the system. Appended to the report is a list of participants, the program, a list of the working papers, the inaugural address of Dr. V.T.H. Gunaratne to the 27 August 1979 meeting, country situation listings, a case study of library facilities in a group of city medical colleges, a student loan scheme, description of MEDLINE services in the region, and a proposed bibliographic control system for the area, as well as a listing of low priced recommended textbooks for students.
Unpublished . Paper prepared for Beijing International Round Table Conference on Demography, 1980, Beijing, 20-27 October 1980. 11 p. (UNFPA Project No. CPR/80/P01; entry no. 0258 (CPR80P010528))A review of international population policies, strategies, programmes, and assistance. The development of national policies addressing population size, growth, distribution, and demographic factors is traced. The World Population Plan of Action, adopted by 135 states at the World Population Conference in Bucharest in 1974, is identified as the most important international population strategy. The general principles on which the plan is based, and its objectives and targets are presented and discussed. Other relevant strategies identified and discussed include the International Development Strategy for the 3rd Development Decade (expected to be adopted by the UN General Assembly) and the WHO-UNICEF declaration of health for all mankind by the year 2000. The increase in population assistance from 125 million in 1970 to 500 million dollars in 1980 is discussed. Over 80 governments have contributed to international population assistance, but most aid comes from less than a dozen countries and is channelled through multilateral organizations such as the UN Fund for Population Activities and the International Planned Parenthood Federation. 121 developing countries receive population assistance. Definite effects of this aid cannot be demonstrated, but a significant accomplishment in promoting awareness of population issues is recognized. Traditionally, donors have stressed fertility control as the major objective of their assistance, but recently some donors have revised their policies to emphasize such problems as migration, urbanization, refugees and aging. Priorities for resource allocation for population assistance are discussed.
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.
New York, Foreign Policy Association, 1980 Feb. 64 p. (Headline Series 248)This essay concerns the place of women in the modern world from both an historical and contemporary perspective. Beginning in the 1970s attention was directed towards the importance of women in the social, economic, and political development of nations. Through ancient and medieval times, several alternatives to traditional roles were chosen by women: celibacy, urban craft communes, and hermits. In the 19th century, the emergence of new socioeconomic doctrines concerning women occurred. Between 1880-1900 5 transnational women's organizations were born: World Young Women's Christian Association, World Women's Christian Temperance Union, International Council of Nurses, General Federation of Women's Clubs, and the Inter Council of Women. In England the 1st appeal for votes for women was published in 1825; in the U.S. the women's suffrage movement began in 1848. By 1965, the International Cooperation Year was organized by the United Nations. In 1975 the United Nations Decade for Women was approved (1975-85). Progress made by women up to the 1980s includes: 1) a voluntary fund for the United Nations Decade for Women ($9 million in contributions), 2) establishment of an International Research and Training Institute for the Advancement of women in the Dominican Republic, 3) an international convention to outlaw discrimination, 4) increasing aid to women in developing countries, and 5) increasing participation of women in the United Nation's international foreign ministries. Although full statistical documentation of women's status in the world are lacking, several calculations indicate that in 1978, 1/3 of the world's work force were women, women earn less than men, and women's political participation is greater in developing countries than in developed countries. Problems will continue to exist in the future. The women's work force in all developed countries was 42% of the world total in 1950. By 1975 it had fallen to 36% and is expected to shrink to less than 30% by year 2000. American women are no model for emulation by the rest of the world. Women are also paid less now in comparison to the past.
[Morocco: report of Mission on Needs Assessment for Population] Maroc: rapport de Mission sue l'evaluation des besoins d'aide en matiere de population.
New York, UNFPA, June 1980. 111 p. (Report No. 29)In December 1979 a mission sponsored by UNFPA visited Morocco in order to evaluate the need for population assistance. Morocco experiences a high population growth rate, a high rate of malnutrition, infant mortality, and illiteracy, and low availability of health care in rural areas. The economy is in crisis, and population growth undermines the efforts toward development. It is suggested that population policy must be introduced along with social and economic development as part of an integrated development plan. The mission recommends exterior aid in cooperation with the government with the inception of the next Development Plan, and in particular the participation of UNFPA in data collection and research. In addition, the government of Morocco is urged to determine which agency is best suited to coordinate development and population activities, and cooperation with outside agencies.
Washington, D.C., World Bank, Sept. 1980. 28 p. (Poverty and Basic Needs Series.)In 1978 the World Bank launched a program of studies to examine the implications for the Bank of undertaking the meeting of basic needs as part of the program for reducing absolute poverty. It is proposed that to reduce poverty the productivity of the poor must be raised, and in order to accomplish this the basic needs such as nutrition, water, sanitation, shelter, and access to public services such as health care and education must be met. The principal concern of these studies is the allocation of resources to most effectively improve the conditions of the poorer segments of a country's population. It was found that in many cases resources were not inadequate, but were used in a way that did not help the condition of the poor, e.g. in one instance a large part of the resources for education was spent on university training rather than on primary education or literacy programs. Another key factor in financing a program was the cost of continuing its operation after it had been instituted: it was recommended that operating costs be carefully reviewed with the consideration that the government will eventually be expected to finance the operation. A list of the published studies that were a part of the program, as well as data tables concerning population, income, and basic needs in 125 countries are appended.
Social Science and Medicine. Medical Psychology and Medical Sociology. 1980 Oct; 14A(5):387-90.The author states that the issues emphasized in J.H. Bryant's paper on WHO's "Health for All By 2000" are American policy and administration, and the WHO, but contends that the real concern is with health today and the "New Health Policy Order" for the next two decades. It is argued that the new policies, which are meant to bring about a dramatic change toward primary health care (PHC) in health priorities in LDCs, will actually fail because of existing social and political structures and health care systems designed to serve the affluent urban population rather than the disadvantaged and rural majority, and because imposed political processes are not likely to be effectively or lastingly implemented. The author examines the implications of international aid, stating that the issue of LDCs' dependence on developed countries is ignored in Bryant's paper and that health improvement in LDCs requires more than simply more resources--it requires internal political will. Political will is seen as the most important factor missing in PHC, and one that can not be imposed by international organizations.
WHO's program of health for all by the year 2000: a macro-system for health policy making--a challenge to social science research.
Social Science and Medicine. Medical Psychology and Medical Sociology. 1980 Oct; 14A(5):381-6.The author reviews the history of the idea behind the Health for All by 2000 (HFA/2000) program of WHO and its subsequent progress, reactions to it, and outcomes. Primary health care was seen as instrumental in attaining the goal of HFA/2000, including health education, nutrition, sanitation, maternal and child health (including family planning), immunization, prevention and treatment of diseases, and provision of drugs; and access to effective health services is central to the goal. Support of 140 countries, the U. S., and the World Bank for HFA/2000 is cited, and the author argues that it is not a passing fad but an enduring concept which emerged from evolving ideas, approaches, and information concerning the nature of development, social justice, medical technology and personnel, primary health care, and political will. The role of WHO in establishing guidelines for member countries and in turn incorporating feedback into guidelines is described, and examples given of successful health programs. The possibility of introducing HFA in the U. N. as a bridge between disparate views of development strategy, because it could contribute to both economic productivity and social justice, is discussed. The author proposes that the HFA movement could benefit from social science research which would clarify the dynamics of health policy formation, the diffusion of ideas, social, ethical, and technical goals and strategies, and international development and cooperation.
WHO CHRONICLE. 1980 Jan; 34(1):9-15.The need for data on socioeconomic differentials in morality and the difficulties encountered in collecting this type of data are discussed, and mortality research priorities for both developing and developed countries are suggested. Socioeconomic factors have an impact on mortality, and mortality levels vary not only by country, but within each country by social class. In recent years mortality levels have declined in most countries; however, differences in mortality levels between social classes have probably increased. Although data on socioeconomic differentials in mortality is needed to adequately access the health status and health needs of a country, mortality data, especially in developing countries, is limited. In developing countries, vital registration systems must either be established or greatly improved. Until these systems are improved, mortality data will have to be collected mainly by survey techniques. The scope of maternal and infant mortality surveys should be expanded to include data on all types of mortality. National survey capabilities should be improved by establishing training programs for survey personnel. WHO could coordinate and direct these mortality data collection efforts. In developed countries, data collection is generally adequate, and the emphasis should be placed on developing better analytical tools for processing existing data. Despite the lack of mortality data in developing countries, it is known that differences in mortality levels between social classes could be reduced by improving: 1) community based preventive healt,h care systems and 2) sanitary conditions.