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  1. 1

    Report of the Expert Group on Population, Resources, Environment and Development.

    United Nations. Expert Group on Population, Resources, Environment and Development

    In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 1-60. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)

    The primary objective of the meeting of the Expert Group on Population, Resources, Environment, and Development was to identify mechanisms through which poulation characteristics conditioned and were conditioned by resource use, environmental effects, and the development structure. This called for a systems approach in which all factors were treated simultaneously and in which the closing of loops through feedback effects was of foremost importance. The 1st item of the agenda called for a general discussion of past and future trends in population, resources, environment, and development. The Expert Group emphasized the need for better knowledge of how the trends of the various variables interacted and modified each other and particularly about the role of population within the interrelationships. The discussion of food and nutrition focused on the demographic, economic, social, political, and institutional aspects of meeting the needs for food and nutrition, while the physical aspects were given greater attention in the discussions of resources and environments. At the center of the deliberations were such concerns as poverty, the food versus feed controversy, food self sufficiency, and the role of population growth. The discussion on resources and the environment covered the resource base, environmental degradation, and nonrenewable resources. Attention was directed to the various mechanisms that could expand resource availability as well as those activities that had caused a degradation of the environment. The discussions of social and economic aspects of development involved 4 interrelated topics: income distribution, employment, health and education, and social security. The last items on the agenda addressed the issue of integrated planning and policy formation. Some members of the Expert Group were concerned with immediate problems. Viewing demographic trends as largely exogenous, they gave highest priority to finding the best way to accommodate the needs of growing populations. Others emphasized longrun problems and considered demographic trends as policy instruments for dealing with problems of resources, the environment, and development.
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  2. 2
    Peer Reviewed

    Effects of hormonal contraceptives on milk volume and infant growth.

    World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Oral Contraceptives

    Contraception. 1984 Dec; 30(6):505-22.

    The World Health Organization (WHO) conducted a randomized comparative trail of th effects of hormonal contrception on milk volume and infant growth. The 341 study participants, drawn from 3 obstetric centers in Hungary and Thailand, were 20-35 years of age with 2-4 live births and previous successful experience with breastfeeding. Subjects who chose oral contraception (OC) were randomly allocated to a combined preparation containing 150 mcg levonorgestrel and 30 mcg ethinyl estradiol (N=86) or to a progestin-only minipill containing 75 mcg dl-norgestrel (N=8). 59 Thai women receiving 150 mg depot medroxyprogesterone (DPMA) intramuscularly every 3 months were also studied. An additional 111 women who were using nonhormonal methods of contraception or no contraception served as controls. Milk volume was determined by breast pump expression. No significant differences in average milk volume were noted between treatment groups at the 6 week baseline visit. However, between the 6th and 24th weeks, average milk volume in the combined OC group declined by 41.9%, which was significantly greater than the declines of 12.0% noted in the progestin-only group, 6.1% among DMPA users, and 16.7% among controls. The lower expressed milk volume among combined OC users did not impair infant growth. No significant differences were observed between treatment groups in terms of average infant body weight or rate or weight gain. Users of combined OCs may have compensated for their decreased milk volume by providing more extensive supplementary feeding or more prolonged suckling episodes. These results suggest that the estrogen content of combined OCs adversely affects the capacity of the breast to produce milk; thus, family planning programs should make nonestrogen-containing methods available to breastfeeding mothers. Although no effects on infant growth were noted in this study, the possibility of such efects cannot be excluded in populations where infant growth largely depends on the adequacy of unsupplemente d lactation.
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  3. 3

    Health and health services in Judaea, Samaria and Gaza 1983-1984: a report by the Ministry of Health of Israel to the Thirty-Seventh world Health Assembly, Geneva, May 1984.

    Israel. Ministry of Health

    Jerusalem, Israel, Ministry of Health, 1984 Mar. 195 p.

    Health conditions and health services in Judea, Samaria, and Gaza during the 1967-83 period are discussed. Health-related activities and changes in the social and economic environment are assessed and their impact on health is evaluated. Specific activities performed during the current year are outlined. The following are specific facets of the health care system that are the focus of many current projects in these districts; the development of a comprehensive network of primary care programs and centers for preventive and curative services has been given high priority and is continuing; renovation and expansion of hospital facilities, along with improved staffing, equipment, and supplies for basic and specialty health services increase local capabilities for increasingly sophisticated health care, and consequently there is a decreasing need to send patients requiring specialized care to supraregional referral hospitals, except for highly specialized services; inadequacies in the preexisting reporting system have necessitated a continuting process of development for the gathering and publication of general and specific statistical and demographic data; stress has been placed on provision of safe drinking water, development of sewage and solid waste collection and disposal systems, as well as food control and other environmental sanitation activities; major progress has been made in the establishment of a funding system that elicits the participation and financial support of the health care consumer through volunary health insurance, covering large proportions of the population in the few years since its inception; the continuing building room in residential housing along with the continuous development of essential community sanitation infrastructure services are important factors in improved living and health conditions for the people; and the health system's growth must continue to be accompanied by planning, evaluation, and research atall levels. Specific topics covered include: demography and vital statistics; socioeconomic conditions; morbidity and mortality; hospital services; maternal and child health; nutrition; health education; expanded program immunization; environmental health; mental health; problems of special groups; health insurance; community and voluntary agency participation; international agencies; manpower and training; and planning and evaluation. Over the past 17 years, Judea, Samaria, and Gaza have been areas of rapid population growth and atthe same time of rapid socioeconomic development. In addition there have been basic changes in the social and health environment. As measured by socioeconomic indicators, much progress has been achieved for and by the people. As measured by health status evaluation indicators, the people benefit from an incresing quantity and quality of primary care and specialty services. The expansion of the public health infrastructure, combined with growing access to and utilization of personal preventive services, has been a key contributor to this process.
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  4. 4

    Demographic trends and their development implications.

    United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]

    In: Third Asian and Pacific Population Conference (Colombo, September 1982). Selected papers. Bangkok, Thailand, Economic and Social Commission for Asia and the Pacific, 1984. 9-40. (Asian Population Studies Series No. 58)

    This report summarizes the recent demographic situation and considers prospective trends and their development implications among the 39 members and associate members of the Economic and Social Commission for Asia and the Pacific (ESCAP). It presents data on the following: size, growth, and distribution of the population; age and sex structure; fertility and marriage; mortality; international migration; growth and poverty; food and nutrition; households and housing; primary health care; education; the working-age population; family planning; the elderly; and population distribution. Despite improvements in the frequency and quality of demographic data collected in recent years, big gaps continue to exist in knowledge of the demographic situation in the ESCAP region. Available evidence suggests that the population growth rate of the ESCAP region declined between 1970 and 1980, as compared with the preceding decade, but that its rate of decline was slow. Within this overall picture, there is wide variation, with the most developed countries having annual growth rates around 1% and some of the least developed countries having a figure near 3%. The main factors associated with the high growth rates are the past high levels of fertility resulting in young age structures and continuing high fertility in some countries, notably in middle south Asia. The population of countries in the ESCAP region is expected to grow from 2.5 billion in 1980, to 2.9 billion in 1990, and to 3.4 billion persons by the year 2000. This massive growth in numbers, which will be most pronounced in Middle South Asia, will occur despite projected continuing moderation in annual population growth rates. Fertility is expected to continue its downward trend, assuming a more widespread and equitable distribution of health, education, and family planning services. Mortality is expected to decline further from its current levels, where life expectancy is often at or around 50 years. In several countries, more than 10 in every 100 babies born die before their 1st birthday. The extension of primary health care services is seen as the key to reducing this figure. Rapid population growth and poverty tend to reinforce each other. Low income, lack of education, and high infant and child mortality contribute to high fertility, which in turn is associated with high rates of natural increase. High rates of natural increase feed back to depress socioeconomic development. High population growth rates and their correlates of young age structures and heavy concentrations of persons in the nonproductive ages tend to depress production and burden government expenditure with high costs for social overhead needs. Rapid population growth emerges as an important factor in the persistence of chronic undernutrition and malnutrition. It increases the magnitude of the task of improving the educational system and exacerbates the problem of substandard housing that is widely prevalent throughout Asia.
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  5. 5

    Ghana: situation analysis of women and children.


    [Unpublished] 1984 Jul. [10], 520, 20 p.

    This 2-volume, 520-page report represents the 1st attempt at a situation analysis of Ghana. Its focus is the effect of Ghana's economic crisis on women and children. Volume I characterizes the macroeconomic situation in Ghana, the dimensions of poverty in the country, recent demographic trends, and the factors affecting infant, child, and maternal nutrition and mortality. Volume II discusses environmental sanitation, Ghana's health sector, education, general living conditions of families, and social services available for children. It is concluded that external assistance is needed to address the massive and widespread problems created by poverty in Ghana. Since the immediate problems of children and mothers are social, assistance is particularly needed in the form of outright grants or official development assistance. It is suggested that UNICEF should support both local and national interventions. There must be clear indications that all projects or programs are within government priorities. In the case of area-specific projects, local support should be assured and the main beneficiaries should be women and children. Finally, 4 possible areas of interventions are outlined: health, water and sanitation, education, and programs for slums. In the area of health, it is recommended that UNICEF devote particular attention to nutrition, immunization, oral rehydration, growth monitoring, and infection control within the context of general support to the development of primary health care.
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  6. 6

    [The significance of "Health for All" and the primary health care approach] La signification de la sante pour tous et l'approche des soins de sante primaires.

    Mirasano C

    Famille, Sante, Developpement. 1984; (1):33-40.

    Health for All was the primary theme of the 30th World Health Assembly held in 1977; the idea was reaffirmed at the Alma Ata International Conference on Primary Health Care in 1978 and currently serves as the goal of the World Health Organization and those individual states, including Rwanda, which form its membership. The Health for All campaign is directed toward the maintenance of primary health care within an established national health care system. It encourages planned action in the health care system and promotes coordination and integration of health care with other sectors. The social objective of Health for All is based on the implementation of primary health care. This was defined at Alma Ata: "primary health care is essential health care based on practical techniques, scientifically valuable and socially acceptable, and rendered universally acceptable to all individuals and families..." The essence of primary health care is fundamental care necessary to promote and protect the physical, mental, and social health of man. The philosophy of primary needs is constituted by the ensamble of biological and physical conditions, wherein satisfaction is necessary for the survival of the individual. A global view of primary health care in Rwanda involves renewed emphasis on health education, the promotion of healthful and nutritious foods, the provision of sufficient and noncontaminated water, and the prevention and treatment of local epidemics. Health for All from now to the year 2000 is an operational objective with a recognized strategy and political framework determined by the states themselves.
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  7. 7

    Population, resources and development.

    Food and Agriculture Organization of the United Nations [FAO]

    In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 267-92. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)

    The 1st section of this paper devoted to population, resources, and development broadly delineates for countries the physiological limits of land to support human populations according to pressure on resources. Subsequent sections examine the impact which an abatement of population growth could have by the year 2000 on resources in general and on the performance of the agricultural sector of developing countries in particular, link poverty to malnutrition, and deal with 1 specific aspect of the relation between distribution and undernutrition. The purpose of the final section is to highlight certain issues of the "food-feed competition" which requires more attention in the future. The frailty of the balance between population and resources is a basic concern of the Food and Agriculture Organization (FAO) of the UN. FAO's purpose is to promote agricultural and rural development and to contribute to the improvement of people's nutritional level. The significant characteristics of the FAO work on "potential population supporting capacity of lands" are the improved soil and climatic data from which it starts and the explicit specification of the assumptions made about technology, inputs, and nutritional intake requirements. Both the carrying capacity project and the results of "Agriculture: Toward 2000" have emphasized the importance of the role that technology will play in world agriculture in the future. Yet, technology is not free and its cost should be compared to alternative solutions. Moving people -- migration -- is an option that suggests itself in relation to the carrying capacity project. Changes in certain institutions, including land reform, size of the farm, market systems, pricing regimes are more suggestions that may arise with respect "Agriculture: Toward 2000" and to the food-feed competition. The ultimate question continues to be whether high agricultural technology is feasible on a world agricultural scale without dire environmental and other effects.
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  8. 8

    General overview. A. Population, resources, environment and development: highlights of the issues in the context of the World Population Plan of Action.

    United Nations. Department of International Economic and Social Affairs. Population Division

    In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 63-95. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)

    The acceptance by the international community of the importance of the interrelations between population, resources, environment, and development has been in large measure an outgrowth of the search for development alternatives that would reduce the disparities between developed and developing countries and ameliorate poverty within countries. Possibly the most important task of the Expert Group on Population, Resources, Environment, and Development is to identify more clearly the role of population within these interrelationships, i.e., to identify through which mechanisms population characteristics condition and are conditioned by resource use, environmental effects, and the developmental structure. To a considerable extent the incidence of poverty forms the root cause of many of the problems derived from the interrelationships between population, resources, environment, and development in developing countries. Affluence appears to be the major cause of many of the environmental and resource problems in the developed countries. The first 2 sections are devoted to issues considered crucial in the alleviation of poverty. Lack of food, adequate nutrition, health care, education, gainful employment, old age security, and adequate per capita incomes perpetuate poverty of large numbers of people in developing countries and therefore also their production and consumption patterns, which undermine, through environmental and resource degradation, the very resources on which they depend for their livelihood. The discussion of environment as a provider of resources first considers supplies of minerals, energy, and water. Attention is then directed to the stock of agricultural land that can be expanded through fertilization and irrigation and which may be reduced as a result of desertification, deforestation, urbanization, salinization, and waterlogging. Another section focuses on the need for integrating population variables into development planning. In the formulation of longterm development objectives, population can no longer be regarded as an exogenous force, but rather becomes an endogenous variable which affects and is affected by development policies, programs, and plans.
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  9. 9

    [A possible objective from now to the year 2000: reduce infant mortality in the third world by half] Un objectif possible d'ici 1' an 2000: reduire de moitie la mortalite infantile dans les pays du tiers-monde

    Berthet E

    Hygiene Mentale. 1984 Jun; 3(2):41-9.

    Every day 40,000 children die throughout the world, most of them in developing countries. There is a close relationship between infant mortality, life expectancy at birth, the adult literacy rate and national income per capita. Why such huge differences between the infant mortality rate of 7/1000 (live births) in Sweden and 208 in Upper Volta? The 4 scourges which afflict developing countries: hunger (malnutrition), disease, ignorance and poverty are responsible for this state of affairs. The author suggests that coordinated action by governments and International Agencies should be taken to halve the infant mortality rate by the year 2000. He notes that in the past 3 mistakes were made which should not be repeated. The 1st was to improve the living conditions of the population. The green revolution in India provides a striking example of an important progress which benefited only the wealthier farmers. A 2nd mistake was to believe that only a medical approach reduces the infant mortality rate. A 3rd error was to overlook the importance of health education and not to seek the active participation of the people concerned. The author recalls that the International Union for Health Education carried out a sanitary and social program from 1975 to 1978 in Africa, south of the Sahara. To this effect, the IUHE had to find out what the people really wanted, whether they could be motivated to increase the welfare of the villagers by measures adapted to existing possibilities, and to study how the people could recruit health workers among the villagers and train them to create village health committees. 4 weapons used together should reduce the infant mortality rate by 1/2 in the developing world before the end of the century. They are: the promotion of breast feeding, the extended coverage of vaccinations, the early detection of malnutrition and the treatment at hoem of diarrheic diseases thanks to oral rehydration. (author's modified) (summaries in ENG, SPA)
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  10. 10

    When breasts are bad for business [letter]

    Chetley A

    BMJ. British Medical Journal. 1984 Sep 15; 289(6446):695.

    John Dobbing's review of the British television program, "When Breasts are Bad for Business," contained a number of inaccurate statements. The World Health Organization's international code for the marketing of breast milk substitutes was not developed by a group of emotional activists; it was carefully developed in consultation with governments, international agencies, and experts in science, medicine, and marketing, and subsequently, ratified by 118 governments. According to the reviewer, the industry is abiding by the code; in reality, only 1 company has agreed to abide by the code, 5 or 6 companies are considering some of the code's provisions, and the approximately 80 remaining companies have given no indication concerning their willingness to adopt the code. Contrary to the reviewer's interpretation, the code does not recommend the promotion of infant formulas by any health facility, including hospitals. Furthermore, the effort to reform the marketing of infant formulas is not a veiled attempt to abolish all processed baby foods. The purpose of the code is to ensure that infant formulas are used only when necessary and not for routine feeding. The benefits of breast feeding are clearly recognized by health professionals. The reviewer's contention that the infant formula industry has been an active supporter of research which has promoted breast feeding must be refuted. Recommendations stemming from research on breast feeding have not been implemented. Neither the medical profession nor the industry has made an effort to disseminate information on the value of breast feeding nor on the methods available for promoting breast feeding.
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  11. 11

    Statistics on children in UNICEF countries.


    New York, UNICEF, 1984 May. 280 p.

    The data in this set of 135 country profiles for 1981 are made up from 9 major sources and cover the countries and territories with which the UN International Children's Emergency Fund (UNICEF) cooperates. In terms of infant morttality, countries are divided into 5 infant mortality groups: a very high infant mortality (a) group of countries, with a 1981 infant mortality rate (IMR) estimate of 150 (rounded) or more deaths per 1000 live births; a very high infant mortality (b) group of countries with a 1981 IMR estimate between 110 (rounded) and 140 (rounded); a high infant mortality group of a middle infant mortality group of countries, with a 1981 IMR estimate of between 26 and 50 (rounded); and a low infnat mortality group of countries, with a 1981 IMR estimate of 25 or less. For each country data are also presented on nutrition, demographic, education, and economic indicators.
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  12. 12

    Report of women, health and development activities in WHO's programmes 1982-1983.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, [1984]. 16 p.

    This report discusses the important place of women in health and development as perceived by WHO and as formulated in various World Health Assembly resolutions, particularly those concerned with the UN Decade for Women. Underlying all objectives is that of increasing knowledge and understanding about how the various socioeconomic factors that make up women's status affect and are affected by their health. The aim of WHO's Women, Health and Development (WHD) activities, is the integration or incorporation of a women's dimension within on-oing programs, specifically as part of "Health for All" strategies. Chief among WHD objectives and groups of activities are the improvement of women's health status, increasing resources for women's health, facilitating their health care roles and promoting equality in health development. Overall WHD activities stress the importance of data on women's health status, the dissemination of this and related information, and the promotion of social support for women. The WHD component of ongoing WHO programs focuses mainly on managerial and technical support to national programs of maternal-child health/family planning care. The present report also includes an update on the incorporation of women's issues within WHO's on-going programs in human reproductive research, nutrition, community water supply and sanitation, workers' health, mental health, immunization, diarrheal diseases, research and training in tropical diseases and cancer. Women's participation in health services is discussed mainly within the context of primary health care and is based on their role as health care providers. The results of a multi-national study initiated in 1980 on the topic of women as health care providers should be ready in early 1984 and are expected to contribute a basis for further action.
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